Culturally responsive understandings for promoting children’s health and wellbeing across diverse communities (part one)

What is this paper about?

This paper is the first of two that discuss practising cultural responsiveness in working with families from diverse communities to support children’s mental health and wellbeing.

The migration experience for families settling in Australia can be both exciting and challenging. Culturally responsive practice can help shape a positive migration experience for children and their families. Familiarity with, and an understanding of, the four key domains that influence the mental health of children in culturally diverse communities provides a foundation for culturally responsive practice. It’s also important practitioners are aware of their own unconscious bias, and the value of engaging cultural brokers and interpreters to avoid misunderstandings that can undermine families’ trust in services.

Terminology

Culturally and linguistically diverse (CALD) is a commonly used term in Australia and is used by the Federation of Ethnic Communities Council of Australia. However, we recognise the limits of its usefulness. When we use this term, we are referring to the vast array of languages, ethnicities, nationalities, traditions, societal structures and religions within families and across many different communities (Joshi & Gartoulla 2022; The UN Refugee Agency, 2023).

Who is this resource for?

This resource is developed for practitioners who work with culturally diverse children and families. It builds on the four key domains that can influence the mental health of children in culturally diverse communities, as introduced in Emerging Minds’ online course, Understanding children’s mental health in culturally diverse communities.

This is followed by the practice paper Culturally responsive strategies for promoting children’s health and wellbeing across diverse communities (part two), offering five practice strategies supporting culturally responsive practice, as demonstrated in the Emerging Minds online course, Culturally responsive practice strategies for children’s mental health.

The experiences of Aboriginal and Torres Strait Islander children and families

Aboriginal and Torres Strait Islander children, families and communities are culturally and linguistically diverse, and face significant barriers to receiving the support they need. The sociopolitical and health impacts that many Aboriginal and Torres Strait Islander peoples have experienced since colonisation are unable to be adequately covered by the scope of this brief paper, given the depth and complexity of these experiences. If you wish to explore strategies for supporting the social and emotional wellbeing of Aboriginal and Torres Strait Islander children and families in greater detail, please browse the Emerging Minds resource library:

There’s much to consider when working to support the mental health of children in families from a culture that is different from your own. Families will often seek guidance from friends, relatives and their communities when in need of support. They are more likely to engage with services recommended by others in their community based on positive experiences.

Migrant families encounter unique challenges in accessing social service supports, particularly due to language barriers and cross-cultural communication (Harrison et al., 2020). The fear of not being heard or understood can also significantly discourage families from seeking services (Blignault et al., 2022).

Additionally, when adjusting to life in a new country, families may face unconscious bias and, at times, racism. All these factors contribute to disproportionately poorer health outcomes for culturally diverse children and families (ABS, 2022).

In the following video (1 minute, 51 seconds) Julie Ngwabi, Emerging Minds’ Senior Child Mental Health Advisor, identifies some of the barriers culturally and linguistically diverse families experience when accessing services in Australia. Parents and Emerging Minds family partners, Lana and Hanan, also talk about how families’ anxiety and fear of services may get in the way of accessing help.

Communication can be challenging, especially when communicating across cultures and languages. Navigating unfamiliar languages, customs and cultural norms can easily create misunderstandings due to differences in communication styles, non-verbal cues and contextual meanings. Language barriers may be difficult to overcome, as intended meaning, cultural expressions and phrases, and tone can be easily misinterpreted. Cultural differences in accepted ways of communicating, such as the degree of directness or indirectness, can lead to confusion or offense if not understood and respected.

Cultural brokers and interpreters

Cultural brokers enhance inclusivity and understanding by bridging cultural gaps. They provide translation, mediate conflicts, and offer cultural education to promote awareness and sensitivity (Kayrouz et al., 2021).

Working with interpreters ensures clear communication, equitable access to services, and fosters cultural sensitivity. Interpreters build trust, facilitate meaningful interactions, and help families express themselves. For free interpreting services, contact the Australian Government Department of Home Affairs’ Translating Information Service (TIS National) at 1300 655 082.

While cultural brokers and interpreters bridge cultural gaps, practitioners often independently build trust, ensure accurate assessments, and provide appropriate services through cultural humility and curiosity (Mental Health Australia, 2021).

In the following video (1 minute, 44 seconds) parent and Emerging Minds family partner Mohamed shares an experience where a misunderstanding resulted in his friend’s unwanted medical treatment. Parent and Emerging Minds family partner Lana then highlights an important consideration when working with an interpreter. Emerging Minds’ Senior Child Mental Health Advisor, Julie Ngwabi also emphasises the importance of using trained interpreters instead of relying on children for interpretation when working across cultures.

When working with families from cultures different to your own, practitioners and parents have identified four key domains to consider that influence the mental health of children:

• migration and acculturation journeys
• cultural identities
• cultural family practices; and
• racism and unconscious bias.

These domains are introduced in the following Emerging Minds online course Understanding children’s mental health in culturally diverse communities.

Migration and acculturation journeys

Understanding a family’s migration journey and their experiences of adapting in Australia helps practitioners recognise the cultural beliefs, values, traditions and customs that the child and family bring with them, as well as what they may be seeking to change. The cultural changes that come from migrants continuing to practise and share their existing cultural behaviours while adopting cultural elements of their new home is known as ‘acculturation’. To define it academically, acculturation is ‘the process of group and individual changes in culture and behaviour that result from intercultural contact’ (Berry, 2019).

As children and families adapt to a new country, their acculturation process is something practitioners can support through therapeutic interventions (Foundation House, 2023).

In the following video (1 minute) counsellor Etty Garabelli, and parent and child and family partner Wei, share some examples of why it’s helpful for practitioners to understand families’ migration journeys.

Cultural identities

The unique ways in which a child and their family celebrate and cherish their cultural heritage, including the faith and other cultural characteristics that enrich their lives, informs children’s and families’ cultural identities. These cultural identities provide children and families with a sense of belonging and pride, which can help them navigate through adversities they may face. Seeking to understand and incorporate this knowledge into therapeutic conversations helps interventions resonate with children and families and achieve more sustainable outcomes (Mwanri et al., 2022).

In the following video (40 seconds) practitioner Etty talks about challenges children may face when managing multiple cultural identities.

In the following video (48 seconds) you’ll hear practitioner Julie Ngwabi introducing culturally curious practice and ways of learning from families.  

Cultural family practices

Cultural family practices are the diverse ways in which families nurture their relationships and uphold their values, beliefs and community ties, drawing upon the collective wisdom and knowledge that reflects their cultural heritage. These practices enable families to deepen their cultural understanding and develop a range of skills that are essential to their children’s wellbeing (Henderson, 2020; Huang, 2018).

In the following video (34 seconds) Etty shares an example of how drawing on family practices can help to identify sustainable and resonant solutions to problems, and ways of healing.

In this next video (57 seconds) Steph Shavin, a mental health accredited social worker, shares how focusing on family wisdom helps families notice their skills and abilities, and identifies opportunities for new solutions.

Interpersonal racism, unconscious bias and microaggressions

The fourth key practice consideration for working with culturally diverse children and families includes understanding experiences of racism. Racism is a widespread social problem characterised by discrimination, prejudice and unequal treatment based on people’s race or ethnicity. It can take various forms, ranging from explicit acts of hatred to subtle biases (Priest et al., 2018).

Unconscious biases are automatic stereotypes and attitudes toward specific groups, that shape behaviour and decision-making, which can lead to disproportionate health inequities. They are often unrecognised as racist; however, unconscious biases fuel inequality and racial marginalisation (Tascón, 2019; Tsipursky & McRaney, 2020).

Interpersonal racism may also take the form of microaggressions, which are subtle and often unintentional forms of prejudice, such as offhand comments or insensitive remarks. While many of these actions are not intended to harm, they also have cumulative and ongoing impacts on the health, wellbeing and adaptability of children and families in a new country (Priest et al., 2018).

In the following video (1 minute, 30 seconds) practitioners Julie and Etty identify the impacts racism can have on children’s mental health and wellbeing. They are followed by parent and Emerging Minds family partner Lemy sharing an experience her family had with racism.

Self-reflective practice 

Unconscious bias and microaggressions can go unnoticed by practitioners, so critical self-reflective practice is fundamental in supporting practitioners’ ongoing cultural learning and development. Self-reflective practice serves as a valuable method for raising awareness of, and addressing, cultural biases and microaggressions for practitioners.

By engaging in self-reflective practices, including supervision, practitioners can systematically identify their assumptions, biases and prejudices. With an understanding of cultural nuances and diverse perspectives, reflective practice helps practitioners recognise and address the unintentional and implicit cultural biases in interactions or decisions, with the aim of preventing the perpetuation of microaggressions. Such self-awareness not only allows for better self-analysis of actions, responses and decision-making in a cultural context, but promotes cultural humility and sensitivity (Cox & Simpson, 2020).

In the following video (1 minute, 35 seconds) practitioner Steph shares her considerations of racism and how she attends to balancing power and privilege in her work with families. Practititioner Julie Ngwabi then shares her reflections on being aware of practitioner privilege and its impact.

To hear more from these parents and practitioners about understanding children’s mental health in culturally diverse communities you can complete the following Emerging Minds online course.

Humility

Cultural humility encourages self-reflection, acknowledges biases and recognises the fluidity of intersecting identities. Rather than assuming a fixed state of understanding, the culturally humble practitioner maintains a curious approach, while being willing to learn from families and privilege their beliefs, customs and values (Hook, 2017).

In the following video (1 minute, 31 seconds) mental health accredited social worker, Steph Shavin shares what cultural humility means to her as a practitioner.

Curiosity

By taking a curious stance, practitioners are well positioned to understand and demonstrate their interest in cultural differences, rather than viewing differences as a problem. Using curiosity helps practitioners to approach families independently of any preconceived ideas, avoiding stereotypes and assumptions. A culturally curious mindset fosters authentic relationships and empowers families to use their wisdom for problem-solving and positive perspectives (Mosher, 2017).

Maintaining curiosity might be challenging where families position practitioners as the expert. Families may invite practitioners to offer ideas and advice based on professional expertise and/or unconscious bias (Zurn, 2021). But recognising children and families as experts in their own lives, learning from their skills and knowledge, and encouraging them to make decisions using their own shared wisdom will help practitioners effectively provide support for children’s experiences.

More information on developing a culturally curious approach is available in the following Emerging Minds practice paper. 

Engaging cultural brokers and interpreters can improve communication between families and practitioners, allowing for better relationship building with culturally and linguistically diverse families and generating greater trust in services. Understanding the influence of migration and acculturation journeys, cultural identities and family practices, and experiences of racism on children’s mental health provides practitioners with the foundational knowledge they need to practise in culturally responsive ways.

To learn more about culturally responsive strategies for promoting children’s health and wellbeing in diverse communities, read part two of this paper, which highlights five key strategies:

1. Responding to experiences of racism
2. Navigating family cultural tensions: Exploring cultural tensions
3. Navigating family cultural tensions: Connecting with what’s valued
4. Navigating family cultural tensions: Protecting family relationships
5. Correcting cultural mistakes made by practitioners.

Practice papers

Webinars

Podcasts

Online courses

Australian Bureau of Statistics. (2022). Cultural diversity of Australia. ABS.

Berry, J. W. (2019). Acculturation: A personal journey across cultures. Cambridge University Press.

Blignault, I., Saab, H., Woodland, L., Giourgas, K., & Baddah, H. (2022). Promoting mental health and wellbeing in multicultural Australia: a collaborative regional approach. International Journal of Environmental Research and Public Health, 19(5), 2723.

Cox, J. L., & Simpson, M. D. (2020). Cultural humility: A proposed model for a continuing professional development program. Pharmacy, 8(4), 214.

Foundation House. (2023). Australian Refugee Health Practice Guide [Website]. The Victorian Foundation for Survivors of Torture Inc.

Harrison, R., Walton, M., Chitkara, U., Manias, E., Chauhan, A., Latanik, M., & Leone, D. (2020). Beyond translation: Engaging with culturally and linguistically diverse consumers. Health Expectations, 23(1), 159–168.

Henderson, L., & Berthelsen, D. (2020). Parents’ and caregivers’ perspectives on raising young children from diverse cultural backgrounds in Australia: A systematic review. Early Child Development and Care, 190(10), 1597–1611.

Huang, C. (2018). How culture influences children’s development. Bournemouth University.

Joshi, A., & Gartoulla, P. (2022). How the experiences and circumstances of culturally and linguistically diverse children and families influence child mental health. Adelaide: Emerging Minds.

Kayrouz, R., Schofield, C., Nielssen, O., Karin, E., Staples, L., & Titov, N. (2021). A review and clinical practice guideline for health professionals working with Indigenous and culturally and linguistically diverse (CALD) populations during COVID-19. Frontiers in Public Health, 25(9), 584000.

Mental Health Australia. (2021). Embrace Project welcomes funding for multicultural mental health [Media release]. Mental Health Australia.

Mwanri, L., Fauk, N. K., Mude, W., & Gesesew, H. (2022). Migration, resilience, vulnerability and migrants’ health. International Journal Environmental Research and Public Health, 19(18), 11525.

Priest, N., Chong, S., Truong, M., Sharif, M., Dunn, K., Paradies, Y., Nelson, J., Alam, O., Ward, A., & Kavanagh, A. (2018). Findings from the 2017 Speak Out Against Racism (SOAR) student and staff surveys. CSRM working paper. Australian National University.

Tascón, S. M. (2019). Disrupting whiteness and decolonising social work: Beyond modernity’s binaries. In S. Tascón, & J. Ife (Eds.) Disrupting whiteness in social work: Decolonising epistemologies for practice. Routledge.

The UN Refugee Agency. (2023). About UNCHR [Web page]. UNHCR.

Tsipursky, G., & McRaney, D. (2020). The blindspots between us: How to overcome unconscious cognitive bias and build better relationships. New Harbinger Publications.