Hold On, It's Not Over

A Blog about Children's Mental Health in Massachusetts

Getting to “culturally comfortable”

When programs strive to be culturally competent, the result should be that families are “culturally comfortable.” Most parents and youth can tell you whether it is easy and comfortable for them to be connected to and involved with a program. Feeling culturally comfortable helps families decide how they view a program, a worker or a service.

I first encountered the term “culturally comfortable” in the guide, Working with Families of Children in the Juvenile Justice and Corrections Systems. As Trina Osher and Barbara Huff note, some families may require a boost to become involved with their child’s services or program. They list some key strategies to provide that boost and providing culturally comfortable settings is a priority.

The term “culturally comfortable” has been cropping up in health and education settings for a number of years now. Many urban health centers have changed how they practice, finding new ways to share health information and deliver care. Some ask patients how they think a condition should be treated before offering their own recommendations. One pediatric practice in Virginia explored creating a “culturally comfortble” medical home. Some preschool educators have also been strong proponents of ensuring that their classrooms are culturally comfortable. Beverly Gulley and Nillofur Zobairi write that educators need to “know and understand the family’s cultural orientation to make a child feel comfortable and secure, and provide a sense of continuity.”

While cultural competence is a core value for both wraparound and creating a systems of care in children’s mental health, the notion of “culturally comfortable” settings or practice has yet to show up. I think it’s about time. Cultural competence is a rich, complex yet formal standard and most parents and youth would be hard pressed to say how close a setting or practice is to getting there. Yet they would be able to judge whether it was culturally comfortable. Feeling comfortable or uncomfortable is something we are all familiar with. Culturally comfortable settings, dialogues and practice make families feel welcome and respected.

Increasing cultural competence in the delivery of mental health services for children can help reduce disparities and increase access. But these results are frequently unknown to families, especially if the changes are gradual. Changing a setting, practice or dialogue so that it becomes more “culturally comfortable” is something that families can notice and determine for themselves. Determining whether that change is happening can empower parents and youth. Early in the family movement, parents often judged whether materials, programs or approaches were family friendly and later family dirven. So, too, can parents and youth figure out if materials or programs today are culturally comfortable.

Building an approach that is “culturally comfortable” starts with communication and awareness. Find out what the family values, who its members are, what the concerns and goals for its children may be. Ask families what matters to them. Find out what is private in a family and what is easily shared. Culture influences parenting and family behaviors, including meals, sleep, how to dress, interaction with both adults and other children, health care, how to show affection and respect, ways of celebrating and what occasions to celebrate. Many different family configurations are out there. Celebrate moms, dads, grandparents, extended family members, siblings, and others important to children. Model respect and show that customs, languages, cultures, and physical attributes different from your own are important and to be honored. Diversity in our society should be valued and enjoyed, not considered a threat to the values or lifestyle of any group.

Catherine Stakeman, Maine NASW, said that “becoming culturally comfortable between all cultures is a journey, and there is always room for improvement.” To make it happen, it must be everyone’s responsibility.


January 16, 2011 - Posted by | children's mental health | , , , , , , , , , , , , , , , , ,


  1. This is a subject worth discussing, supporting, believing and talking about often. I have to wonder how many providers, agencies, communities have “heard” from families on what works. As a very involved mom on giving feedback I have realized the audiences that understand- need for change, flyers/postings and pictures that welcome me. Have you ever been to a waiting room that isn’t big enough? Have you ever been to the waiting room that doesn’t have items for children? Have you heard staff talk about families at the reception desk about “those” parents that don’t watch their kid/or the kid is like the mom? Finally have you been in the locked room waiting needed water after 10hrs? Its hard to talk about making mental health and emotional health real!!!!! Let’s all talk it will get better- comfortable!

    Comment by Meri | January 17, 2011 | Reply

  2. I agree that “culturally comfortable” is a concept that I can identify when I take my children to a setting, school, doctor, health setting, ect. Because, I feel as thought I am included and accepted. I have seen a shift in certain settings that we come in and have that feeling right away. In other settings, myself and my children have been very uncomfortable, and at times it takes a bit to identify just what made us feel that way. It can be the language that is used when we are spoken to, a look, or not taking the time to ask if we need anything. When I hear about Cultural Competence and culturally comfortable, my mind goes to respect and acceptance of those who are perceived to be different. That difference can be in nationality, health needs, economic status or education…

    Comment by mary | January 18, 2011 | Reply

  3. I agree that “Increasing cultural competence in the delivery of mental health services for children can help reduce disparities and increase access. But these results are frequently unknown to families, especially if the changes are gradual. Changing a setting, practice or dialogue so that it becomes more “culturally comfortable” is something that families can notice and determine for themselves.” Very true.
    We have to move the cultural and linguistic competency movement to the next level. For me, the culturally comfortable care relates to the feeling and being comfortable as recipients of service(s). It extends beyond cultural awareness and cultural sensitivity. Feeling comfortable and I would add “culturally secure” provides families, children, adolescents and young adults the power to comment on practices planned and received. It also enables us as partners to participate in changing any negatively perceived or experienced services. A culturally and linguistically comfortable service environment is the gold standard of care of shared respect, shared knowledge and shared learning together to achieve wellness and recovery.

    Comment by Ed | January 23, 2011 | Reply

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