Culture and symptomatology--the role of personal meaning in diagnosis and treatment: a case study

Cultural Diversity in Grief

"Culture in its broadest sense, is what makes you a stranger when you are away from home. It includes all those beliefs and expectations about how people should speak and act which have become a kind of second nature to you as a result of social learning. However, direct exposure to an alien society usually produces a disturbing feeling of disorientation and helplessness that is called 'culture shock.'"1 This article explores various cultures and beliefs and attitudes concerning death and grief. By reexamining attitudes toward patients of different cultures and gaining understanding of their cultures and psychosocial environment, the caregiver begins to develop cultural competence in dealing with cross- cultural issues.

Multicultural Assessment:

Current suggestions for assessing clients across cultures fail to adequately aid the average practitioner This failure arises from unresolved issues and problems, interfering with the ability of most counselors and therapists to render sound clinical judgments. In response to these issues and problems, a procedure is described that sensitizes counselors to cultural data in assessment and case conceptualization. Grounded in a guiding philosophy of assessment, the Multicultural Assessment Procedure (MAP) was developed in consideration of a number of relevant critical issues. The procedure entails identifying cultural data through multiple methods of data collection, interpreting cultural data to formulate a working hypothesis, incorporating cultural data with other relevant clinical information to test the working hypothesis, and arriving at a sound (i.e., comprehensive and accurate) assessment decision. A case illustration demonstrates how to use the proposed procedure.

Barriers to mental health care for Hispanic Americans: a literature review and discussion

The Hispanic American population, the second largest and fastest growing minority population in the United States, faces barriers to access to both medical health and mental health care. This paper examines both financial and cultural barriers to utilization of mental health care services; it is a broad review of the literature and is not intended to be comprehensively detailed. The research review suggests that the financial barrier is a major determinant of mental health service access for Hispanic American populations. Also, nonfinancial barriers such as acculturation are examined. A two-part plan is suggested to reduce both financial and nonfinancial barriers. Very little literature on utilization of substance abuse services was found; suggestions for further research are thus proposed.