Review of Strategies for building multicultural competence in mental health and educational settings.

Reviews the book, Stategies for building multicultural competence in mental health and educational settings edited by M. G. Constantine and D. W. Sue (2005). Strategies for Building Multicultural Competence in Mental Health and Educational Settings is an excellent resource designed for mental health professionals who may lack knowledge and expertise in working with diverse clients. It provides hands-on strategies and suggestions in a variety of contexts, using the Multicultural Guidelines as a framework. This book is strongly recommended for clinicians working with culturally diverse populations. The Surgeon General's report Mental Health: Culture, Race and Ethnicity (U.S. Department of Health & Human Services, 2001) clearly demonstrates the disparity in the mental health care of racial and ethnic minorities as compared with Whites. This book is useful not only to novices exploring diversity but also to those who are already cross-culturally competent. The authors successfully apply the APA Multicultural Guidelines in clinical practice and educational, training, and organizational settings while providing specific strategies for clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multicultural research and practice: Theoretical issues and maximizing cultural exchange.

This article reviews literature on cross-cultural approaches to assessment, research, and clinical practice, culminating in recommendations for using a “cultural exchange” approach when working with multicultural clients. It examines challenges in studying culture and mental illness, including methodological issues and problems in defining constructs in multicultural research. Measurement of disorders cross-culturally, including efforts to validate depression measures for use with multicultural populations, is also discussed. Perspectives on cultural competence are presented, including the American Psychological Association Multicultural Guidelines, and a “cultural exchange” approach to therapy is presented as a tool for maximizing the benefit of therapy with multicultural clients. Three clinical vignettes are presented to illustrate the use of this approach and how identifying the commission of Type I and Type II multicultural errors can enhance clinical work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward cultural competence in child intake assessments.

As cultural diversity within the U.S. population increases, cultural competence in service delivery to children, youths, and families is a growing necessity. This article presents a process for integrating assessment of cultural data with the traditional intake assessment in children's mental health. The purpose and process of integrating cultural assessment throughout the child intake are presented. By using the cultural formulation guidelines proposed in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), the content of a culture-integrated assessment is conceptualized and organized. The purpose of this article is to assist child, youth, and family psychologists with developing applied cultural competency skills in the context of the intake assessment with children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-Behavioral Therapy With Chinese American Clients: Cautions and Modifications.

The purpose of this article is to examine the application of cognitive-behavioral therapy (CBT) in working with Chinese American clients with a focus on exploring the potential weaknesses and providing modifications for effective therapy with this population. The contents include (a) an overview of CBT, (b) Chinese American cultural values, (c) parallels between Chinese cultural norms and philosophy of CBT, and (d) cautions and modifications when applying CBT to Chinese American clients. Because of its high level of compatibility with Chinese values, beliefs, and cultural characteristics, CBT, with a few modifications, appears to be a viable model when working with Chinese American clients in a short-term therapy setting or in the beginning phase of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural socialization in families with internationally adopted children.

Cultural socialization attitudes, beliefs, and parenting behaviors were examined in families with internationally adopted children. The authors hypothesized that parents with lower color-blind racial attitudes would be more likely to engage in enculturation and racialization parenting behaviors because they hold stronger beliefs in the value and importance of cultural socialization. Using data from the Minnesota International Adoption Project, the results support this mediation model of cultural socialization. Individual variations in cultural socialization also are discussed in terms of child development and shifting adoption attitudes and practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive neuroanatomy of language: contribution of functional cerebral imaging]

Each year a number of Haitians enter the United States and may become part of the U.S. health care system. Nurses need to be sensitive to cultural differences and should assess clients for special needs that may arise because of cultural diversity. This article provides strategies for interacting with the Haitian American client in a clinical setting to ensure success in providing nursing care.     

Improving mental health services for Latino and Asian immigrant elders.

Given the changing demographics of the aging population in the United States, it is likely that professional psychologists will encounter elderly clients from diverse backgrounds in their practice. Asians and Latinos represent the 2 fastest growing groups of elderly immigrants. This article offers information and practical suggestions to assist clinicians working with elderly Asian and Latino immigrant clients. Specific recommendations for enhancing assessment and treatment efficacy with these populations are also provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociodemographic diversity and behavioral medicine.

The broad array of economic and cultural diversity in the U.S. population correlates with and impacts on the study of behavioral aspects of health. The purpose of this article was to provide a selective overview of behavioral medicine research on sociodemographically diverse populations, with a focus on ethnicity, gender, and socioeconomic status. Suggestions are provided with regard to methodological refinement of research and insights into possible future directions in behavioral medicine research on ethnically and economically diverse populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Radiographic and endoscopic evaluation of the upper GI tract

As the U.S. population grows increasingly diverse, health care professionals will need to develop skills that allow them to provide quality care to patients from a variety of racial and ethnic backgrounds. Chief among these skills is the ability to communicate effectively. This article discusses the demographic shifts occurring in the United States today and reviews the concept of cultural diversity. It also presents information about how to communicate with patients from diverse cultural backgrounds.     

Current perspectives on using linguistic and cultural factors in counseling the Hispanic client.

This review of the literature examines the role of language and culture in the mental health treatment of Hispanic clients. Several innovative approaches including the use of dichos and cuento therapy are described that incorporate linguistic and cultural traits in treatment. The article proposes that the assessment of such factors as language proficiency, level of acculturation, and the degree to which cultural expressions represent symptomatology should be considered in the development of an effective treatment plan. The process of acculturation is presented as a critical dimension influencing language, cultural beliefs, and mental health. Recommendations are made for future research on issues relating to the use of language switching and language mixing in therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural considerations when providing rehabilitation services to American Indians.

American Indians make up a small percentage of the U.S. population but reside in all states and territories and in all major cities. It is critical for rehabilitation psychologists to have an understanding of the unique cultural and ethnic issues associated with service provision to American Indian clientele. Considerations to be taken into account when providing culturally competent care to American Indians include general knowledge about sociopolitical history and current demographics, acculturation and racial identity, important health issues, and beliefs about health and illness. This article provides a brief introduction to facilitate more effective and culturally appropriate rehabilitation and health care to patients of American Indian heritage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics and multiculturalism: Advancing cultural and clinical responsiveness.

The provision of ethical and responsive treatment to clients of diverse cultural backgrounds is expected of all practicing psychologists. While this is mandated by the American Psychological Association’s ethics code and is widely agreed upon as a laudable goal, achieving this mandate is often more challenging than it may seem. Integrating culturally responsive practices with more traditional models of psychotherapy into every practitioner’s repertoire is of paramount importance when considering the rapidly diversifying population we serve. Psychologists are challenged to reconsider their conceptualizations of culture and of culturally responsive practice, to grapple with inherent conflicts in traditional training models that may promote treatments that are not culturally responsive, and to consider the ethical implications of their current practices. Invited expert commentaries address how conflicts may arise between efforts to meet ethical standards and being culturally responsive, how the application of outdated theoretical constructs may result in harm to diverse clients, and how we must develop more culturally responsive views of client needs, of boundaries and multiple relationships, and of treatment interventions. This article provides additional considerations for practicing psychologists as they attempt to navigate dimensions of culture and culturally responsive practice in psychology, while negotiating the ethical challenges presented in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Congruence between culturally competent treatment and cultural needs of older Latinos.

This study investigated a new 2-factor construct, termed cultural congruence, which is related to cultural competence in the delivery of mental health services to ethnic minority clients. Cultural congruence was defined as the distance between the cultural competence characteristics of the health care organization and the clients’ perception of those elements according to their cultural needs. The measure evidenced both reliability and validity in predicting criterion-related indicators. Older Hispanic/Latino clients (N = 272) receiving mental health services either through integrated primary care or referral to specialized mental health care were assessed for depression and anxiety symptomatology and health status at baseline, 3-, and 6-month follow-up treatment. Results indicated that cultural congruence predicted treatment outcomes (reduction of symptomatology) independent of treatment and evidenced moderator effects with respect to depression, suicidality, anxiety, and physical health criteria. Cultural congruence was more effective under the condition of the enhanced specialty referral model than under the integrated primary care model. Results are discussed in terms of how the new construct of cultural congruence extends knowledge of culturally competent mental health practice among the older Hispanic/Latino population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do therapists address ethnic and racial differences in cross-cultural psychotherapy?

Ethnic and racial differences between client and therapist affect therapy processes and outcomes, but little is known about the extent to which therapists have dialogues about their differences in therapy. A survey on this topic was completed by 689 APA-licensed psychologists with experience conducting cross-cultural therapy. Most psychologists reported having such discussions, but with less than half of their cross-ethnic/racial clients. Therapists and clients were equally likely to initiate discussions. Reasons for discussing differences varied greatly. Therapists consistently described themselves as comfortable with and skilled at these discussions, and reported that discussions facilitated therapy. Therapists who were female, older, nonminority, less experienced with diverse clients, and viewed training as an important factor were more likely to have discussions about differences. Results point to the need to better understand if, when, and how ethnic and racial differences should be addressed in therapy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Beyond instrument selection: Cultural considerations in the psychological assessment of U.S. Latinas/os.

Currently the second largest U.S. ethnic group, U.S. Latinas/os are projected to continue increasing as a proportion of the U.S. population over the next century. The culturally competent psychological evaluation of U.S. Latinas/os requires both the use of instruments that are adequately validated in that population and the adequate consideration of culturally linked factors known to influence the assessment process and its findings. This article makes foundational recommendations in this second area, organizing them along 4 stages of professional practice in psychological assessment. Consultation with qualified professionals is discussed as being important in ensuring the accurate and ethical psychological assessment of U.S. Latinas/os at all stages of professional practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Program evaluation for organizational cultural competence in mental health practices.

Mental health practices that lack cultural competence prevent diverse clients from receiving the care they deserve. As providers and program administrators, psychologists currently have a responsibility to ensure high quality of care for diverse clients at the clinic level. This article deciphers extant empirical research, organizational theory, public policy literature, and best practices to identify which recommendations are most relevant for those in small mental health practices and clinics. The authors present 10 components for culturally appropriate care, ranging from policies and procedures to needs and satisfaction level of clients. This overview can be used to help evaluate and develop a mental health practice's ability to meet the needs of diverse clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing and treating culturally diverse clients: A practical guide.

Reviews the book, Assessing and treating culturally diverse clients: A practical guide by Freddy A. Panaigua (see record 1996-97152-000). This book is a timely and provocative delineation of highly relevant considerations to be made by counselors, psychotherapists, and other mental health professionals in the delivery of services to multicultural groups. The book deals with four ethnic populations in the United States—African American, Hispanic, Asian, and American Indian. Panaigua's contribution is part of a series on Multicultural Aspects of Counseling by Sage Publications. The purpose of the series is to increase the mental health practitioner's knowledge and sensitivity to cultural differences and to assist in alleviating bias in the therapeutic process. This purpose is accomplished with precision and insight by Panaigua. Unlike some other books dealing with cultural diversity, Panaigua's work offers specific treatment methods which have been demonstrated to be successful in treating members of the targeted groups. Problem solving and social skills training are recommended in some cases. In other instances, assertiveness training, music therapy, or direct advice are the modalities of choice. In other cases, education, medication, or behavioral approaches are preferred. Assessing and Treating Culturally Diverse Clients can serve the educational needs of graduate students in the fields of psychology, counseling, family therapy, and social work. It is an excellent guide for use in either the training or practice of these helping professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loss, psychosis, and chronic suicidality in a Korean American immigrant man: Integration of cultural formulation model and multicultural case conceptualization.

Culture shapes the nature, experience, and expression of psychopathology and help-seeking behavior across ethnically diverse groups. Although the study of psychopathology among Asian Americans has advanced, clinicians remain in need of culturally appropriate tools for the assessment and diagnosis of severe mental disorders including psychotic symptoms among Asian Americans. In this article, we present a brief overview of two culturally relevant conceptual tools: a) the Cultural Formulation Model, and b) the Multicultural Case Conceptualization approach. We use a case scenario to illustrate the integration of these two approaches in providing culturally responsive clinical conceptualization, assessment and treatment of a Korean American immigrant suffering from prominent psychiatric symptoms. We intend this discussion to engender further empirical work to advance our knowledge of the manifestation and experience of severe mental illness including psychotic disorders among Asian Americans, and contribute to culturally competent prevention and intervention of chronic and persistent mental illness within this group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial/ethnic disparities in therapist effectiveness: A conceptualization and initial study of cultural competence.

As a result of mental health disparities between White and racial/ethnic minority clients, researchers have argued that some therapists may be generally competent to provide effective services but lack cultural competence. This distinction assumes that client racial/ethnic background is a source of variability in therapist effectiveness. However, there have been no direct tests of the therapist as a source of health disparities. We provided an initial test of the distinction between general and cultural competence by examining client racial/ethnic background as a source of variability in therapist effectiveness. We analyzed cannabis use outcomes from a psychotherapy trial (N = 582) for adolescent cannabis abuse and dependence using Bayesian multilevel models for count outcomes. We first tested whether therapists differed in their effectiveness and then tested whether disparities in treatment outcomes varied across therapist caseloads. Results suggested that therapists differed in their effectiveness in general and that effectiveness varied according to client racial/ethnic background. Therapist effectiveness may depend partially on client racial/ethnic minority background, providing evidence that it is valid to distinguish between general and cultural competence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)