Working across and within cultures
• Careful listening to avoid assumptions
• Making cultural differences explicit and available for negotiation

There are a range of features of Johnella Bird’s work which are very helpful in working across cultures. Carefully negotiating meaning and minimizing assumptions increases the possibility of useful understanding. Negotiating engagement gives an opportunity for cultural differences to be made explicit and the person consulted on the experience they have of them in the conversation. For example, in many Asian cultures the custom is for the doctor or health professional to tell the person consulting them what they should do. Making explicit the different approach being offered in collaborative practice allows this to be specifically negotiated as an option.

Practices and values around confidentiality can be very different across cultures and making this explicit means expectations can be addressed. There are cultural differences with respect to who might speak for whom and who can and cannot contradict others. A clinician from another culture can be very useful in making these practices explicit and opening inquiry as to how well they are working in this context. Researching differences can bring knowledge that the person has about their culture into conscious awareness, thus it becomes available as a resource. Working in the present moment, whereby noticing of changes in facial expression, body language, tone, etc, are explicitly addressed. Understanding of these is thought particularly important in working across cultures as it facilitates bringing forward of meanings in the conversation which may not otherwise have been appreciated by the clinician.

Paradoxically, these aspects of the work are also valuable in working with someone with apparent cultural similarity. In this situation there may be increased risk that understanding will be assumed. In a context of apparent cultural similarity, contradicting such an assumption may be even more difficult to challenge than where there is obvious cultural difference, particularly as in the context of the power relation and the role of help-seeking, the person is likely to feel the experience they have is to be valued less. There may also be a perception that to challenge an assumption of sameness is to risk being 'outside' and lose a sense of connection.