Culture & Psychological Interventions

Question 1

Psychotherapy

Answer 1

method of healing the emphasises an explicit focus on self.
a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors.

Question 2

Psychanalytic model

Answer 2

comprehensive theory on structure of personality contributing to knowledge about origins of psychopathology.

Question 2

Carl Rogers

Answer 2

American psychologist, developed client-centered approach to psychotherapy, emphasised client’s self-propelled growth.

Question 3

Cognitive behavioural therapy (CBT)

Answer 3

emphasises development of strategies for teaching cognitive skills.
It may help you to change unhelpful or unhealthy ways of thinking, feeling and behaving. CBT uses practical self-help strategies. These are designed to immediately improve your quality of life.

Question 4

Cultural Assumptions of Psychotherapy

Answer 4

Psychotherapy may not be effective for those of non-European descent.
Abnormality, and causes, are bound to culture.
Cultures differ on notions of self.
Ability of therapist to assess behaviours is intimately related to knowledge, understanding, and appreciation of cultural context.
Goal of psychotherapy is to help people become more functional w/in society; thus, functionality itself is culturally determined.

Question 5

Psychotherapy in Diverse Cultures

Answer 5

Psychotherpay exported to other parts of world (Singapore, Pakistan, India, Malaysia, China)
Psychologists incorporate essential elements of their culture to make psychotherapy useful.
Incorporating religion into psychotherapy can be valuable.

Much work needed to:
- Carefully examine whether psychotherapy is appropriate.
- Find an effective way to treat psychological disorders in various cultures.

Question 6

Psychotherapy in Diverse Cultures w/in the US

Answer 6

American psychological association created guidelines for providing mental health services to ethnic minority groups in US.

Using mindfulness as framework for treatment strategies is culturally salient way to modify and enhance cognitive behavioural therapists for Asian.

Culturally adapted cognitive behavioural therapies effective for African American, Native American, Latino, and refugees.

Question 7

Disparities in Receiving Treatment

Answer 7

Not all people receive treatment
- Those in lower income countries are less likely to receive treatment than those in countries w/more economic resources.
- Disparities for receiving treatment exist w/in one country.
Mental health utilisation and length of treatment differ by “racial” or ethnic group.

Question 8

Removing Barriers to treatment

Answer 8

Focus – to examine how barriers interact w/racial/ethnic backgrounds, immigrations status, and socioeconomic status.
Hiring bilingual and bicultural staff.
Increasing outreach and the # of practitioners in the community.
- Having flexible hours
- Reducing stigma associated w/mental illness

Question 9

Cultural challenges to psychological interventions

Answer 9

Problem with conceptualisation & communication issues.
Expectations about roles, treatment modalities, & outcomes.
Face concerns and role of extended familes.

Question 10

Problem Conceptualisation and Communication issues

Answer 10

Considerations for clinician and patient w/different cultural background:
- Different ways of thinking about illness
- Language difficulties
- Variations in communication patterns of different ethnic groups
- Cultural variations in importance of hierarchy in interpersonal relationships
- Role of therapists as authority figure
- Recognising and involving members of extended family.

Question 11

Expectations about Roles, treatment modalities & outcomes

Answer 11

Different cultures may have different expectations about different aspects of treatment:
- Therapists are authority figures
- Directive and strategic interventions vs. Client-centered/reflective therapy
- Active, direct, pragmatic approaches vs. Inactive/indirect approaches that include “talk” therapy.
- Goal: improve productive life roles vs. Gain better insight about oneself in order to feel better

Question 12

Face concerns and role of extended families

Answer 12

Face - refers to claims about one’s social character, integrity, reputation, public appearance/social images
- concerned w/”loss of face”
- Self-disclosure, sharing private thoughts and feelings w/a stranger.
Recognising and involving family members may be useful and present a more familiar approach to problem-solving.

Question 13

Culturally informed services

Answer 13

Involves understanding and respecting the histories, traditions, and value systems of the various cultural groups.

Acculturation status and ethnic identity are determinants of client response to treatment.
e.g. Matching
Culturally competent counsellor
Community Approach to treatment
Indigenous Healing
Blending Indigenous Healing Practices w/Traditional Western-Based Treatment Approaches

Question 14

Matching

Answer 14

Attempt to provide more effective services by examining the cultural, ethnic, or racial match between therapists and clients
However, other factors may be more crucial than simply ethnic or racial similarity
- Cognitive matching
- Cultural matching
- Cultural sensitivity and responsive of therapist
- Client characteristics and preferences

Question 15

Culturally Competent Counsellor

Answer 15

Cultural awareness and beliefs:
- counsellor is sensitive to personal values and biases and how these may influence perceptions of client, client’s problem, and counseling relationship

Cultural knowledge:
- counsellor has knowledge of client’s culture, worldview, and expectations for counseling relationship

Cultural skills:
- counsellor has ability to intervene in manner that is culturally sensitive and relevant

Question 16

Community Approach to Treatment

Answer 16

Analysis of mental health at a community level.
Combines traditional principles of clinical psychology with an emphasis on multiple/diverse ecologies of individuals.
Community-based treatments help immigrants and refugees.

Question 17

Indigenous Healing

Answer 17

Indigenous healing: therapeutic beliefs and practices rooted within given culture
For majority of world (especially developing countries): indigenous, traditional healers, and doctors are primary systems of care

Indigenous healing shares several commonalities:
- reliance on family and community
- incorporation of traditional, spiritual, and religious beliefs
- use of shamans in treatment

Question 18

Blending Indigenous Healing Practices w/Traditional Western-Based Treatment Approaches

Answer 18

James Gone’s work w/Native Americans:
- Traditional healing “emphasises rank, status, role, relationship, and protocol much more than personal dispositions, private sentiments, or inner states of processes”
- Understanding traditional ways of healing can be integrated into contemporary psychotherapy by utilising psychotherapeutic methods and reframing problems to Native American worldview.