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.
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
The American Psychological Association (1993) guidelines acknowledge the necessity of assessing individuals in the context of their ethnicity and culture, respecting their indigenous beliefs and practices (including those involving religion and spirituality), assessing the patients’ support systems, evaluating the patients in their primary language, and taking a history that accounts for immigration and acculturation stresses.
In summary, the consideration of cultural factors in the assessment, diagnosis, and treatment of culturally diverse individuals has gained recognition in a variety of disciplines in the last decade.In this chapter, we present a brief history of psychiatric case formulation; define culture, ethnicity, and race; and focus on an explication and elaboration of the DSM-IV outline for cultural formulation. Aspects of cultural formulation include assessing a patient’s cultural identity and understanding how culture affects the explanation of the individual’s illness, support system, and the clinician-patient relationship as well as understanding how culture affects the assessment and diagnosis of culturally diverse individuals
From a clinical point of view, understanding the patient’s view of his or her illness helps determine our assessment and our treatment plan. Different cultures express their symptoms differently (Kleinman 1988), and concepts of illness also vary with culture. For example, for the Chinese in Hong Kong, Cheung (1987) found that patients had three explanatory models for mental disorders. They could explain their illness as based on psychological, somatic, or mixed factors. Their explanation of the illness influenced how they went about getting help. The patients who had purely psychological explanations were the least likely to seek help. Because of this, Cheung recommended that clinicians specifically inquire about psychological symptoms, because these patients were not likely to volunteer them.
Special Issues in Assessment
Professionals working in systems that link treatment and corrections must be aware of a broad range
of special issues in assessment related to clients' gender, culture, ethnicity, sexual orientation,
educational level, religious affiliation or spirituality, and other such sociocultural characteristics. Issues
related to a number of these characteristics are discussed below.
It may be necessary to perform the assessment in the primary language of the individual, which may
not be English. Assessors should avoid the assumption that a speaker of any given language can also
read that language. The client may not be functionally literate in any language. Another part of the
staff member's sensitivity to language should be an awareness that the client may need to
communicate in "street language." The assessor should be attentive to the kind of vocabulary that the
individual client feels most comfortable using. To the extent possible, concepts should be stated in lay
language, even street language, if appropriate,...
Please join StudyMode to read the full document