Cultural Competence: Definition, History, and Practice in Human Services
Cultural competence is a set of behaviors, attitudes, and policies that enable professionals to work effectively across cultural differences. In human services, it means recognizing how a client’s cultural background shapes their needs and adjusting your approach accordingly. It’s an ongoing process, not a credential you earn once.
Every human services professional will work with people whose cultural backgrounds differ from their own. That’s not a niche scenario — it’s the job. And how well you bridge those differences has direct consequences for the people you serve. A landmark 2003 Institute of Medicine report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, found that racial and ethnic minorities receive a lower quality of care than non-minorities even when insurance status and income are held constant. Cultural competence exists, in large part, to address that gap.
The term gets used broadly across fields from healthcare to education to social services, but understanding what it actually means, where it came from, and how to practice it makes a real difference in the quality of care you’re able to provide.
A Definition of Cultural Competence
Historical Perspectives on Cultural Competency Definitions in Human Services
Taking Cultural Competence Concepts Beyond Definitions
Even Program Accreditors Have Something to Say About Cultural Competency
Cultural Competence Eventually Leads To Cultural Proficiency
A Definition of Cultural Competence
Cultural competence is a term that shows up across social justice, healthcare, psychology, and policy — often with slightly different meanings depending on context. Even breaking it into its parts only gets you so far.
Cultural: Of or relating to the customary beliefs, social forms and material traits of a racial, religious or social group
Competence: The quality or state of having sufficient knowledge, judgment, skill or strength (as for a particular duty or in a particular respect)
The challenge is that culture isn’t fixed. Think of people who grew up in immigrant households but attended school alongside everyone else in their neighborhood, absorbing local culture alongside the one they brought home. Culture blends. It shifts over time. And no matter how much you know about where someone came from, you can’t assume you fully understand their cultural experience.
That’s what makes cultural competence more of a practice than a destination. There’s no single body of knowledge that certifies you as competent across every culture. There are thousands of distinct cultures and hundreds of thousands of combinations as they merge and evolve. Part of respecting that diversity is accepting that you’ll never fully master it — and staying curious enough to keep learning.
Not only is cultural competence a moving target, but it’s also a two-way street. Your own cultural background shapes how you relate to others and how they relate to you. That self-awareness is part of the work, too.
What Cultural Competence Means in Human Services
Cultural competence is widely described in the literature as a process rather than a fixed outcome. Four core elements feed into it:
- Awareness — of your own cultural worldview and its limits
- Attitude — toward the difference between cultures
- Knowledge — of diverse cultural beliefs, values, and practices
- Skills — for working effectively across cultural differences
In practice, cultural competence looks different depending on the field you’re in. In psychology, some studies suggest that Interpersonal Psychotherapy can be particularly effective with Latino youth because it aligns with cultural values around family and interpersonal relationships. In social services, workers at the Charles B. Wang Community Health Center in New York take careful note of traditional Chinese herbal remedies their patients may be using — information that directly shapes treatment decisions. In counseling, some research indicates that marriage and family therapists may see improved outcomes with Black clients when treatment incorporates the documented strengths of Black family culture.
The Centers for Disease Control and Prevention offers a working definition that’s become widely used in health and human services:
“Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” ~ Centers for Disease Control
This definition gained traction after research — including the IOM’s Unequal Treatment report — documented that racial and ethnic minorities receive lower-quality care even when controlling for income, wealth, and geographic location. That disparity isn’t limited to healthcare. It shows up across the full spectrum of human services.
Historical Perspectives on Cultural Competency in Human Services
Social workers and human services professionals have always had to navigate cultural differences to do their jobs effectively. You can’t build rapport with a community you don’t understand. But for most of the profession’s history, cultural competence wasn’t explicitly named or formally taught.
A retrospective study published in 2000 found that human diversity issues appeared in only about 8 percent of social work literature published between 1970 and 1997. It wasn’t that practitioners didn’t recognize cultural differences — it’s that the dominant approach was assimilation rather than adaptation.
Social services for immigrants in the United States originally focused on assimilation rather than cultural recognition.
Early American social services were built around the idea of the melting pot — a blending of cultures into a shared national identity. That framing celebrated cultural mixing but often ignored or appropriated what was being lost. Social work educators pushed Native Americans, African Americans, and Asians toward a dominant Western ideological framework, treating assimilation as the goal.
By the 1960s, that approach was visibly failing. Threads of multiculturalism began to emerge. By the 1970s, researchers were examining why traditional Western psychotherapeutic techniques failed with patients from less verbal cultural backgrounds, including many African nations. Western psychology’s assumptions about individualism and structured talk therapy weren’t universal, and treatments built on those assumptions weren’t serving broad populations well.
In 1982, anthropologist James W. Green published Cultural Awareness in the Human Services: A Multi-Ethnic Approach, one of the first works to bring an ethnographic lens to culturally aware social services practice. And in 1989, Terry Cross — founder of the National Indian Child Welfare Association, co-author of Towards a Culturally Competent System of Care, and a member of the Seneca Nation — helped formalize and popularize the term “cultural competence,” defining it in a way that became foundational to the field.
The Original Definition of Cultural Competence
“Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enable that system, agency, or those professionals to work effectively in cross-cultural situations.” ~ Terry Cross et al
The 2000s marked a turning point. The field moved from tolerance and diversity awareness toward active appreciation and adaptation — from treating other cultures as a starting point for transitioning to a Western lifestyle, to recognizing them as worthy of respect in their own right.
The Six Points of Cultural Competence As Defined by Terry Cross
Cross’s definition was particularly useful because it emerged from a continuum — a range of behaviors rather than a binary of competent or not. The six points along that continuum:
- Cultural destructiveness — Active attitudes, policies, and practices that destroyed cultures, including institutions like Indian boarding schools and the Chinese Exclusion Laws.
- Cultural incapacity — Systems that treat cultural perspectives with disregard, presuming the majority culture is the only valid one. Racist or stereotypical policies reward cultural dominance without explicitly attempting to destroy others.
- Cultural blindness — A policy of treating everyone the same, which in practice simply defaults to dominant-culture norms. These approaches may ignore strengths in minority communities and measure outcomes against majority-culture standards.
- Cultural pre-competence — Organizations that recognize disparities and begin correcting them — hiring diverse staff, launching outreach efforts — but fall into tokenism and lack genuine self-assessment.
- Cultural competence — As Cross defined it, a set of behaviors, attitudes, and policies that enable effective performance in cross-cultural situations.
- Cultural proficiency — The highest point on the continuum. Proficient organizations and practitioners actively pursue deeper competency, contribute to the field’s knowledge base, and seek out staff with diverse perspectives.
The transition from lower to higher points on this continuum is rarely clean. There are Western cultural norms that human services professionals will carry into their work, no matter how culturally aware they become. The goal isn’t to pretend otherwise — it’s to work harder at shifting expectations and habits than at changing the people you’re serving.
Taking Cultural Competence Beyond Definitions
Ultimately, cultural competence is defined by action. How you treat people reveals whether respect and awareness are real or theoretical.
Something important distinguishes culturally competent practice from simply being fair: what’s equal isn’t always equitable.
Equality is culturally blind. Culturally competent practitioners aim for equity, instead.
Interaction Institute for Social Change | Artist: Angus Maguire.
Equity means approaching every individual with what they actually need, as an individual. That’s cultural competence in practice: seeing the person in front of you as a person, not a case file or a cultural representative.
How to Develop Cultural Competence in Human Services
Some culturally competent practices are straightforward: employ staff who speak the community’s language, provide access to interpreters, schedule services at accessible times, and be mindful of cultural customs and taboos. But much of the work is harder to systematize.
A human services professional visiting a client who is a recent Korean immigrant might not know, without prior exposure, that in some Korean cultural contexts, writing a person’s name in red ink carries associations with death. Attitudes toward time can also vary significantly across cultures — what reads as chronic lateness in one framework may simply reflect a different relationship to scheduling in another. The answer isn’t to memorize every possible cultural nuance — it’s to stay open.
Being Culturally Sensitive Doesn’t Mean Pandering
The Charles B. Wang Community Health Center primarily serves recent Chinese immigrants. Staff largely speak different Chinese dialects and maintain extra awareness of traditional herbal remedies. But the center deliberately avoids being too culturally narrow. Posters and murals appear in Chinese, English, Korean, and Spanish — reflecting the actual diversity of New York rather than a single cultural identity.
Ddmmen, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons
The American Psychological Association’s competency framework for Individual, Cultural, and Disciplinary Diversity breaks culturally competent practice into two areas: monitoring and applying knowledge of self and others as cultural beings, and identifying how social and cultural factors shape the problems clients face. From there, the practical work unfolds in three steps.
Asking and listening. Competence starts with assuming you don’t know. Human services professionals are trained to ask about cultural identities, health beliefs, and history rather than assuming the answers. Giving clients the space to speak freely and without judgment is how you get the information you actually need.
Respect and awareness. Competence requires genuine respect for ideas and perspectives from other cultures, including those that conflict with your own values. A professional poker face matters here — appearing judgmental shuts down the conversation before it starts.
Continuing education. Cultural competence is never finished. The communities you serve are changing, and so are the best practices for working with them. Programs that train human services workers build cultural competency into their curricula precisely because this foundation matters from day one.
What Program Accreditors Require on Cultural Competency
Major accrediting bodies in human services and related fields include requirements that accredited programs address diversity and cultural competency. Here’s what each one mandates:
Council on Social Work Education (CSWE) — Competency 2: Engage Diversity and Difference in Practice requires social workers to understand the intersectionality of multiple factors — including culture — in clients’ identities, and to apply that understanding in practice. Social workers must present themselves as learners and manage personal biases through self-awareness and self-regulation.
American Psychological Association Commission on Accreditation (APA) — Guiding Principles of Accreditation, Professional Values Standard 2a: Commitment to Cultural and Individual Differences and Diversity requires accredited psychology programs at every level to hold a broad definition of cultural and individual differences.
Council for Accreditation of Counseling and Related Educational Programs (CACREP) — Core Curriculum Areas C.5.8 and C.7.6 require counselors to understand and analyze cultural implications and to consider cultural influences when conducting assessments and making treatment decisions.
Master’s in Psychology and Counseling Accreditation Council (MPCAC) — Standard C, Multiculturalism and Diversity Part 1 requires programs to demonstrate that students have knowledge and awareness of themselves and others as shaped by cultural diversity, and that they apply that knowledge across all professional interactions.
Council for Standards in Human Services Education (CSHSE) — Standard 8: Fostering the Development of Culturally Competent Professionals is devoted entirely to demonstrating how accredited programs include cultural competence training, build it into institutional policies and practices, and develop competency skills in graduates.
Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) — Standard 2: Commitment to Diversity and Inclusion defines specific learning outcomes related to diversity and inclusion, requires that the program environment be safe and respectful of students’ cultural backgrounds, and mandates hands-on experience in diverse, marginalized, or underserved communities.
Cultural Competence Eventually Leads to Cultural Proficiency
Cultural competence is valuable — and it’s also a starting point. The goal for human services professionals is cultural proficiency: an ongoing awareness of your own limits, combined with a genuine commitment to learning across them.
Culture shapes people, but it doesn’t define them. Every client brings experiences, perspectives, and preferences that go beyond any cultural category. The person in front of you isn’t a cultural representative — they’re an individual whose specific history has shaped them in ways you won’t fully know without asking.
A Broad Range of Perspectives Leads to Many Different Interpretations
Meredith Minkler, a professor of public health at the University of California, Berkeley, was accustomed to taking a knee during the national anthem in solidarity with the Black Lives Matter movement — a gesture initiated by San Francisco 49ers quarterback Colin Kaepernick in 2016. According to reporting by NPR and multiple other outlets, Kaepernick switched from sitting to kneeling after a conversation with former Army Green Beret and NFL player Nate Boyer, who felt kneeling would be a more respectful gesture than sitting.
At a large gathering of public health professionals, Minkler knelt and found herself alone. Two African American military officers standing next to her remained standing.
Afterward, a diverse group of professionals produced a broad range of interpretations of kneeling: as deference, humility, respect, or weakness. Military experience shaped one set of views. Religious upbringings shaped others. Even among veterans, there was no single cultural view. Boyer himself has said that his own feelings about the gesture were conflicted — shaped simultaneously by his military service and his belief in the First Amendment right to protest.
Mike Morbeck, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons
Cultural proficiency means holding a constant awareness of your own unawareness. You can’t assume you know which experiences have most shaped the person. And as the example above shows, even your assumptions about what might be sensitive or offensive are often rooted in your own background, not theirs.
Even your ideas about what may be problematic, offensive, or insensitive to someone from another culture are themselves usually rooted in your own cultural background — not theirs.
Communication is the only reliable path forward. Asking what someone’s perspective actually is offers the ultimate form of respect — and the most useful information you can get.
Frequently Asked Questions
What is the definition of cultural competence?
Cultural competence is a set of behaviors, attitudes, and policies that enable individuals and organizations to work effectively in cross-cultural situations. The most widely cited definition comes from Terry Cross (1989): a system, agency, or group of professionals that is culturally competent can recognize cultural differences and adjust their approach to serve diverse populations effectively. It’s understood as an ongoing process, not a fixed credential.
What is the difference between cultural competence and cultural humility?
Cultural competence describes the skills, knowledge, and behaviors needed to work effectively across cultures. Cultural humility goes a step further — it’s a disposition of openness and self-reflection that acknowledges you’ll never fully understand another person’s cultural experience. Many practitioners in human services now treat the two as complementary: competence gives you tools, humility keeps you from overusing them.
Why is cultural competence important in social work and human services?
Research consistently shows that racial and ethnic minorities receive lower-quality care in health and human services settings, even when controlling for income and geography. The 2003 Institute of Medicine report Unequal Treatment documented this gap across dozens of conditions and service types. Culturally competent practice directly addresses this disparity — when clients feel understood and respected, they’re more likely to engage with services and get the outcomes they need.
How do you develop cultural competence as a human services professional?
Cultural competence develops through a combination of education, self-reflection, and direct experience. Formal training in accredited human services or social work programs builds the foundation. Ongoing practice means asking rather than assuming, seeking out diverse professional experiences, and staying current with research on the populations you serve. The professionals who become most culturally competent treat it as a career-long commitment, not a training box to check.
What are the six points on the cultural competence continuum?
Terry Cross’s cultural competence continuum runs from cultural destructiveness (actively harmful policies like Indian boarding schools) through cultural incapacity, cultural blindness, and cultural pre-competence, to cultural competence and finally cultural proficiency. Most organizations sit somewhere in the middle of the continuum. The framework is useful because it shows cultural competence as a direction of travel rather than an all-or-nothing state.
Key Takeaways
- Cultural competence is a process, not a credential. Formalized by Terry Cross in 1989, it describes the behaviors, attitudes, and policies that enable effective cross-cultural work. No one becomes permanently competent. The practice is ongoing.
- The field has a documented history. Before the 1980s, assimilation was the default approach. Understanding that history helps practitioners recognize how far the field has come and where blind spots still exist.
- Equity, not equality, is the goal. Treating everyone the same defaults to dominant-culture norms. Culturally competent practitioners adjust their approach to meet each person’s actual needs.
- Major accrediting bodies require it. CSWE, APA, CACREP, MPCAC, CSHSE, and COAMFTE all include cultural competency requirements in accredited programs. If you’re considering a degree in social work, counseling, or psychology, this will be part of your training.
- Cultural proficiency is the higher goal. Competence is a starting point. Proficiency means actively pursuing a deeper understanding, contributing to the knowledge base, and staying aware of your own limits as a practitioner.
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