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Cultural and other considerations that can influence effectiveness within the rehabilitation system

The complexities of identifying cultural characteristics.

Discussions of what are commonly labeled as "cultural differences" between specific groups are inevitably problematic. Most authors focus on what Mason (1994) terms "ethnic cultural groups." "Minority" populations tend to be grouped into the broad categories that, in the U.S., generally are used as racial designations — typically, African American, Hispanic, American Indian, and Asian Pacific American — despite the fact that the categories jumble geographic, racial, ethnic, and cultural characteristics. These groups are contrasted with "mainstream U.S. culture," which is (often implicitly) considered to be white, affluent, and native-born. Race, culture, language, economic and social status, and religious beliefs often are intermingled without explicit consideration of their distinctions or relative importance.

Authors who describe cultural differences generally note that, within each broad category, groups and individuals do vary in terms of nationality, language, religion, and other characteristics. Leung (1996), for example, identifies 47 different cultural groups within the broad category of Asian Pacific Americans. Many also point out that culture is only "one of several significant variables" that influence human interactions (Duarte & Rice, 1992, p. 42). Some reports address other considerations as well, as the following sections describe.

Acculturation.

Most authors emphasize that "traditional patterns in all groups may be affected significantly by acculturation" (Harry, 1992, p. 55). Leung (1988, cited in Harry) identifies six factors that appear to most strongly influence acculturation, including "time in the host culture; proximity to the traditional culture, which… deters the acculturation process; age; birthplace; gender, with females being more open to acculturation than males; and intermarriage" (Harry, 1992, p. 14). To this list Harry adds "the variables of social class and educational level" (p. 14).

Several studies describe frameworks for levels of acculturation; though these vary somewhat, they all outline a continuum moving from immersion in one's traditional culture through a bicultural or "dualistic" orientation to immersion in or accommodation to the host culture, with the last stage variously described as "atraditional" (Ramirez & Castañeda, 1974, cited in Harry, 1992, p. 14) or "overacculturation" (Leung, 1988, cited in Harry, p. 14). Soriano (1995) distinguishes between acculturation and assimilation, characterizing acculturation as biculturalism, or the capacity to function in both the traditional and the host or mainstream culture, and assimilation as absorption into the mainstream.

Immigrant vs. indigenous groups.

Harry observes that "the concept of stages of acculturation is more difficult to apply" to African Americans, "whose native culture was forcibly undermined by slavery, with no allowance for a period of continuing traditional belief and practice" (pp. 14-15). Similar problems apply in considering American Indians and their relationships to mainstream U.S. culture, and some Hispanics as well, since many Mexican Americans have deeper roots in U.S. soil than most white Americans.

Ogbu (1992), among others, has conducted research exploring differences among immigrant and indigenous minority cultures in the U.S. He distinguishes among "autonomous" (for example, some Mormon and Jewish immigrants), "immigrant," and "caste-like" minorities, characterizing the first two groups as "voluntary" and the third group as "involuntary" minorities. Ogbu theorizes that voluntary minorities, believing in the possibility of improving their lives in the United States, are more likely to succeed in school and society than are caste minorities who, experiencing persistent discrimination, "tend to try to preserve linguistic and cultural differences as symbolic of their ethnic identity and their separation from the oppressive mainstream culture" (cited in Minami & Ovando, 1995, p. 438). A recent study of immigrant children includes findings that reinforce Ogbu's work. The study takes note of students' "rising awareness ‘of the ethnic and racial categories in which they were persistently classified by mainstream society'" (cited in Dugger, 1998, p. A11). Researchers found that study participants who began to identify themselves by ethnic categories such as Chicano or Latino had lower grades and higher dropout rates than other participants. This finding "lends support to analysts who have suggested that children of immigrants who come to identify with American minorities may take on ‘oppositional' identities" (Dugger, p. A11).

Some researchers, however, argue that Ogbu's categories "are painted with too broad a brush stroke" (Zentella, 1997, p. 272). Valdés (1997), in discussing children of Mexican origin, notes that both voluntary and involuntary minorities "exist within this single population" (p. 406). Zentella makes a similar observation regarding students she studied in a Puerto Rican neighborhood in New York City, noting further that "any model that polarizes accommodation and resistance cannot capture the ways both coexist in the daily lives" of the students she observed (p. 273). Trueba (1989, quoted in Harry, 1992) also criticizes Ogbu's framework for "its inability to account for the success of many so-called caste-like minorities" (p. 20).

Racial identity development.

Considerations of assimilation and of immigrant and indigenous minorities also must take race into account. Harry cites work by Spener (1988), who points out

that the racial background of immigrants is important because, after the "outward ethnolinguistic markers" are no longer evident, racial differences are. Consequently children of immigrant racial minorities remain minorities, while the children of White immigrants become part of the majority. (Harry, 1992, p. 17)

Some researchers, particularly those focusing on African Americans, emphasize racial rather than cultural identity, with cultural considerations being subsumed within those of race. Alston, Bell, and Feist-Price (1996) describe racial identity in terms of four dimensions:

Racial identity development may be defined as the process through which an individual examines the psychological (sense of belongingness and commitment), cultural (awareness, knowledge, and acceptance of cultural and social traditions), physical (acceptance of physical features of the racial group) and sociopolitical (attitudes toward social and economic issues of the racial group) aspects of being a member of one's racial group along with the value and emotional significance associated with that membership. (p. 11)

A psychological theory of African American racial identity development described by Cross (1995) is frequently used as a framework for discussions of racial identity. This theory describes "the psychology of becoming Black" (p. 94), a multi-staged process through which individuals move "in the transformation of … a non-Afrocentric identity into one that is Afrocentric" (p. 97). This theory has been adapted and applied not only to other minority populations, but also to considerations of racial identity development among whites (Cross, 1995; see also Tatum, 1997).

Distinguishing cultural factors from socioeconomic status.

Many scholars discuss "the danger of confusing culture with socioeconomic level," observing that "much of what is thought to be culturally derived is actually a result of economic conditions" (Smart & Smart, 1992, p. 31). As an example, Harry (1992) points out that "the stereotype of the absent Black father is tied to economics and class rather than being characteristic of African Americans as a whole" (p. 49). Some reports on cultural differences that influence the effectiveness of rehabilitation services discuss the need for programs that are easily accessible (meaning, in this instance, located within the client community), that offer flexible service hours, or that offer assistance with child care (see, for example, Duarte & Rice, 1992; Flaskerud, 1986). While these are important considerations in improving access to services, they are a function of socioeconomics rather than of culture. Smart and Smart conclude:

Poverty may lie at the root of many behaviors which could be misdiagnosed as having an internal locus… Upon closer inspection… it becomes apparent that "free" services are costly when the client must leave work, pay for child-care, pay transportation costs, and provide an interpreter, all problems with an economic basis rather than a cultural or psychogenic basis. (p. 32)

Some writers have suggested that the condition of poverty itself has given rise to a distinctive cultural group. As Luft (1995) describes it, poverty "frequently is viewed as a distinctive subculture of American life, and one that carries with it an intergenerational cycle" (p. 13). However, McLemore (1994) reports that "most of the research conducted to determine whether poor people do, as claimed, possess a specific, distinctive culture has not supported this idea." He further notes, "Many critics see the culture of poverty thesis… as an elaborate way to shift the responsibility for social change away from the majority and onto the shoulders of the minority," a process characterized as "blaming the victim" (p. 342).

Facing the dilemma.

Given the complexities described above, most authors acknowledge the severe limitations of cultural characterizations but then proceed to make them. The dilemma lies in the question posed by Tatum (1997): "How can I make the experiences of my Latino, Asian, and Native students visible without tokenizing them?" (p. 132). She concludes, as do most scholars pursuing this topic, that "a sincere, though imperfect, attempt to interrupt the oppression of others is usually better than no attempt at all" (pp. 132-133).

Descriptions of mainstream culture in the United States.

As noted earlier, the norms and beliefs of mainstream U.S. culture shape the organizational goals, policies, norms, procedures, and interactive styles of most organizations and institutions in this country. Very few reports, however, attempt to profile these characteristics except as they contrast with characteristics identified for other cultures. As is true with other broad cultural categories, "mainstream U.S. culture" is an encompassing term that belies the diversity of those it includes. Descriptions of what it means to be "in the mainstream" generally refer to white, middle-class Americans. Other significant characteristics are often mentioned as well, as the following sections discuss.

"Whiteness."

Though a person does not necessarily need to be "white" to participate in mainstream U.S. culture, characteristics of those in the mainstream are inextricably tied to that dubious but powerful racial designation. Maher and Tetreault (1997), citing Thompson et al., attempt to make sense of this apparent paradox by

distinguishing among "Whiteness as description," referring to the assignment of racial categories to physical features, "Whiteness as experience," referring to the daily benefits of being White in our society, and finally, "Whiteness as ideology," referring to… beliefs, policies, and practices. (p. 324)

Individualism.

The literature describes individualism as one of the most dominant values operating in mainstream U.S. culture. Rehabilitation counseling and the work of independent living centers, for example, focus on the individual with a disability; services, procedures, and rules are geared to that person. However, Leung (1993) notes that "one of the common elements in the value/belief systems of all four major minority groups is the emphasis on the group, rather than the individual" (p. 96). With a "collectivist" rather than an individualist orientation (Gudykunst & Ting-Toomey, 1988, p. 40), decisions may be based on the needs of the family group rather than on those of one particular member. Hong (1995), in discussing Asian Pacific cultures, describes this orientation as familism:

As opposed to individualism in Western cultures, Asian cultures are focused on the family… The idea of familism prescribes that the family is more important than the individual. The welfare of the family takes precedence over the welfare of the individual. (p. 60)

The focus on the individual functions not only as a goal but also as an explanation for differences in status and achievement. As discussed earlier, individualism helps to mask social inequities by attributing "success" and "failure" to the behavior and characteristics of each person rather than to patterns of access and opportunity (Harry, 1992; Scheurich & Young, 1997). The pervasiveness of this belief is illustrated in the results of a study by Conner (1988), who examined the approaches used in health promotion and disease prevention programs in a number of western and eastern countries. Conner found that:

The U.S. programs emphasize changes that the individual is supposed to make in his or her behavior; success or failure is very much dependent on individual effort. Likewise, attributions for success or failure are focused on the individual (good personal will-power, in one case; lack of conviction or self-control in the other), as are the outcomes of success or failure (an improved or diminished self-confidence, for instance). (p. 182)

This orientation contrasts strongly with approaches used in other countries. For example, Conner observes, "In Western European countries, the medical model is mixed with and sometimes superseded by a public health model with more focus on groups and communities and much less on individuals" (Conner, 1988, p. 182). In eastern countries, there is "a strongly individualist focus, in that different balances are appropriate for different individuals." However, this perspective is

mixed with a strong community focus, in that complex belief systems surround activities of daily life… The respect for individuals which is a part of these systems is very different from the respect for individuals that characterizes the western approach, particularly the strongly-individualistic U.S. approach. Individuals in the Eastern view have limited power to change their current situation; individuals in the Western view are seen as nearly all-powerful in changing their current situation. (p. 183)

High vs. low context.

Duarte and Rice (1992) note that the literature of intercultural communication emphasizes "cultural differences related to context," which they characterize as "the information that surrounds events" (p. 17). Harry (1992), among others, cites Hall (1977), who "used the concept of ‘high- and low-context' cultures to describe the potential of the law in various societies to address human issues in a more or less personalistic manner." Mainstream U.S. culture "is, in comparison to that of many other countries, markedly ‘low-context' in its reliance on positivistic criteria for truth and in its tendency to exclude and treat as irrelevant the complexities of human perception and personal interaction" (pp. 111-112).

In this country, laws, policies, procedures, application criteria, and other requirements are designed to be "low context," independent of circumstance and equally applicable to the full spectrum of the populations addressed. The intent of such an approach is often fairness, for example, stating job requirements as concretely as possible so that all applicants are judged according to the same criteria and none receives preferential treatment. But since mainstream cultural standards are embedded in these requirements, as well as in the expectations and perceptions of the gatekeepers who apply them, the rules become skewed toward those in the mainstream (Scheurich & Young, 1997; Tatum, 1997).

The concept of low versus high context also applies to communicative styles, particularly in organizational or service settings. Harry explains that

In high-context communication there is a tremendous reliance on personal delivery, which may include affective as well as factual information, thus making meaning dependent on personal interaction. By contrast, low-context communication relies, according to Hall, on the actual language code isolated from the interpersonal aspects of communication. The goal of this form of communication is a high level of objectivity — on the assumption that such objectivity reflects greater precision in meaning. The latter will only be true, however, if both parties in the communicative act hold shared meanings of the language being used. (p. 172)

Harry further notes that members of the mainstream culture who work in service settings tend to combine a casual, informal style of greeting and speech with a low-context, impersonal approach to the content of the conversation. For members of most non-mainstream cultures, "an underlying commonality is a frequent discomfort with the informal and egalitarian approach typical of most White Americans." She recommends that those in professional settings, at least initially, should "approach culturally different families in a polite and more formal manner… . while striving to create communication that is personal rather than impersonal" (p. 57).

Valuing reason, science, and technology.

Haymes (1995) and others note the emphasis in mainstream U.S. culture on rationality, the positivistic pursuit of scientific "truths," and technological advancements. These beliefs exert a particularly strong influence on approaches to rehabilitation and education (Schaller, Parker, & García, 1998; Scheurich, 1993; Duarte & Rice, 1992).

Attitudes regarding disability.

As suggested above, attitudes about the causes and appropriate responses to disability within mainstream U.S. culture are strongly influenced by beliefs in individualism, rationality, and science. The medical model, which is structured to identify "disease" and treat it largely in isolation from other aspects of a patient's life, permeates mainstream perspectives regarding disability (Conner, 1988; Duarte & Rice, 1992; Harry, 1992).
 


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