A consideration of culture is essential in the process of the interview, case formulation, diagnosis, and treatment of culturally diverse individuals. The evaluation of these individuals raises many issues that clinicians need to address to formulate an accurate diagnosis and treatment plan that will be acceptable to the patient.
Full Answer
What is the purpose of cultural elements in the diagnosis?
The purpose of including cultural elements in the diagnosis is neither to homogenize diagnostic procedures to the point of vague generalizations, nor to accentuate heterogeneity in the name of an ill-conceived thoroughness. The cultural components of modern psychiatric diagnosis cover a variety of areas.
What is the role of Culture in the medical field?
All cultures have developed systems of beliefs to explain the cause of illness, how illness can be cured or treated, and who should be involved in the health care process. In other words, every culture has beliefs about health, disease, treatment, and health care providers. Culture plays a huge role in medical interactions.
How does culture play a role in the diagnosis of psychopathology?
Involving a crucial set of factors, culture plays several roles in the diagnostic process 29. Cultural factors may have a powerful pathogenic impact as triggers of psychopathology (e.g., the role of violence in television shows in the development of violent behavior among probably predisposed children or adolescents 30).
What do cultural differences have to do with psychiatric diagnosis?
Similarities and differences between ethnicity and identity, religiosity and spirituality are topics of worthy connections with psychiatric diagnosis in a variety of cultural settings 55.
How can culture affect diagnosis and treatment?
Culture significantly impacts various aspects of mental health including the perception of health and illness, treatment-seeking behaviour and coping styles. As such, simplified mainstreaming of mental health approaches may not cater to the needs of a culturally diverse population from different communities.
What role does culture play in the diagnosis of disorder?
Culture can influence how people describe and feel about their symptoms. It can affect whether someone chooses to recognize and talk about only physical symptoms, only emotional symptoms or both.
What is the role of culture in the treatment of disorders?
For instance, culture affects the way in which people describe their symptoms, such as whether they choose to describe emotional or physical symptoms. Essentially, it dictates whether people selectively present symptoms in a “culturally appropriate” way that won't reflect badly on them.
Why is cultural consideration important in healthcare?
Why Is Cultural Respect Important? Cultural respect is critical to reducing health disparities. It helps improve access to high-quality health care that is respectful of and responsive to the needs of diverse patients.
How could cultural differences impact treatment?
Misunderstandings of and/or ignorance toward cultural differences may lead to physical violence, which may require medical attention. Studies have also demonstrated minorities may be less likely to seek both medical and mental health treatment, which may be because of fear, stigma, discrimination, or other factors.
What is culture diagnosis?
Diagnostic cultures are commonly used to identify infectious microbes from samples isolated from urine (urinary tract infections), stool (diarrheal and foodborne diseases), the genital tract (STDs), the throat (strep throat), and the skin (skin infections).
How does culture influence health beliefs?
The influence of culture on health is vast. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer.
How does culture influence aspects of mental health?
Cultures may influence and contribute to the causation of mental illnesses, mould symptoms, render certain sub-groups more vulnerable as well as modify beliefs and explanations of illnesses. This demonstrates that cultural beliefs and values represent a crucial factor in mental illness.
Why is it important for mental health professionals to consider cultural factors when diagnosing psychological disorders?
Cultural formulation It provides a better understanding of symptoms, therefore increasing the accuracy of conventional clinical assessments.
What are cultural considerations in health care?
Cultural Considerations for Health ProfessionalsLanguage barriers.Unfamiliarity with the concept of palliative care/hospice settings.Distrust of health care services/clinicians.Personal experiences/past trauma.Religious differences.Belief in alternative medicines.Fear of the unknown.
What are cultural considerations in healthcare?
According to the American Hospital Association, cultural competency in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients' social, cultural and linguistic needs.
Why are cultural considerations important?
Cultural considerations apply to research because diversity is essential to the generalizability of study findings and ultimately usability of results, like being able to recognize if a medicine/vaccine has a different efficacy or side effects in different subgroups.
What are the differences between cultures?
One of the main differences seen across cultures is the way anxiety and depression is expressed . Someone from a culture where it is common to know psychological terms, could easily describe anxiety and depression using those specific words. In other cultures, other words might be more common.
Does culture affect anxiety?
May 15, 2019. Influences of Cultural Differences in the Diagnosis and Treatment of Anxiety and Depression. Share. No. Culture affects the way we express our thoughts, behaviors and emotions. It is therefore not surprising that there are cultural differences in the way anxiety and depression is manifested and treated.
What is cultural psychiatry?
Cultural psychiatry deals with the description, definition, assessment, and management of all psychiatric conditions, inasmuch as they reflect and are subjected to the patterning influence of cultural factors.
What did Mayer consider mental illness?
Mayer considered mental illnesses as “reactions” to a variety of psychobiological factors and, like Freud did with the “unconscious” phenomena, conferred them a categorical, irrefutable etiological nature. This approach persisted in the second edition of DSM (1968), regardless of the elimination of the term “reaction”.
Is cultural psychiatry the same as international psychiatry?
It goes without saying that cultural psychiatry is not the same as international psychiatry, nor it is limited to race, gender and ethnicity as its leading indicators.
Is the environment a pathogenic factor?
The environment ( or “macro-environment”, to be more precise) is an almost inexhaustible source of both benign (or preventive) and harmful factors in the development of any clinical condition . For the purposes of a culturally-based diagnosis, the identification of environmental pathogenic factors is essential.
Is culture heterogeneous or complex?
Culture is said to be too broad a concept, too complex in content, and too heterogeneous in nature (the hundreds, even thousands of cultural and subcultural groups, languages and dialects all over the world are frequently cited as proof) to be covered by relatively simple clinical interactions 32.
Is a well-based diagnosis relevant?
There is no question about the new relevance that a well-based diagnosis acquired for research work, teaching activities, and actual treatment approaches. Lawyers, administrators, insurance companies, bureaucrats and politicians paid more attention to diagnoses and their implications.
Is psychiatry in transition?
From a strictly clinical and scientific vantage point, the current state of diagnosis in psychiatry can respond better to the label “in transition”. The last 15 years have witnessed significant advances in epidemiological research, neuroscientific inquiries, and clinical management of many mental disorders.
How does cultural diversity affect mental health?
Cultural diversity across the world has significant impacts on the many aspects of mental health, ranging from the ways in which health and illness are perceived, health seeking behavior, attitudes of the consumer as well as the practitioners and mental health systems.
What are the differences in cultures?
The differences in cultures have a range of implications for mental health practice, ranging from the ways that people view health and illness, to treatment seeking patterns, the nature of the therapeutic relationship and issues of racism and discrimination.
What does "society as a patient" mean?
Society as a patientis a term that Marsella (45) uses to point out that not all problems are located within the individual, and that the patient's well-being or lack thereof is often a product of the impacts of the external environment.
What is Helman's view of disease?
To begin with, the perceptions ofetiology of disease can be very different across cultures. Helman (20) presents us with a framework of views of illness causality that may be at the individual level or situated in the natural world or in the social world, and argues that each cultural group views these differently.
What is culture in the context of a tribe?
Culture is a broad and vexed term that can be defined in a range of ways, depending on the field of study and the perspective of the person using the term. As Tribe (1) argues, it is a multi-layered concept influenced by a range of issues such as gender, class, religion, language, and nationality, just to name a few.
What is stigma in treatment seeking?
Stigmacan play a key role in terms of variations in treatment-seeking. Stigma can be viewed as a “mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against, and excluded from participating in a number of different areas of society” [(29), p. 16].
Why is cultural diversity important in addiction treatment?
While honoring the cultural diversity of your client is important, you must remember that your primary purpose in addiction treatment is to help the client get clean and stay sober. Any issue the client raises may be important.
What is the best advice for cultural groups?
Beware of generalizations and stereotyping. The best advice is to use good therapeutic skills.
What does it mean when someone avoids contact with other members of his culture?
Often sees other members of his race and culture as ‘the enemy’ and/or a source of shame and embarrassment. Has difficulty trusting other members of his own culture and usually feels ‘better than’ or ‘less than’.
Why is it important to identify your own prejudices?
Identifying your own prejudices makes it clearer when you are attempting to work with your client’s problems. After all, counselors’ issues often get confused as the client’s issues. The old adage, “If you can’t name it, you can’t tame it”, comes to mind.
What is cultural competence?
In other words, a clinician’s “cultural considerations” and “cultural competence” cannot guarantee proper diagnosis and care for all patients. That process requires the clinician to embrace cultural humility.
What is the role of a clinician in a child's care?
The clinician educates the patient and family about ADHD, and the caregiver informs the clinician about the child’s realities, challenges, and ideas about ADHD and other neurological and mental health issues.
Why is context important for ADHD?
Context is extremely important when evaluating for ADHD in children, especially Black children. Symptoms of ADHD can overlap with other mental health conditions. ADHD is often the default diagnosis when a clinician observes symptoms that resemble inattention, hyperactivity, and impulsivity, which may be caused by other drivers, including:
Is culture more than race?
Culture is More Than Race. A patient’s race does not entirely define their cultural picture, and cultural considerations in health care should not hinge on race alone. This is a meaningful starting point for clinicians; it sets the tone for patient care at all phases.
What is culture in psychology?
Dwight Heath1 offers a simple definition: "It [culture] is a system of patterns of belief and behavior that shape the worldview of the member of a society. As such, it serves as a guide for action, a cognitive map, and a grammar for behavior.". There have been numerous definitions of culture.
How does culture affect substance abuse?
Culture plays a central role in forming the expectations of individuals about potential problems they may face with drug use. 1 For many social groups, this may provide a protective factor.
What is a related situation?
A related situation is that of the immigrant who has moved from his homeland to a new country. Immigrants leave the protective environment of their family behind and are faced with a new set of cultural norms and values. This has been seen in Hispanics who have moved to the United States.
What are the problems that drugs and alcohol bring to communities?
Treatment interventions should be designed with input from the community. It is in this task of community healing that hope is rekindled, and it is this hope that initiates and drives the healing process. Tribal groups , families, traditional healers , religious entities, legal authorities, and local health care providers should all be involved in the healing and recovery process.
What is the goal of a clinician?
The goal of the clinician should be to uncover sociocultural issues that will affect acceptance, retention, and ultimately, treatment outcome. Access to treatment is facilitated by locating treatment facilities in easily accessible geographic areas.
What is the degree to which an individual identifies with his or her native culture?
Acculturation, the degree to which an individual identifies with his or her native culture, is thought to be related to substance use and abuse. Native American elders believe that many substance abuse problems are related to the loss of traditional culture. Higher rates of substance use have been found in persons who closely identify ...
Should patients have access to facilities and counselors in their own community?
Patients should have access to facilities and counselors in their own community rather than in remote treatment locations. One caveat is that in small rural communities, ease of access may reduce the ability to keep treatment confidential.
How does culture affect health care?
The Influence of Culture on Health Care Decisions. Culture plays a huge role in medical interactions. It influences how an individual might view an illness or treatment, for example, and affects how a physician should address an older patient. Culture may also affect the decision-making process. Cultural beliefs can affect how a patient will seek ...
What is cultural compliance?
Cultural issues play a key role in compliance, which is a person’s willingness to adhere to the doctor’s recommendations. Culture influences healthcare at all levels, including communications and interactions with doctors and nurses, health disparities, health care outcomes, and even the illness experience itself.
Why do cultures have beliefs?
All cultures have developed systems of beliefs to explain the cause of illness, how illness can be cured or treated, and who should be involved in the health care process. In other words, every culture has beliefs about health, disease, treatment, and health care providers.
Why is communication gap important for seniors?
The communication gap can prevent some seniors and families from getting the health information they need to make informed decisions. They may not know where to access information in another language, or they may not know how to find a health care provider that speaks the language.
Why are there many components to a patient's cultural identity that go beyond the concepts of ethnicity and race?
There are many components to a patient’s cultural identity that go beyond the concepts of ethnicity and race, because a person may have several cultural reference groups. For example, two Hispanic persons may come from Mexico but may have different cultural identities depending on what socioeconomic status and geographical region from which they originated. Multiple factors affect an individual’s cultural identity (Table 18—1).
Why is it important to consider culture?
A consideration of culture is essential in the process of the interview, case formulation, diagnosis, and treatment of culturally diverse individuals. The evaluation of these individuals raises many issues that clinicians need to address to formulate an accurate diagnosis and treatment plan that will be acceptable to the patient.
How to make culturally appropriate formulations?
The first step is to show empathy during the interview and then to elicit the patient’s perspective on the illness. Next, the patient’s experience can be assessed in the context of the patient’s family, workplace, health care systems, and community. Finally, the patient’s illness can be diagnosed both through DSM-IV categories and through the patient’s cultural idioms of distress. Hinton and Kleinman’s overall schema is similar to the one developed by the National Institute of Mental Health (NIMH) Culture and Diagnosis Group (Mezzich et al. 1993). The DSM-IV outline for cultural formulation includes the following: Cultural identity of the individual. Note the individual’s ethnic or cultural reference groups. For immigrants and ethnic minorities, note separately the degree of involvement with both the culture of origin and the host culture (where applicable). Also note language abilities, use, and preferences (including multilingualism).
What is the purpose of migration history?
As described by Lee (1990) (Table 18—2), the purpose of a migration history is to determine the patient’s background history and to measure their baseline functional level as well as the generational status of the patient. There are actually two parts to the migration history: the premigration history and the immigration history.A pre-migration history includes country of origin, position in the family, education, employment status, level of support, political issues, experiences of war, and traumatic events. It may be helpful to know the recent history of the region, common religious beliefs, and from which social class the patient originated. The clinician’s goal is to understand the patient’s former baseline life experience in their native country prior to migration.
What is the difference between Eastern and Western cultures?
In general, Eastern cultures favor a group identity, whereas Western cultures favor individual autonomy. Another significant difference is the concept of the body. Western societies tend to see the mind and body as separate, whereas Eastern societies tend to see the mind and body as a whole.
What are the external components of culture?
The external components include beliefs, laws, traditions, customs, morals, and habits; the internal components consist of norms, rules, standards, ideals, and values. Cultures also differ in their conception of personal identity.
What is culture in psychology?
Culture has many meanings and can be thought of as the beliefs, customs, technologic achievements, language, and history of a group of similar people (Johnson 1988). Alternatively, it can be thought of as the values, meaning, and behaviors that are transmitted by the dominant group.
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