Viability of concept mapping for assessing cultural competence in children's mental health systems of care: a comparison of theoretical and community conceptualizations
Definitions of cultural competence, a dynamic and evolving concept, are based on the respective worldviews of social science theorists. In an increasingly diverse society, developing effective human services requires contextual responsiveness. Mental health systems in the United States have an unsatisfactory performance history in serving children and families with diverse backgrounds. Moreover, a lack of empirical research delineating the models and impact of culturally responsive practice on mental health inhibits knowledge-based progress. Cultural competence is essential at all levels of a service system. However, the lack of clarity around its meaning raises critical questions about the constructs underlying current practice models and measurement instruments developed from these models. Concept Mapping, a structured participatory mixed-method research approach, was used to conceptualize and assess cultural competence in four children’s mental health systems of care communities. Conceptualizations generated from relational map structures and rating scales were compared for differences and similarities across communities. An adapted relational competence theoretical framework provided a useful structure for further comparing community conceptualizations for congruence with current models of culturally diverse practice. Analyses indicated that no one practice model accounted for all community concepts generated. The extent to which community conceptualizations included the practice models' elements varied across communities. Similarly, multiple elements of the practice models were absent from community conceptualizations but several of the models' elements were identified across communities. Thus, the study provides additional insight into the practice models' application to systems of care. The study assisted multiple systems of care in identifying training needs and establishing baselines to monitor cultural competence development. As a function of this process, social work was positioned to effect change in state mental health policy. The findings suggest that current models of culturally diverse practice have questionable applicability across varied systems of care. Relational competence theory was a good fit with the models examined and offers a foundation for future development and empirical validation of a theoretically-based model of cultural competence. Additionally, Concept Mapping was found to offer a promising alternative research method for conceptualizing and assessing culturally responsive practice within specifically identified cultural contexts.