What is this resource about?
This paper provides an overview of some important considerations in relation to ‘culturally competent’, ‘culturally curious’ and child-focused practices when engaging with children and parents¹ from refugee and migrant communities².

It will invite you to reflect upon your current practice with children and families from migrant and refugee communities, asking:

• What is currently working?
• What improvements can be made?
• What might get in the way of genuine curiosity in your practice?
• What assumptions and biases might you hold?
• What practices would you like to develop?

It will also provide observations from practitioners who work with children and parents from migrant and refugee communities about the successes, challenges and lessons they have experienced through adopting a culturally curious stance.

Who is this resource for?
This resource is designed for practitioners and organisations in the health, social and community service sectors who work with children and families from refugee and migrant communities.

Practice positions
A key aim of the National Workforce Centre for Child Mental Health is to encourage and support practitioners to engage parents in conversations about their parenting role and their child’s wellbeing, and to work confidently with infants and children. To help guide this work, Emerging Minds has developed six practice positions (shown below) that support practitioners to consistently apply a child-focused lens to their work with children and parents:

• Curiosity
• Collaboration
• Context
• Respect
• Strengths and hopes
• Child-aware and parent sensitive.

This paper extends on these practice positions in the context of working with children and families from migrant and refugee communities.

¹The term ‘parent’ will be used throughout this resource to describe a person undertaking the role of parenting and includes caregivers (e.g. grandparents, foster carers, kinship carers).

²See https://www.iom.int/key-migration-terms for brief descriptions that draw distinctions between these terms.

In recent decades, the term ‘cultural competence’ has been adopted in response to the increasingly diverse cultural experiences of children, adults and families attending mainstream services. It has been described as ‘the organisational and professional capacity to provide effective and appropriate service delivery to individuals from non-dominant cultural groups’ (Armstrong, 2013, p.49).

From a practitioner perspective, cultural competence focuses on the development of awareness (both of one’s own cultural values, attitudes and biases, and those of clients), knowledge (of other cultures), and practice skills including those of engagement, assessment, intervention, communication, and working with interpreters (Beagan, 2018).

Cultural competence is now considered a fundamental aspect of effective and ethical practice. Today, new and experienced practitioners alike are expected to have the knowledge, skills and attitudes to work in culturally competent ways with children and families (Azzopardi & McNeill, 2016; Furlong & Wright, 2011; Hunter & Price-Robertson, 2014).

Strategies aimed at improving cultural competence focus on improving interactions between the practitioner and family, with the aim of making services more accessible. This in turn leads to increased health care utilisation, ultimately improving outcomes for children and families from diverse cultural backgrounds (Thackrah & Thompson, 2013).

However, despite its popularity, many practitioners still feel unsure when it comes to working confidently and competently with children and families from diverse communities. This may be because cultural competence is sometimes seen as a skill to be learned, separate to practitioners’ direct client work; leaving them wondering how to find the time to acquire this knowledge, or even where to start.

When working with children from culturally diverse backgrounds, a lack of confidence can make practitioners reluctant to ask important questions about the child’s social and emotional wellbeing. This counteracts the curiosity required to provide children and parents with the help and support that they need.

This paper focuses on an understanding of cultural competence that includes the complementary concept of ‘cultural curiosity’. It provides some practical examples of competence that can be demonstrated by any practitioner who is committed to genuine curiosity.

The nature, scope and theoretical foundations of cultural competence have been widely debated (Beagan, 2018, Fisher-Borne et.al., 2015; Garran & Rozas, 2013). Critiques include:

• The knowledge base acquired by practitioners is commonly founded on broad generalisations about ‘different’ cultures and portrays each as knowable, homogenous and unchanging (Azzopardi & McNeill, 2016).
• Some approaches risk generalising differences between cultural groups and stereotyping members within groups, as culture is often conflated with race and ethnicity. This increases the possibility that ‘culture’ is inadvertently viewed only as a ‘risk factor’ and a potential source of the child or family’s problems (Fisher-Borne et.al., 2015; Murdolo & Quiazon, 2016; Thackrah & Thompson, 2013).
• Cultural competency also risks diminishing practitioners’ curiosity in the diversity that is present within cultures. It can obscure other aspects of people’s identity and the power relations that also significantly shape their lives – such as gender, sexuality, age, ability, language, finances, housing and employment, racism and discrimination, and visa or residency status.These factors influence how families access power and privilege and experience marginalisation and oppression in their everyday lives, and therefore have implications for children’s mental health and wellbeing.Some readers will be familiar with the concept of ‘intersectionality’, which among other things challenges the concept of culture as static and the use of one-dimensional categories to describe people’s social identities and experiences of power and oppression (Beagan, 2018; Chen, 2017; Fisher-Borne et.al., 2015; Thackrah & Thompson, 2013).

Developments in cultural competence have taken the pressure off practitioners to be ‘all knowing’ about diverse cultures. Instead, the focus is now on providing a tailored framework which helps practitioners to develop their enquiry, assessment and support skills. These skills enable practitioners to understand how cultural contexts help, challenge or affect a parent’s capacity to nurture their child’s mental health and wellbeing.

To achieve this, the following practitioner understandings become critical:

• Practitioners need to be aware of how their beliefs, values and assumptions have been influenced by their own culture, and of how these assumptions may diminish curiosity or fairness in their practice (Beagan, 2018).
• Knowledge about particular cultures must be seen as a starting point for conversations with culturally diverse children and parents, rather than as a set of immovable facts.
• Children and families should be given opportunities to tell their stories and supported to develop their own responses to the adversities that affect children’s mental health.
• Agency processes need to be critically reviewed, to ensure that the experiences of children are regularly assessed, regardless of their cultural background.
• It is also important to include cultural information in assessment processes to inform case planning. This can include descriptions of identity, language needs, and other cultural considerations for practice, including both protective factors (e.g. connection to cultural community, practices and values) and risk factors (e.g. mistrust of formal services).

Cultural curiosity acknowledges that practitioners cannot know or predict what life has been like for the child and family they are working with; nor can they know or predict the client’s relationship with their culture, its history and traditions. Rather, it is a commitment to understand and find ways to acknowledge the experience of a child and their family.

It is well documented that children and families from migrant and refugee backgrounds face multiple barriers to service engagement (El-Murr, 2018), including a fear and distrust of authorities resulting from both pre- and post-arrival experiences. In this context, cultural curiosity enables the practitioner to demonstrate both an ‘informed not-knowing’ position³ and an intent to know and understand, as well as to sit comfortably with uncertainty and unknowing.

As the practitioner and child and family come to a shared understanding, trust can begin to develop.

³‘Informed not-knowing’ regards knowledge (and therefore generalisations) about cultural groups not as universally true but as ‘useful starting points to one’s curiosity’ (Laird, 1998, cited in Furlong and Wright, 2011, p.48). The practitioner uses their questions to position the child or parent as the expert on their relationship to their own culture, thus testing the validity of generalised knowledge.

Curiosity about a practitioner’s own culture includes critically reviewing the personal and professional biases, assumptions, beliefs and values that shape their work (Beagan, 2018, p.131). This means assessing the ideas gathered from personal/social lives and professional disciplines – e.g. about children, families, relationships and ‘a good life’ – that may be routinely taken-for-granted as reflecting universal truths or norms.

Identifying, challenging and attempting to unlearn such assumptions and biases is the beginning of a larger, ongoing process of awareness-gathering for the practitioner around power and privilege (Beagan, 2018; Wear et. al., 2012). It can also encourage practitioners to be open when seeking to understand how the families they are working with view identity, relationships, parenting, wellbeing, and connections to community and place.

⁴Some of these questions are from Raheim, S., et. al. (n.d.)

Whilst the refugee and migrant experience can bring significant opportunities for children and families, there can also be an immense sense of loss. particularly when there are concerns about the safety of family members and loved ones who remain behind. These concerns can have a significant impact on family functioning.

It is also important for practitioners to demonstrate curiosity in relation to the child and family’s pre-arrival experience, and to be open to hearing the particulars of this. An understanding of the potential pre-arrival torture, trauma, perilous migration and negative experiences of settlement a family may have experienced plays a key role in this work, as does an awareness of the potential for intergenerational and community trauma. These understandings can attune a practitioner to the potential effects on children’s mental health and wellbeing and highlight the importance of practicing trauma-informed care (El-Murr, 2018).

Children and families may experience significant shifts in gendered family dynamics and roles following settlement in Australia, as they attempt to integrate whilst preserving aspects of their original culture (El-Murr, 2018). Sometimes called ‘acculturation stress’, this process can result in differences in the extent to which rights and social freedoms are taken up by family members. In turn, this can create conditions for relationship tensions, conflict and family violence, and is important for practitioners to be aware of. It is also important to note that with appropriate information and practical support, many families are able to respond to acculturation stress in ways that demonstrate resilience and adaptability.

Being subjected to racism and discrimination has a significant impact on children and parents from migrant and refugee communities as well. This can affect parent-child relationships; relationships between parents; children’s schooling; and participation in daily activities, social networks and community activities (Saunders et. al., 2015), as well as the family’s overall sense of safety. Experiences of racism and discrimination form part of the broader context surrounding the child and family’s presenting concerns.

Cultural curiosity is not just about gathering information from the child and family in order to understand their context. Respectful, collaborative and curious conversations can also help the child and family to reconnect with skills and wisdoms that can help them to respond to the problems they are facing. The practitioner can then find ways to acknowledge these skills and wisdoms and incorporate them into their practice; or circulate them more broadly so they become useful for other families.

Respectful, collaborative and curious conversations with children and families do not mean that practitioners need to disown their own knowledge. The provision of important localised information in relation to health, education, and Centrelink services can help parents to draw on their own skills and wisdoms in empowering ways.

Engaging with children involves practitioners partnering with children in conversations about the important aspects of their lives, and the decisions that affect them. The National Workforce Centre for Child Mental Health invites practitioners to adopt a perspective of children as:

• Active
  Children are active in shaping their own lives, making meaning of their experiences, and possessing an array of skills, know-how, creativity & imagination.
• Knowledgeable
  Children possess significant knowledge, language and understandings to define and describe both problems and solutions.
• Contributors
  Children are skilled and capable collaborators in the task of finding useful responses to problems and can make helpful contributions to others facing similar circumstances.
• Contextual
  Children’s views and experiences exist in the broader contexts, circumstances and relationships that surround them, that they can evaluate for themselves.

Cultural curiosity asks practitioners to extend on these perspectives, and to be especially interested in how the child’s connection to cultural and community stories and heritages can support and sustain their mental health and wellbeing.

Organisations can play an influential role in supporting their staff’s culturally curious practices. Although significant, visible markers of cultural diversity in organisations (such as brochures in multiple languages) and practitioner awareness are often not sufficient to ensure cultural competency and curiosity. Leadership sets the tone for an organisational context that supports reflective practice and supportive peer-to-peer conversations. Formal training and supervision processes are also essential in supporting staff to develop a culturally curious approach and manage the uncertainty that accompanies a commitment to these practices.

Other structural enablers include an intentional diversity and inclusion plan, accompanied by policies and procedures that facilitate the employment of a diverse workforce, and budgetary allocations for interpreters.

Summary

This paper has provided some reflections and observations about working in genuinely curious ways with children and families from culturally diverse backgrounds. It challenges some common beliefs about cultural competence and hopefully helps you to reflect on your own work with children and families, and how this can be enhanced by a position of curiosity.

Continued conversations around effective practice with culturally diverse families are crucial, as are consistent organisational responses. The intention of this paper is to continue the conversation; and to encourage organisations and individual practitioners to reflect on their practice policies, assessment tools, supervision and professional processes, with the view to providing child-focused service delivery to suit clients of all cultures.

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