The Components of CQ 

David C. Thomas and Kerr Inkson, co-authors of the book, Cultural Intelligence: People Skills for Global Business, define CQ as being skilled and flexible about understanding a culture, learning more about it from your ongoing interactions with it, and gradually reshaping your thinking and behavior to be more skilled and appropriate when interacting with others from the culture.  According to the authors, there are three components of CQ:

1. Knowledge of culture and the fundamental principles of cross-cultural interactions.  In other words, you need to do your homework about what culture is, how cultures vary and how cultures affect behavior.

As an illustration, consider that there are 22 different Native American tribes within Arizona - all with different cultures and traditions.  Within Maricopa County itself, there is an urban Indian population of about 85,000 people from more than 65 tribes from around the country.

That's a lot of cultural diversity, and yet there's a common misconception here that "all Indian people are the same," says Kenneth G. Poocha, executive director of the Arizona Commission of Indian Affairs.  How do these cultures affect behavior?  One common example is the use of traditional medicine.  "Traditional healers take the approach that when you're sick your body is out of balance - mentally, physically or spiritually," Poocha says.  "They have as much validity as any other doctor in the world."

2. Mindfulness, or the ability to pay attention in a reflective and creative way to the cues in cross-cultural situations encountered. According to the authors, most of us are going through life on "cultural cruise control" - making our own culture the center of our mental universe and discarding others as deviant.  "Scripts from other cultures are not considered, and if practiced by others, are likely to be unnoticed, ignored or misunderstood."

For example, a clinician might not notice that an Asian man is reticent about discussing his mental well-being, says Doug Hirano, executive director of the Asian Pacific Community in Action (APCA).  "In some Asian countries, mental illness is very stigmatized, so many times Asians will wait until mental illness manifests physically as hypertension, headaches or other ailments," he says.

3. Developing behavioral skills that allow you to choose the appropriate behavior for different intercultural situations.  Our attitudes reflect a basic world view - how we relate to nature, other people and time - as well as certain values, such as society versus community, children versus elders and independence versus dependence.  "Etiquette, modesty, touching and spatial distance convey significant nonverbal messages about relationships and traditions that, if violated, can undermine rapport and even disrupt treatment," write Joseph Hartog, M.D., and Elizabeth Ann Hartog, R.N., M.A., in The Western Journal of Medicine.

While a Muslim woman might be horrified by the thought of a gynecological exam by a male physician, other cultural differences are more subtle.  For example, while Anglo-Americans tend to be informal and appear rushed, if not brusque, this can be interpreted as uncivilized, rude and disrespectful by members of other cultures, including Native Americans.  "The most important thing a healthcare provider can do, aside from listening to their patients, is being patient with their patients," Poocha says.