w1 - culturally reflexive & first nations mental health Flashcards
Q: What is culture in the context of mental health?
A: An intergenerational system of meanings including beliefs, values, traditions, and practices that shape how individuals interpret experiences and influence behaviour.
Q: Why does culture matter for mental health?
A: Culture affects how people understand mental health, experience symptoms, seek help, and respond to treatment. It also shapes interactions with health, social, and justice systems.
Q: What is cultural reflexivity?
A: A practice involving self-awareness, critical thinking, and adaptability in understanding a client’s unique cultural context, avoiding assumptions and stereotypes.
Q: What are the four pillars of culturally reflexive practice?
A: 1) Assessment & Diagnosis, 2) Language, 3) Treatment, 4) Organisational Planning.
Q: How should clinicians approach assessment and diagnosis in a culturally reflexive way?
A: Use the DSM-5 with cultural judgment, ask questions, and consider if symptoms are distressing within the client’s cultural context. Use the Cultural Formulation Interview.
Q: Why is language important in mental health care?
A: Clients must fully understand what is being discussed; interpreters should be used when needed to avoid misunderstandings of complex mental health concepts.
Q: What is the “Matryoshka doll” metaphor in cultural understanding?
A: The smallest doll is daily interpretation of events; the largest is cultural background. Cultural influences layer on how individuals perceive and respond to the world.
Q: What is Australia’s cultural and linguistic diversity context?
A: ~50% of Australians were born overseas or have a parent who was; 21% speak a language other than English at home.
Q: What are CALD populations?
A: Culturally and Linguistically Diverse people, either born in a non-English-speaking country or whose parents were.
Q: What barriers do CALD populations face in mental health care?
A: Stigma, shame, discrimination, language issues, visa insecurity, lack of trust in government systems, and culturally mismatched models of care.
Q: What is the “double burden” faced by CALD individuals?
A: They are more likely to need psychological support but less likely to access and complete treatment due to cultural, systemic, and interpersonal barriers.
Q: What is the “triple burden” in CALD mental health?
A: Lack of psychological services, reduced access and engagement, and underrepresentation in mental health research.
Q: Why is building a strong therapeutic relationship important?
A: Studies show that over 80% of recovery is linked to the strength of the client-practitioner relationship.
Q: How effective are culturally adapted interventions?
A: Up to 4x more effective than non-adapted ones; even more effective when conducted in the person’s native language.
Q: What defines a refugee?
A: Someone with a proven, well-founded fear of persecution who is unable to return to their home country.
Q: What is an asylum seeker?
A: A person seeking protection in another country whose request for sanctuary has not yet been processed or approved.
Q: What are the 3 stages of the refugee experience?
A: Pre-flight (trauma, loss, war), Flight (fleeing, uncertainty, lack of basic needs), Post-migration (acculturation stress, visa insecurity, systemic barriers).
Q: How do mental health outcomes differ for refugees?
A: Refugees have much higher rates of PTSD and depression (~31%) compared to the general Australian population (6% PTSD, 4% depression).
Q: What is a dose-response relationship in mental health?
A: The more trauma a person experiences, the greater the likelihood of developing mental health conditions like PTSD.
Q: Why is it important to ask families how they understand their child’s mental health?
A: To respect cultural perspectives and gain insight into how their community interprets and responds to mental health issues.
Q: Why is clinical psychology often hard to understand for CALD clients?
A: It uses heavy jargon that even native English speakers find complex; clear, intentional communication is essential.
Q: How can clinicians increase access for CALD clients?
A: Provide psycho-education and culturally-focused resources in the client’s first language.
Q: What is case management in mental health care?
A: Clinicians advocating on behalf of clients by navigating systems (e.g. applying for NDIS, liaising with services, coordinating care).
Q: How should progress be assessed in refugee mental health cases?
A: Qualitatively through collaboration with schools, families, and interpreters—not just standardized metrics.
Q: Why is consistency with interpreters important?
A: Builds trust, reduces client stress, and supports continuity in discussing sensitive topics.
Q: What should clinicians consider when working with interpreters?
A: Book in advance, brief and debrief interpreters, and adjust pace and complexity of speech.
Q: Why might a client request an interpreter outside of their cultural group?
A: To avoid judgment or discomfort from someone within their own community.
Q: When might clinician self-disclosure be helpful?
A: If sharing cultural background or language builds rapport and trust with the client.
Q: What is positionality?
A: Awareness of how your background influences your worldview and interactions, especially important in working with Aboriginal clients.
Q: Why is psychology often culturally unsafe for Aboriginal Australians?
A: It is grounded in dominant (Western) paradigms that don’t reflect Indigenous ways of understanding mental health.
Q: What is decolonisation in mental health care?
A: Challenging dominant Western frameworks and re-centering Indigenous knowledge, practices, and wisdom.
Q: What is SEWB (Social and Emotional Wellbeing)?
A: A holistic Aboriginal model of wellbeing that includes connections to body, mind, community, culture, land, spirit, and ancestry.
Q: What are some causes of poor wellbeing for Aboriginal communities?
A: Unresolved grief, racism, dislocation, trauma, disadvantage, and loss of cultural connection.
Q: What was the APS apology in 2016?
A: Acknowledgment of psychology’s role in dismissing Aboriginal wisdom and harming communities through biased systems and research.
Q: What did the APS pledge to do after the apology?
A: Listen more, follow Indigenous leadership, advocate, include Indigenous voices, and collaborate rather than control.
Q: What are some key mental health disparities facing First Nations Australians?
A: Historical trauma, financial barriers, cultural stigma, and lack of accessible, culturally safe services.
Q: What is Indigenous Standpoint Theory (IST)?
A: A challenge to Western epistemology that promotes valuing Indigenous knowledge and examining power dynamics in knowledge construction.
Q: What does axiology refer to?
A: Ways of doing—what is considered valuable and why—which varies across cultures.
Q: What does ontology refer to?
A: Ways of being—beliefs about how we should exist and live life.
Q: What is cultural safety in mental health care?
A: Creating environments where clients feel seen, respected, and safe to share their worldview without being spoken for.
Q: What is the main idea regarding Indigenous and Western knowledge in mental health?
A: A comprehensive, effective system must integrate both, through ongoing respect, dialogue, and partnership.
Q: What does UNDRIP (2017) advocate for in mental health?
A: Indigenous peoples’ rights to design and deliver mental health services through their own institutions.
