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Despite the growing awareness of cultural differences and the challenges of multicultural counseling, critics have noted that understandings of culture within psychology remain largely cursory. Philosophical hermeneutics help to remedy this situation by offering a comprehensive theory of culture that (a) details how the self is embedded in culture, (b) highlights culture's inherently moral nature, and (c) shows how cultural conflict be can be mediated through dialogue. Hermeneutics provides a means of thinking interpretively about cultural meanings and discerning their specific manifestations. It can be utilized by psychotherapists not only to help understand clients from different cultural backgrounds but also to better recognize how the dominant Western cultural outlook-individualism-influences psychotherapy theory, research, and practice.
American Psychologist, 1987
This article examines the role of cultural knowledge and culture-specific techniques in the psychotherapeutic treatment of ethnic minority-group clients. Recommendations that admonish therapists to be culturally sensitive and to know the culture of the client have not been very helpful Such recommendations often fail to specify treatment procedures and to consider within-group heterogeneity among ethnic clients. Similarly, specific techniques based on the presumed cultural values of a client are often applied regardless of their appropriateness to a particular ethnic client. It is suggested that cultural knowledge and culture-consistent strategies be linked to two basic processes--credibility and giving. Analysis of these processes can provide a meaningful method of viewing the role of culture in psychotherapy and also provides suggestions for improving psychotherapy practices, training, and research for ethnic-minority populations.
Professional Psychology: Research and Practice, 2003
As the United States population grows more culturally diverse, it is increasingly likely that psychologists will treat patients from dissimilar cultural backgrounds. Psychologists are often undecided about whether it is therapeutically appropriate to address cultural differences. Ten clinical considerations regarding the appropriateness of discussing cultural differences with patients are described. Examples are provided of how these suggested guidelines may apply to clinical practice. The literature that has supported addressing differences, including selected theoretical models, is cited in the context of these recommendations. All psychotherapy cases are distinct; therefore, these general guidelines should be adapted to the requirements of the individual patient. Theoretical Perspectives Cultural differences have been understood through three distinct perspectives: universalism, particularism, and transcendism (Se-MARTIN J. LA ROCHE received his PhD in clinical psychology from the University of Massachusetts at Boston. He is currently an instructor in the Department of Psychiatry at Harvard Medical School at the Children's Hospital Boston/Martha Eliot Health Center and is in independent practice in the Cambridge, MA, area. His current areas of research are multicultural psychotherapy and health psychology. APRILE MAXIE received her PhD in clinical psychology from the University of Massachusetts at Amherst. She is a postdoctoral fellow in the Department of Psychiatry at Kaiser Permanente in Oakland, CA. Her current area of research is cross-cultural psychotherapy and treatment-seeking in ethnic minority populations.
2022
Culture governs a group's way of life that is passed from one generation to the next. It shapes what people make, think, value, and do to ensure their existence. It influences what we think is appropriate, what we eat, drink, wear, what we believe and much more. Culture is simple yet complex. It is static yet dynamic. Each generation acts upon it, causing modifications, even though the basic components such as language, religious practices, and system of government usually resist significant change. Like a river, culture has many sources . Given the dynamic nature of culture, this article discusses an interpretation and reinterpretation of culture as the world moves into a modern era of globalization where cross-cultural exchanges are the norm. This paradigm shift creates a host of new challenges for organizations and mental health professionals as they seek to find new strategies to effectively address a new globalized world where self-expression, individualism and a re-invigorated awareness of interpersonal connection is upon us. This article seeks to address these issues and provide some strategies for effective cross-cultural awareness and mental health counseling.
Almost half of Australia's people have non-English speaking backgrounds, but psychotherapy remains geared to the mainstream and ignorant of the stamp of culture. In this lecture, based on 35 years' experience as a psychotherapist-anthropologist in multicultural Australia and Cambodia, I will consider some of the cultural cornerstones of psychotherapy such as attachment theory, loss and bereavement; sanity and madness; the biological basis of mind such as cultural neurosciencje; excavations of mind, especially dream analysis; local notions of cause and effect such as contagion; structures of emotion such as anger; idioms of distress as seen in dissociative states; the preternatural, shown in possession states and demonology; family therapies withi ancestors; local forms such as traditional healing or religious interventions; and evil as manifested in wholesale violence against women and children. A culturally responsive psychotherapy allows the clinician to identify what matters to the patient as a participant in multicultural Australia and in a global world.
American Journal of Psychiatry, 2008
This case illustrates how cultural issues can influence the progression of psychodynamic therapy. During the course of supervision, the resident learns how understanding the cultural similarities and differences between patient and therapist both enhances and hinders the treatment. The supervisor demonstrates the utility of parallel process during supervision in general and as a tool to uncover key cultural issues. The Grand Rounds discussant highlights cultural aspects of the case such as psychotherapy in a second language, assumptions about traditional roles, and demonstrations of closeness. "Ms. B" is a 38-year-old Ecuadorian woman in her first year of medical school who presented with the chief complaint: "I wish I could just accept and love my boyfriend." Ms. B was receiving therapy in a psychopharmacology clinic for 1 year from a psychiatry resident when she began describing worries about conflicts with her boyfriend of 2 months. The psychopharmacology resident referred Ms. B to the psychodynamic therapy clinic for a consultation. Ms. B's past psychiatric history is contributory for recurrent major depression, which had been in remission for 3 years since she began taking fluoxetine. She had no prior suicide attempts or hospitalizations. She reported no other symptoms of axis I pathology. The family history was notable for multiple family members being depressed and one family member attempting suicide. She reported no substance abuse and did not have any medical problems.
The Encyclopedia of Cross-Cultural Psychology, 2013
2007
Abstract Psychotherapies are distinguished from other forms of symbolic healing by their emphasis on explicit talk about the self. Every system of psychotherapy thus depends on implicit models of the self, which in turn, are based on cultural concepts of the person. The cultural concept of the person that underwrites most forms of psychotherapy is based on Euro-American values of individualism.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2003
To provide effective psychotherapy for culturally different patients, therapists need to attain cultural competence, which can be divided broadly into the 2 intersecting dimensions of generic and specific cultural competencies. Generic cultural competence includes the knowledge and skill set necessary to work effectively in any cross-cultural therapeutic encounter. For each phase of psychotherapy--preengagement, engagement, assessment and feedback, treatment, and termination--we discuss clinically relevant generic cultural issues under the following headings: therapist, patient, family or group, and technique. Specific cultural competence enables therapists to work effectively with a specific ethnocultural community and also affects each phase of psychotherapy. A comprehensive assessment and treatment approach is required to consider the specific effects of culture on the patient. Cultural analysis (CA) elaborates the DSM-IV cultural formulation, tailoring it for psychotherapy; it i...
Transcultural psychiatry, 2006
call creolization the meeting, interference, shock, harmonies and disharmonies between the cultures of the world. .. [it] has the following characteristics: the lightening speed of interaction among its elements; the awareness of awareness: thus provoked in us; the reevaluation of the various elements brought into contact (for creolization has no presupposed scale of values); unforeseeable results. Creolization is not a simple cross breeding that would produce easily anticipated results.' (Edouard Glissant, 1997) The practice of psychotherapy depends on a fund of tacit knowledge shared by patient and clinician (Frank, 1973). Intercultural work challenges this shared 'assumptive world' and poses problems of translation and positioning, working across and between systems of meaning and structures of power that underpin the therapeutic alliance and the process of change. The encounter of patient and clinician from two different cultures is not simply a matter of confrontation or exchange between static systems of beliefs and values. Once viewed as self-contained worlds of meaning, cultures are now seen as systems of knowledge and practicesustained by cognitive models, interpersonal interactions, and social institutions-that provide individuals with conceptual tools for selfunderstanding and rhetorical possibilities for self-presentation and social positioning. Moreover, cultural worlds are open-systems, shaped by forces of migration, globalization, and hybridization (Hannerz, 1996; Papastergiadis, 2000). This flux destabilizes old values, identities and ways of life
Frontiers in Psychiatry
The present paper discusses the role of culture in understanding and treating psychopathology. It describes new perspectives on the conceptualization of psychopathology and on the definition of culture, and how these are intertwined. The impacts of culture, explicit and implicit discrimination, and minority stress on mental health are reviewed, especially in the current era. Culturally-sensitive assessment practices in psychopathology are emphasized, including addressing the multiple cultural identities of the patient, the explanatory models of the experienced distress, specific psychosocial stressors and strengths, and the cultural features of the practitioner-patient relationship in the clinical encounter. The particular case of psychotherapy in working with culturally diverse patients is explored. Finally, mainstreaming of culture in research and clinical training in psychopathology is highlighted, acknowledging that each clinical interaction is a cultural one.
Psychotherapy: Theory, Research, Practice, Training, 2006
The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman's (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor's (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups.
Psychotherapy: Theory, Research, Practice, Training, 2006
International journal of psychology and behavioral sciences, 2016
The world is changing very fast toward cultural pluralism. It is predicted that most of the societies will be more diverse in 21st century. Cultural differences denied for centuries in therapeutic interventions are no more acceptable. Multicultural counseling and therapy are in fact a strong trend in response to this urgent need. That is the reason for multiculturalism to be considered the fourth force in psychology. All counseling and therapy issues and interventions are somewhat cross-cultural. How a client views the world is important insofar as it contrasts with the counselor’s. Many Eastern and Western cultures are considered different according to different perspectives. Family as a powerful social institution is the matrix of cultural identity of its members. In recent years, culture turned to occupy a key position in family therapy. Couples have learned to identify with cultural values and biases of their own families throughout their childhood. Family counselors and therapi...
2018
Rowe whose example and towering legacy was equal parts challenge and inspiration; and Dr. Francesca Parker whose excellent questions and support helped push the process further and faster. I owe a debt of gratitude to the entire Psychology faculty of Pepperdine University's Graduate School of Education and Psychology; the deep bench of excellent scholars in multicultural psychology is an unmatched treasure. I wish to thank my parents, who provided the foundation and whose influence can clearly be seen in this intersection of clinical and critical inquiry. I am grateful for the legacy received from my ancestors: a group of rebels, thieves, artists, justice seekers, gadflies, and healers whose example I do my best to follow. I'm grateful for my treasured readers and thought leaders: Amy Bloom, Sarah Moon, and Rachel Weller. Finally, none of this would have been possible (or even attempted) were it not for Corey Sorenson.
2016
Imagine the work of a mental health professional who accepts a new position in a close-knit community with cultural lifestyles very different from mainstream society. The therapist was born and raised far from that community but had been successful elsewhere. Although the therapist uses the same approach and techniques that had previously worked well, most clients fail to return after the first or second session. The few clients who remain in therapy seem to understand the therapist's intentions and respond to treatment, but reluctantly, the therapist begins to face the fact that the approaches taken in therapy do not align with the experiences and worldviews of most of the new clients. The clients perceive situations in ways unanticipated by the therapist. The clients' explanations about emotional events seem peculiar to the therapist, who realizes that trying to interpret the clients' behavior, feelings, and thoughts often results in misattributions. Desiring to better understand local lifeways and thoughtways and to acquire the skills necessary to implement that understanding, the therapist searches for evidenced-based guidelines Recognizing that all behavior is learned and displayed in a cultural context makes possible accurate assessment, meaningful understanding, and appropriate intervention relative to that cultural context. Interpreting behavior out of context is likely to result in misattribution.-Paul Pedersen (2008, p. 15)
Journal of Counseling Psychology, 2011
In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The authors challenge the wisdom of exploring MCCs in psychotherapy research and provide a different framework to understand therapists' multicultural effectiveness with clients based on their cultural race/ethnicity. Additionally, the concept of therapists' multicultural orientation or approach is introduced to illuminate the process of aligning with clients about salient cultural issues in psychotherapy.
Journal of Social Distress and the Homeless, 1995
and experience is selectively reviewed, and several conclusions are drawn about the nature, extent, and impact of such influence. Although a number of demonstrated universals exist in the manifestations of schizophrenia and depression, the scope of cultural variation in all aspects of psychopathology is vast. Both universalist and relativist positions in their pure or exclusive form are rejected and the view is espoused that psychological manifestations are the joint result of panhuman and culture-specific factors. Several conclusions concerning the operation and the results of such influences are presented and the issues that are as yet unresolved are identified. The self is introduced as the key concept in explaining both the constancy and the variation of experience across cultures and four dimensions derived from Hofstede's worldwide multicultural research are described. Their potential relevance is spelled out for systematically investigating the culturally preferred and~or characteristic modalities of psychotherapy.
The focus of this research is in the area of psychoanalysis investigating factors influencing psychotherapeutic relationship from psycho social perspective. Such a study is important in order to identify level of influences of culture involvement in therapeutic relationship. This research conducted to provide an evidence for mental health professionals to understand cultural background of mental discomfort.
Applied and Preventive Psychology, 1996
The purpose of this article is to present an integrative model of cross-cultural counseling and psychotherapy. Illustrated by a series of critical incidents, it is argued that unidimensional models of cross-cultural counseling and psychotherapy are inherently limited. Using Kluckhohn and Murray's tripartite model of personality, an integrative, sequential, and dynamic model of cross-cultural counseling is advanced. Support for the validity of the Kluckhohn and Murray model is first reviewed. This is followed by a delineation of the components of the current integrative model: (a) Outgroup homogeneity effect, (b) Cultural schema theory, (c) Complimentarity theory, (d) Science of complexity, and (e) Mindfulness. The operation of this model is described in a series of figures and the implications for counseling practice and future research is discussed.
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