Disability Studies Quarterly
Summer 2001, Volume 21, No. 3
pages 54-55 <www.dsq-sds.org>
Copyright 2001 by the Society
for Disability Studies


Beyond "Cultural Competency"

Devva Kasnitz, Ph.D.
Mary Switzer Fellow


In Your Values, My Values: Multicultural Services in Developmental Disabilities, Lilah Morton Pengra (2000, Paul H. Brooks, Baltimore) has written an unusually successful and useful book. Marketed for service providers, it also belongs in the collections of disability studies scholars and applied anthropologists. And, it is a good read. It is not a research piece. For those interested in Pengra in research mode, I direct you to her dissertation.

This book is both theoretical and practical. She uses a theoretical framework of "value based services" and "schema analysis," the analysis of groups of meanings and norms that together underlie "definitions and beliefs that specify what features of the environment to notice" (p. 26). This framework is well described and documented with scholarly care. Her bibliography alone is valuable.

In the heart of the book each new topic is introduced with reference to the literature and demonstrated with examples of real-life situations. She culls these examples from her South Dakota career in social services to people considered developmentally disabled, many of them Dakota or Lakota. She then follows with service protocols. These are actual fill-in-the-blanks and check-off assessment, progress, and evaluation tools. She closes each chapter with "Points to Remember." At first this seemed too "teachy" to me. Then, I realized, that is exactly the point. You can read the book on many levels. Why not remind those who may skip some of the scholarly text and go directly to the protocols what to remember during their use as you photo-copy and enlarge and try to decide if you will need to retype and edit a protocol for your own situation. The book also hangs together if you skip the protocols entirely and read for the theory and its implications. Taken together, policy makers and service directors will gain insight.

I called this brief book reviewing "Beyond Cultural Competency" out of my biases. I remember Cultural Competency as an idea creeping in and around medical anthropology more than twenty years ago. It started innocently enough with the assertion that service providers needed to understand the culture of the people with whom they work. However, it quickly devolved into a cook-book approach, this is what to do with a Latino patient, this is how to treat a Chinese person, Native American, Black, etc. This is more dangerous than a travel phrase book without a dictionary. And who certifies "competence?"

Hiring a token person of the culture in question then became the next step. This, of course, puts tremendous pressure on the supposedly "representative" staff member. First, it ignores intracultural variation. Second, if the individual wants to succeed in their career in the service sector they can usual only do so by bolstering the existing structure. They effectively become the one who helps their cultural group reinvent themselves in the image of the dominant culture so that they can fit in and receive services through the existing structure. We all know that minority culture groups adapt to new bureaucracies much faster than bureaucracies change to reflect diversity.

What are needed are approaches that expect and value cultural diversity. We need scholars, policy makers, and service providers who are skilled at recognizing, including, and protecting cultural diversity. This book makes a significant contribution in that direction. Read it.