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Objectives
Communicating Effectively in Diverse
Communities
Helen L. Masin, PT, PhD
 Participants will:
 Identify and respect their own cultural assumptions
 Identify and respect the cultural assumptions of the children and
families whom they serve
 Learn strategies to assist in communicating effectively with
families from diverse communities
Who has experienced cross cultural
challenges in your setting?
Think, pair, share
Count off by two’s
Each person write down your culture/
ethnicity on a sheet of paper
Pair off with someone who does not
have your number
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Write down what you think the
culture/ethnicity of your partner might be
Think, pair, share
Compare what you wrote with how the person
describes him/herself
Iceberg metaphor
What did you discover?
How might your cultural assumptions impact your
interactions the families you serve?
Differing communication styles and
expectations may contribute to
misunderstandings with families
What is communication?
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Culture is communication and
communication is culture
What is culture?
Edward T Hall
Ryszard Kapuscinski stated:
Communication takes multiple forms
“Tell me how you dress, how you act, what are your habits,
which gods you honor—and I will tell you who you are.”
 Within one person—internal and external communication
 Between people—verbal and nonverbal
“Man not only creates culture, he inhabits it, he carries it
around with him—man is culture.”
 Among people of different cultures, different behavioral
norms exist and may not be known by both parties e.g.
Native American
Low context and high context
assumptions
What are they and how do they impact communication?
What is context?
High context assumptions
 We greater than I
 Indirect communication, spiral and circular logic are
assumed
 More implicit meaning is assumed (where the
communication occurs, who is speaking, and what are
their credentials?)
 Nuances in communication are considered important
 Listener focused communication patterns
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Low context assumptions
 I greater than we
 Direct, linear, logical communication patterns assumed
 More explicit meaning is assumed (the words express the
Where does biomedical western
culture fit?
meaning)
 Less dependent on contextual cues
 Sender focused communication patterns
Where does your culture fit on the
high-low continuum?
Where do the families whom you
serve fit on the high-low continuum?
How many are primarily low context ?
How many are primarily high context?
How might these differences impact
your effectiveness ?
A tool to assess both culture and spirituality is
the Adapted HOPE Spiritual Assessment Tool
H: Sources of hope, meaning , comfort, strength , peace, love and connection
O: Organized religion
P: Personal spirituality
and practices
E: Effects on care
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How nonverbals impact communication
 Proxemics
See Project Craft Video
 Haptics
Look for nonverbal communications including
facial affect, gestures and eye movements
 Oculesics
There may be significantly different
cultural assumptions
 Beliefs-what people think is true
 Attitudes—how people feel about their beliefs
 Behaviors—what people do based on their beliefs and
attitudes
What can you do to learn more
assumptions of the families whom you
serve?
Use medical interpreters—recent research indicates that the use of professional
interpreter services dramatically increased satisfaction with patient-provider
interaction in the ER with non-English speaking patients
Use cultural informants from your setting
 Examples from clinical practice (food play and meds) and
Fadiman’s book, When the spirit catches you, you fall down
Ask Kleinman’s Eight Questions
What is rapport?
See handout
How do you know when you have it?
How do you know when you don’t have it?
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Rapport
Enhancing rapport in cross cultural
communications
 Establishment of a cooperative communication mode in
 One can match in a similar way one person or a group of
which the individuals are aware of and responsive to one
another
persons
 One can pace at three levels
 It is marked by harmony but does NOT necessarily indicate
agreement
 Cultural—form of dress or greeting
 Verbal—using similar phrases or content
 When people are in rapport, they have a variety of behavioral
pattern such as postures, breathing rates, and language
patterns that become similar in nature
How might rapport help you in
cross cultural communication?
 Behavioral—use similar body language, vocal tonality and
tempo, posture and breathing rate
Examples from clinical practice
Working with children and families who are Deaf
and Hard of Hearing
How might this information be helpful
in your setting?
Questions?
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