DOI: 10.1097/01.nmd.0000082187.22378.97
,
Issn Print: 0022-3018
Publication Date: 2003/08/01
Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
Culture imparts meaning to our life, affecting how we think, behave, get sick, and ask for help. Recognizing the central role of culture, the field of mental health is incorporating cultural variables into assessment and treatment. The three publications that I review here place an emphasis on the role of culture in clinical work.
Cultural Assessment in Clinical Psychiatry, formulated by the Group for Advancement in Clinical Psychiatry’s Committee on Cultural Psychiatry, elaborates on the American Psychiatry Association’s “Cultural Formulation” by discussing the main cultural variables influencing clinical assessment. The contributors emphasize the complexity of cultural variables and how they affect clinical work. As an illustration, they identify some of these variables as ethnic identity, race, gender and sexual orientation, age, religion, migration and country of origin, socioeconomic status, acculturation and acculturative processes, language, and education. Additionally, the authors discuss dietary influences, eloquently expanding culture’s influence into biology. The contributors envision the future of cultural psychiatry, identifying 1) the interactions between culture and personality, 2) conflicts and problems in environments of rapid social change, 3) communication styles, 4) assessment of stress, and 5) cultural determinants of public policy as unfolding areas. The book’s main addition is its rich description and clinical use of the cultural formulation.
Cultural Assessment in Clinical Psychiatry works like an effective how-to-do manual. Interesting case examples add to the rich application of the cultural formulation. This is a must-read book for all trainees in mental health.
Cultural Competency: A Practical Guide for Mental Health Service Providers, by Delia Saldaña, is a practical guide for increasing cultural competence. Simple and accessible, this concise manual offers concrete and useful steps for augmenting cultural clinical knowledge. It covers areas such as cross-cultural therapeutic processes, cross-cultural communication (including the use of interpreters), and cultural syndromes, as well as conducting culturally sensitive assessment and psychologic testing. Although this succinct guide seems to be more relevant to delivering services to patients in lower socioeconomic strata, its practical advice is useful for clinicians aspiring to develop cultural competence.
Culture and Psychotherapy: A Guide to Clinical Practice goes a step beyond the previously reviewed publications. This well-organized and edited book moves beyond the cultural formulation to provide useful information, recommending the use of the cultural dimension to increase psychotherapy’s effectiveness. Culture and Psychotherapy effectively demonstrates how culture becomes a central domain in healing. Clinical vignettes show culture’s impact on the meaning of patients’ lives, the nature of their stress, their coping mechanisms, and their psychopathology. In addition to the contributors, the editors Wen-Shing Tseng and Jon Streltzer offer vivid clinical portraits illustrating these issues. I enjoyed reading the book, in particular the section on Special Issues in Therapy, including chapters on “Lessons From Folk Healing Practices,” “Therapist-Patient Relations and Ethnic Transference,” and “Psychologic Aspects of Giving and Receiving Medications.” Overall, the volume is well conceived, organized, and executed. Its format is effective, providing a coherent introduction and a thorough conclusion. Although I found the section on “Treating Special Populations” interesting, I am not sure how the editors selected the subjects of their chapters; in other words, what was their rationale for including some groups and not others? Perhaps I wanted more discussion on additional groups. Culture and Psychotherapy: A Guide to Clinical Practice moves the field to the next step, articulating culture’s complexities and intricacies in healing.
