Elements of a Culturally Competent Prevention System

Valuing Diversity

Prevention practitioners in a prevention system cannot begin to develop policies and procedures around cultural competence if the organization and its staff do not value diversity. The system must embrace the key role that diversity plays in strengthening accessible, efficient, and cost-effective care.

Awareness of the “Dynamic of Difference”

The prevention system must be conscious of the inherent dynamic of interacting cultures. This is a critical component in the design of service delivery. Having access to service delivery is not enough. How, where, and by whom the service is provided must also be considered.


This element reflects earlier cross-cultural models in its concern with worker knowledge and beliefs, or the area of cognition as expressed by Harriet Lefley and Paul Pederson in their 1986 book Cross-Cultural Training for Mental Health Professionals. One initial concern involves cultural and color blindness—the concept that practitioners should and can treat everyone the same.

Ability to Institutionalize Cultural Knowledge

The prevention system must sanction and in some instances require the incorporation of cultural knowledge into the service delivery framework. This knowledge must be available at all system levels.


The practice element considers the following issues:

  • The interview process
  • Diagnostic and assessment approaches
  • Treatment planning techniques

Practitioners are also encouraged to consider other practice skills that are culturally appropriate. Practice skills may be adapted to accommodate within- and between-group differences.

Adaptation to Diversity

Prevention interventions must be modified to meet the unique needs of program participants. Programs and services should be delivered in a way that reflects the culture and traditions of those being served. The prevention system should also take the necessary steps to scientifically adapt the prevention program, including cultural diversity criteria and indicators.

Cultural Self-Assessment

A culturally competent organization continually assesses organizational diversity. Organizations should conduct a regular assessment of its members’ experiences working with diverse communities and focus populations. It also regularly assesses the range of values, beliefs, knowledge, and experiences within the organization that would allow for working with focus communities.

Cultural competence is a key principle of SAMHSA’s Strategic Prevention Framework (SPF). Learn more about applying the SPF.

Last Updated: 09/04/2018