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SEPTEMBER 2004
36th
Annual NASW-NYC Addictions Institute
Sharp Insights into Language, Culture and
Addictions
Dr. Frances Brisbane
Keynote speaker, Dr. Frances Brisbane shared her perspectives on chemical dependency, language and cultural competence with a packed auditorium at NASW’s 36th Annual Addictions Institute in May 2004. Dr. Brisbane is Dean of the School of Social Welfare at SUNY Stony Brook, Director of the Center for Culturally Competent Education and Training, and Dean of the Black Alcoholism and Addictions Institute.
Language Matters
Dr. Brisbane led the audience into understanding the ways language is
used to make others feel comfortable with the devastation that drugs wreak
on communities.
She offered the term, “recreational drugs”, and then asked
the audience – what was “recreational” about it? She
noted other terms for drugs like, “ecstasy,” “special
K,” “candy,” “coke,” which suggest something
positive or pleasurable, when in reality these drugs are devastating and
the terminology is not humorous at all.
It’s Marijuana “Abuse”
- Not Just “Smoking Marijuana”
She said that children listen carefully to language and observe the behaviors
of adults around them – that is how they learn. This terminology
makes it critical, she suggested, that drug-related terminology is used
correctly, so that the wrong message is not inadvertently conveyed. It
is important to say, “marijuana ABUSE”, she claimed, instead
of making light of it by referring to the practice as simply, “smoking
marijuana”.
Alcohol – Still the Most Damaging Substance
to a Majority of People
Dr. Brisbane reminded the audience that society makes light of the dangers
of alcohol. She said that combinations of the other drugs still do less
harm than alcohol to the majority of people in our country. She reminded
everyone that “just plain drinking” is often behind “road
rage,” when someone who is not legally “drunk” goes
and shoots another driver for “stealing” his or her parking
space; or when domestic violence occurs after a few beers and turns anger
into something deadly.
Dr. Brisbane called upon social workers to put alcohol abuse “back
on the radar screen” with other chemical abuse – the alternative
is that it may “metastasize in every other area of the lives of
clients.” She recalled behaviors which emerge as a result of alcohol
abuse that impact on people’s family and work lives.
Culture Matters
Dr. Brisbane moved to a discussion of the importance of culture when dealing
with addictions. She said social workers must see people, their addictions,
and the “whole” person in their cultural context. Dr. Brisbane
went on to provide an example about the limits of cultural awareness,
saying that there is “...no such thing as providing treatment for
‘Asians’…since nothing designed for ‘Asians’
will work…[This is] because there are at least nine very distinct
Asian groups…who are as different as night and day.”
She reminded the audience that African Americans, Latinos and other racial
and cultural groups are similarly complex. Dr. Brisbane said that due
to her own family cultural context, she sees drug abuse in a unique way,
causing her to conclude that each person’s experiences are important
in developing an appropriate treatment plan.
Dr. Brisbane acknowledged that funding limitations did create the environment
for the use of a “cookie-cutter approach” to cultural context
for treatment, but that those generic “cultural” approaches
render treatment totally “irrelevant”.
It is Our Differences that Make the Difference
It has no relevance to observe that “we all have red blood”,
said Dr. Brisbane. She argued that the reason for needing cultural competence
training is because of the differences, and it is “our differences
that make the difference.” African Americans, for example, she claimed,
are as different as the different skin shades evident in the room. If
we don’t get it right that those differences exist, “our sameness
makes no difference at all,” she said.
We Can Be Culturally Proficient for About 2 Minutes!
Dr. Brisbane suggested that no one could ever be culturally competent
all the time for all people, but that ways to work with people are needed
to “…use their sameness, but never forget their differences…”
The message was that cultural competence is ever changing, and that no
absolute understanding of any one person can be derived from taking one
class. It takes continual communication with all sorts of people to learn
who they are within their own contexts – precisely the formal orientation
of social workers.
Don’t Depend on Hearsay to Learn About
Other Cultures
Dr. Brisbane presented a cultural competence model that is based on “process”;
it notes the significance of developing ways of knowing about each cultural
group in a work situation – learning directly from the group rather
than just learning based on hearsay.
She was adamant that cultural competence would never be substituted for
“forcefully and legally eliminating racism”. She said she
is often asked to come to organizations to work with the “resident
racists” in the organization, and that she always refuses those
invitations.
Dr. Brisbane discussed examples from several cultural groups. She said
that African Americans have a great value for interpersonal relationships
which affect all their interactions. She explained that cultural sensitivity
for an African American client would mean inquiries into their behaviors,
and realizing that they often equate liking an individual with respect
for that individual.
She observed that a major value to Euro Americans was the “acquisition
of the object” much more than relationships. By that term, she referred
to a focus on goals, almost to the exclusion of considering relational
factors. In a story she recounted, an African American parents’
and a Euro American parents’ views are vastly different in the way
their child deals with a teacher who apparently does not “like”
them – based on those different value emphases, she said that the
African American child felt disrespected and could not learn, while the
Euro American child was instructed to essentially “grin and bear
it” because the teacher would be instrumental in helping the child
achieve the family’s goals for the child.
Dr. Brisbane cautioned against defining bad behaviors in a culture, saying
it was important to distinguish fads from culture; so baggy pants are
not “African American culture”, but merely a subculture of
the overall youth culture. Culture is comprised of things valued as part
of one’s identification.
Dr. Brisbane ended by reminding the audience that cultural training wouldn't
be needed if interventions worked. It is the cultural competence training,
she declared, that helps to bring similarities to the forefront, while
still acknowledging the differences.
She reiterated that the clients themselves are the best experts on their
own cultures and values, and that it is best to learn from them. She said
that there is also a lot to learn about how different groups deal with
social and economic status, and that one can never assume an individual’s
capabilities simply based on their origins. She said, “the way we
think about ourselves has more to do with our value systems than with
our money”. Her family raised leaders as well as individuals with
serious troubles, such as alcoholism, but it was not the culture that
created their troubles.
The question implied for social workers is to determine to what extent
are assumptions about clients’ possibilities constrained by the
limits of understanding them within their cultural contexts.
For more information on the “Cultural Competence Model,” contact
Dr. Brisbane at the Center for Culturally Competent Education & Training,
School of Social Welfare, Stony Brook University, Health Sciences Center,
L-2, Room 093, Stony Brook, New York 11794-8231, or call (631) 444-2139.
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