An important step during the initial evaluation of clients from culturally diverse groups is the assessment of culture-specific disorders known as “culture-bound syndromes” (e.g., koro among some Asian clients, and ataques de nervios among some Hispanic clients). This chapter suggests that these culture-specific disorders should be distinguished from generic cultural variables (e.g., acculturation, religion rituals, and social unrest) that might also explain symptoms suggesting a given mental disorder. This distinction is accomplished with the identification of those generic cultural variables across most mental disorders in the DSM-IV-TR (APA, 2000).

Inhaltsübersicht: Contributors, Preface, I. Overview Theory, Models, and Demographics, II. Methodology, III. Assessment and Treatment, IV. Training in Cultural Competence, Index.

Spirituality and culture are both recognized as important elements for providing culturally competent mental health services to ethnically and religiously diverse populations. They rarely, however, are considered together within a common conceptual framework. In this chapter, relationships between religiousness, spirituality, acculturation, and theological understandings of inculturation (e.g., how religious/spiritual beliefs and practices cannot be understood apart from their cultural context) are explored. Empirical evidence regarding the influence of religion and spirituality on mental health, as well as the effectiveness of spiritually and culturally accommodative approaches to treatment is also examined. Finally, the impact of spirituality and culture on mental health interventions is considered within two different paradigms: (a) how psychotherapy may be adapted to be more culturally sensitive to diverse populations, and (b) how indigenous notions of well-being, illness, and healing may help mental health providers broaden their notions of interventions.

In this chapter, the authors discuss the assessment, diagnosis, and treatment of mental disorders among American Jewish populations. Information about American Jews is provided, including important contextual information on antisemitism and Christian privilege. This is followed by attention to the assessment of American Jews in clinical settings (including clinical interviewing, psychological testing, and other forms of assessment), diagnosis (including cultural bound conditions), and treatment (including culturally responsive treatment and issues related to Jewish identity). Differences between and within Jewish subgroups (e.g., Orthodox vs non-Orthodox) are highlighted and discussed. Future research directions are also offered.

A major challenge for mental health professionals who seek to practice effectively in contemporary US society is the increasing cultural diversity of the population. This chapter examines the competencies required for effective mental health practice with culturally and linguistically diverse clients. It also explores curriculum development and training strategies for implementing these competencies that are crucial for preparing graduate students as well as professionals to respond to the challenges posed by the demographics in contemporary US society. The chapter proposes using the Cultural Competence Continuum as a tool for self-examination, and proposes an integrated etic–emic approach for addressing the domains of awareness, knowledge, and skills in cultural proficiency training.

The goal of the first part of this chapter is to understand the uniqueness of the military as a culture. Next the chapter provides an overview of sociocultural constructs associated with military culture. The second part of the chapter presents an overview of diversity elements (e.g., gender, sexual orientation) intersecting with military culture. Understanding the diversity within the US Armed Forces is clinically relevant for culturally responsive mental health service delivery to military service members. The third part of this chapter addresses military cultural issues with potential to affect the mental health of military service members. We describe mental health challenges that have been experienced by military personnel in light of the conflicts in Iraq and Afghanistan and the US involvement in the Global War on Terror, and highlight the resilience of this population under stress. We conclude with recommendations for culturally competent treatment approaches for working with military service members.

The chapter focuses on multicultural issues in the definition, epidemiology, diagnosis, assessment, and treatment of racially and ethnically diverse clients with intellectual disabilities (IDs). Prevalence rates of mental health problems for persons with IDs are significantly higher than their peers without IDs. Psychological assessment and treatment are especially complex with persons from culturally diverse groups with IDs. Despite the growing recognition of the importance of considering diversity issues, there is a paucity of appropriate assessment measures and methods, evidence-based interventions, and clinicians trained to address the mental health needs of racially and ethnically diverse people with IDs and related disabilities. Recommendations for future directions and research are discussed.

This chapter provides an overview of research on the mental health of Latinos in the United States with emphasis on the cultural constructs and theories with relevance for assessment and intervention with this population. A distinction is made between factors that confer advantages and those that may increase vulnerability at both the individual and environmental levels. This chapter suggests that treatment considerations need to be tailored based on individual needs that incorporate complexities of culture and gender so that clients are not viewed in a stereotypical manner. This discussion is followed by a summary of contemporary research rooted in positive and resilience psychology in order to build on strengths within the culture, such as positive ethnic identity, civic engagement, family support, bicultural teaching in the home, spirituality, and storytelling.

This chapter describes basic principles and processes in the clinical mental health interview of a person from any cultural group. Because of the author’s own background and the characteristics of his clinical work, the emphasis of the chapter is on the Hispanic/Latino group, specifically Mexican Americans. The principles outlined can apply to many types of interviews: diagnostic, psychotherapeutic, emergency, and so on. The approach can best be described as dynamic but also available to gathering information for formal DSM diagnoses and formulations. Nuances of the cross-cultural dynamic process in the areas of language, intrapersonal attitudes/feelings, communication patterns, and other areas are covered. Specific psychotherapy techniques and explicit details about diagnostic formulation are beyond the scope of this chapter and are not examined.

Evidence-based bias reduction in low-inference and high-inference personality assessment instruments is now consensually recognized. Bias in standard psychological tests such as the Minnesota Multiphasic Personality Inventory (MMPI-2), Rorschach (RCS), and Thematic Apperception Test (TAT) has been dramatically reduced. MMPI-2 deficiencies in items, norms, flawed psychometric properties, and construct meanings have been minimized in a restructured MMPI-2-RF. The Rorschach Comprehensive System (RCS) recently incorporated revised diagnostic constructs and a theoretical model of affect contributing to therapeutic feedback. In addition, the new Rorschach Performance Assessment System (R-PAS) is an evidence-based internationally focused and culturally relevant system using externally accessed behavioral criteria. The TAT now has a reference compendium of objective scores representing a number of systems for both high-inference and low-inference interpretation of this test. The Tell-Me-A-Story test (TEMAS) provides scores and interpretations for cross-cultural and multicultural groups.