Cultural Competence

Cultural Competence Case Study

Rapid demographic changes in today’s society require health care professionals to deliver
care that demonstrates respect to patients’ diverse beliefs, preferences, and values. By providing
culturally responsive care, health care practitioners help to promote improved health outcome for
patients and encourage sufficient use of resources by their employing organizations. In their
effort to deliver culturally sensitive care, therapists must be able to differentiate cultural
differences from other related client characteristics that may have an impact on patient outcomes
(Saha, Beach, and Cooper, 2008).
In the given case study, the physical therapist should take cultural, physical, cognitive,
communicative, and environmental factors into consideration in working with Hernando
Gonzales in a home care situation. The cultural factors that should be taken into account include
age, nationality, gender, marital status, religion, ethnicity, and beliefs about health. The therapist
should understand that Mr. Gonzales is a 63-year old Mexican male who is currently a widower.
Also, Mr. Gonzales goes to church regularly, and being a Catholic; he believes that God is the
provider of strength. Furthermore, the therapist should consider the fact that Mr. Gonzales may
want to use many herbs in the course of therapy (Saha, Beach, and Cooper, 2008).
The physical factor that the therapist should consider is that Mr. Gonzales once had a
partial knee replacement and he still needs assistance with activities of daily living, despite the
fact that he has made good physical recovery since he had an accident. The cognitive,
communicative, and environmental factors that the therapist needs to consider include; reduced
mental functioning as a result of traumatic brain injury, limited spoken English, and limited
social support in Maria’s house respectively (Saha, Beach, and Cooper, 2008).

Lack of cultural competence by the therapist may make him or her to confuse cultural
variations with other physical, communicative, environmental, and cognitive characteristics in
this case. For instance, if the therapist is not culturally competent, he or she may think that Mr.
Gonzales reactions due to influence from cognitive problems and environmental factors are as a
result of cultural beliefs and values (Santisteban, Mena, and Abalo, 2012). Furthermore, the
therapist may think that Mr. Gonzales’ incapacities to speak fluent English and to carry out his
physical activities normally are as a result of cultural influence. It is important to differentiate
cultural differences from those related to the client’s other characteristics because positive health
outcomes for the patient largely depend on the therapist’s ability to deliver culturally sensitive
care (Sue, Zane, Hall, and Berger, 2009).
The therapist should make adjustments in both assessment and intervention based on Mr.
Gonzales’ cultural, cognitive, and linguistic backgrounds. Since the therapist does not speak
fluent Spanish, he or she should consider using a translator to help Mr. Gonzales to understand
any information that may be presented in English during the assessment. Also, the therapist
should use a cultural broker to help reduce cultural-related conflicts that may arise during the
assessment (Sue et al., 2009). Furthermore, the therapist should approach Mr. Gonzales with a
lot of humility because he currently has traumatic brain injury. Again, he or she should
recommend interventions that Mr. Gonzales can easily implement, bearing in mind that he has
some form of physical inability and limited family support in Maria’s house (Saha, Beach, and
Cooper, 2008).
The therapist can enlist the help of Mr. Gonzales’ family to facilitate therapy in two
different ways. First, the therapist can advise the family on the types of social support that they
should give Mr. Gonzales to promote quick recovery. Second, the therapist can help Mr.

Gonzales’ family to identify the most appropriate forms of physical support that are necessary to
promote positive health outcomes for him (Santisteban, Mena, and Abalo, 2012).



Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence, and
health care quality. Journal of the National Medical Association, 100(11): 1275-1285.
Santisteban, D. A., Mena, M. & Abalo, C. (2012). Bridging diversity and family systems:
Culturally informed and flexible family based treatment for Hispanic adolescents. Couple
and Family Psychology, 2(4): 246-263.
Sue, S., Zane, N., Hall, G. & Berger, L. K. (2009). The case for cultural competency in
psychotherapeutic interventions. Annual Review of Psychology, 60: 525-548.