Papers by Alessandra Miklavcic
International and cultural psychology series, Jul 16, 2013
ABSTRACT Interpreting in medical and especially in psychiatric and psychotherapy settings is an e... more ABSTRACT Interpreting in medical and especially in psychiatric and psychotherapy settings is an ethical imperative. In mental health, clinical assessment and intervention require that the interpreter have specific skills and sensitivity to work with a patient-centered approach. This chapter provides an orientation to working with mental health interpreters, with a review of relevant research literature and theoretical models followed by guidelines and practical recommendations relevant to cultural consultation. Key principles are presented on how to work with interpreters in various contexts (e.g. CBT, psychodynamic, family therapy). Case vignettes from the CCS are provided throughout the text to illustrate the main points. In cultural consultation, issues of roles, neutrality and the interpreter’s identity (age, gender, ethnicity, religion, political orientation) should be carefully considered. In addition to the individual characteristics of interpreters, it is essential that organizational efforts are made to adapt institutional policies to patients’ linguistic and cultural diversity. Institutional change depends on recognizing interpreters’ skills and contributions to clinical work and encouraging practitioners to work with trained interpreters rather than untrained or ad hoc interpreters, especially family members. Quality assurance standards must formally require the routine use of interpreters in mental health and there must be mechanisms in place to monitor and enforce these standards.
American Ethnologist, Jul 31, 2008
In this article, I look at the ways in which contested memories, imagined communities, and social... more In this article, I look at the ways in which contested memories, imagined communities, and social ressentiment are embraced and filtered by Slovenian and Italian youth as postmemory and transformed into symbolic weapons that exclude, make demands, or simply provoke. Drawing on fieldwork conducted in the Italo-Slovenian border area of Trieste, I analyze two settings in which these symbols are used: a soccer match between Slovenia and Italy played in the summer of 2002 at which a mysterious banner provoked diplomatic tensions and the everyday graffiti war waged on the walls of the city of Trieste. [political symbols, memories, youth, Italy, Slovenia, soccer match, graffiti]
Transcultural Psychiatry
Previous research has demonstrated that without the use of professional interpreters, language ba... more Previous research has demonstrated that without the use of professional interpreters, language barriers interfere with patient care. The literature recommends documenting the presence of language barriers in medical charts. To our knowledge, this mixed methods study is the first to examine language documentation practices in a Canadian inpatient psychiatry setting. The research team interviewed 122 patients admitted to a tertiary care psychiatry ward in Montreal, Canada between 2016−2017 to assess their ability to communicate in the healthcare establishment's languages (English/French). Nineteen participants identified as having a language barrier were selected for a qualitative analysis of the retrospective audit of their medical charts. The presence of a language barrier was reflected in 68% of these charts. When a language barrier was documented, professional interpreters were never used. Our qualitative analysis, informed by literature on medical discourse, aimed to provide ...
International and Cultural Psychology, 2013
This chapter looks at the practice of cultural mediation and the role of culture broker in medica... more This chapter looks at the practice of cultural mediation and the role of culture broker in medical settings with a focus on the cultural consultation service (CCS) of the Jewish General Hospital in Montreal and ethnopsychiatric consultation clinics in France and Italy. We first provide an overview of the concept of culture broker and culture in anthropology and its introduction into the medical settings of underserved communities, especially Aboriginals and immigrants. We then explore the most recent cultural mediation models emerging in the last 20 years in Europe, focusing on a few examples of implementation and policies. The culture broker is a go-between who sensitizes clinical practitioners to patients’ belief systems and encourages patients to “trust” the institutional system. Definitions of culture brokers, their professional recognition, and the roles they play in mediation vary cross-nationally and depend on different ideologies of citizenship and power relations. In practice, culture brokers are usually situated between two approaches: one, aimed at assimilating the immigrant’s point of view to the healthcare system and larger society, and the other, a more inclusive two-way exchange that offers space for each participant to understand the other’s point of view through providing opportunities for negotiation and empowerment strategies. We illustrate the complex and challenging role of culture broker at the CCS service through significant vignettes. They aim to show how culture brokering practices are context-based, depending on the embodied ability to recognize, tolerate, and mediate between diverging regimes of interpretation.
International and Cultural Psychology, 2013
ABSTRACT Interpreting in medical and especially in psychiatric and psychotherapy settings is an e... more ABSTRACT Interpreting in medical and especially in psychiatric and psychotherapy settings is an ethical imperative. In mental health, clinical assessment and intervention require that the interpreter have specific skills and sensitivity to work with a patient-centered approach. This chapter provides an orientation to working with mental health interpreters, with a review of relevant research literature and theoretical models followed by guidelines and practical recommendations relevant to cultural consultation. Key principles are presented on how to work with interpreters in various contexts (e.g. CBT, psychodynamic, family therapy). Case vignettes from the CCS are provided throughout the text to illustrate the main points. In cultural consultation, issues of roles, neutrality and the interpreter’s identity (age, gender, ethnicity, religion, political orientation) should be carefully considered. In addition to the individual characteristics of interpreters, it is essential that organizational efforts are made to adapt institutional policies to patients’ linguistic and cultural diversity. Institutional change depends on recognizing interpreters’ skills and contributions to clinical work and encouraging practitioners to work with trained interpreters rather than untrained or ad hoc interpreters, especially family members. Quality assurance standards must formally require the routine use of interpreters in mental health and there must be mechanisms in place to monitor and enforce these standards.
American Ethnologist, 2008
In this article, I look at the ways in which contested memories, imagined communities, and social... more In this article, I look at the ways in which contested memories, imagined communities, and social ressentiment are embraced and filtered by Slovenian and Italian youth as postmemory and transformed into symbolic weapons that exclude, make demands, or simply provoke. Drawing on fieldwork conducted in the Italo-Slovenian border area of Trieste, I analyze two settings in which these symbols are used: a soccer match between Slovenia and Italy played in the summer of 2002 at which a mysterious banner provoked diplomatic tensions and the everyday graffiti war waged on the walls of the city of Trieste. [political symbols, memories, youth, Italy, Slovenia, soccer match, graffiti]
Medical Anthropology, 2011
Illegal immigration in Canada is characterized mainly by non-status immigrants who legally enter ... more Illegal immigration in Canada is characterized mainly by non-status immigrants who legally enter Canada and stay after their legal status expires and by failed refugee claimants. For these persons, immigration status or its absence plays an important role in determining the degree of access to Canadian health care. This article situates the clinical setting as a site of contention and negotiation of citizenship and care in social networks as well as pragmatic and discursive strategies. Drawing on the case of a patient who faced imminent deportation and became suicidal, in this article I depict how psychiatrists and other health practitioners embrace "bearing witness" as an ethical practice, which intersects the medical and legal spheres.
This paper explores how in the border city of Trieste, located in the north-eastern corner of Ita... more This paper explores how in the border city of Trieste, located in the north-eastern corner of Italy, the contested memories of the past impinge upon the every day life of the Italian majority and Slovene minority’s inhabitants. It argues that their embodied memories and practices, which are rooted in historical power inequalities and struggles over territory, are reinterpreted and played out in the midst of a wave of new immigrants, the new minority: former Yugoslav citizens, Albanians, Chinese, Romanians, North Africans who have arrived in the last fifteen years as a consequence of the post-socialist disintegration and geopolitical global changes. In addressing the conference theme on diversity I intend to explore how discourses of inclusiveness and exclusiveness turn around the slippery concept of territory. The paper draws on an ethnographic fieldwork I conducted as part of my doctorate in 2001-2002 and on some new material gathered from a more recent visit I made to the area in ...
Semiotica, 2006
This article looks at card playing practices among elderly people in Koper, a town on the border ... more This article looks at card playing practices among elderly people in Koper, a town on the border between Slovenia and Italy. It foregrounds card playing as a constitutive social field where subjects share and negotiate their border identities. The 'extrasituational context' provides the complexity of the games invoked at the table such as the repressed memories and the stigmatized mother tongue. This article draws attention to 'language games' and the extent to which by changing games, different rules imply a shifting of roles. By suggesting that card playing is not simply a ludic activity, this article offers a psychoanalytical reading of both the importance and fragility of the Batesonian 'it is a play' frame.
In this paper, we examine the differential strategies employed by Canadian print and broadcast me... more In this paper, we examine the differential strategies employed by Canadian print and broadcast media with respect to reporting of mental illness. Specifically, we analyse media coverage in newspaper articles and television news broadcasts of two separate, violent events that occurred in July 2008, involving racialized persons with lived experience of mental illness. We follow these events over a 3-year period across the national Canadian Broadcasting Corporation news network to examine the role of media in constructing ideas and images about mental health issues and persons with lived experience of mental illness. our work is situated within a growing body of literature on media and mental illness which has, to date, demonstrated both challenges to, and perpetuation of, stigmatization and discrimination against persons with lived experience of mental illness. the role of the media in constructing negative images of mentally ill people and perpetuating stigmatization has been drawn i...
This paper explores how in the border city of Trieste, located in the north-eastern corner of Ita... more This paper explores how in the border city of Trieste, located in the north-eastern corner of Italy, the contested memories of the past impinge upon the every day life of the Italian majority and Slovene minority's inhabitants. It argues that their embodied memories and practices, which are rooted in historical power inequalities and struggles over territory, are reinterpreted and played
This paper explores how in the border city of Trieste, located in the north-eastern corner of Ita... more This paper explores how in the border city of Trieste, located in the north-eastern corner of Italy, the contested memories of the past impinge upon the every day life of the Italian majority and Slovene minority's inhabitants. It argues that their embodied memories and practices, which are rooted in historical power inequalities and struggles over territory, are reinterpreted and played
Uploads
Papers by Alessandra Miklavcic