Operationalising cultural competency in the context of substance use treatment: a qualitative analysis

Abstract

The concept of cultural competency raises questions about the meaning of culture, difference and professional practice as well as how best to address religious and cultural marginality, epistemologically and practically, within codes of ethical practice. Despite continued policy and research emphasis on delivering culturally competent substance-use services to the Muslim and Arabic speaking community, limited evidence exists about what health practitioners consider to be culturally competent care for this group. To explore how practitioners operationalise cultural competence, qualitative interviews were conducted with 32 staff working in Sydney, Australia. Differences in epistemological bases of practice were present across the interviews which resulted in a variety of ways cultural competence became operationalised. Three broad epistemological approaches emerged in the data which can be classified as instrumental, comprehensive and connection-centred. These ranged in emphasis from provision of basic education around cultural traits; a heightened awareness of difference; and lastly a focus on minimising difference through enhancing relatability. Our findings highlight the importance of fostering an open and reflective attitude towards the ambiguity and complexity inherent in drug health encounters between practitioners and culturally diverse consumers. Such openness may provide opportunities to challenge structures and ideologies that reinforce points of difference and disconnection.

Keywords:

• Drug and alcohol use
• drug services
• ethnicity
• qualitative research
• treatment philosophy

Acknowledgments

The authors are grateful to the practitioners who were generous in sharing their time and experiences with us. The authors thank the Advisory Committee members for their recommendations, advice and feedback: Ahmad Malas, Lebanese Muslim Association; Danny Mikati, AusRelief; Nasreen Hanifi, Hayat House, Professor Paul Haber, Sydney LHD, Drug Health Services, Keren Kiel, Sydney LHD, Drug Health Services; Jennifer Luksza, Western Sydney LHD, Drug Health Services; Andrew Miles, South Western Sydney LHD, Drug Health Services.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded by the Drug Health Services from Sydney Local Health District, Western Sydney Local Health District and South Western Sydney Local Health District.