ental Health Services Administration (SAMHSA)

Acknowledgments
This publication was produced by The CDM Group, Inc., under the Knowledge Application
Program (KAP) contract numbers 270-99-7072, 270-04-7049, and 270-09-0307 with the
Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of
Health and Human Services (HHS). Andrea Kopstein, Ph.D., M.P.H., Karl D. White, Ed.D.,
and Christina Currier served as the Contracting Officer’s Representatives.
Disclaimer
The views, opinions, and content expressed herein are those of the consensus panel and do not
necessarily reflect the views, opinions, or policies of SAMHSA or HHS. No official support of
or endorsement by SAMHSA or HHS for these opinions or for particular instruments, software,
or resources is intended or should be inferred.
Public Domain Notice
All materials appearing in this volume except those taken directly from copyrighted sources are
in the public domain and may be reproduced or copied without permission from SAMHSA or
the authors. Citation of the source is appreciated. However, this publication may not be
reproduced or distributed for a fee without the specific, written authorization of the Office of
Communications, SAMHSA, HHS.
Electronic Access and Copies of Publication
This publication may be ordered or downloaded from SAMHSA’s Publications Ordering Web
page at http://store.samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-
4727) (English and Español).
Recommended Citation
Substance Abuse and Mental Health Services Administration. Improving Cultural Competence.
Treatment Improvement Protocol (TIP) Series No. 59. HHS Publication No. (SMA) 14-4849.
Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
Originating Office
Quality Improvement and Workforce Development Branch, Division of Services Improvement,
Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services
Administration, 1 Choke Cherry Road, Rockville, MD 20857.
HHS Publication No. (SMA) 14-4849
First Printed 2014
ii
Contents
Consensus Panel ………………………………………………………………………………………………. vii
KAP Expert Panel and Federal Government Participants ……………………………………………ix
What Is a TIP? …………………………………………………………………………………………………..xi
Foreword ……………………………………………………………………………………………………….. xiii
Executive Summary …………………………………………………………………………………………… xv
Chapter 1—Introduction to Cultural Competence ……………………………………………………. 1
Purpose and Objectives of the TIP………………………………………………………………………………. 2
Core Assumptions……………………………………………………………………………………………………… 4
What Is Cultural Competence? …………………………………………………………………………………… 5
Why Is Cultural Competence Important? …………………………………………………………………… 7
How Is Cultural Competence Achieved?……………………………………………………………………… 9
What Is Culture?…………………………………………………………………………………………………….. 11
What Is Race?…………………………………………………………………………………………………………. 13
What Is Ethnicity? ………………………………………………………………………………………………….. 15
What Is Cultural Identity? ………………………………………………………………………………………. 16
What Are the Cross-Cutting Factors in Race, Ethnicity, and Culture? ………………………….. 16
As You Proceed ……………………………………………………………………………………………………….. 33
Chapter 2—Core Competencies for Counselors and Other Clinical Staff ………………………35
Core Counselor Competencies………………………………………………………………………………….. 36
Self-Assessment for Individual Cultural Competence ………………………………………………….. 55
Chapter 3—Culturally Responsive Evaluation and Treatment Planning ………………………..57
Step 1: Engage Clients……………………………………………………………………………………………… 59
Step 2: Familiarize Clients and Their Families With Treatment and Evaluation Processes . 59
Step 3: Endorse Collaboration in Interviews, Assessments, and Treatment Planning……….. 60
Step 4: Integrate Culturally Relevant Information and Themes…………………………………….. 61
Step 5: Gather Culturally Relevant Collateral Information ………………………………………….. 64
Step 6: Select Culturally Appropriate Screening and Assessment Tools………………………….. 65
Step 7: Determine Readiness and Motivation for Change ……………………………………………. 69
Step 8: Provide Culturally Responsive Case Management ……………………………………………. 70
Step 9: Integrate Cultural Factors Into Treatment Planning …………………………………………. 71

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ental Health Services Administration (SAMHSA)
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