Elements of Culture and Mental Health Critical Questions for Clinicians

It is not enough for mental health professionals to make best use of the evidence base; they must also ensure that interventions are culturally appropriate, acceptable and ethical. This is a very complex task - to work with culturally diverse populations who may not expect the same sort of treatments or interventions or even assessment processes as the cultural majority. How can professionals work confidently with people from diverse cultural backgrounds, engage with the emotional and professional demands, and be more creative about how to improve the quality of care and the take up of care? This short volume, developed by service users, practitioners, teachers and researchers, aims to address this issue. Each chapter is a concise, thought-provoking, engaging and creative essay about a clinical scenario that is central to improving the quality of care to culturally diverse populations. The scenarios are common, and the essays set out beautifully some of the obstacles to improving care, dilemmas facing the clinician, and how they might be overcome.

Foreword. Desire and commitment: essential ingredients to learn about cultural and mental illness; 1. Is trauma-focused therapy helpful for survivors of war and conflict?; 2. Will ethnopsychopharmacology lead to changes in clinical practice?; 3. Does cognitive-behavioural therapy work in people with very different cultural orientations and backgrounds?; 4. Can you do meaningful cognitive-behavioural therapy with an interpreter?; 5. Are specific psychotherapeutic orientations indicated with specific ethnic minority groups?; 6. Can psychotherapeutic interventions overcome epistemic difference?; 7. The role of culture and difference in evaluation, assessment, and diagnosis; 8. Necessary and sufficient competencies for intercultural work; 9. The validity of existing Eurocentric diagnostic categories; 10. What are the limitations and benefits of the cultural formulation in intercultural work?; 11. Barriers to the intercultural and interracial therapeutic relationship and how to overcome them; 12. How does intercultural interpretation work in the mental health setting?; 13. Do the power relations inherent in medical systems help or hinder in cross-cultural psychiatry?; 14. Recovery and well-being: a paradigm for care; 15. Social perspectives on diagnosis; 16. Public mental health and inequalities; 17. Does psychotherapy work through an interpreter?; 18. Can race and racism be recognised and acknowledged in the transference in the therapeutic setting without it becoming a source of therapeutic impasse?; 19. Cultural competence: models, measures and movements; 20. Spirituality and mental health.