Australian mental health care practitioners’ construing of non-White and White people: implications for cultural competence and therapeutic alliance

2021 ◽  
Vol 9 (1) ◽  
Tinashe Dune ◽  
Peter Caputi ◽  
Beverly M. Walker ◽  
Katarzyna Olcon ◽  
Catherine MacPhail ◽  

Abstract Background The development of cultural competence is central to the therapeutic alliance with clients from diverse backgrounds. Given that the majority of Australia’s population growth is due to migration, mental health practitioner construing of non-White and White people has a significant role and impact on client engagement. Method To examine the impact of mental health practitioner construing on their strategies for cultural competence and the therapeutic alliance, 20 White and non-White mental health practitioners and trainees providing mental health services were purposively sampled and interviewed face-to-face or via videoconferencing. Data was analysed thematically and the impact of construing on practitioner cultural competence and the therapeutic alliance were interpreted using Personal Construct Psychology. Results Practitioners demonstrated cultural competence in their acknowledgement of the impact of negative construing of ethnic, cultural, religious, social, racial and linguistic diversity on client wellbeing. Practitioners sought to address these negative impacts on clients by drawing on the client-practitioner relationship to improve the therapeutic alliance. Conclusions The results reinforce the need for mental health care workers to develop cultural competence with a focus on developing awareness of the impact of frameworks of Whiteness on the experiences of non-White people. This is central to the development of a therapeutic alliance where clients feel understood and assured that their mental health concerns will not be constructed (and treated) through a framework that constrains both White and non-White people’s opportunities for improved mental health and wellbeing.

2007 ◽  
Vol 29 (3) ◽  
pp. 204-225 ◽  
Kevin Kaut ◽  
Josephine Dickinson

Today's mental health practitioner is likely to be quite familiar with a rather diverse range of pharmacological issues confronting clients seeking mental health services. Indeed, drug therapies are commonplace, and in some cases, might be viewed as the primary intervention for a presenting problem. Pharmacological approaches to mental health concerns can be effective, and provide treatment options with significant therapeutic potential. Nevertheless, the current pharmacological and ever-growing biomedical milieu that so often characterizes modern health care can potentially undermine the importance of the bio-psycho-social perspective of mental health assessment and intervention. The growing emphasis on pharmacotherapy must certainly be recognized by the mental health practitioner, but frameworks for mental health service delivery should continually identify better ways to integrate pharmacological options with the psychological and socio-cultural context that influence the behaviors, cognitions, and emotions of clients.

2014 ◽  
Vol 106 ◽  
pp. 42-49 ◽  
Georgia Michalopoulou ◽  
Pamela Falzarano ◽  
Michael Butkus ◽  
Lori Zeman ◽  
Judy Vershave ◽  

2019 ◽  
Vol 14 (1) ◽  
pp. 130-138
Julio C. Jiménez Chávez ◽  
Esteban Viruet Sánchez ◽  
Fernando J. Rosario Maldonado ◽  
Axel J. Ramos Lucca ◽  
Barbara Barros Cartagena

ABSTRACTMeteorological and even human-made disasters are increasing every year in frequency and magnitude. The passage of a disaster affects a society without distinction, but groups with social vulnerability (low socioeconomic status, chronic medical, or psychological conditions, limited access to resources) face the most significant impact. As a result, psychological and behavioral symptoms (eg, depression and anxiety) can ensue, making the immediate response of mental health services crucial. Secondary data from a database of a temporary healthcare unit were analyzed. A total of 54 records were reviewed to collect information; univariate and bivariate analyses were done. The purpose of this article is to present our experience regarding the incorporation of a mental health services model, with its respective benefits and challenges, into a temporary healthcare unit, after Hurricane Maria in 2017.

2017 ◽  
Vol 42 (2) ◽  
pp. 104-107 ◽  
Dilip Balu

The author's clinical experience with the Child Protection and Mental Health Care systems informs this brief practice-focused paper. The author posits that Secondary Traumatic Stress and Vicarious Trauma are central to understanding the impact of relationally traumatic material and the experience of individuals, families, team and the wider ecology of care systems. In particular, the author hypothesises that the tendency of systems to become fragmented in operation, with silos of sub-parts working parallel to each other, may be a natural adaptation to the ways in which traumatic experience ripples across system boundaries. This ‘ripple effect’ may lead to increasing emotional and relational reactivity, and survival-oriented inward focus of energies and efforts. The metaphor of the brain and nervous system is used to explore ideas of connection and integration in care systems. Trauma-informed leadership by individuals and teams is also touched upon in relation to reducing fear-driven clinical practice.

2006 ◽  
Vol 30 (2) ◽  
pp. 261
Michael Summers ◽  
Peter McKenzie

IT IS ONLY BY EXAMINING the impact of public policies on the lives of people that we can begin to assess the success or failure of those policies. With this as a starting point, Not for service presents an extensive (just over 1000 pages) and balanced picture of the impact of policies on the lives of people with mental illness and their families and friends. The authors take care to state that their research is not a rigorous examination of the extent to which the National Standards for Mental Health Services have been implemented, but do observe that the ?volume and consistency of the information demonstrate the gaps and difficulties governments have had in meeting these standards? (p 14). The report is lengthy, but is well laid out and ?easy? to read, although the content will leave any reader feeling uneasy about the current state of our mental health system. There is also a shorter (96 page) summary report available.

2016 ◽  
Vol 25 (5) ◽  
pp. 410-416 ◽  
S. P. Segal ◽  
S. L. Hayes

Mental health consumers/survivors developed consumer-run services (CRSs) as alternatives to disempowering professionally run services that limited participant self-determination. The objective of the CRS is to promote recovery outcomes, not to cure or prevent mental illness. Recovery outcomes pave the way to a satisfying life as defined by the individual consumer despite repetitive episodes of disorder. Recovery is a way of life, which through empowerment, hope, self-efficacy, minimisation of self-stigma, and improved social integration, may offer a path to functional improvement that may lead to a better way to manage distress and minimise the impact of illness episodes. ‘Nothing about us without us’ is the defining objective of the process activity that defines self-help. It is the giving of agency to participants. Without such process there is a real question as to whether an organisation is a legitimate CRS or simply a non-governmental organisation run by a person who claims lived experience. In considering the effectiveness of CRSs, fidelity should be defined by the extent to which the organisation's process conveys agency. Unidirectional helping often does for people what they can do for themselves, stealing agency. The consequence of the lack of fidelity in CRSs to the origins of the self-help movement has been a general finding in multisite studies of no or little difference in outcomes attributable to the consumer service. This, from the perspective of the research summarised herein, results in the mixing of programmatic efforts, some of which enhance outcomes as they are true mutual assistance programmes and some of which degrade outcomes as they are unidirectional, hierarchical, staff-directed helping efforts making false claims to providing agency. The later CRS interventions may provoke disappointment and additional failure. The indiscriminate combining of studies produces the average: no effect.

2017 ◽  
Vol 54 (4) ◽  
pp. 445-465 ◽  
Gesine Sturm ◽  
Zohra Guerraoui ◽  
Sylvie Bonnet ◽  
Françoise Gouzvinski ◽  
Jean-Philippe Raynaud

This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.

1997 ◽  
Vol 21 (5) ◽  
pp. 260-263 ◽  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan

The difficulty in achieving good quality community mental health care for homeless people has received increasing attention during the last few years. Less consideration has been given to the provision of inpatient care. By comparing data collected before and after its inception, we examined the impact of a specialist community mental health team for homeless people on ‘no fixed abode’ admissions in Birmingham. Although the team was successfully involved in the admission and discharge process in a substantial proportion of cases, many admissions still took place out of hours and involved the police, while discharge was often against medical advice and occurred without follow-up. These findings and their implications for the provision of homeless services are discussed.

2011 ◽  
Vol 2 (3/4) ◽  
pp. 432
Athena Madan

<p class="Default">“Refugee war trauma” is a poor adjunct to post-traumatic stress, lacking context for a civilian survivor of war. The “therapeutic mission”, or consolidating a therapeutic agenda with political reconstitution, has its tensions: Such founders embody politics of “emotionology” (Humphrey, 2005, p. 205) bound largely to pharmaceuticals, from a land of “freedom” (where emphasis is on market) and “democracy” (where emphasis is on autonomy of choice, not accountability). Additionally, how people “cope” or “solve problems” is not universal: Therapy speaks of self-empowerment, self-actualisation, and self-control; reconciliation speaks of collective citizenship, national participation, and group reform. Instituting participation in rituals that ‘help” according to predefined norms of an American prescription to suffering speaks more to the globalisation of the American psyche (Watters, 2010; Venne, 1997) than of humanitarian relief. This paper looks at the absence of cultural and socio-political specificities within the dominant discourse on “war trauma”, that are however of ultimate relevance for people affected by war. Using a case example from my own practice with a Rwandan woman living now in Canada, I question the “helpfulness” of post-traumatic stress treatment with this instance of refugee war trauma, and the impact of power systems in mental health care. How can the therapeutic encounter, given its genesis in Eurocentric, patriarchal, enlightenment thought, pause to better consider its potential for injury, especially within contexts of post-colonial genocide? How to avoid a new “mission to civilise”? What tensions to note as the advent of “trauma counselling” seeks more global application and transnational legitimacy?</p>

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