Cultural Awareness in Therapy with American Indian Clients. By Patti Higgins. Guidelines APA & DSM-IV. American Psychological Association and the Diagnostic and Statistical Manual IV recommend several guidelines and ethical principles regarding treatment of culturally diverse clients.
America's multicultural society needs increased development, implementation and assessment of culturally sensitive drug and alcohol awareness, prevention and treatment programs (Gordon, 1994).
Ellen (1999) reported that the increasingly diverse U.S. population indicates a need to focus on culturally competent interventions. Existing research emphasizes the urgency of culturally competent treatment models (Ellen, 1999).Culturally sensitive therapy
Studies have revealed that people generally develop a rapport more easily with people from similar ethnic backgrounds than with those from different ethnic backgrounds (Diller, 1999).
People of color have been turned off by the one-size-fits-all approaches (Diller, 1999).
Ask about clients’ background, beliefs, customs, traditions, etc. in order to get to understand them better. Respect their differences!Cultural rapport-building
includes information on the use of assessment in general and with special populations. It states:
(a) Psychologists who perform interventions or administer, score, interpret, or use assessment techniques are familiar with the reliability, validation, and related standardization or outcome studies of, and proper applications and uses of, the techniques they use.
(b) Psychologists recognize limits to the certainty with which diagnoses, judgments, or predictions can be made about individuals.
(c) Psychologists attempt to identify situations in which particular interventions or assessment techniques or norms may not be applicable or may require adjustment in administration or interpretation because of factors such as individuals' gender, age, race, ethnicity, national origin, religion, sexual orientation, disability, language, or socioeconomic status. (APA, 1992)
Koocher and Keith Spiegel (1998) illustrate need to investigate before diagnosing. 5-year-old Native American girl who was in critical need of an organ transplant gained inspiration from talking to dead ancestors. Talking to dead is not unusual for Indians and does not signify disorder.
Need for understanding culture is reflected in the DSM-IV’s section on cultural factors to consider. It includes an outline for cultural formulation and a glossary of culture-bound syndromes.Cultural differences - not disorders
Healer and client both bring to the session investigate before diagnosing. 5-year-old Native American girl who was in critical need of an organ transplant gained inspiration from talking to dead ancestors. Talking to dead is not unusual for Indians and does not signify disorder.
a set of assumptions about the nature of the
universe, sociocultural models, the type of
information that promotes healing, how it should be applied and why it works. Cross-cultural observations tell us that the more congruent these assumptions are between healer and healee, the more likely it is that healing will happen. (Gagan, 1998, p. 42)
Sacred dances investigate before diagnosing. 5-year-old Native American girl who was in critical need of an organ transplant gained inspiration from talking to dead ancestors. Talking to dead is not unusual for Indians and does not signify disorder.
Shamans, medicine men
Healing ceremoniesHealing practices
“Culture is not a vague or exotic label attached to faraway persons and places, but a personal orientation to each decision, behavior, and action in our lives” (Pedersen, 1988, p. vii).