There are many, many substance abuse treatment programs out there that, sometimes, they might put some pictures in the wall or just hire a bilingual person to work in the treatment facility, and they say that they are culturally competent. But that barely begins to scratch the surface of what it really means to be culturally competent.

The way that I view the whole issue of being culturally sensitive with a population is very, very connected with the whole issue of community participatory research. One example that I envision would be researchers coming into the community. I'm a big fan of the work of Paulo Freire, a classic researcher in education. He advocates working with people and trying to promote dialogue that promotes critical thinking.

So his approach is basically trying to bring a discussion to the concrete level in terms of what is going on in people's lives and interviewing them, showing them pictures, videos, and letting them talk about what those images bring to mind and encourage them to talk about their own environment. And then through that data that you're already collecting, to try to develop, "Okay, what are the problems? How does the community view these problems, and what are some of the solutions that we can try to be working on and have the community involved, not only at the formulation of the problem, but also at developing the solutions, developing the interventions?" And then from there, start developing all of that theory base.

Also, of course, bringing information from the literature, bringing from other populations, and starting that dialogue with the community in terms of, "Okay, so maybe you don't like this particular approach because you don't think it works in your community for these particular reasons. What if we modify it a little bit in this and this and this way and try that with your community?"

And then develop that intervention, adapt that intervention based on what we already know works in the literature. Implement that with the community, with the people who are going to be benefiting from it. And then develop the evaluation also with the input from that community, so that you can really be developing interventions with the dialogue going on from the very beginning and creating the interest in both sides.