Having examined the strategy for addressing general cultural characteristics and specific group differences, we will now consider particular issues relating to curriculum and training cultural proficiency. Although this discussion is focused more on preservice training in university programs, many of the issues discussed here are also applicable to in-service training or professional development of clinicians who are practicing in the field.
Cultural proficiency is a continuum rather than a dichotomous "all-or-nothing" professional skill or personal quality. One important consideration in training is that course work must be designed to meet the level of competence from which the students or trainees are starting. It must also be geared towards a level that they can be realistically expected to achieve at the conclusion of training. There are two very useful paradigms in the literature for conceptualizing the levels of cultural competence: (a) the cultural competence continuum, and (b) the three domains of multicultural competence. From our perspective, these paradigms can be used to complement each other in curriculum and training.
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