Cultural Competence

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Cultural competence in mental health care has many goals. Which one is not such a goal?

a) improve the quality of care
b) improve access to care
c) build trust among consumers and promote their engagement and retention in care
d) identify segments of the society that use up disproportionate share of resources

2. It is agreed that culture affects the quality of care, but whose culture are we to consider? Culture of the

a) consumer
b) provider
c) administrator
d) all of the above

3. The consumer bears a great share of responsibility to ensure that he or she receives culturally competent care.

a) True
b) False

4. Read Vignette 1 — Dual Diagnosis. Which of the following culturally competent practice steps was taken to provide treatment?

a) Translate your forms and brochures.
b) Offer to match a consumer with a practitioner of a similar background.
c) Have access to trained mental health interpreters.
d) Ask each client about his or her cultural background and identity.

5. In Vignette 2 — Assertive Community Treatment, which of the following culturally competent practices was applicable?

a) Understand that some behaviors considered in one culture to be signs of psychopathology are acceptable in a different culture.
b) Be aware that a consumer from another culture may hold different beliefs about causes and treatment of illness.

6. In Vignette 4 — Medication Management, which practice step helped the caregiver to arrive at a diagnosis and treatment?

a) Incorporate cultural awareness into the assessment and treatment of each consumer.
b) Tap into natural networks of support, such as the extended family and community groups.
c) Create a cultural competence advisory committee consisting of consumers, family and community organizations.
d) Offer training to staff in culturally responsive communication or interviewing skills.

7. In Vignette 5 — Illness Management and Recovery Skills, the key to helping Lupita was in the following competency:

a) Have access to trained mental health interpreters.
b) Incorporate cultural awareness into the assessment and treatment of each consumer.
c) Translate your forms and brochures.
d) Understand the racial, ethnic, and cultural demographics of the population served.

8. Identify the culturally competent practice employed in Vignette 6 — Family Psychoeducation.

a) Be aware that a consumer from another culture may hold different beliefs about causes and treatment of illness.
b) Offer to match a consumer with a practitioner of a similar background.
c) Reach out to religious and spiritual organizations to encourage referrals.
d) Tap into natural networks of support, such as the extended family and community groups representing the culture of the consumer.

9. In cross cultural discussions which term is now more in vogue?

a) minority
b) diversity

10. The terms race and ethnicity are interchangeable and synonymous.

a) True
b) False

11. Most social scientists agree that melting pot ideology is a failed concept.

a) True
b) False

12. Not many examples of cultural destructiveness are currently seen in the mental health system.

a) True
b) False

13. A culturally competent agency should provide services with the express philosophy of being unbiased. It functions with the belief that color or culture makes no difference and that all people are the same.

a) True
b) False

14. Hiring culturally assimilated minority workers is a sign of cultural competence.

a) True
b) False

15. Funding can be used as an incentive for developing cultural competence.

a) True
b) False

16. Which of the following explains the "dynamics of difference?"

a) acknowledge cultural differences
b) recognize the influence of practitioner's own culture
c) interaction between a worker of one culture with a client of another
d) acquire knowledge about diversity within groups
e) understand the meaning of a client's behavior within his or her cultural context

17. Which of the following models designed to bridge cultural gaps is least successful in its results?

a) mainstream agencies providing outreach services to minorities
b) mainstream-supported minority services within minority communities
c) bilingual/bicultural agencies
d) minority agencies servicing minorities without mainstream agency sponsors

18. Low number of Asian people entering the mental health system is due to:

a) a lack of need
b) culturally defined, help-seeking patterns

19. For an agency providing services to children, the identified client preferably would be the:

a) family
b) child

20. Although many minority clients expect helpers to deal with a variety of problems, it is best to focus on the core problem.

a) True
b) False

21. A Hispanic parent wants to consult a natural healer about his child's emotional problems in addition to the services provided by the agency. The mental health worker should discourage such dual treatments as confusing and counterproductive.

a) True
b) False

22. How do Latinos perceive U.S. mental health models?

a) efficient and effective
b) unnecessary
c) unwelcoming
d) not useful
e) all but (a)

23. Latinos are more likely to use mental health services primarily in crisis circumstances.

a) True
b) False

24. In which environment Latinos are found to have lower utilization rates of mental health services?

a) fee-for-service
b) managed care

25. Which of the following groups had the highest rate of admissions to inpatient psychiatric facilities?

a) whites
b) Hispanics
c) Native Americans
d) African Americans

26. Select the true statement about people of African descent from below:

a) they under-consume community mental health services of all kinds
b) they over-consume inpatient psychiatric care in state hospitals
c) both of the above

27. People of African descent tend to delay seeking help for psychiatric problems until conditions have become more serious or chronic.

a) True
b) False

28. Select incorrect statement from below:

a) Asian Americans generally have lower rates of admission for health services.
b) Asian Americans exhibit less severe disturbances compared to non-Asians.
c) Asian Americans are more likely to drop out after initial contact or terminate prematurely from service settings.

29. Why do Asian Americans under-use mainstream mental health services?

a) shame and stigma
b) limited knowledge about the availability of local mental health services
c) tendency to seek more culturally congruent care
d) all of the above

30. Native Hawaiians enjoy one of the highest life expectancy rates of any ethnic group in Hawaii.

a) True
b) False

31. Native Americans are at higher risk for mental disorders than most ethnic groups in the United States.

a) True
b) False

32. Presently few Hispanics in need of mental health care are receiving such services.

a) True
b) False

33. Which of the following groups comprises the largest proportion of Hispanics in the United States?

a) Mexicans
b) Puerto Ricans
c) Cubans
d) Central and South Americans

34. Which Hispanic group has the highest level of education?

a) Mexican Americans
b) Puerto Ricans
c) Cuban Americans

35. Which group has the highest unemployment rate?

a) Mexican Americans
b) Puerto Ricans
c) Cuban Americans

36. What is the most significant barrier for Hispanics to obtain appropriate care for their mental health problems?

a) language
b) low level of education
c) lack of insurance
d) family structure

37. Which group has higher lifetime prevalence rates of major mental disorders?

a) Mexican immigrants
b) U.S.-born Mexican Americans

38. Select the true statement from below:

a) Overall, Hispanics' use of drugs, such as marijuana, inhalants, and nonmedical use of prescription drugs, is higher than that of non-Hispanic whites.
b) Hispanics report greater use of alcohol, heroin, and cocain than do non-Hispanic whites.
c) Generally, Hispanics have lower suicide ideation and specific suicidal attempts than whites and Blacks.

39. Low acculturated Mexican Americans are particularly high users of mental health services.

a) True
b) False

40. When programs include staff who share the cultural background of their consumers, the programs tend to be more effective.

a) True
b) False

41. Identify the elements that constitute culture:

a) race
b) ethnicity
c) age
d) geographic location
e) all of the above

42. In creating audiovisual materials for a group, culturally competent practice requires the use of people, places, language, music, etc. familiar to and preferred by the target audience. This is an example of:

a) surface structure
b) deep structure

43. The concept of cultural competency has two primary dimensions. Which determines the efficacy or impact of a program?

a) surface structure
b) deep structure

44. On the Cultural Sensitivity Continuum, which stage signifies full cultural competency?

a) superiority
b) empathy
c) denial
d) integration
e) relativism

45. Family members or friends make the best interpreters as they have the client's confidence and are familiar with the client's situation.

a) True
b) False

46. There are three levels of culturally competent interventions: macro, mezzo, and micro. The Older Americans Act is an example of:

a) macro
b) mezzo
c) micro

47. Organizing church groups to provide specific services is an example of one of the following interventions:

a) macro
b) mezzo
c) micro

48. Understanding the values, attitudes, and beliefs of particular population groups is an example of _______ level intervention.

a) macro
b) mezzo
c) micro