Behavioral Health Disparities Practice Behaviors

1

Advanced Social Work

Practice Behaviors

to Address

Behavioral Health

Disparities

Prepared by:

National Association

of Deans and Directors

of Schools of Social Work

Funded by:

U.S. Department of Health

and Human Services

Office of Minority Health
Behavioral Health Disparities Practice Behaviors

1

Contents

Overview............................................................................................................................................................................. 1

Authors | Executive Committee...................................................................................................................... 2

Introduction...................................................................................................................................................................... 3

Advanced Competencies and Practice Behaviors

2.1.1................................................................................................................................................................................... 7

Identify as a professional social worker and conduct oneself with cultural humility.

2.1.2................................................................................................................................................................................... 8

Apply social work ethical principles to guide professional practice approaches

to address behavioral health disparities and health equities.

2.1.3................................................................................................................................................................................... 9

Apply critical thinking to inform and communicate professional judgments.

2.1.4.................................................................................................................................................................................10

Engage diversity and difference in practice.

2.1.5.................................................................................................................................................................................11

Advance human rights and social and economic justice.

2.1.6.................................................................................................................................................................................12

Engage in research-informed practice and practice-informed research.

2.1.7.................................................................................................................................................................................13

Apply knowledge of human behavior and the social environment.

2.1.8.................................................................................................................................................................................14

Engage in policy practice to address the social determinants of health, advance social, 

economic, psychological and environmental well-being and deliver effective culturallygrounded social work services to prevent, reduce and eventually eliminate behavioral 

health disparities.

2.1.9.................................................................................................................................................................................15

Respond to contexts that shape practice.

2.1.10 .............................................................................................................................................................................16

Engage, assess, intervene and evaluate with individuals, families, groups, 

organizations and communities.

a. Engagement............................................................................................................................................................17

b. Assessment..............................................................................................................................................................17

c. Intervention..............................................................................................................................................................17

d. Evaluation.................................................................................................................................................................18

References ......................................................................................................................................................................19

Panel Participants ....................................................................................................................................................25

About NADD..................................................................................................................................................................27
Behavioral Health Disparities Practice Behaviors | Overview

1

This publication is based on research conducted by the 

National Association of Deans and Directors of Schools of Social 

Work (NADD) and proceedings from the 2012 Behavioral 

Health Disparities Curriculum Infusion Project National Panel 

Meeting on Advanced Practice Behaviors meeting under the 

guidance of the Behavioral Health Disparities Curriculum 

Infusion Initiative Executive Committee. The Behavioral Health 

Disparities Curriculum Infusion Project is funded by a grant 

from the Office of Minority Health, the U.S. Department of 

Health and Human Services. 

The views, opinions and content expressed in this publication 

are those of the authors and conference participants and do 

not necessarily reflect the views, opinions or policies of the 

Office of Minority Health, the U.S. Department of Health and 

Human Services, or the National Association of Deans and 

Directors of Schools of Social Work.

This document is in the public domain and may be used and 

reprinted without permission except for noted copyrighted 

materials for which further reproduction is prohibited without 

the specific permission of copyright holders. Appropriate citation 

is requested by the authors when the document is cited.

Overview
2

Behavioral Health Disparities Practice Behaviors | Authors | Executive Committee

Authors: James Herbert Williams, PhD., MSW, MPA

Teresa Chapa, PhD, MPA

Eric A. Des Marais, MSW

Behavioral Health Disparities Curriculum Infusion Initiative 

Executive Committee

Federal Staff: Teresa Chapa, PhD, MPA

Senior Policy Advisor, Mental Health 

US DHHS Office of Minority Health

Rockville, MD

NADD Representatives Laura Lein, PhD

Dean & Katherine Reebel Collegiate Professor of Social Work 

Professor of Social Work and Professor of Anthropology

School of Social Work

University of Michigan

Ann Arbor, MI

Larry Ortiz, PhD, MSW

Professor of Social Work & Social Ecology

Department of Social Work and Social Ecology

Loma Linda University 

Loma Linda, CA

Edwina S. Uehara, PhD, MSW

Professor & Ballmer Endowed Dean of Social Work

School of Social Work

University of Washington

Seattle, WA

James Herbert Williams, PhD., MSW, MPA

Dean & Milton Morris Endowed Chair

Graduate School of Social Work

University of Denver

Denver, CO
”

“

Behavioral Health Disparities Practice Behaviors | Introduction

3

A new commitment to eliminating health and health care disparities is underway. For several decades, 

governmental and non-governmental organizations, including the World Health Organization, Institute of 

Medicine, and the U.S. Department of Health and Human Services have worked diligently to identify and 

define health and behavioral health disparities while attempting to achieve health equity for all. Landmark 

reports, legislation and standards helped drive new policies, programs and practices aimed at establishing 

viable public health and service models that are culturally and linguistically appropriate (Bravermen, 2006; US 

HHS, National CLAS Standards, 2013; Dahlgren & Whitehead, 2007; Grando-Villar et al., 2010; Huang & Chau, 

2012; Smedley, Stith, & Nelson, 2002; U.S. Congress, 2010; US HHS, Secretary’s Report, 2011; Whitehead, 

1992; WHO: Commission on Social Determinants of Health, 2008). As the United States increasingly diversifies, 

addressing health inequities is becoming more urgent.

It is estimated that by 2050, the majority of the U.S. population will be comprised of 

racial and ethnic minorities (Mather, Pollard, & Jacobsen, 2011; U.S. Census, 2012). 

Disadvantaged population and social groups, particularly racial and ethnic minorities 

and those with limited English proficiency, systematically experience worse health and 

behavioral health risks and outcomes (Braverman, 2006; US HHS SAMHSA Mental 

Health: Culture Race and Ethnicity, 2001). Given the population growth and changing 

demographics across the world, health disparities must be addressed and solved. 

Considering this level of discourse across health, behavioral health and social welfare 

disciplines to address health disparities, progress has been negligible in reducing gaps in 

health access, quality and outcomes (Williams, Costa, Odunlami, & Mohammed, 2008).

Despite decades of efforts to improve and protect the health of racial and ethnic 

minority populations, disparities persist in health, safety and wellbeing, infrastructure 

and workforce, scientific knowledge and innovation (U.S. Department of Health and 

Human Services Plan to Reduce Health Disparities, 2010). Evidence shows that racial and 

ethnic minorities experience worse outcomes for health, behavioral health, substance 

abuse and disability when compared with Whites, even when receiving services (Sue 

& Chu, 2003; U.S. Department of Health and Human Services, 2001; Williams, Costa, 

Odunlami, & Mohammed, 2008). A lack of diversity and representation of racial and 

ethnic minorities in the health and behavioral health workforce continues to contribute 

to barriers to improving access to quality care. Targeted efforts to build a diverse and 

culturally competent workforce must be part of our nation’s educational and workforce 

plan (Chapa & Acosta, 2010; U.S. Department of Labor, 2011).

Similar to disparities in health care, behavioral health disparities exist in access, delivery and quality of care. 

As a concept, behavioral health refers to the relationship between physical and psychological well-being 

Advanced Social Work Practice Behaviors to Address 

Behavioral Health Disparities

Introduction

It is estimated 

that by 2050, the 

majority of the U.S. 

population will 

be comprised of 

racial and ethnic 

minorities.
Behavioral Health Disparities Practice Behaviors | Introduction

4

of the body and mind (Matarazzo, 1980). The study of behavioral health encompasses a range of health, 

mental health and substance abuse disorders, recognizing that the biological and psychological components 

occur within a larger societal and cultural context while also stressing the ability of individuals to proactively 

affect change in their own lives. Within this context, health is impacted by personal choice, health and 

behavioral delivery systems, social determinants of health, social inequality, beliefs, geography, religion, 

sexual orientation, educational attainment, family structure, oppression, culture and historical precursors 

(Brave Heart, 2003; Kumanyika & Morssink, 2006; Nagata, 1998; Smedley, 2006; Steinberg, 1989; Whitebeck, 

Adams, Hoyt & Chen, 2004; US DHHS, 2001; Yehuda, 1999).

Behavioral health care is an umbrella term and refers to a continuum of services for 

individuals at risk of, or suffering from, mental, behavioral or addictive disorders, as 

well as health behaviors. Behavioral health services include mental health, psychiatric, 

marriage and family counseling, addictions prevention and treatment, and public 

health. Finally, behavioral health services are typically provided by social workers, 

counselors, psychologists, psychiatrists and other physicians, as well as community 

health workers, health representatives, promotores de salud, health navigators and 

case managers (Peek, C. J. & the National Integration Academy Council, 2013).

While overall prevalence rates for mental health and substance abuse diagnoses are 

generally similar across racial and ethnic groups, minority populations tend to suffer 

greater impacts and worse outcomes (McGuire & Miranda, 2008; US DHHS, 2001). Racial 

and ethnic groups tend to experience higher mortality rates from health complications 

associated with substance use, with Alaska Natives and American Indians experiencing 

mortality rates five times that of the general population for heart disease and stroke 

(Casper et al., 2005; Lo & Cheng, 2011, Indian Health Service, 2011). Racial and ethnic 

minorities also experience higher levels on subclinical measures of mental stress. In a 

study examining depression among a community population, Brondolo and colleagues 

found that both Blacks and Latinos have higher rates of self-report for feeling sad and 

hopeless every day for two or more weeks (Brondolo et al., 2009). Racial and ethnic 

youth fare worse than non-Latino Caucasians for emotional distress, physical health, 

teen births and school achievement (Cauce, Cruz, Corona, & Conger, 2010; Center for 

Disease Control and Prevention, 2010). Finally, minority communities often have fewer 

sources of health care than non-Hispanic white communities or none at all (Institute of Medicine, 2003).

Health disparities are impacted by a constellation of social determinants including poverty, employment, 

neighborhood violence, community disorganization, underperforming schools, trauma, racism, discrimination, 

social isolation, acculturation stress, lack of health insurance and poor access to health care (Braveman, 

Egerter, & Mockenhaupt, 2011; Brondolo, Gallo, & Myers, 2009; US DHHS, 2001; Healthy Communities 

Matter, 2010). These social determinants are cumulative and increase levels of stress that directly impact 

health and behavioral health of racial and ethnic minorities (Healthy Communities Matter, 2010; Kaholokula, 

Macapoy, & Dang, 2009). According to Williams & Mohammed (2009), racism and perceived discrimination 

have negative impacts on health, mental health and substance use. Furthermore, racial and ethnic minorities 

”

“

Racial and ethnic 

groups tend to

experience higher

mortality rates 

from health 

complications 

associated with 

substance use...
Behavioral Health Disparities Practice Behaviors | Introduction

5

are often exposed to higher levels of stress, impoverished environments, violence, trauma and social 

disruption; all linked to higher rates of mental disorders and substance use. Children exposed to these social 

determinants tend to have poor school performance, increased behavioral problems and a higher likelihood 

of depression (Cauce, Cruz, Corona, & Conger, 2010; Healthy Communities Matter, 2010; Stein et al., 2003). 

Historically oppressed groups also face the added difficulty of the effect of generations of cultural disruption 

and destruction known as historical trauma (Brave Heart, 2003). Evidence of the power of historical trauma 

has been identified in American/Alaska Natives, survivors of the European Holocaust, and Japanese American 

Internment camp survivors (Nagata, 1998; Steinberg, 1989; Yehuda, 1999). Children of trauma survivors also 

report higher levels of cumulative stress and PTSD, suggesting a multi-generational 

impact of such historical events (Nagata, 1998; Steinberg, 1989; Yehuda, 1999).

Several studies examining the role of racial and ethnic identity in health and behavioral 

health disparities have shown evidence that a strong sense of ethnic identity serves as 

a protective factor against discrimination, leading to better academic outcomes and 

general physical and mental health, while other studies have found that a strong sense 

of ethnic identity does not buffer against depression (Brondolo, Brady, Pencille, Beatty, 

& Contrada, 2009; Whitbeck, Hoyt, Stubben, & LaFromboise, 2001). LaFromboise 

and colleagues, (2006) found that a strong ethnic identity among American Indian 

youth was associated with pro-social outcomes; with similar effects found for adults 

(Children’s Defense Fund, 2011; LaFromboise, Hoyt, Oliver, & Whitbeck, 2006; 

Whitbeck, McMorris, Hoyt, Stubben, & LaFromboise, 2002).

Studies examining the role of religious and spiritual practices among racial and ethnic 

minority communities denote healthier behaviors and overall wellbeing, with lower 

rates of mental illness and substance use, and increased engagement and utilization of 

treatment services (Ortiz, Arizmendi, & Cornelius, 2004). American Indians, Native 

Hawaiians, Hispanic/Latinos, and Alaska Natives often use traditional approaches 

before seeking-out the western health care paradigm (e.g., herbal remedies, folk 

healers and prayer) (US DHHS, 2001; Ortiz, Arizmendi, & Cornelius, 2004). Concerns 

have been raised that racial and ethnic minorities utilize religious and spiritual leaders 

and organizations in lieu of services provided by mainstream behavioral health care professionals (Davis, 

2011; Gallo, et al, 2009; Koenig, 2009). However, a failure to recognize cultural beliefs and traditions can 

result in high levels of frustration for patients, misdiagnosis, ineffective treatment and, ultimately, lack of 

follow through for behavioral care plans that fail to consider the whole person (Ida et al., 2012). Culturally 

competent care is essential to improve the quality of overall health care and reduce health disparities. The 

intersection of traditional and mainstream treatment must be met with an experienced and culturally sensitive 

approach

_further validating the need for cultural and linguistic competency and training (US HHS, National 

CLAS Standards, 2013).

Racial and ethnic minority communities tend to have fewer sources of health and behavioral health care, and 

a number of factors have been cited as barriers to quality care. Although the lack of health insurance is the 

single largest predictor of non-utilization of health care services (Agency for Healthcare Research and Quality, 

”

“

Racial and ethnic 

minorities tend 

to have fewer 

sources of health 

and behavioral 

health care...
Behavioral Health Disparities Practice Behaviors | Introduction

6

2012), mistrust of health care institutions, lack of knowledge of available resources, language barriers, and 

stigma about mental health and illness also contribute to disparities, further reinforcing the need to build 

a workforce that will deliver culturally and linguistically competent care to a diverse population (Escarce & 

McGuire, 2004; Hasnain-Wynia, Baker, Nerenz, Feinglass, Beal, Landrum, Behal, and Weissman, 2007; Jha, 

Fisher, Li, Orav, & Epstein, 2005; Klonoff, 2009; Schneider, Zaslavsky, & Epstein, 2002; Trivedi, Zaslavsky, 

Schneider, & Ayanian, 2006; US HHS, National CLAS Standards, 2013).

Lack of diversity among the health and behavioral health care workforce is also considered a significant 

contributor to disparities in care for minority and LEP populations because it limits 

availability, access and engagement to culturally and linguistically competent care 

(Chapa & Acosta, 2010; Greer, 2005; McGuire & Miranda, 2008). African Americans, 

American Indian/Alaska Natives and Latinos are severely underrepresented as 

physicians, registered nurses, clinical social workers and psychologists. Asian 

Americans are underrepresented as psychologists and social workers (Chapa & 

Acosta, 2010; U.S. Department of Labor, 2011). Efforts are needed at the federal, 

state, local and philanthropic levels to help build a critical mass of diverse providers. 

Enhancing the health and behavioral health workforce with Social Workers, Clinical 

Case Managers, Navigators, Community Health Workers, Health Representatives, 

and Promotores de Salud (e.g., para-professionals) can help serve as vital 

connectors for a patient, family and community, and the health and behavioral 

health care delivery system. Studies show evidence of positive outcomes in health 

and behavioral health measures, including managing chronic disease, smoking 

cessation, increasing immunization rates, mental health and cardiovascular health 

with workforce development initiatives (Balca’zar et al., 2005; Plescia, Herrick, & 

Chavis, 2008; Reinschmidt et al., 2006; Rhodes et al., 2007; Spencer et al., 2011). 

The delivery of culturally adapted and culturally grounded programs has increased 

both engagement and compliance with treatment and satisfaction with programs 

(Williams, et al, 2006).

The following sections define a set of practice behaviors for social workers to 

diminish behavioral health and health disparities and promote health equities. 

These practice behaviors are anchored in the social work competencies as defined 

in the Council on Social Work Education (CSWE) 2008 Educational Policy and 

Accreditation Standards (EPAS). They were developed in the course of a meeting 

on October 1-2, 2012 of a national panel of program administrators, faculty and practitioners. During 

the meeting, participants provided expert input on knowledge, values and practice behaviors to 

address behavioral health disparities for each of the ten social work competencies. This meeting 

was facilitated by members of the project’s executive committee. The materials were correlated and 

a document drafted by the Principle Investigator. These practice behaviors provide a framework to 

guide curriculum development for training social work practitioners to integrate behavioral health 

disparities content into social work curricula to implement comprehensive and innovative interventions 

that promote behavioral health equity. 

”

“

. . . Latinos are 

severly underrepresented 

as physicians, 

registered nurses, 

clinical social 

workers and 

psychologists. 
Advanced Competencies and Practice Behaviors | 2.1.1

Knowledge

•	Understand multidimensional determinants of behavioral health disparities

and their interacting nature.

•	Understand multidimensional strategies in order to promote behavioral

health equities at all levels.

Practice Behaviors

Social workers will:

•	Demonstrate a commitment to the ongoing assessment of behavioral

health needs and strengths of individuals, families, groups, communities, 

and organizations.

•	Participate in the ongoing development and use of evidence-informed and

community-based strategies that promote behavioral health equity.

•	Promote behavioral health equity across social, psychological, environmental

and economic contexts.

•	Actively engage in inter-professional collaborations at all levels of practice

with knowledge of multidimensional aspects of behavioral health disparities 

awareness.

•	Follow the research literature on best practices for addressing behavioral

health disparities.

2.1.1 | Identify as a professional social worker and conduct oneself with cultural humility. 

Social workers serve as 

representatives of the profession, its 

mission and its core values. 

Social Workers with advanced 

competence in behavioral health 

disparities are keenly aware of 

the multidimensional, interactive 

determinants of behavioral health 

disparities and the deleterious 

impacts they have upon individuals, 

families, communities and 

populations.

 

As social workers they apply a 

strengths-based approach to 

practice; demonstrate self-reflection, 

self-awareness, and cultural 

humility in practice; and integrate 

an understanding of the social 

determinants of behavioral health 

and health equity into all aspects 

of their practice. They continually 

seek supervision that prepares 

them to confront biases and value 

conflicts in their practice. They are 

committed to life-learning and 

continually updating knowledge 

and skills necessary to understand 

and intervene to reduce behavioral 

health disparities and enhance 

health equity, including through 

increasing access, continuity, quality, 

appropriateness, and effectiveness 

of behavioral health care.

7
Advanced Competencies and Practice Behaviors | 2.1.2

8

Knowledge

•	Have a strong working knowledge of how the NASW Code of Ethics supports health

equity.

•	 Understand the basic principles and concepts of equity and health.

•	Understand the Universal Declaration of Human Rights, and, as applicable, the IFSW/

IASSWE Ethics in Social Work.

•	Have a basic knowledge of ethical principles from related behavioral health

disciplines. 

Practice Behaviors

Social workers will:

•	Manage personal values in a way that allows professional values to guide practice.

•	Apply social work values and ethical principles in practice approaches to address

behavioral health disparities that reflect health and wellness as a social justice and 

human rights issue.

•	Practice ethically, using a cultural humility and social justice practice paradigm.

•	Integrate the ethical codes for practice from multiple professions when using a transdisciplinary approach to reduce behavioral health disparities.

•	Apply strategies of ethical reasoning across social and ecological systems to arrive

at principled decisions towards preventing, reducing and eventually eliminating 

behavioral health disparities.

Social workers 

have an obligation 

to conduct 

themselves 

ethically and to 

engage in ethical 

decision making. 

Social workers are 

knowledgeable 

about the value 

base of the 

profession, its 

ethical standards 

and relevant law.

2.1.2 | Apply social work ethical principles to guide professional practice

approaches to address behavioral health disparities and health equities.
Advanced Competencies and Practice Behaviors | 2.1.3

Knowledge

•	Skills to conduct analysis and assessment of behavioral health disparities in

the context of diverse identities drawing on race, ethnicity, culture, social 

economic status, gender, sexual orientation, immigration status and other 

socially constructed factors.

•	The structural and community factors of behavioral health disparities in the

context of public health and prevention.

•	Within-group differences and across-groups similarities.

•	 A critical consciousness drawing from the combination of self-knowledge and

considerations of power and privilege.

Practice Behaviors

Social workers will:

•	Use cultural and community-focused and informed adaptations of evidence-based

practices in order to prevent, reduce and eventually eliminate behavioral health 

disparities.

•	Address health status and behavioral health disparities in the context ofcommunity

and societal strengths and challenges.

Social workers are 

knowledgeable 

about the principles 

of logic, scientific 

inquiry, and reasoned 

discernment of 

behavioral health 

disparities affecting 

disadvantaged 

groups, including 

racial and ethnic 

minorities globally. 

They use critical 

thinking augmented 

by creativity and 

curiosity. Critical 

thinking also requires 

the synthesis and 

communication of 

relevant information. 

2.1.3 | Apply critical thinking to inform and communicate professional judgments.

9
Advanced Competencies and Practice Behaviors | 2.1.4

10

Knowledge

•	Understand social dynamics such as discrimination, biases, institutional racism, and

unequal access to resources, poverty, and differential environmental challenges. 

•	Understand the vulnerability of marginalized populations to social determinants

of health and behavioral health care delivery barriers. 

Practice Behaviors

Social workers will:

•	Recognize the extent to which the health care delivery system, societal structures,

agents, values, and cultural systems may oppress, marginalize, alienate, exclude, 

or create and enhance privilege and power.

•	Demonstrate self-awareness to work towards eliminating the influence of

personal biases and values in working with diverse groups in social and ecological 

systems.

•	Apply themselves as learners and engage clients and client’s systems as informants

and experts.

•	Actively promote and engage in inter-professional collaborations and co-learning

environments.

Social workers 

understand how 

diversity characterizes 

and shapes the 

human experience 

and is critical to the 

formation of identity. 

The dimensions 

of diversity are 

understood as the 

intersectionality 

of multiple 

factors including 

age, SES color, 

culture, disability, 

ethnicity, gender, 

gender identity 

and expression, 

immigration status, 

political ideology, 

race, religion, sex and 

sexual orientation. 

Social workers 

appreciate that, as 

a consequence of 

difference, a person’s 

life experiences 

may include 

oppression, poverty, 

marginalization and 

alienation as well as 

privilege and power.

2.1.4 | Engage diversity and difference in practice.
Advanced Competencies and Practice Behaviors | 2.1.5

Knowledge

•	Understand various advocacy strategies for promoting health equity and

health justice.

•	Understand culturally grounded practice guidelines.

•	Understand that quality health and behavioral health care is a basic human

right.

•	Understand that barriers related to access and services are rooted in power

imbalances, social location and social policies

Practice Behaviors

Social workers will:

•	Engage in advocacy to reduce behavioral health disparities.

•	Engage in activities to eliminate access and service barriers to quality

behavioral health services.

•	Work collaboratively with all stakeholders to decrease behavioral health

barriers to access and services.

Each person, regardless 

of position in society, has 

basic human rights, such as 

freedom, safety, privacy, an 

adequate standard of living, 

health care and education. 

Social workers recognize 

the global interconnections 

of oppression and are 

knowledgeable about 

theories of justice and 

strategies to promote 

human and civil rights. 

Social work incorporates 

social justice practices in 

organizations, institutions 

and society to ensure that 

these basic health and 

human rights are distributed 

equitably and without 

prejudice. 

2.1.5 | Advance human rights and social and economic justice.

11
Advanced Competencies and Practice Behaviors | 2.1.6

12

Knowledge

•	Well-grounded in the communities that are the focus of their practice.

•	Understand how to develop and assess culturally-grounded approaches to

behavioral health disparities.

•	Have recent knowledge of various models of service utilization.

•	Understand the ethical guidelines for undertaking research in diverse communities

around concerns with behavioral health disparities.

•	Have knowledge of the various non-communicable diseases (e.g., obesity, diabetes,

osteoporosis, hypertension, mental health, etc.).

Practice Behaviors

Social workers will:

•	Participate in research that illuminates causes of behavioral health disparities at

community, national, and international levels and strategies for the implementation of 

responses to prevent, reduce and eventually eliminate behavioral health disparities.

•	Develop communication skills appropriate for the translation of research findings to

diverse community members.

•	Draw with discernment on culturally sensitive research on health and behavioral

health disparities.

•	Engage effectively with stakeholders in developing evidence-supported and practicerelevant social work interventions to behavioral health disparities.

Social workers use 

evidenced-based 

culturally grounded 

practice experience 

to inform research, 

employ evidencebased interventions, 

evaluate their own 

practice and use 

research findings 

to improve practice 

across care settings 

and populations. Social 

workers comprehend 

quantitative 

and qualitative 

research methods 

and understand 

scientific and ethical 

approaches to building 

knowledge. 

2.1.6 | Engage in research-informed practice and practice-informed research.
Advanced Competencies and Practice Behaviors | 2.1.7

13

Knowledge

•	Understand advanced theoretical frameworks and models of social

determinants of health to guide the processes of assessment, 

intervention, and evaluation.

•	Understand social and psychological change theories and the

intersections between behavioral health and other service systems (e.g., 

criminal justice, child welfare, schools, etc.).

•	Understand proximal and distal contextual risk factors for behavioral

health disparities. 

Practice Behaviors

Social workers will:

•	Utilize epidemiological data that are rooted in social and environmental

contexts to understand how they differentially affect marginalized 

populations’ environments to impact behavioral health and genetic 

susceptibilities.

•	Identify strengths and culturally grounded protective factors as assets in

addressing behavioral health dipartites.

•	Promote and implement a wellness practice paradigm.

•	Engage in inter-professional practice across disciplines to reduce behavioral

health disparities.

•	Critique and apply knowledge about person and environment in the

context of behavioral health disparities. 

Social workers are 

knowledgeable about 

human behavior across the 

life course; the range of social 

systems in which people live; 

and the ways social systems 

promote or deter people 

in maintaining or achieving 

health and well-being. Social 

workers apply theories and 

knowledge from the liberal 

arts to understand biological, 

social, cultural, psychological, 

and spiritual development. 

2.1.7 | Apply knowledge of human behavior and the social environment.
Advanced Competencies and Practice Behaviors 2.1.8

14

Knowledge

•	Understand the implications of fiscal, welfare, and health policies for practice

approaches that address behavioral health inequalities.

•	Understand the policy process and how to intervene to change and develop

new policies related to behavioral health inequalities.

•	Understand the process of policy evaluation and advocacy and their use in

improving and reforming policies.

Practice Behaviors

Social workers will:

•	Apply analytical knowledge to assess the impact of policies on behavioral

health practices and their outcomes.

•	Engage in the development of evidence-based policies to address behavioral

health disparities.

•	Engage in community-based participatory research and policy assessment

in partnership with affected communities.

•	Engage in advocacy for evidence-based and community-based practice in

partnership with communities, other professions and other stakeholders.

Social workers apply 

knowledge of the history 

and current structures of 

societies to develop policies 

that support health equity, 

the development of healthier 

communities and the 

improvement of behavioral 

health care service delivery. 

2.1.8 | Engage in policy practice to address the social determinants of health, 

advance social, economic, psychological, and environmental well-being 

and deliver effective culturally-grounded social work services to prevent, 

reduce and eventually eliminate behavioral health disparities.
Advanced Competencies and Practice Behaviors | 2.1.9

Knowledge

•	Understand how organizational and community structures impede and

impact health access and quality.

•	Anticipate and know how to respond to changing cultural, political,

economic and societal contexts. 

Practice Behaviors

Social workers will:

•	Appraise and address changing and/or emerging social and ecological

trends and processes to provide culturally informed services.

•	Engage with strategies for working with clients’ settings and systems to

effect environmental and policy change towards the prevention, reduction 

and eventual elimination of behavioral health disparities.

•	Utilize leadership skills to promote sustainable changes in service delivery

and practice to improve the quality of interventions.

•	Work with clients and systems to effect environmental and policy change.

Social workers are informed, 

resourceful and proactive 

in responding to evolving 

organizational, community, 

societal, environmental and 

cultural contexts at all levels 

of practice. Social workers 

recognize that the context 

of practice is dynamic, and 

use knowledge and skill to 

respond proactively. 

2.1.9 | Respond to contexts that shape practice.

15
Advanced Competencies and Practice Behaviors | 2.1.10

16

Knowledge

•	Understand how culture and social context influence relationships and their

development.

•	Have expertise in working relationships with community members,

organizational partners, and cultural brokers.

•	Have expertise in working with multiple agency partners from different

disciplines.

•	How to engage with cultural narratives and local health practices.

•	Understand how to develop tools such as logic models and measurement

instruments in partnership and resonance with communities and their 

values.

•	Know how to apply evaluation strategies to decisions in daily practice.

•	Understand the lack of fit of many mainstream measures in a range of

cultural contexts.

•	 Have awareness of and conduct cultural adaptation when needed of

evidence-informed interventions. 

Professional practice 

involves the dynamic and 

interactive processes of 

engagement, assessment, 

intervention and evaluation 

at multiple levels. Social 

workers have the knowledge 

and skills to practice 

with individuals, families, 

groups, organizations 

and communities. Practice 

knowledge includes 

identifying, analyzing and 

implementing evidencebased interventions designed 

to achieve client goals; using 

research and technological 

advances; evaluating 

program outcomes and 

practice effectiveness; 

developing, analyzing, 

advocating and providing 

leadership for policies and 

services; and promoting 

social and economic justice.

2.1.10 | Engage, assess, intervene and evaluate with individuals, 

families, groups, organizations and communities.
Advanced Competencies and Practice Behaviors | 2.1.10 a-c

Practice Behaviors

a. Engagement

Social workers work across all client systems to:

•	Implement approaches for working in the context of diverse agency cultures.

b. Assessment 

Social workers work across all client systems to:

•	Collect, organize and interpret health and behavioral health data.

•	Assessclients and client’s health and behavioral health service delivery systems and community

resources for strengths, limitations, relevance and impact.

•	Develop mutually agreed-upon service plans.

•	Select appropriate culturally-grounded interventions.

•	Engage in scenario-building and apply systems thinking.

•	Develop a more advanced understanding of and empathy for community members and

local community leaders and community organizations.

•	Learn to assess using a culturally grounded approach and be responsive to client needs.

c. Intervention 

Social workers work across all client systems to:

•	Utilize culturally grounded approaches in interventions addressing behavioral health

disparities.

•	Employ transdisciplinary and inter-professional intervention strategies in practice.

•	Engage cultural humility in collaborative practices with stakeholders at all levels.

•	Engage in practice methods to reduce inequities linked to behavioral health disparities

stemming from obstacles to access, equity and culturally grounded services.

2.1.10 a-c | Engage, assess, intervene and evaluate with individuals, 

families, groups, organizations and communities.

17
Advanced Competencies and Practice Behaviors | 2.1.10d

18

d. Evaluation 

Social workers critically analyze, monitor and evaluate interventions, and

•	Collaborate on definitions of outcomes and measures with clients, organizations and

communities.

•	Apply assessment and evaluation tools to their practice and measure progress and outcomes.

•	Translate and return the results of research and evaluation to clients and communities.

2.1.10 d | Engage, assess, intervene and evaluate with individuals, 

families, groups, organizations and communities.
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Behavioral Health Disparities Practice Behaviors | Panel Participants

Yolanda Anyon, PhD

University of Denver

Graduate School of Social Work

Denver, CO

Robert Atwell, PsyD

Private Practice

Denver, CO

Terri Browne, PhD

University of South Carolina

College of Social Work

Columbia, SC

Leopoldo J. Cabassa, PhD

Columbia University

School of Social Work

New York, NY

Teresa Chapa, PhD, MPA

U.S. Department of Health and Human Services 

(HHS)

Office of Minority Health

Latino Behavioral Health Institute

Rockville, MD

Jim Garcia, MPA

Clínica Tepeyac

Denver, CO

Sarah Gehlert, PhD

Washington University in St. Louis

George Warren School of Social Work

St. Louis, MO 

Antonio Gonzalez-Prendes, PhD

Wayne State University

School of Social Work,

Detroit, MI

Behavioral Health Disparities Curriculum Project

Advanced Practice Behaviors Panel Participants

Hyeouk Chris Ham, PhD

Boston University

School of Social Work

Boston, MA

Emily Ihara, PhD

Department of Social Work

College of Health & Human Services

George Mason University

Fairfax, VA 

Vivian H. Jackson, PhD

National Center for Cultural Competence and 

National Technical Assistance

Center for Children’s Mental Health

Georgetown University 

Center for Child & Human Development

Washington, DC

Sharon Johnson, PhD

Department of Social Work 

University of Missouri St Louis

St. Louis, MO

Laura Lein, PhD

University of Michigan

School of Social Work

Ann Arbor, MI 

Flavio Marsiglia, PhD

Southwest Interdisciplinary Research Center 

Arizona State University

School of Social Work

Phoenix, AZ

Joseph R. Merighi, PhD

University of Minnesota

School of Social Work

Saint Paul, MN

25
Behavioral Health Disparities Practice Behaviors | Panel Participants

26

Von Eugene Nebbitt, PhD

Jane Addams School of Social Work

University of Illinois Chicago 

Chicago, Illinois

Larry Ortiz, PhD, MSW

Department of Social Work & Social Ecology

Loma Linda University 

Loma Linda, CA

Juan Pena, PhD

Silberman School of Social Work 

Hunter College

New York, NY

Lissete M. Piedra, PhD

University of Illinois at Urbana/Champaign

School of Social Work

Urbana, IL

Guitele Rahill, PhD

University of South Florida

School of Social Work

Tampa, FL

Jo Ann R. Coe Regan, PhD

Council on Social Work Education

Alexandria, VA

Katherine Sanchez, PhD

University of Texas at Arlington

School of Social Work

Arlington, TX

Lorraine Moya Salas, PhD

Unlimited Potential

Phoenix, AZ

Yvette Sealy, PhD

Fordham University

School of Social Service

New York, NY

Michael Spencer, PhD

University of Michigan

School of Social Work

Ann Arbor, MI

Patrick Sullivan, PhD

Indiana University

School of Social Work

Indianapolis, IN

Edwina S. Uehara, PhD, MSW

University of Washington

School of Social Work

Seattle, WA

James Herbert Williams, PhD, MSW, MPA

University of Denver

Graduate School of Social Work

Denver, CO

Staff

Vitali Chamov, MA

National Association of Deans and Directors of 

Schools of Social Work

Alexandria, VA

Eric A. Des Marais, MSW

University of Denver

Graduate School of Social Work

Denver, CO
Behavioral Health Disparities Practice Behaviors | About NADD

NADD

The National Association of Deans and Directors

of Schools of Social Work

The National Association of Deans and Directors of Schools of Social Work (NADD) is a 

volunteer membership organization working to promote excellence in social work education. 

NADD achieves this by enhancing the leadership of social work education programs. Our 

membership is comprised of deans and directors of graduate social work programs that are 

accredited or advanced to candidacy. NADD supports deans and directors in their professional 

development and effectiveness as academic administrators.

NADD offers leadership support involving:

• Educational excellence

• Research infrastructure development

• Fundraising and development agendas

• Outreach and community capacity building

• Evidence based and culturally competent practice in social work

• Effective impacts on educational and practice policies

• The promotion of strong local and global partnerships

NADD also sponsors several Task Forces.

1701 Duke Street, Suite 200

Alexandria, VA 22314

naddssw@cswe.org

Phone: 703-683-8080

Fax: 703-683-8099

www.naddssw.org

27
1701 Duke Street, Suite 200

Alexandria, VA 22314

naddssw@cswe.org

Phone: 703-683-8080

Fax: 703-683-8099

www.naddssw.org