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The interaction of culture and mental illness is the focus of the Clinical Manual of Cultural Psychiatry, which is designed to help mental health clinicians become culturally competent and skilled in the treatment of patients from diverse backgrounds. The product of nearly two decades of seminar experience, the book teaches clinicians when it is appropriate to ask "Is what I am seeing in this patient typical behavior in his or her culture?" The ability to see someone else's worldview is essential for working with ethnic minority and culturally diverse patients, and the author, who designed the course that was this handbook's precursor, has expanded the second edition to take into account shifting demographics and the changing culture of mental health treatment. The content of the new edition has been completely updated, expanded to include new material, and enhanced by innovative features that will prove helpful for mental health clinicians as they encounter diverse patient populations. The new chapter on women reflects the fact that mental health disparities extend beyond ethnic minorities. Women have significantly higher rates of posttraumatic stress disorder and affective disorders, for example, yet research on women has been limited largely to the relationship between reproductive functioning and mental health. Two new chapters address the alarming number of unmet mental health needs that lesbian, gay, bisexual, and transgender patients suffer from. These chapters emphasize the need for mental health providers and policy makers to remedy these disparities. A new chapter has been added to help clinicians determine the role religious and spiritual beliefs play in psychological functioning, because religious and spiritual beliefs have been found to have both positive and negative effects on mental health. The newly introduced DSM-5® Cultural Formulation Interview (CFI) is addressed in the book's introduction and is included in its entirety, along with an informant module, 12 supplementary modules, and guidelines for their use in a psychiatric assessment. In addition, the reader has access to videotaped examples using simulated patients to illustrate practical application of the DSM-5® Outline for Cultural Formulation and CFI. Extensive information on ethnopsychopharmacology, reviewing clinical reports of ethnic variation with several different classes of psychotropic medications and examining the relationship of pharmacogenetics, ethnicity, and environmental factors to pharmacologic treatment of minorities. The book updates coverage of African American, Asian American, Latino/Hispanic, and Native American/Alaskan Native cultures as they relate to mental health issues while retaining the nuanced approach that was so effective in the first edition. Course-tested and DSM-5® compatible throughout, the Clinical Manual of Cultural Psychiatry is a must-read for clinicians in our diverse era.
Building on their previous works about cultural competency in clinical areas and in psychotherapy, the editors have created in this volume an exceptional and entirely new approach to understanding and acquiring cultural competency. Instead of examining populations of different ethnic groups, particularly minority groups (as is typical in the literature), this illuminating volume examines cultural issues as applied to the practice of virtually every psychiatric service (e.g., inpatient, outpatient, consultation-liaison, pain management, and emergency) and specialty (e.g., child and adolescent, geriatric, addiction, and forensic psychiatry). Concluding chapters discuss cultural factors in psychopharmacology and psychotherapy. Thirteen distinguished contributors bring these issues to life with numerous case vignettes in all 11 chapters. The foundation for this breakthrough approach rests on Culture -- The unique behavior patterns and lifestyle that encompass a set of views, beliefs, values, and attitudes shared by a group of people that distinguish it from other groups. Culture and people influence each other reciprocally and interactionally -- on a conscious or unconscious level. Cultural competence -- Clinicians need to master cultural sensitivity, knowledge, and empathy; they need to be flexible, and they need to be skilled in culturally relevant doctor-patient relationships and interactions and to know how to use these elements therapeutically. The critical importance of cultural competence -- Clinicians typically work in multiethnic-cultural societies, providing care for patients of diverse backgrounds. For this reason, virtually all clinical practice can be seen as transcultural. Even when clinicians treat patients who share cultural backgrounds similar to their own, it is inevitable that some differences exist. Further, in the medical setting, three types of culture are present: the culture of the patient, the culture of the physician, and the medical culture in which the clinical work is practiced. Understanding these three cultural dimensions is essential to comprehending and carrying out culturally competent clinical work. This practical and innovative guide -- designed to help mental health care professionals meet the new requirements for cultural competence in clinical work -- will find a welcoming audience among students, residents, educators, and clinicians everywhere.
The publication of the Cultural Formulation Outline in the DSM-IV represented a significant event in the history of standard diagnostic systems. It was the first systematic attempt at placing cultural and contextual factors as an integral component of the diagnostic process. The year was 1994 and its coming was ripe since the multicultural explosion due to migration, refugees, and globalization on the ethnic composition of the U.S. population made it compelling to strive for culturally attuned psychiatric care. Understanding the limitations of a dry symptomatological approach in helping clinicians grasp the intricacies of the experience, presentation, and course of mental illness, the NIMH Group on Culture and Diagnosis proposed to appraise, in close collaboration with the patient, the cultural framework of the patient's identity, illness experience, contextual factors, and clinician-patient relationship, and to narrate this along the lines of five major domains. By articulating the patient's experience and the standard symptomatological description of a case, the clinician may be better able to arrive at a more useful understanding of the case for clinical care purposes. Furthermore, attending to the context of the illness and the person of the patient may additionally enhance understanding of the case and enrich the database from which effective treatment can be planned. This reader is a rich collection of chapters relevant to the DSM-IV Cultural Formulation that covers the Cultural Formulation's historical and conceptual background, development, and characteristics. In addition, the reader discusses the prospects of the Cultural Formulation and provides clinical case illustrations of its utility in diagnosis and treatment of mental disorders. Book jacket.
DSM-5® Handbook of the Cultural Formulation Interview provides the background, context, and detailed guidance necessary to train clinicians in the use of the Cultural Formulation Interview (CFI), which was created as part of the 2007-2013 DSM revision process. The purpose of the CFI -- and this unique handbook -- is to make it easier for providers to account for the influence of culture in their clinical work to enhance patient-clinician communication and improve outcomes. Cultural psychiatry as a field has evolved enormously from the days when it was principally concerned with epidemiological and clinical studies of disease prevalence; it now examines a multitude of issues, primary among them the differing patient, family, and practitioner models of illness and treatment experiences within and across cultures. The editors, all of whom have been intimately involved in the evolution of the field, have designed the book and accompanying videos for maximum instructional and clinical utility. The Handbook boasts many strengths and useful features, including: A detailed description of each of the three CFI components: a core 16-item questionnaire, which can be applied in any clinical setting with any patient by any mental health clinician; an informant version of the core CFI used to obtain information from caregivers; and 12 supplementary modules that expand on these basic assessments. This material facilitates implementation of the CFI by clinicians. Over a dozen clinical vignettes are included to illustrate use of the three components, and the Handbook also includes multiple videos that demonstrate the application of portions of the core CFI, and several supplementary modules. Strategies for incorporating the CFI into clinical training are identified and discussed, furthering the objective of developing culturally-sensitive and astute practitioners. The theoretical bases of the CFI are explored, raising questions for discussion and identifying areas for further research. The CFI is a valuable tool for all patients, not just those judged to be culturally different. The CFI has been called the single most practically useful contribution of cultural psychiatry and medical anthropology to clinical psychiatry, primary care, and medicine in general. DSM-5® Handbook on the Cultural Formulation Interview is the only book on the market that equips readers with the skills and insight to incorporate the CFI into practice, making it a critically important addition to the clinical literature.
This book offers practical advice on the role that cultural factors play in the way psychiatric symptoms are presented to clinicians.
Culture permeates human activity the world over. In today's technological "global village," people from very different cultures are interacting more closely and more often than ever -- making it critical for clinicians to understand and incorporate cultural dimensions into their daily practices. This volume offers a contemporary pragmatic understanding of how culture is inextricably intertwined with mental health and mental illness. In Chapter 1, the 17-member GAP Committee on Cultural Psychiatry begins by discussing the history (particularly within the last two decades) and scope of culture in clinical psychiatry. In Chapter 2, the authors describe 11 selected cultural variables that strongly influence clinical work: ethnic identity, race, gender and sexual orientations, age, religion, migration and country of origin, socioeconomic status, acculturation and acculturative processes, language, dietary influences, and education. In Chapter 3, the authors present a brief history and detailed analysis of the Cultural Formulation, the newest instrument for ensuring thorough clinical assessments, explaining its clinical use based on DSM-IV guidelines. In Chapter 4, the authors integrate the 11 cultural variables described in Chapter 2 with the use of the Cultural Formulation described in Chapter 3, producing an extraordinary cross-section of case vignettes: How the son of Irish Catholic immigrants struggles to reconcile old-country traditions with life in modern American society The sometimes painful and always complex process and outcomes of acculturation for a Pakistani Muslim family who had come to the United States for only a temporary period but ended up staying permanently Diagnosing social phobia in an Asian American, whose traditional reticence must be viewed within the context of Asian culture Loss of country of origin and family ties as catalysts leading to significant behavioral changes and severe depressive symptoms in an African immigrant tribesman from Kenya and the cultural context of his recovery The interplay of gender, age, and religion with developmental issues, personality organization, and symptom development for a "good Catholic girl" The existential, interpersonal, and clinical experiences of a Protestant minister from predominantly Catholic Ecuador, who came to the United States as pastor of an Hispanic church in a predominantly white city In Chapter 5, the authors conclude with a summary and suggestions regarding the complex issues raised by a thorough cultural assessment. Enhanced by a detailed index, this powerful work meets the significant -- and rapidly growing -- need for psychiatrists and other mental health professionals to understand the role of culture in psychiatry and to integrate this knowledge into their practice so that they can provide the most comprehensive and useful care to their patients.
Based on a recently completed project of cultural consultation in Montreal, Cultural Consultation presents a model of multicultural and applicable health care. This model used clinicians and consultants to provide in-depth assessment, treatment planning, and limited interventions in consultation with frontline primary care and mental health practitioners working with immigrants, refugees, and members of indigenous and ethnocultural communities. Evaluation of the service has demonstrated that focused interventions by consultants familiar with patients’ cultural backgrounds could improve the relationship between the patient and the primary clinician. This volume presents models for intercultural work in psychiatry and psychology in primary care, general hospital and specialty mental health settings. The editors highlight crucial topics such as: - Discussing the social context of intercultural mental health care, conceptual models of the role of culture in psychopathology and healing, and the development of a cultural consultation service and a specialized cultural psychiatric service - Examining the process of intercultural work more closely with particular emphasis oto strategies of consultation, the identity of the clinician, the ways in which gender and culture position the clinician, and interaction of the consultant with family systems and larger institutions - Highlighting special situations that may place specific demands on the clinician: working with refugees and survivors of torture or political violence, with separated families, and with patients with psychotic episodes This book is of valuable use to mental health practitioners who are working in multidisciplinary settings who seek to understand cultural difference in complex cases. Psychiatrists, psychologists, social workers, nurse practitioners, primary care providers and trainees in these disciplines will make thorough use of the material covered in this text.
This work is a vital set of insights and guidelines that will contribute to more aware and meaningful practice for mental health professionals. Focusing equally on theoretical concepts, culturally valid assessment methods, and cultural adaptation in trauma and resilience, an array of experts present the cutting edge of research and strategies. Extended case studies illustrate an informative range of symptom profiles, comorbid conditions, and coping skills, as well as secondary traumas that can occur in asylum seekers.
Cultural psychiatry is primarily concerned with the transcultural aspects of mental health related to human behavior, psychopathology and treatment. At a clinical level, cultural psychiatry aims to promote culturally relevant mental health care for patients of diverse ethnic or cultural backgrounds. From the standpoint of research, cultural psychiatry is interested in studying how ethnic or cultural factors may influence human behavior and psychopathology as well as the art of healing. On a theoretical level, cultural psychiatry aims to expand the knowledge and theories about mental health-related human behavior and mental problems by widening the sources of information and findings transculturally, and providing cross-cultural validation. This work represents the first comprehensive attempt to pull together the clinical, research and theoretical findings in a single volume. Key Features * Written by a nationally and internationally well-known author and scholar * The material focuses not only on the United States but also on various cultural settings around the world so that the subject matter can be examined broadly from universal as well as cross-cultural perspectives * Proper combination of clinical practicalities and conceptual discussion * Serves as a major source for use in the training of psychiatric residents and mental health personnel as well as students of behavior science in the areas of culture and mental health * A total of 50 chapters with detailed cross-referencing * Nearly 2000 references plus an appendix of almost 400 books * 130 tables and figures