Flashcards in Cultural Deck (27)
Gilligan viewed kohl bergs theory of moral development in what way? How did she think of it?
Thought is was based on men. She said male morality is more law and rule centered.
Female morality is based on caring and compassion.
What is the difference between emic and etic?
Etic is a non cultural specific approach that looks at universal principles, like Maslow. Using cultural general or universal criteria for all cultures . Views different cultures through the same lens.
Emic is a culture specific approach. Looking from the inside. Intrinsic distinctions that are meaningful to members, like Gillian.
Why do ethnic minorities tend to be under served or I appropriately served by the mental health care system?
Most important variable is the inability of therapists to provide culturally responsive tx.
Also, less acculturated individuals tend to prefer a racially similar therapist.
New immigrants often have family conflict over different levels of acculturation. Often psych distress 1 or 2 years after arrive...figure out country not all thought it would be; reality of leaving home and difficulty of it sets in.
Describe berry's acculturation model.
I A S M
Proposed a multidimensional construct with two independent dimensions that make 4 modes.
Retention of one's minority culture
Maintenance of mainstream culture.
1. Integration. Hi retention of minority, hi mainstream. Synthesis of two cultures.
2. Assimilation. Lo minority, hi mainstream. Movement to dominant culture. Moderate stress
3. Separation. Hi minority. Reject mainstream. Retain original and reject dominant. Hi stress
4. Marginalization. Lo minority. Lo mainstream. Hi stress
What is the stance on therapist/client racial similarity?
Most believe similarity by itself is not related to outcome. May reduce premature termination. Other factors include:
Attitude similarity..may he crucial factor for preference
Therapist sensitivity..important for alliance.
Racial/cultural identification..stronger identification, stronger preference for racially similar tx
Who does the minority identity model apply to and what are the 5 stages?
African Americans and other oppressed minority groups.
One: conformity..prefer dominant
Negative to own culture
Positive toward dominant
Prefer majority grp therapist
Question dominant grp
Ethnically matched therapist
Three: resistance and immersion
Combat racism; hate white
Ethnically matched therapist
Question absolute stance, conflicted
Five: synergistic articulation and awareness
Objectively examine; resolves conflict
Tx w attitudes and beliefs most similar to ct ; desire rid of oppression.
What is helms white racial identity developmental model?
Based on the assumption that racial identity status affects how ppl relate and distinguishes 4 intx patterns: parallel, regressive, progressive, crossed. This model has two phases...abandonment of racism
Defining non racist white identity.
6 sequential Stages:
Contact..ignorance, unaware diff
Disintegration intx leads awareness
Reintegration whites superior
Immersion-emersion..don't reject minorities
Autonomy...non racist based on objective view
Model of psychological nigrescence?
5 stage development of an African American identity
Pre encounter..blame black for prob
Encounter leads to search identity
Internalization resolve conflicts, open. Some white pals
Communication can be a barrier in tx. Discuss hi and lo context communication.
Hi context communication relies on restricted codes. Words and sentences shortened without loss of meaning. Relies on non verbal, culturally defined messages.
African American, Asian, Hispanic and Native American.
Lo context communication
Emphasizes direct, verbal messages and elaborated codes
How does healthy cultural paranoia and power/status position impact tx?
Blacks may be less willing to disclose to white. Tx should help bring feelins abt white ppl into cs awareness and identify when it is safe to disclose.
Lower status ppl better at reading higher status grp. White tx may be less familiar w experiences of minority.
What is a culturally encapsulated therapist?
Someone who defines reality according to own beliefs, stereotypes. Insensitive to variations, disregards evidence disproving their assumptions
Compare to cultural universality...
Western concepts of normality considered universal and applicable across all cultures.
Culturally competent...appreciates differences.
Define cultural overgeneralization.
Cultural overgeneralization. Is when tx assumed all presenting problems are directly related to culture vs other factors. Contributes to drop out and underutilization.
Dx overshadowing ...attribute all problems to dx while other explanations, diagnosis not considered.
Ethnic matching is not consistent regarding outcome. It does seem to increase Treatment durations
And Decreased drop out rates.
All ethnic groups especially Asians and less so African Americans.
What should therapists be aware of according to sue?
1. Language. Verbal expression valued in us. Standard English not used by bilingual ppl.
2. Nonverbal styles vary re: eye contact and gestures etc..
3. Middle class values...framework of tx doesn't work for lower income cts. Ie. more concerned with immediate concerns and want advice and not explore in depth
4. Culture bound values...if formal, structured culture and in open ended tx that is hard. Some taught only talk to authority when spoken to. Individual vs collective value
Verbal, emotional, behavioral expressiveness is often goal but not so for all cultures. Or may make uncomfortable.
Healthy cultural paranoia...distrust of whites. Normal rx to racism. Should not be viewed as pathological.
How conduct tx with African American pts?
More brief and concise statements
Less verbal and more emotionally expressive
Work with analogy
Emphasis on nonverbal
Make less eye contact ESP when listening
Benefit from time limited, problem solving, child focused
Expect tx to be active and directive
Acknowledge discrimination may be part of problem and part of their life.
Multi systems approach..family, non bold, outside systems
Need to tend to cultural issues but not over emphasize.
Latino family needs?
Close knit and aware of importance of family
Rigid sex roles
Prefer personal contact/ attention
Short term goals
Don't seek tx bc lack bilingual tx, unwilling to seek help outside family, less concern over psych issue.
Cuento therapy...read folktales and grp discussions; dramatize. Original and rewritten form (Americanized).
Family, age, sex determine social roles.
Families are traditional, patriarchal, respectful of elders
Family and cultural roles defined and rigid
Problems addressed within family (underuse of mental health)
Directive , structured, short term
Reserved and rigid in tx; hard to talk about problems ESP emotional ones
Couch in academic or vocational issue
Benefit from told expectations ahead of time.
New immigrants and their needs
Different levels of acculturation.
Most likely to experience distress one or two years after getting here. Problems set in...not all thought it would be.
Discuss utilization of mental health services by minority groups, inpatient and outpatient.
Outpatient: in general, minorities under represented in outpt services.
Asian and Mexican under represented relative to their proportions in the population
African Americans..over represented. However, AA generally had less positive outcomes than whites, Asian, Mexican. Also tended to terminate more quickly.
Inpatient: ethnic minorities over represented as inpatients at state and county mental hospitals.
What is important when working with a Native American?
Knowledge of tribe and family system.
Prefer non directive, hx oriented, accepting, cooperative approach.
Goal often happiness, wisdom or peace vs fix problem.
Tx...reserved, open, accepting, willing to listen.
Discuss tx with older clients.
Need to avoid stereotypes (they are physically or mentally impaired, irritable, resistant to change). Found intellectual stability and tend to stay active and involved.
Under use mental health. Underuse outpt. Over rep inpt
When seek outpt..deal w changes that occur in later life..need to integrate all aspects.
Remember common occurrence of depression in elderly
Specific tx for elderly...
Reminiscence therapy...life review to accept successes and short comings. Stress resolution and future goals. Usually grp and tends to decrease sx of depression.
Apa...older may respond slower to tx but few significant differences in effectiveness compared to young. Tailor to them may increase effectiveness.
Tx with gay and lesbian cts
Consider how comfortable with status, process of coming out, gay identity.
Know support systems and if benefitting
HIV an issue?
Cass model of homosexuality development. 6 stage, non age specific
Troidens model. Four age related stages.
Identity awareness. Cs different
Identity comparison..acts hetero
Identity tolerance..realize homo
Identity acceptance..explore gay community
Identity pride..active in community
Synthesis accepts self and others
Sensitization...b4 puberty; homo feelings wo understand them. Sense of differentness but more related to gender.
Identity confusion..self recognition
Adolescent males 17 yrs; female 18
And feeling excluded from world.
Conflict. Some try be heterosexual
Identity assumption...comes out
19-21 male; 21-23 female
Reduce isolation; increase gay contacts. Can immerse in gay community and still have negative feelings about it.
Id commitment..adopt lifestyle
21-24 males; 22-23 females
More open about their life style
What is a good replacement word for homophobia and why?
Sexual prejudice is more descriptive and doesn't convey any assumptions about the origins of attitudes.
More encompassing term.
According to the minority stress model, what are the distal and proximal factors that contribute to mental health outcomes for gay,..populations?
Expectation of rejection
Concealment of sexual orientation
Minority group status
Exposure to prejudice events like discrimination and violence
Prejudice, discrimination, stigma linked to mental health probs.
The steps in the nigrescence models are:
Pre encounter or conformity
Encounter or dissonance
Immersion-emersion or resistance and immersion
Internalization or integrative awareness.
Preencounter..prefer dominant culture; deracinated
Conflict old attitudes and new
Resistance and immersion
Strong id w minority and reject dominant
Acceptance and valuing self and dominant culture