Browse through our Medical Journals...  

Cultural Aspects of Assessing and Enhancing Parenting

Dorothy N Sebuliba, Child and Adolescent Mental Health Team, Gulson Clinic, Gulson Road, Coventry, CV1 2HR, UK

Bringing up children is one of the most important jobs that adults undertake and yet the vast majority receive little or no training. Most parents learn about parenting from the way they were parented and as parents themselves tend to repeat or react against same patterns whether negative or positive. The enhancement of the parent's self esteem and that of their children is essential to positive parenting.

Christine Cooper in her work on Adoption and Fostering devised a checklist which has been quoted in the UK Department of Health 1988 guidelines. They offer a comprehensive assessment guide to child care/child protection work. It includes; basic physical care, affection, security, stimulation of innate potential, guidance and control, responsibility and independence commensurate with level of maturity.

Some of the most common concerns raised by ethnic minority parents include their children's future employment, religious and cultural needs, their cultural identity, racism, discipline and so on (Evans and Grant, 1995). Among other black groups, especially when parenting involves children of dual parentage, second and third generation black parents whose children consider themselves British, parents are concerned about how to instil a positive black identity and enhancing self esteem in their children.

Within the general population if parents are not able to cope with the task of bringing up their own children, there is a tendency for them to feel stigmatised, and ethnic minority groups are no different. The anxiety of bringing shame to the family and past experiences of contact with the service providers will also come into play for this group of the population. Professionals may perceive this as secrecy or as restrictiveness of such parents which denies "much needed help" for their children. Measures taken to minimise the stigma are helpful to all families. Practitioners also need to be aware of the factors that will affect accessibility, of the services we offer to ethnic populations. Involvement of professionals from black and ethnic minority background in the delivery of such services, can help improve access to the services. My experience of working with Asian families, is that they are more likely to take up the services, when they are provided within their localities, eg, a health centre.

In light of the above, it is not surprising that the notion of parenting problems and ethnic minority families raises anxiety amongst professionals working with them. In this paper I make an attempt to discuss some of these issues on the basis of my clinical experiences. The cultural aspects are illustrated by case vignettes which depict cultural diversity and examine a variety of parenting problems. My intention is to make a contribution to appropriate, practical ways which professionals will find usefu.


When making the initial contact with the family it is advisable for the appointment letter to explain what parents should expect from the interview.

It is desirable to send a letter that gives the family the opportunity to discuss the appointment beforehand and who should attend the interview would also depend upon the particular ethnic perspective as regards family, hierarchy of authority, and roles and responsibilities. Thus the significant other carers could be present, to enable one to gather the necessary information, otherwise one may be relying only on assumptions.

Similarly language and communication are recognised as important in conducting an effective interview, especially when dealing with ethnic minority populations. The need for an interpreter experienced in the specific area of practice should be established before meeting with the family. Using children or other people who are able to speak the language, such as domestic staff has its complications in addition to the usual pitfalls of using interpreters. A child will have difficulty in relaying therapeutic advice given to parents, grandparents, aunt or uncle because of their position in the family. It will also distort the "ethnic family" system, boundaries and dynamics and will affect future management. Teenagers are likely to rephrase such advice to suit their needs and although this is what they may desire it is not always in their interest. Such advice (relayed by the child) may also be contrary to parents wishes and views and could affect the professional's working relationship with the family.

The issue of establishing rapport is important in any successful intervention and is essential when we are dealing with minority ethnic groups.

The interpretation of interactions should be made in the context of the ethnic perspective. Hence, avoiding eye contact does not always symbolise shyness, embarrassment, fear or anxiety nor is it a sign of a failure by the professional to establish rapport. Usually it represents respect especially between children and adults and parents and professionals. One should note however that this does not preclude ethnic minority groups from experiencing these emotions. Sometimes verbal and physical interaction may appear limited during the interview for a variety of reasons. Apart from the usual anxieties, there is a tendency for children amongst some families not to talk while adults are in conversation. They tend to keep 'a respectful’ distance and will not volunteer to speak unless invited to do so. Some other cultural aspects are discussed below with case examples.

Cultural considerations.

Parental expectations vary from culture to culture, and whether a person belongs to a majority or minority ethnic group, there are cultural variations between and within the groups. Culture usually applies to patterns of behaviour that are linked to cultural identity including origins, physical appearance, language, family structure, religious beliefs, politics, food, art, music, literature, attitudes towards the body, gender roles, clothing and education.

One's upbringing is also the product of economic and social circumstances. In an affluent family, for example, with a fair amount of living space, money, books and toys, 'a good child' may be energetic, inquiring, active voluble and out-going. However, in a low-income working family, living in smaller accommodation in the inner city, 'a good child' may be the quiet one. Hence, economic factors, housing and the environment, all influence behaviour, the way children are brought up and the lives and values of the whole family. For many minority ethnic groups, the constraints of industrial inner-city environment and poor housing will seriously restrict their ability to bring up their children as they wish. From an early age children vary greatly in their experiences of life even within similar cultural groups. Some lead circumscribed lives; confinement in a detached villa in a large garden can be almost as isolating as confinement in a top-storey flat. Farmer (1980) asserts that a child living in a crowded street, and within a large kinship network, absorbing the conversation of his aunts and uncles on concrete facts of life, who is permitted to wander freely and taste the excitement of city streets and shops, may well have a highly stimulating environment if he survives the obvious hazards!

The culturally sensitive perspective necessitates that the assessment of strengths, aspirations and adaptability of black families must include a good understanding of the special socio-economic pressures that black and ethnic minority families endure as a result of racism and discrimination.

Parenting should be seen in the cultural context of the family, as various members of the family will have a role to play. Amongst some Asian families, the older children will be expected to take on responsibility for the younger siblings. In the Western cultural context, the scenario could be perceived as parentification or bullying by an older sibling.Gender relationships and inter-generational hierarchical structures are transformed by cultural influences. The most important quality of the head of the family is that of acting in a nurturing way so that the 'subordinates' either anticipate his or her wishes or accept them without questioning. It is emancipation and renunciation through which the individuals within the family establish the superiority of their love and express it in the form of loving kindness, empathic joy, compassion and equanimity. The paradox of love turns the acts of humility into pride and servitude into respect. In an atmosphere that engenders dependability, children model upon their parents and grow up to become model dependable parents themselves whilst also caring for their elderly parents (Dwivedi, 1996a).

There is usually a formal hierarchy of responsibility and authority, eg, older members of the family having to be consulted about any major decisions concerning the upbringing of children. These family experts are not always the biological parents. Within the same generation adults usually have a clearly defined structure of family responsibilities. Amongst some Asian and African groups older brothers and their wives have responsibility for the younger brothers and their wives children. Men are expected to have responsibility for the women. Respect for the advice and authority of older adults or of men within the family is important. Older children have authority over and expect respect from younger brothers, sisters, cousins. In some Asian populations men fulfil the role of breadwinner. For Asian girls growing up in Britain the thought of these teenagers taking on a paper round like their white counterparts will be seen as the man failing in his role to provide for the family.The Asian role expectation is not only different from that amongst white groups, but also differs from African Caribbean peoples. Amongst the latter the women take on the economic responsibility for historic reasons, founded in the colonial era (Mares et al 1985).

Amongst the Asian families and some African groups, marriage does not mean setting up a new independent unit. The married couple remain physically and emotionally part of the extended family. Even when the families split into nuclear units, close bonds of

love and responsibility are maintained between units.

In dealing with the physical aspects of care, namely food and feeding, various cultural issues need to be considered. In most families religious practices follow the family from generation to generation and these have an impact on the diet and food routine. The family may be of Hindu religion and are vegetarian or Muslim and would therefore not appreciate a suggestion of pork as a viable alternative source of protein. Muslim families who are not vegetarian have other norms that prevent them from eating meat that is not 'halal meat'. This can only be obtained at specific butchers and not in the large store supermarkets, but there are no substitutes for it. Out of politeness and sometimes desperation, families appear interested and listen but that sadly can be the only thing we achieve unless we are aware of the differences and take them into consideration. It is not uncommon for professionals to advise the significant carer to make sandwiches for the child as alternative food. This great British tradition does not extend to every culture especially in the older generation, hence the professional may be required to demonstrate how these are done. One will need time and patience to gain the carers confidence and for the professional to feel confident enough to venture into their kitchen. For professionals to feel confident about giving advice they need to have researched the information beforehand.

The difficulties following immigration, are more likely to stem from economic and social problems, however, most young people tend to cope well with immigration (Rutter and Hersov 1985). Parents who are immigrants, eg, from Asia, West Indies and Africa would also like their children to share their cultural and ethnic identity. The children on the other hand are easily influenced by the enormity of outside pressures such as from the media, school, peer group and so on, often undermining the value of their heritage. This can lead to a divergence between the value systems and friction between parents and their children.

The professional may become concerned about what seems to them to be parent's inability to encourage independence in their children, and repressive and restrictive practices, and the child as needing 'rescuing'. The extended family can provide a safe place for many of those who experience considerable hostility in the world out there. Children need to come back home in times of trouble. It stands to reason therefore to acknowledge that their allegiances are with the extended family.

Case 1

A 15 year old Asian girl took an overdose and was admitted to hospital. This followed an argument with the father because she had stayed out late (until 9 pm), with mother's consent. She has got an older brother at university, and a younger sister. She is due to do her GCSEs and is concerned about not getting good grades. School are happy with her academic work but have raised concerns about the family's extended visit to Pakistan because it will mean that the girl will miss an extra two weeks off school. She is reported to have told her P.E. teacher that she wants to finish her education before considering marriage, which school have interpreted as her anxiety about an arranged marriage.

Obtaining a full account of the difficulties is crucial and may need to be supplemented by obtaining a school report, with the parents' consent. Individual work with a child or adolescent can help reaffirm the importance the family places on religious/cultural aspects and can explore communication and social skills which should enable the youngster to form an alliance or negotiate with others.

As with any other case of deliberate self-harm in children, medical management of the physical harm, mental state examination, assessment of suicidal intent and further risk and a full exploration of the complexity of various difficulties and relationships should be completed through interviews with the girl and her parents together and separately. Deliberate self harm is often associated with relationship difficulties between children and parents, siblings, peers, as well as anxieties about the future.

In this case exploration of the child's anxieties about the trip to Pakistan and the issue of an arranged marriage would be required rather than jumping to stereotypical assumptions such as 'cultural conflict', 'men domineering women' and so on.

  • When the parents are also confronted by images of violence, drugs and overt sexuality in Western media, they fear for the safety and well-being of their children and many respond with protective gestures of panic. Parental protectiveness, in turn can escalate as the youngsters attempt to resist it'.

    (Dwivedi, 1996b, p.162)

  • Although the parents may want the best for their children, most youngsters find the parental response rather distressing. Ahmed. (1986), highlights the role of Eurocentric imperialistic ideologies that lead many young Asians, at times of distress, presenting to professionals with problems in a way that is more likely to elicit a sympathetic response from the professionals. Thus, institutional racism begins to distort the process of negotiation between the parents and their adolescent children in the ethnic minorities. The dominant culture's 'poisonous view' regarding the minority cultures is therefore acted out and symbolised through attempted suicide (Goldberg and Hodes, 1992).


    The black parents' observation of the job market and their experiences of racism and discrimination convinces them that their children must work doubly hard as white children and must do as well as possible at school. The pressure that parents exert is rational and has often been proven effective, quite contrary to the commonly held view that the black families had 'high, inappropriate and unrealistic expectations'.

    In the case of some African Caribbean children the realisation of their failure at school is combined with an awareness of their parents' disappointment with their lack of progress. These parents are aware that their children will stand little or no chance in a society where they are in a minority without education.

    There are other factors that affect these children's level of functioning at school which professionals should take into consideration. For some, they will be joining the British education system not like the one they attended before coming to Britain. Language problems, the family's social and economic circumstances, and peer group pressure especially for the adolescents are all important. In a bid to identify with their peers whilst under achieving at school will result in a poor relationship with their parents. Yet the child will also be aware that as a West Indian child, acceptance by the group with which he identifies is limited to a few rather than the wider general peer world. He is likely to have experienced some form of ridicule or bullying associated with his ethnic background.

    Case 2

    A 9 year old boy of African Caribbean descent is referred by the general practitioner but referral is instigated by the school. They encourage the mother, a single parent, to seek help saying that her son is fighting with other children who call him such names as "banana boy", ‘black board etc.’ The school are aware of the teasing and an incident when the boy was physically assaulted, but have concluded that the boy has an 'identity problem' or in their words 'has a chip on his shoulder'. They point to the fact that in art lessons he always draws white people. He is under-achieving and school say that if the mother does not take action they will exclude him from school. The mother comments that she had similar problems with two older sons who had ultimately been expelled. She complains that the school have done nothing for her family and wonders, that if the teachers are not sufficiently disciplinary in their approach then what can youngsters expect of them.

    Here one needs to establish the nature of the problem and explore the possibility of racial harassment, mother's anxieties about the repercussions on the child's chances in life and also the response the child's behaviour will elicit from the neighbourhood. It is clear from the referral that the family's experiences with the authorities have been negative. The consultation may be the first chance the parent has had to talk about the family's previous experiences and it is important that professionals take the time to allow the mother to ventilate her feelings. Another important aspect is to establish whether the child has been in the British education system from the beginning. It is easy to assume that if the child has been described as having ‘a chip on the shoulder’, the difficulties are all to do with this. It is crucial to establish the identity needs nevertheless. Because of the nature of teasing, the child's self esteem will have suffered as happens with cases of bullying, so we need to clarify/establish if the issue of name calling is causing the child such distress as to affect his general functioning. This may involve preoccupation about being ‘black’ and an expressed desire to be ‘white’ or behaviours like sitting in a bath of bleach, as in the next case.

    The support networks for the mother as well as for the child are important. The mother may be receiving support from family, her local church or a community group. Some black families who mistrust the existing social systems turn to their local churches for support, and our own stereotypes about religion will have to be put aside if we are to gain a better understanding to enable the families to manage the difficulties. Similarly for the child we need to look at the external influences on them. Some black children feel alienated from main stream society may turn to less desirable support such as local gangs of youths. The case of the stabbing of a London headmaster in June of 1996 highlights this.

    Black children's difficulties are not, always as is often assumed, to do with an inferiority complex. The child may have learning difficulties. It is not uncommon for such children to go undetected and expelled for behavioural problems. In my experience learning difficulties can set off a cycle of behavioural problems, which in turn lead to further difficulties in learning and so on. Sometimes the professionals may start off with the assumption that black children are nothing but trouble and may, by action or omission, deny the parent an opportunity for their child to be assessed under the Education Act. What follows will be worsening behaviour often leading to expulsion.

    Strategies to deal with bullying also need to be explored by the child, parent and school. Children regardless of ethnic origin are more likely to talk about bullying when seen on their own. They do not want to "grass", and are often afraid of reprisals. A school report is also essential and it is important to get the facts that led the school to conclude that the child has an identity problem. We need to establish what support networks exist for black children in school and the school's policy on bullying.

    Therapeutic work on identity issues with the child may also be indicated and this should be aimed at enabling the child to have a positive view of himself and a realistic view of life in a society. Use of projective techniques through play is a useful tool. Social skills training to deal with bullying is useful for all children. Involving the mother in the identity work will encourage her to support the intervention programme. She may be sceptical because of her own experiences, but getting her on board will go some way to improve the mother-child relationship. Some schools have a black support work facility and in my experience black children find the service beneficial. The professional may be able to liaise with this 'key service' by way of consultation, who will in some cases implement or offer support to the family and the programme.

    Care System

    Children can be the recipients of substitute care for a variety of reasons, such as, bereavement, parents illness or incapacity, abuse, neglect, being beyond parental control and other special needs. For black families the term ‘fostering’ has had a different meaning and has been almost synonymous with care by a member of the extended family, with no legal strings attached. The experiences of black people who have come into contact with British care system especially before the advent of The Children Act 1989, has been one that has engendered mistrust. Having placed their children in foster care, black parents faced the prospect of their children "being" taken away. For the African Caribbean families whose forefathers experienced slave trade, where the children of slaves belonged to the master, fostering within the British legal framework poses a poignant reminder of these past experiences. For some parents, they cannot entrust their child to a system which they believe has left them socially and economically disadvantaged. They express their disapproval by making themselves absent at child care and child protection reviews and not co-operating with the Contact Arrangements.

    The idea of fostering among African and African Caribbean people has been practised for a long time within the extended family. And yet they find that their financial circumstances in Britain mean that they cannot offer this service to relatives without facing undue financial hardship.

    For the black and ethnic minority child the substitute care should recognise the different cultural content of both physical and social needs, for food, hair and skin care, clothing, religion, education and history. The care provided should therefore aim to;

    Case 3

    A 13 year old girl of dual parentage, (father a single parent of African Caribbean descent and mother white), lives with her father. Her parents separated several years ago and contact with her mother is sporadic. She has a brother 19 years and a sister 17 years from her father's first marriage, and they are African Caribbean. There is no contact with them. The referral says that since she joined the comprehensive school at the start of term, she spends a lot of time by herself. The father reports that she spends endless hours in the bathroom scrubbing herself. This causes arguments between them especially when the parent has to leave early for work. He has threatened to have her accommodated again by the Local Authority. She had been accommodated for a brief period when her parents separated and she did not like it there. School have expressed some concerns about the teenage girl being cared for by a male parent. When younger, she is reported to have told a friend that she wants to be white and there was an incident at the time, when she was admitted to casualty having sat in a bath tub of bleach. Her school work is reported to be adequate although school have noticed that she isolates herself and appears preoccupied especially during the break times.

    Here, the form and quality of contact with the mother needs to be explored with the child. Is she experiencing ridicule from her mother's family or rejection? Similarly her views with regard to her siblings should enable professionals to gauge relationships, support networks and the extent of identity problems. The child's previous experiences in care and the likelihood of her being accommodated should be ascertained.

    A school report about social functioning may be helpful. Has the child been bullied? The aspect of modelling on same sex parent and other dynamics associated with loss, separation and divorce, and parental expectations should be considered.Identity work with the child should take place in a secure and safe environment. The threat of being put into care will result in feelings of insecurity, so by initially focusing on the issues that the parents considers necessary, this will help to keep the child with her family. Hence such practical things as rescheduling the time for her somewhat long stays in the bathroom will lessen the opportunity for conflict and improve relationship with the parent. Acknowledging parents difficulty in dealing with adolescents will also help the process on. Identity work with the child should be within a range of individual positive characteristics as well as with culture of heritage. Exploration of the meaning of being black or white to the child can be done using projective techniques; in imaginative play and through the use of comic strips and life story work. Initially this work will be more appropriately done with the child individually. Reassurances that the child is "black and beautiful" will not stand up in a wider racist and discriminating environment. There should be a facility for the parent to explore his views about identity, racism and discrimination. The mother is more likely to offer support if she is aware of the child's anxiety. For the child, coping techniques based on cognitive therapy approaches in an individual, family or group setting could be useful.

    * * * * * *

    Thus, in this paper through an examination of case vignettes, I have highlighted some of the parenting issues in relation to black and minority ethnic families. The task of enabling black and ethnic minority parents to fulfil their role in a manner that wi

    ll prepare their children for the 'real world', whilst at the same time to not antagonise and isolate them against the rest of the general population, may appear insurmountable but has got to start somewhere.




    Ahmed, S. (1986) Cultural racism in work with Asian women and girls. In: Ahmed, S., Cheetham, J. and Small J. (eds) Social work with black children and their families. London: Batsford.

    Department of Health (1988), Protecting Children: a Guide for Social Workers undertaking Comprehensive Assessment. HMSO Publications. p. 33

    Dwivedi K N (1996a) Culture and personality. In: Dwivedi K N and. Varma V. P(eds)

    Meeting the Needs of Ethnic Minority Children: A Handbook for Professionals. London: Jessica Kingsley Publishers.

    Dwivedi, K. N. (1996b) Race and the child's perspective. In: Davie, R., Upton, G., and Varma, V. (eds) The Voice of the child. London: Falmer Press.

    Evans, G. and Grant, L. (1995), Moyenda Project Report 1991-1994: Exploring Parenthood. British Library Cataloguing in Publication Data. p. 48

    Farmer, M (1980), The Family: Aspects of Modern Sociology. (Second Edition).London: Longman. pp 99-121.

    Goldberg, D. and Hodes, M. (1992) The poison of racism and the self poisoning of adolescents. Journal of Family Therapy,14, pp. 51-67

    Mares, P., Henly, A.and Baxter, C.(1985) Health Care in Multicultural Britain. Health Education Council and National Extension College. pp. 80-94

    Rutter, M. and Hersov, L. (1985) Child and Adolescent Psychiatry Modern Approaches. Oxford: Blackwell Scientific Publications. pp 58-97

    Version 1.0 first published 8/6/97

    This version published 18/02/00

    Click on these links to visit our Journals:
     Psychiatry On-Line 
    Dentistry On-Line
     |  Vet On-Line | Chest Medicine On-Line 
    GP On-Line | Pharmacy On-Line | Anaesthesia On-Line | Medicine On-Line
    Family Medical Practice On-Line

    Home • Journals • Search • Rules for Authors • Submit a Paper • Sponsor us   

    Rules for Authors
    Submit a Paper
    Sponsor Us
    priory logo


    Default text | Increase text size