Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enable that system, agency, or those professionals to work effectively in cross cultural situations. The word "culture" is used because it implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs ,beliefs, values, and institutions of racial, ethnic, religious, or social group.
      The continuum of cultural competence ranges from cultural destructiveness to cultural proficiency. Historically, some agencies have been actively involved in services that deny people of color access to their natural helpers or healers, removed children of color from their families on the basis of race, or purposely risked the well being of minority individuals in social or medical experiments without their knowledge or consent. Cultural incapacity occupies the next position on the continuum  and reflects a system or agencies that do not intend to be culturally destructive but rather lack the capacity to help minority clients or communities. These agencies may disproportionately apply resources, discriminate against people of color based on whether they "know their place", and believe in the supremacy of dominant culture helpers.
     Cultural blindness may be found at the midpoint, with the system and agencies provide services with the express philosophy of being unbiased. They function with the belief that color or culture make no difference and that all people are the same. Culturally blind agencies are characterized by the belief that helping approaches traditionally used by the dominant culture are universally applicable: if the system worked as it should, all people - regardless of race or culture - would be served with equal effectiveness. This view reflects a well intentioned liberal philosophy; however the consequences of such a belief are to make services so ethnocentric as to render them virtually useless to all but the most assimilated people of color. Such services ignore cultural strengths, encourage assimilation, and blame the victim for their problems. Members of  minority communities are viewed from a cultural deprivation model which asserts that problems are the result of inadequate cultural resources. Outcome is usually measured by how closely the client approximates a middle class, non-minority existence. These agencies may participate in special projects with minority populations when moneys are specifically available or with the intent of "rescuing" people of color. Unfortunately, such minority projects are often conducted without community guidance and are the first casualties when funds run short.
     Cultural pre-competence implies movement along the continuum, and the pre-competent agency realizes its weaknesses in serving minorities and attempts to improve some aspects of their services to a specific population. Such agencies try experiments, hire minority staff, explore how to reach people of color in their service area, initiate training for their workers on cultural sensitivity, enter into needs assessment concerning minority communities, and recruit minority individuals for their boards of directors or advisory committees. They respond to minority communities' cry for improved services by asking "What can we do?" One danger at this level is a false sense of accomplishment or failure that prevents the agency from moving forward along the continuum. An agency may believe that the accomplishment of one goal or activity fulfills their obligation to the minority communities. The pre-competent agency has begun the process of becoming culturally competent and often only lacks information on what is possible and how to proceed. Cultural competence is reflected in agencies that are characterized by acceptance and respect for difference, continuing self-assessment regarding culture, careful attention to the dynamics of difference, continuing expansion of cultural knowledge and resources, and a variety of adaptations to service models in order to better meet the needs of minority populations. Culturally proficient agencies seek to add to the knowledge base of culturally competent practice by conducting research, developing new therapeutic approaches based on culture, and publishing and disseminating the results of demonstration projects.