Cultural Proficiency in Drug Court: Introduction to Culture (part 1)

Cultural Proficiency in Drug Court: Introduction to Culture (part 1)


ANDREW OSBORNE: We are
looking at what works in treatment and prevention. This is part one of a
three part webinar series, and you can see that at
the bottom of the slide, this is March 30th. Therefore, part two
of this web event will take place
on April the 6th. And part 3, of
this web address– web event will take
place on April 13th, at 1:00 Eastern Standard Time. So that’s your information
to tie into the second one. I would now like to give
you some information about the context, on how
this particular weapon was developed. This is a collaborative effort. This is a collaboration
between the Bureau of Justice Assistance. And we will refer to them as
BJA throughout the presentation. American University,
we will refer to our American
University as AU. And the National
Development and Research Institutes, which we
will refer to as NDRI Now BJA provides a
host of assistance to grantees of BJA contracts. Now BJA contracted with
American University to provide this
technical assistance to courts in the field. One of the things that
AU did, if they’re going to be providing
technical assistance have to do a needs assessment. What does the field need? What are courts struggling with? And as a result of
that needs assessment, three webinars have
been developed. One on co-occurring
disorders, which was hosted by Paul Warren,
that some of you who are sitting
out there now sat through some three weeks ago. The second webinar is
on cultural proficiency. And there will be
another webinar where we conclude this
trilogy on working with 18 to 25-year-olds. For those of you who
are banging your head against the wall working
with 18 to 25-year-olds, don’t take it personally. Take a number. Everyone is having problems
with 18 to 25-year-olds. It’s a very difficult
age bracket. So we’ll examine who
are these individuals, and what interventions
might work with them. So the National Development
and Research Institute– as I shared with you earlier, where
behavioral science research and training organization. What the Training
Institute does, we disseminate
research findings, and we train the
workforce in skills. We enhance their skill
levels with as a result of the research
that has been done. We train courses like– I’ll give you a few titles– assessment interviewing. We have to assess everyone
who comes to drug court, everyone who comes through
treatment, so that we can make good treatment matches. We also train courses
like group facilitation. In the business that we’re
in we do group to death. We have all sorts of
groups, and you can really do more harm than good if you
don’t know what you’re doing. So it would behoove you, you
folks who are essentially using group as an
intervention, to have people who have been well trained. And lastly, another
course that we will train at the
Training Institute here, motivational interviewing. Evidence based, we want to
share motivational interviewing with the field, because
it’s been proven to work. Well, we’re a behavioral
science research and training organization, let
me just say this. Everyone within earshot of
this webinar is a behaviorist. You’re working– no
matter what your title is. Could be judge. Could be case manager. Could be paraeducator. Could be probation officer. Could be police officer. Everyone is a behaviorist. You’re working with
individuals who are exhibiting risky behavior. And what you’d like to do is
move them down the continuum, so they can exhibit
less risky behavior. Eliciting behavior
change is difficult so we don’t want you to waste
your time on interventions that have been proven not to work. Now being that this is
a collaborative effort, we’re concerned about behavior. And we’re going to be sharing
with you some things that you can put in place in your
court to essentially enhance behavior modification. On this slide in the
left hand column, you see the disciplines that
make up behavioral science. Behavioral science
is a collection of a number of
different disciplines. Recently, or not
too recently, I see that you can now get a
degree in behavioral science. You couldn’t always do that. You either had to
get a psychology degree, or a sociology degree,
or an anthropology degree. But now you can get a degree
in behavioral science. So we have the domains of
behavioral science listed out there in the left hand column. The right hand column has some
of the components of drug court that pretty much
mirror the disciplines of behavioral science. We have evaluation treatment. And you see there I have
court and treatment twice. For one for sociology,
and one for anthropology. Let me just share with you
where I’m going with this. The disciplines of
behavioral science, the first one I’ll talk
about epidemiology. We have a lot of
epidemiologists working here at NDRI, because we’re
behavioral science research outfit. Well what do they do? I call them my bean counters. OK, they collect data. They make comparisons. They look they establish
prevalence rates. How many individuals
out of a 1,000 are at risk for developing this
particular condition, or become engaged with this
particular drug. That is important information
to pass on to policy makers, to treatment
providers, so they know what to anticipate that’s going
to be coming down the road. An example of an
epidemiological study that we have been involved
with, the DAWN study. That’s D-A-W-N. That’s
Drug Alert Warning Network. Was a 12 city study. Went on for quite some time
comparing drug use patterns throughout the country. The east coast is different
from the West Coast, which is different from
the Midwest, which is different from the South. All the patterns are not alike. They’re different, and we
need to advise individuals who are working in
the field of this is what you need to look for. Why should you be
testing for a drug that people are not
using in your region? You don’t have money to waste. And BJA would be glad to
know that you’re thinking in that particular matter. OK, well on the drug
court side, what is the parallel to epidemiology? Evaluation. I am so enthused when I see
researchers or evaluators attending training. Most of the time we don’t get
the research or the evaluator in training, but they
are a critical component in the drug court. They can essentially
establish systems so that you know
what works on who. Who are you doing
a bad job with? Who are you doing
a good job with? This will become
infinitely more important as we start to get more
information from the latest census that was just conducted. People are moving
around the country. Migration patterns
are different. No longer are we seeing
people come from the South to the urban North. We’re seeing the reverse. They’re moving from
the urban North, because of the economy issues,
they’re moving to the South. They feel that they can raise
their children in a safer environment. They can get educated there. So we’re starting to
see population shifts. So if you have been involved
in drug court for some time, perhaps you got used to a
certain type of diversity amongst the participants
in your court. Well guess what? That’s going to change. Therefore, you’re going to
have to become more culturally proficient to meet the needs
of this new crop of individuals who may be accessing your court. So that’s epidemiology
and evaluation. Psychology is also an
important component of the behavioral sciences,
because obviously a person’s mental status has a lot to
do with the behavior they’re exhibiting at that
particular point in time, and their ability
to alter or change that particular behavior. I want to share with you a
case example from years ago. I used to direct the Day
Treatment Program for the New York City Department of
Probation, that pretty much mirrored drug court. That operated pretty much
as drug court does now. Instead of having a judge,
I had a commissioner that I had to report to. That was one of the differences. We are sitting around. The treatment staff,
the probation staff, we’re talking about cases. We’re having a case conference. We’re talking about one
particular young man. We go around the table checking
in with the drug treatment provider who says, this
young man is a model. At morning meeting, he’s
such a positive influence that we’re thinking about hiring
him as a junior counselor when he gets off probation. I said, oh, well then
that sounds pretty good. Keep going around the table,
getting more glowing reports. I hear from the educational
provider, and what do they say? They say, this
particular young man is going to take the
GED exam next week. We know he’s going to pass,
because he really did well on the predictor examination. And not only that, he’s tutoring
other guys in the class. I said well that’s
pretty positive. I’m glad to hear that. Keep going around the table
get more glowing reports, until I get to the
probation officer. And what’s the
probation officer do? Pulls out the
latest urine report that indicates the young man
tested positive for marijuana. And the probation
officer is saying, he’s violated the
conditions of his probation, therefore, he goes
back to Rikers Island. Now I have a problem, because
the problem in my mind is, how do you define success? Should I take into consideration
these other reports that I’m getting about
his behavior, which are very positive. Or should I go with
the probation officer who’s going on pass/fail. It’s either true or false,
he’s clean or is dirty. Case closed, those are the
conditions of his probation. I realized that I need
some more information. Things are just
not making sense. I then request a
psychiatric evaluation. I make an appointment for him. Took me about a week to do that. I sent him to
Columbia Presbyterian. He goes. The psychologist runs
whatever screening tests that they had available at
that particular point in time. And the young man
is then diagnosed. They then write up the report. They get it back to me. The whole process
took about a month. When I get the report
back, the psychologist is being very specific. They’re saying in this
particular case, and only this case, marijuana
medicates for this young man’s schizophrenia. Wow, we had no idea
that this was occurring. So we were able to get
the young man on a med that the PO could live with. It was a success story. He graduates the program, moves
down the yellow brick road, graduates, we don’t
see him any more. We’re giving each other high
fives that probation saying, boy we’re doing
quality work here. When in fact, we got lucky. But what that told us, was
that it’s very important to have your mental health
treatment component in place. And that goes to whether or not
you have a mental health court, or whether you have
an adult drug court, you need access to
mental health services. So the drug court is
concerned about treatment there, mental health treatment
in that particular case. How about sociology? What do sociologists study? Well they study the effect
of environment on behavior. And when people come
to our programs, or when we’re intaking
them in drug court, we ask some very
poignant questions. We ask questions like anybody
in your family on medication? Anybody institutionalized? Anybody in prison? Those types of
questions are going to give us a snapshot of
who’s sitting in front of us. It’s not going to
tell the whole story, but it’s a starting point. So we need to be concerned
about their environment in behavioral science. And you know what? [SNEEZING] Excuse me. When we flip to the
court side of the fence, the court is also
concerned with environment. What do we do with drug court? We make home visits. We check on curfew. We want to make sure that
the environment is not conducive to using drugs. Treatment people are
also very much concerned with environment. We want to occupy
people’s leisure time. So we want to make sure
they’re going to groups. They’re going to NA, AA. Again, we want the
environment to be a healthy, positive environment,
not necessarily an environment that they have been
involved with in the past. So sociology, an important
part of behavioral science, and an important
component in drug court. And lastly, you see
there anthropology. Now, what do
anthropologists study? Well, culture is one thing that
anthropologists study there, because culture
influences behavior. And that’s something also
that the court and treatment programs are very
much concerned about. Let’s take the example
of home visits. Now, we know that the
court sends people to the home to do a home visit
just to check on the home. Well, suppose this individual
is from a culture that frowns on men being alone
with women in their house. Well, we don’t want to
step on cultural toes. Because if we step
on cultural toes, do you know what’s
going to happen? That person is going to leave
the program because you’ve disrespected their culture. So we don’t want to do that. How about the treatment folks? What about culture
concerns them? Well, how about their
attitude toward women? In some cultures– and again,
we have a lot of people coming from all over the planet
Earth coming to this country– what about their attitude
toward women and children? In some cultures,
women and children are considered property. And the men can do whatever the
hell they want to do with them. Now, here you can’t do that. So there may be an
education component that needs to take place
to advise individuals who come from those cultures. This is how you stay
out of trouble here in the United States. So there are a number
of commonalities between behavioral science
in the research arena and behavioral science
in the drug court arena. What I’d like to
do now, I’d like to have my colleague, Diana
Padilla, launch a poll. And I’d like that poll– I’d like you guys to answer
that poll in this respect. I’d like to know of
the treatment providers that you have available
to refer people to, how many of you
sitting out there have one to three substance
abuse and mental health providers? How many of you have three
to six substance abuse or mental health providers? Or how many of you have six plus
mental health substance abuse providers? And Diana is going
to put that up. Just check yes next
to the designated area that your court falls into. I want to get an idea of, how
much choice do you have when referring participants
for services? And we’ll give you
a minute to do that. OK. We’re going to give
you another 30 seconds. OK. Now I’m getting a
sneak preview here. Oh, it changed drastically. OK. You’ve got another
15 seconds left. Let’s get those votes in now. OK. According– and Diana,
you can close that poll. And if possible can we
share that with the group? Fantastic. I see that 50% of you have
one to three providers to choose from. Another 50% have three to
six providers to choose from. And none of you have six
or more to choose from. I was hoping that
you might get– we might get some who had six
or more, because in our business we call those folks
the educated consumers. You have to be able to choose
the most appropriate program intervention for that
particular client or that particular participant. And the more information you
have about the individual, the better off it’s going to be. So now I know that most of you–
half of you have one to three providers in mental health
and substance use and another half– 50%– of you have three to
six providers to choose from. Thank you very much for
participating there. Now, why cultural proficiency? Well, first of all, let’s
just talk about the wording. Many of you have probably
been to a cultural competency training session. Why did we choose to use
the word proficiency? Because there’s a
difference between the two. When you are
culturally competent, we’re referring to
your individual skills. Proficiency is embedded in the
protocol of the organization, the agency that is basically
employing the case managers who are working in the field. So proficiency is something
that’s institutionalized. Competency is your
personal skill level. What I’d like to– I would like to use an Iraqi
war term to make a point. I’d like cultural
proficiency– or we would like cultural
proficiency to be embedded in the protocols
of your drug court. And we’re going to share
with you how to do that. And what we’re
going to find out is that you’re doing some
of these things already. You’re just not connecting
it or the information isn’t getting passed from
one end of the program to the other. But again, I will repeat this
probably three more times. The more information you
have about the individual, the better off
you’re going to be in pulling off behavior change. Behavior change
is difficult. You want as much information as
possible on the individual. You do not want to essentially
be groping in the dark. Well, why cultural proficiency? What do we hope will happen? Well, we hope as a result
of this new dialogue that we’re going to have
between participant and staff, we’re going to have
higher retention rates. We’re going to hold
on to people longer. Now, think about
it, those of you who have been working in
drug court for a while now. When do people
split the program? They don’t wait around for eight
months to split the program. They split in the
first three months. They’re gone. So if we step on
any cultural toes, that’s very likely to happen. They’re going to
leave the program. As a result of us holding
on to people longer, we’ll have higher
graduation rates. People will be around longer. Therefore our graduation
rates will go up. And we will also
have as a result of this new communication
back and forth, enhanced quality insurance. We will be able to
glean information from our participants that we
can use to better the program to meet their needs. Remember, that’s what
the program has to do. Those are our customers. We have to essentially enhance
the quality of what we do. If your program is
exactly the same today as it was three
years ago, something is wrong, because your
participant population has changed. Your providers have changed. The world has changed. And guess what. You’re going to have to change
a little bit also in order to effect that behavior change. And the last bullet we see
there is lower attrition rates. We’re going to lose less
people, because we’re going to be culturally proficient. And people will get connected
to essentially what we’re doing and are not likely
to leave the program. Now, that’s why
cultural proficiency. Now, how do we pull this off? How do we essentially
get these results? Well, this particular slide
is going to tell us how. In general, what we want to
do by becoming culturally proficient, we’re going to
enhance our observation skills. And we’re going to enhance
our assessment skills. And how do we do that? We’re going to be doing
cultural assessments, both on the participants or the
individuals in our drug court program, and of the
providers that we essentially refer them to. Those three to six
providers that many of you have, we want to
make good matches. You’re going to have to– you may have five providers. Which one do you choose for
that particular participant? You have to know something
about the participant. You have to know something
about the provider to indicate that that
would be a good match. Now, to assist you
in that endeavor, after the third webinar
on cultural proficiency, we’re going to attach
to our NDRI library– I will let you know
where you can find it. We have an instrument that has
a list of questions that need to be asked of participants. And what I’m going to be
encouraging teams to do is sit down. Court people, treatment
people, sit down together and determine, who’s the best
person to ask this question? It may be a treatment provider. It may be a particular group in
the treatment provider program. It may be a group that the
probation officers run. But who’s the best person
to ask that question? We have sample questions. It’s a rough cut, but
that’s intentional, because every
court is different. And you know what
works in your court. And you know who’s
the good questioner. We have some people who
are excellent assessors and others who are maybe
not so good assessors. They have other talents. So we’re going to list that. We then have a provider
assessment tool that we will discuss
on the third delivery. We will go over that. We have a number of
questions that you need to ask not only
of your drug court, but also of the
providers that you are sending your participants to. And by doing so, you’ll know
a little bit more about, is that going to
be a good match? Can this particular program
accommodate all the needs of this particular participant? Sometimes you don’t
have that choice. You just have to make
the best possible choice. But nevertheless,
that’s what we’re going to attempt to assist you with. The next bullet that you see
there is treatment matching. And as I just said, we’ll be
able to do treatment matching better than we do it now. We are improving, because we
know more about the provider. And we’ll know more about
the participant just to say, is it appropriate? Does this stand a
chance of working? So we’ll be doing better
treatment matching. The next bullet that you
see there, incentives and sanctions. Every court has a list of
incentives and sanctions. And as I’ve traveled
throughout the country, very often those
are short lists. What I would love
for you guys to do would be to lengthen
those lists. And I’m just going to give
you an example of two; one incentive and
one sanction that was shared with me as I traveled
around the country visiting some drug courts. I’ll give you a
culturally-proficient incentive. And I call this one
the Big Mama incentive. Now, when I was
working in treatment, I would dedicate a day
for my female clients to bring in their children. I wanted to see the kids. I wanted to see if there
were any special needs that needed to be
addressed, because that can be very hard on a
parent who’s in recovery. Many needs, they don’t
need that kind of stress, so I wanted to see them. There was an 8-year-old
that came in, had on a lovely, lovely jacket. And I said, did your
mother buy you that jacket? The 8-year-old looked at
me and said, no, my mother didn’t buy the jacket. Big Mama bought the jacket. Now, who’s Big Mama? That’s what this
child called grandma. Grandma is Big Mama. Now, in this particular court
that I was involved with, what happened was that the young
lady is going from phase one to phase two. The court wanted to acknowledge
the hard work that she put in. They wanted to reward
her with an incentive. And they were
thinking of getting her a voucher to get a
pedicure and a manicure. It sounds real good. However, when it came time
to give up the incentive, they did not give the
incentive to the participant in the program. They gave the incentive
to Big Mama, to grandma. Why? Grandma was providing
child care services. She took care of the kid while
the participant in our drug court program made
all the referrals that we had set up for her so
she could get out of phase one and move on to phase two. And we wanted to
acknowledge the assistance that grandma was giving, because
if grandma did not provide child care services, this young
lady would have dropped out of the program. Because she’s a mom
first, she’s going to make sure her child is safe. She has to be comfortable
with the provider. If that doesn’t happen, she’s
not going to make drops. She’s going to miss court dates. And you know where the
story goes from there. So that’s a very
interesting incentive. It does not go to
the participant, but it goes to the
participant’s mother who’s providing child care services,
and we wanted that to continue. Well, how about sanctions? Do I have an example of a
culturally-proficient sanction? Well, you know I do. I asked the question. I’m not going to ask a question
about something I don’t have. So one young lady, she was a
participant in the drug court program and had been a member
of the state girls championship softball team. She loved playing softball. She played softball
on the weekends. That occupied the
majority of her time. Well, she missed a drop. She missed a court date. The court people get
together and say, we need to sanction
her, because she has to take these
appointments seriously. So what can we do? They said, well, we
have to find something– we’ll find a community service
that she can do on the weekend so that she can’t play softball. And that way this will
really have some– this sanction will
have some bite to it. She’ll get the point that
it’s very important for her to make the court date,
very important for her to make the drop. Well, they find a community
service assignment for her at the women’s clinic answering
the 800 line on the weekend. Now, little did the drug court
staff know this young lady had OBGYN problems. When she went to volunteer
on the weekend at the women’s clinic, she met other women
who had similar issues. She found out as a result
of dialoguing with them how she could get those
issues resolved. She got the issues resolved. She was very, very
grateful for that. And the situation
worked out so well that the women’s clinic
offered her a job. Now, remember, this all
started out with a sanction. You start out with a sanction,
and you wind up with a job. Not bad. I really like that one for its
creativity and for the outcome. So by becoming more
culturally proficient, we will have different types
of incentives and sanctions that the individual
can essentially elicit that behavior change. They can move forward. They get the point. And maybe something
good will happen. The next bullet you
see there I have listed as positive referrals. I could have said,
no blind referrals. And very often we do
that in this business. We send people to a lot
of referral agencies for all sorts of services. Very often we don’t prepare them
for what’s about to greet them. And I’m going to share
with you how I shot myself in the foot years ago. I had a young man. I wanted to send him to what
they called at that time a TAP center; Testing,
Assessment, and Placement. It was a job training
organization. I shared with the
young man, listen, it’s going to take about two
hours, or two or three hours, for you to move through this
particular intervention here. They’re going to test you. They’re going to interview you. But when you’re all done, I want
you to come back to the office and let me know how it went. His appointment
was at 10 o’clock. So he shouldn’t be back at
my office till 1 o’clock in the afternoon. At 10:30, he’s standing
outside my door. I said, how did you– did you go to the
referral I set up for you? He said, yes. I said, well, how could
you get here in 30 minutes? He said, I didn’t stay. I left. I said, why did you leave? He said, everyone was
dressed better than I was. I did not prepare him. Now, think about it. If you were referred to
a job training center and you walked in the door and
everybody was dressed better than you were, would you stay? I wouldn’t stay, because I know
it’s stacked up against me. I did not prepare the
young man for what he was about to encounter. One thing that participants
love, they like a heads up. They love it when we give
them information about, here’s what you can
expect to happen when you go to that
particular referral source. So we don’t want to
send people blindly places, because we can do more
harm than good on occasion. The next one, the next bullet,
alumni feedback loop or focus groups. Now, focus groups can
be very powerful means of you getting information
about your program from the participants’ side. Now, very often, we don’t want
to hear from the participants. We say, oh, listen,
that’s Johnny Jones. Every time he comes in here,
he gives me a hot urine. And I just really don’t want
to basically– you know, have to entertain his stuff. Well, when you construct a
focus group, my colleague, Joe Lunievicz, who’s
the director now, we went and co-facilitated focus
groups in Brooklyn treatment court and got some very good
information that we could plow back into the program
to improve the program, because– believe me– participants know the
program inside out. They have a different
perspective on the program than we have of the program. Well, in another situation–
and I’m going to mention the state’s name– Missouri. I had to go to Missouri;
conducted a focus group of participants in the program,
and the open-ended question was, how can we
improve the program? Are there things that we’re
not doing too good a job with? Are there things that
we could do better? Are other needs that
are not being met? You’d be surprised that the
information that you get. Well, in this particular
case, I go around the room. One young lady
chimes in and says, my probation officer
is my lifeline. If it wasn’t for my probation
officer, I’d be dead. She connected me with
the women’s clinic. I had OBGYN problems. I got them resolved as a
result of her referral. Things couldn’t be better. Keep going around the room. Another young lady
chimes in and says, I didn’t know that the
program could connect you to health services like
that at the women’s clinic. Now, what was the difference
between the two young ladies? The first young lady had
a female case manager. The second young lady
had a male case manager. And what that told
the people who were running or administering
that drug court is that maybe we need to do a
training for the men on women’s issues. We’re servicing a lot of women. We have a lot of
case managers who are males who may
not be sensitive or may not be knowledgeable
of women’s health issues. So we have to conduct a
training to lift their game, so to speak, around
women’s issues. And when you do that,
clients essentially stay with the program
longer because the program has something that they want. It has health services that
are made available to them. And the last bullet you
see there, analyze data. And that’s where our
researcher evaluator comes in. That person can tell you the
nuts and bolts of your program. Who are you doing
a good job with? Who are you doing a
not-so-good job with? Which programs are servicing
which participants best? You want to make the
best possible match. So as a part of
cultural proficiency, we like to analyze data. At this point, I
can’t take credit for the quotation that is
up at the top of the slide. You see it there in quotations. You can’t do the same
thing to everybody and expect the same results. Now, this is stolen– I just have to
put it out there– this is stolen from Carson
Fox and Carolyn Hardin at a coordinator
training in Dallas where they have placards
made up that basically say, you can’t do the same
thing to everybody and expect the same results. And as a trainer, I’m
very sensitive to, where do they position
those messages? They put them at
either end of the stage so no matter where you’re
sitting in the room, you can read that particular
slide, because it’s such an important point. Everybody is not alike. You can’t have the same
sanctions and incentives for the men as you
do for the women. You can’t have the same
sanctions and incentives for your 50-year-old
participants as opposed to your 25-year-old
participants. You have to be a little bit
more targeted than that. So what we’d like you to do
is be able to, by becoming culturally proficient, we want
you to recognize differences. And remember, it’s
not right or wrong. It’s just different. And we want you to be able to
interpret behavior accurately. We have a habit of
interpreting behavior. We put it through our
own cultural lens unaware of the participant’s culture. And again, how behavior
is driven perhaps in a different
direction as a result of them being a member of
that particular culture. What I want to do now–
there’s an expression that says if you want to be
culturally proficient, you have to know about your own culture
and how your own culture has impacted on your behavior. And at this point, I’m
going to ask Diana, who’s going to launch another poll. And we’re going to poll
on three particular items. One, eye contact. And so let’s just do
eye contact first. And just hold up
a second, Diana. With eye contact, it’s always
the context of the eye contact that’s most important. I’ll give you an example,
a personal example. When I was a young man
and going to school, if I messed up in
school and I went home, my mother would want
to talk to me about it. And what would she say? She would say to
me, boy, you better look at me when I talk to you. Wait till your father gets home. So I internalized that message. As my mother is talking to me,
I’m looking at her directly in the eye. Now, when my father gets home,
he’s there to do follow-up. So essentially she debriefs him
on what happened, then he says, young man, I want
to talk to you. We go in the other room. Dad is talking to me. And what does dad say to me? Dad says to me–
now, I remember what mom said to me about looking
people in the eye when they talk to you. So I’m looking at my
father in the eye. What does my father say to me? Boy, you better not
look at me like that. So I get two completely
different messages from my parents. A lot of this has to do with
who’s giving the message, who’s reading the eye contact. So what I’d like you to know
when Diana launches this poll, as far as eye
contact is concerned, were you given a message
to look people in the eye? If so, indicate yes. If you were given the message,
don’t look people in the eye, indicate no. And we’ll give you about 30
seconds just to poll yourself on eye contact. And it’s all about you. And there is no right
or wrong answer. It’s just that different
cultures handle the eye contact issue very differently. All right. We’ll give you another
15 seconds there. And oh, look at this. I’m looking at this every– I got 100% of the people
indicated, yes, they were instructed to look
people directly in the eye. Well, I think that some of that
has to do with the profession that you’re working
in right now. What does Judge– I’ll use a pop icon
right now before we move on to the other items. What does Judge Judy say? Judge Judy says, look at me. Look at me. Because in the criminal
justice system, we like people, if we’re
working in that system, we like people to
look us in the eye when we ask them a question. That way we feel
more comfortable that they’re telling the truth. Oh, well, look at that. Things changed. It’s now 88%
indicated, yes, they were given the message to look
people directly in the eye. And 13% of you indicated that
you were given the message, don’t look people
directly in the eye. So there’s a minority
and a majority there. Very good. Very good. You probation
officers out there, when you ask
somebody a question, you like people to look
you directly in the eye. But if you’re in a gang
and you look somebody directly in the eyes, that
can mean a whole other thing altogether. If you have spent
time in prison– now this is important
for you folks who are entertaining
reentry courts. Because prison culture
is a separate culture. You look at somebody
directly in the eye, you’re sending a message that
you may not want to send. And if you don’t look somebody
in the eye, what might the individual suspect of you? You’re sneaky. You’re a snitch. Something negative. Let’s take a poll on
the next item now. And this is basically
around decision making. Were you given instructions
to make decisions around individual needs or
do we take into consideration the family welfare? Is it individual focus
or is it family focus? And let me just share
a short story with you to help you poll
this particular item. We have a colleague in
Rhode Island who’s a Latina. She gets a full scholarship
to Columbia University to get her MSW. When we heard this, we said,
we know she’s going to take it. That’s a fantastic opportunity. And we just said,
that’s a no brainer. She’s going to take it. But she did not
take it right away. Why? In her culture, decisions are
made from a family welfare focus. She had a role in her family. She made sure her
younger siblings got up, went to school,
had something to eat. She did the laundry
on the weekend. She did the shopping. She made sure her mom made
her medical appointments. So she could just not
get up and leave and go to Columbia University
to take advantage of this fantastic opportunity. She had to go home and talk
it over with the family. Many of the individuals that
you are working with currently in drug court come from cultures
where they make decisions from a family focus. They look at the family welfare. What’s going to be
good for the group? So what I’d like
to know right now– and Diana’s going to
poll you on this– were you directed
to make decisions based on individual needs
or family welfare needs? And we’ll give you 30 seconds to
complete that particular poll. Oh, look at this. OK. Well, I’m going to
count you down now. 10, 9, 8, 7, 6, 5, 4, 3, 2, 1. OK. And what does my polling say? Oh, look at this, Diana. 25% of the individuals
in the audience indicate that they
were sent messages around making
decisions individually, and 75% were instructed–
were sent messages, you make decisions and
you bring into context what’s best for the family. And you know what? That’s very consistent with
the American way of life. What does the army ad say? Be all you can be. It’s individual focus. But what does the marine ad say? Be one of the few,
the proud, the brave. They’re selling group. So on either end of it,
neither one is right or wrong, but we have both. And we ask some people in
drug court to make decisions. This is what’s happened. What are you going to choose? You’ve got curtain number
one, curtain number two, or curtain number three. Pick one. And they just stand there. And they don’t say anything. Why? Because perhaps they
come from a culture where decisions are made from a
group focus or a family welfare focus. So again, your responses
indicate this split in people. And again, there’s not a right. There’s not a wrong. But just be aware
that it could be both. And the last bullet we have
there is on mental health. And I’m going to ask
Diana to poll you on this. And let me give you some
background information. You just had a
co-occurring trilogy that was conducted by Paul Warren. So mental health
issues are going to be issues that you’re
going to need to process. But because there is a
stigma with mental health, very often what
happens, families don’t want to talk about it. Talk about a family member who
may have a mental health issue. And it’s something that is not
discussed openly in the family. Just not discussed at all. On the other hand,
there are some families that are very open with
mental health issues. And they discuss that. And you would not have a problem
discussing the mental health issues of the particular
participant in your program with family members. So what I’d like you to do now
with the poll is just indicate, is it OK to talk about
mental health issues? If it’s OK to talk
about it, check yes. If mental health issues are
issues that are not discussed, check no. And we’ll give you
30 seconds to vote. And we’ll see what happens here. Another 15 seconds. I’m on a timer, you folks. I’m going to count you down. 10, 9, 8, 7, 6, 5, 4, 3, 2, 1. OK. Let’s close this poll. It said 73% of people voted. And look at what we found. 75% of you indicated, yes, it’s
OK to talk about mental health issues in the family. However, 25% of you indicated
that it was something that was not discussed. And you know what? That probably is the
break out that you have amongst the
participants in your program. It’s probably very
similar to that. And again, there’s no
right or wrong there. It’s just a
difference, and we have to acknowledge that difference. OK, great. So now we start
to see how culture has impacted on our own behavior
in these three particular ways. At this point, if
we’re going to have a conversation about
culture, we have to have what we call a trainer
definition, or a working definition. And this culture means different
things to different people. So it’s difficult to get
consensus on a definition, but I’m going to
ask that you rent this definition for the
hour that you spend with me, because we have to have
a working definition. So culture is the things
that people historically have learned to do,
believe, value, and enjoy. It’s the ideals,
beliefs, tools, customs, and institutions into which
each member of society is born. Now, a couple of things
about this definition. We are not totally happy
with this definition. It was very difficult to come
up with a working definition or a trainer definition. The biggest problem I
have with this definition, which comes out of an old
Columbia University social work book by Edgar Goldman,
is the last word, born, because people
belong to cultures that they’re not born into. By our definition, now, we’ve
expanded our definition, so how might people identify? What cultures do
people think that they will have available to them? Well, look at the cultures
that people choose. And this is– Diana and I could probably
spend a day expanding this particular slide,
but this will give you a flavor for how people
choose to identify culturally I have LGBT– that’s Lesbian,
Gay, Bisexual, Transgender– people may choose to identify
culturally in that manner. And that is a culture unto
itself by our definition. People may choose to
identify gender-wise. I’m a liberated woman. I’m a progressive woman. They may choose to
identify racially. I’m a black man. I’m going to essentially
combine gender and race in my cultural definition. Ethnicity. I’m Dominican. I’m Mexican. I’m Salvadoran. I’m from Thailand. I’m Vietnamese. So again, they may choose
to identify in that manner. Class. I’m middle class. I’m upper middle class. I’m upper class. Age. We have Generation X, which is
different from Baby Boomers. And if you have
disparity in ages amongst the participants
in your program, you can’t do the same
thing to everybody. That’s the mantra. Professionally. People identify professionally. They may work in the
criminal justice system. But if you’re a
probation officer, talk to a probation officer
who doesn’t work drug court. Tell them what you do. And they may look at you funny. They will say, you mean people
can come in and give you a hot urine and you don’t
send them to the hoosegow? What is that all about? What are you running over
there, a hug-a-thon program? What are you doing? I just don’t get it. So there are subcultures within
these professional cultures. Drug culture. There’s a drug culture. But there are many
subcultures, depending upon the drug of choice and
the region of the country where the individual is residing. Treatment. Treatment is not unified,
but people may identify. I’m a therapist. They may choose to– I’m a peer educator. They may choose to
identify in that manner. A veteran. We’re putting together
a veteran’s curriculum now for people who want
to do veterans court. There is a distinct military
culture, a distinct veterans culture that revolves around– much of it revolves
around disclosure. An individual with
a military history may not want to
disclose information about what happened to him
while they were deployed, because that may not be looked
upon favorably for promotions for getting deployed again. So you see this list. So we have a host of
cultures that people may choose to identify with. And I’ve been given
the high sign. Now, I want to end up here. Look at the cultures that
collide in drug court. So you folks who are
working drug court, you have to be master chefs. You’ve got to mix all
these cultures together to effect behavior change. We have the culture of
drug abuse and addiction. What do people say on day one? They don’t say, I’m going
to stop using drugs. What they’re
internalizing is, how can I reduce the
consequences of my use? I got in a tight spot. I’ve just got to get out
of here so I can get back to what I was doing. We have the culture
of drug treatment. Drug treatment is
not monolithic. Drug treatment providers
operate very differently. But that’s a good
thing because we have different types of people. Therefore we need different
types of modalities and interventions. We have CBOs. That stands for
Community-Based Organizations. And we also have drug court. So all of these different
cultures are coming together. And what we’re going
to do next time is essentially pick
it up from here. There was just one
more slide after this. We’ll pick it up from
here and move forward looking at how to culturally
assess our participants and look at what behaviors
culture impacts on. At this time, I’ve
been slipped a note to remind you that there is a
survey that you need to fill out at the end of the session. So what will happen? We will see you seven days from
now, next Wednesday, April 6, at 1:00 Eastern Standard time,
same place, same station, for Part 2 of Cultural
Proficiency in Drug Court. Don’t forget those surveys.

Leave a Reply

Your email address will not be published. Required fields are marked *