The Need for Cultural Humility in Social Work Education

The DSM-5 includes an overview of environmental factors that contribute to post traumatic stress disorder, such as low socioeconomic status, education, or minority racial/ethnic status. Each of these factors points towards the theory that a substantial number of inner-city youth and adults suffer from PTSD. The more violent the city and the more disenfranchised the people, the more cases of undiagnosed PTSD. The stress of racism and disenfranchisement do not get the attention that they deserve with respect to stress, and trauma related mental health diagnosis.

Social workers are trained to work in a plethora of social service capacities and maintain the end goal of improving human condition using strength-based approaches. Front line workers often encounter those considered least likely to succeed, and they often find themselves facing clients that they are ill-prepared to work with. As the income gap widens and disparities persist, it is imperative that social work education include information about the individuals impacted — it is these communities who receive the majority of clinical services. Thus, it behooves social workers to understand the way the inner-city residents are affected by systems which perpetuate oppression. There should be a course to shed light on the trauma experienced by inner-city residents.

Cultural competence has been a necessary part of the educational portion of social work for decades. What we now refer to as cultural competence was once called “multicultural” or “cultural sensitivity training.” In the 60s and 70s social workers, predominantly those of color, questioned the Eurocentric lens that social work was taught through. The limited lens they critiqued often did not view people of color or communities of color from a strength-based perspective but instead blamed them for systemic issues. This same lens promoted colorblindness as an ideal approach to treatment. This pattern is reinforced by curriculums that encourage students not to notice differences amongst races.

A few studies have shown that social work students who participate in colorblind cultural diversity classes may develop a greater belief that things are fair, and others may show signs of complacency when it comes to the existence of racism. By denying the reality that color exists, one is denying the individual a monumental piece of their identity. For marginalized people, identifying as part of a group provides a sense of belonging which is very important as it determines how they move through the world.

By the 1980s, there were several books directly addressing the needs of people of color from a strength-based perspective. These books challenged social workers to face their personal biases and acknowledge systematic racism and its effect on communities and people of color. The teachings in the 1980s stressed that individuals of color have their own set of beliefs and values that may be beneficial in their interactions with social workers. In turn, social workers were asked to table their biases. This tabling was referred to as “bracketing” and it was seen as unrealistic by some because it is not possible to be morally neutral.

Individuals must be given the opportunity to reveal their ethnicity because, like culture, ethnicity is subjective. With the influx of first- and second-generation immigrants in the United States, it is imperative that clinicians delve into the psychological importance of ethnicity in all its dimensions. Too often clients and patients are lumped into categories based on biases and stereotypes that do not align with their ethnicity. It is common for a Latino person to be labeled white or a West Indian person to be labeled Black when their cultures and ethnicities are not like the labels that they are given. When patients and clients are allowed to self-identify, they bring their heritage into the therapeutic relationship. Clinicians who choose to overlook this information underutilize their client's valuable experiences and will be doomed by the biases of the greater society.

Because their educational diversity training may not have been adequate, many school social workers miss the mark when it comes to understanding children of color and immigrant children. They are often unable to grasp the importance of cultural norms and family history, and the roles that they play in the mental and social development of the children they serve. This lack of understanding can be crucial when it comes to making decisions that will influence the child’s future, i.e., considering special education placement, instigating Department of Children and Families involvement, and an overall misunderstanding of immigrant children and children of color. The most damaging process is when school social workers who can only operate from a middle-class, Anglo, English-speaking perspective project that experience onto poor clients of color.

Many times, social work students are not prepared to have conversations about race and diversity as they may cause the classroom to become uncomfortable. At the same time, teachers may not be prepared for the discussion or the resistance that they are met with. Professors are often not adequately trained in diversity or oppression and therefore are unable to facilitate what may prove to be a difficult conversation. Until teachers are comfortable with facilitation, curriculums that deal with diversity will not be effective. It has been ascertained that faculty often report teaching more about oppression than students report learning. 

In terms of course design, in order to educate human service professionals in a culturally humble way, the core of the course must inform clinical practice to recognize that urban PTSD is not “post,” but persistent. This course will have to explore specific groups of people who experience urban trauma on a consistent basis, i.e., gang members, low-income families, victims of violence, homicide survivors, and inmates. The course must elucidate how interaction with specific systems such as the education system, legal system, medical system, and social service system all play a role in the persistent traumatization of some inner-city communities. Lastly, the course must introduce social work students and practitioners to treatments that may work best to address this specific type of PTSD and empower these individuals through a culturally humble lens. Given the number of social workers who go on to work in social service agencies that serve inner-city residents, a curriculum that teaches cultural humility and urban PTSD is long overdue. 

Editor’s note: The Consortium is proud to offer a collection of trainings relating to urban trauma and racism. The most pertinent, An Overview of Trauma in Urban Communities, was offered in July 2021. The training description explains: “Often exacerbated by a lack of social support, financial struggles, unsafe living conditions, violent communities and more, urban trauma is systematic trauma which creates an environment of chronic stress for both children and adults. Individuals that are impacted by urban trauma may not even know it but identifying instances earlier is pivotal to prevent long-term effects on the brain.” For upcoming related trainings, view our store.

This article is adapted from Erica Reshard’s 2015 Southern Connecticut University Master of Social Work capstone project. Her sources are included below.

Erica Reshard LCSW, LADC, ADS has worked in the human service field for over twenty-five years. She received her MSW from Southern Connecticut State University in 2015. Erica has supported marginalized populations for much of her career, developing a passion for work with the disenfranchised and individuals suffering from Urban PTSD. Erica has worked at the Emergency Shelter for men, Project M.O.R.E, the Maternal and Child Health division of the New Haven Health Department, the Department of Correction in the female facility and multiple male facilities. She is currently employed by DHMAS and works in a community mental health center. In 2015, she opened Sankofa Counseling where she provides individual counseling using a trauma-informed culturally competent approach. She is currently pursuing her Doctor of Social Work degree at Southern Connecticut State University.

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