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Table of contents

Sociocultural Theories of Learning and Motivation. Handbook of Dialogical Self Theory. Second Language Teacher Education. Motives in Children's Development. Qualitative Research in Counselling and Psychotherapy. Second Language Acquisition in Childhood. The Education of English Language Learners. Moral Development, Self, and Identity. Fundamentals of Research on Culture and Psychology. Culture, Thought, and Development. Case Study Research in Applied Linguistics. The New Reflectionism in Cognitive Psychology. Second Language Writing Research.

Developmental Perspectives on Embodiment and Consciousness. Contemporary Debates in Childhood Education and Development. Methods of Literacy Research. Understanding and Teaching the Intuitive Mind. Character and Moral Psychology. The Perception of People. The Handbook of Language Socialization. Sociocultural Contexts of Language and Literacy.

Writing in Foreign Language Contexts. Trends and Contexts - Oxford Applied Linguistics. Languages and Languaging in Deaf Education.

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  • Cultural Psychotherapy.

Toward a Feminist Developmental Psychology. How We Understand Others. Post-existentialism and the Psychological Therapies. Another reason why narrative therapy is helpful is because telling stories is part of the culture. Talking about feelings, on the other hand, is not part of the lexicon so client-centered, experiential, or psychodynamic therapy would be a challenge to work with this population. For instance, I heard that there was a really good psychotherapy group for the women; a group they really enjoyed.

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Portuguese immigrants do not usually like attending therapy sessions so I wanted to talk to the therapist who was obviously doing excellent work. She said, sheepishly, it started out as a psychodynamic group but no one would talk about their feelings so now participants bring their knitting and talk about their aches and pains, mirroring the knitting circles in the Azorean Islands. Despite the increasing acceptance of spirituality and religion in psychology by many psychologists and the APA, therapists are still not routinely trained to competently address religion in therapy Aten and Hernandez, How can this session be a spiritual experience?

The first level explores the personal domain of the therapist. The second level is structural. For example, the time of day that a client is seen can be a hindrance e. The third level is theoretical and involves understanding the assumptions about spirituality as it is recognized or not in the psychotherapy model that is being used as discussed earlier. It is helpful to take time before each session to acknowledge these barriers and to try to minimize their effect. Once the session is in process, one can promote spiritual discourse in a culturally appropriate way Frame et al. For instance, when the therapist takes a stance of quietness and compassion Peavy, as suggested by wisdom-based therapy, the client may feel the space and respect to fully explore spiritual issues.

In Portugal, at Easter, there are many contemplative activities in which the whole family participates. For instance, the men who participate in Ramirez an Easter vigil will walk in bare feet all the way from their house to the church where the Easter procession begins, sometimes many, many kilometers.

During Easter there are also many processions happening where all off the family members will be in the procession. They all walk with the cross. These activities are very important to the faith and many people fly in from all over the world to attend.

The processions allow the family to embody the faith and for this to be witnessed by the community. There are also Easter processions in Toronto and Boston that are also well attended. When I James asked in a therapy session what made my anxious client feel better, she said reading Bible verses so I integrated that into her treatment.

If that is something that gives the person strength, there are also other Christian contemplative practices that could be included in therapy, such as practicing gratitude Stiendl-Rast, , walking the labyrinth, prayer, and Lectio Divino reading a Bible passage in a contemplative manner.

Lastly, we value the inquisitive stance of not knowing on the part of the therapist. Barsness explains from a Christian tradition:. In order to know we must not know, in order to find ourselves we must lose ourselves, in order to experience we must forfeit explanation. It is in this space that the potential for something other than ourselves, the transcendent revelation of God, can be experienced. The main limitation with this quantitative study is the limited sample size, but this should be viewed in light of the fact that it is hard to recruit this population. With regard to the qualitative research, the most valuable aspect of ethnography is the depth of engagement, which in ways mirrors the therapeutic relationship; however, the findings must be considered in light of the limitations that result from this type of research relationship.

Although it is human desire to generalize, ethnography is highly situated in time and place and as such the findings of ethnography often ask more questions than that it answers. The results cannot be unilaterally generalized to other Azoreans, Portuguese, or to the experience of other ethnic populations. Another limitation that must be considered is the translation of stories and beliefs from Portuguese to English at many different levels.

In some ways, this can be considered a strength, as the researcher is forced to attend to the intricacies of language on a more obvious level as they try to understand not only the spoken but also the unspoken messages of a different culture. In short, this ethnography provided an interpretation of cultural knowledge that deepened the understanding of healing within this immigrant group.

The cultural psychotherapeutic approach demonstrates its value with ethnic minority clients by situating the client within the context of their multi-layered social reality. This approach allows the therapist to better understand the client through exploring the various dimensions of their immediate reality by way of dialog. In this process, the therapist portrays his or her own self as part of the process of therapy, thereby encouraging an open-ended, self-reflexive, dialogic turn of mind.

This is reminiscent of ethnographic techniques used by anthropologists Shweder, Meanwhile, the client gains a better understanding of his or her own self by coming to understand this way of deriving meaning and by articulating a story or narrative which gives coherence to her or his lived experience. At the individual level, our findings provide evidence for the reliability and validity of the Agonias Scale for male Portuguese immigrants. As for female Portuguese immigrants, the scale showed a unidimensional factor structure. This factor addresses psychological and physical aspects, which is in line with our previous qualitative research with Portuguese immigrants in that psychological and physical aspects are seen as integrated.

Furthermore, the Agonias Scale was positively correlated to measures of depression and anxiety, with small and medium effect sizes as was hypothesized, indicating that these variables are related, yet distinct and indicative of different aspects of distress. This is noteworthy as agonias is typically conceptualized and treated as anxiety or depression by health-care professionals James and Prilleltensky, In the study by James et al. This gender difference in reporting the experience of agonias is in line with other culture bound syndromes for which gender differences have been reported, such as ataques de nervios in the Latino cultures e.

Furthermore, this is in line with the results of a focus group that was conducted by our research team in Portugal with women and men. Suffering is a family event and often intergenerational. Receiving healing from the curandeiro is also a family event; the curandeiro may have all family members attend the visit. Another new paramount insight that will change how we conduct our research, is that agonias is an infinitely open signifier, which means that it has multiple significations or meanings de Saussure, Thus, agonias can be a health problem or an acceptable way to talk about family problems because its meaning is relational de Saussure, The Azorean research revealed new insights at the socio-cultural level as well.

First, the importance of understanding that there may be language barriers when moving between the different systems in Portugal such as medical, healers, and community members. Thus the importance being tentative when presenting results becomes important. Another discovery was that curandeiros are well integrated into the community, and many are employed and attend the local parish. Certainly, when you live on a small remote island the lives of all of the inhabitants are intertwined. You see how interrelated the levels are and how a discovery at one level can be used to inform future research in a way that we never would have discovered by researching one level.

For example, the speculation that Agonias is an open signifier came from the family level but will affect the research that we do at all of the levels. For example we will now give the Agonias Questionnaire James et al. It would be helpful to give the Hassles Scale Delongis et al.

In addition, because of the importance of the family level, we should also give the Agonias and Hassles scale to all family members.

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Accordingly we need to change how we do the qualitative data collection as well. Presently, we interview individuals or members of a focus group when we conduct individual interviews Instead it would be beneficial to interview multiple members of a family together.

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With parallel studies conducted both in the Azores and in Canada, the similarities and differences in family dynamics could be better understood. This would also yield valuable information regarding how families change with acculturation and exposure to a new majority culture. Another area of the family domain that remains unexplored is how families change over time in the Azores.

This has been examined in Canada, and while change is largely attributed to acculturation, there may be other aspects at play. It would be beneficial to interview multiple generational levels of families in the Azores and learn how different generations observe customs and traditions, how they adopt new customs and traditions, including religion, and what conflicts or resolutions emerge. At the socio-cultural level, we will interview curandeiros to understand their theory of change and treatment rationale.

How does language impact the efficacy of their practices? How do they engage in Portuguese communities? How do they conceptualize suffering and healing? How did they become curandeiros and how do they view their roles in the community? Do they collaborate with other mainstream or alternative healers? At the religio-moral level, unanswered questions that would be worth further investigation include, for both Portuguese Canadians and Portuguese in the Azores, the following:.

How do they view traditional healers in the context of their religious beliefs? Are there similarities and differences between the two cultures? How did those patterns come about over time? How do community members integrate mainstream and traditional healing, and how do curandeiros collaborate with other mainstream or alternative healers? This research on agonias illustrates the importance of using a mixed-method and multi-leveled approach to examine idioms of distress in a culturally sensitive way. Quantitative and qualitative research will be conducted to explore the aforementioned questions.

Traditionally, attempts to understand culture tend to focus on race. For example, Sue and Sue have historically divided their crucial multicultural counseling texts into race-specific chapters, although recent editions have included more dimensions i. With Portuguese Canadians, a focus on race by researchers and clinicians may lead to an unfortunate assumption that members of this group are not culturally unique. This could lead to misunderstandings, premature termination of treatment, and unintentional discrimination. As discussed thus far, Portuguese Canadians have rich cultural distinctions, which permeate all aspects of life and health and behavior.

They also do experience discrimination and limited economic opportunities in mainstream culture. For instance, while for most immigrants in North America the socio-economic status improves from generation to generation no matter what their race, for the Portuguese, their poverty often does not improve Reeve, It is laudable that Sue and Sue have included information about culture bound disorders with case examples. We have provided examples from our program of research with the Portuguese both in Canada and the Azorean Islands of Portugal and we have outlined a model for conducting psychotherapy with people of diverse cultural backgrounds based in the theories of clinical and cultural psychology.

By integrating psychology and anthropology we gain a more complex understanding of both culture and the individual within his or her cultural context. Our program of research with the Portuguese cultural group both in Canada and Portugal has informed our clinical work with this group and other diverse groups. By better understanding how Portuguese suffer and heal, we have sought to develop a model for conducting psychotherapy specific to Portuguese immigrants.

We believe the model can be utilized with other non-dominant cultures living in North America. Our model focuses on understanding the person in a multicontextual way and utilizes the four contexts or domains discussed above: By exploring each level we understand the person in a multicontextual way with the understanding that all levels are interrelated and significant. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

National Center for Biotechnology Information , U. Journal List Front Psychol v. Published online May Author information Article notes Copyright and License information Disclaimer. This article was submitted to Frontiers in Cultural Psychology, a specialty of Frontiers in Psychology. Received Aug 20; Accepted Mar This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

Abstract This article outlines a model for conducting psychotherapy with people of diverse cultural backgrounds. Introduction Culture is given increased attention in psychology Cole, ; Leong and Lopez, ; Sue and Sue, as a result of increasing diversity, immigration, and globalization.

Open in a separate window. The Individual Domain As discussed earlier, there is an intentionality of both the individual and her or his changing world Shweder, Table 1 Factor loadings of the items of the Agonias Scale. Item Factor 1 1. Premonition that something bad was going to happen 0. Burning from within 0.

Method The sample consisted of Portuguese immigrant men living in the Waterloo region. Measures Besides the Agonias Scale, the following commonly used instruments to assess mental health symptoms were administered to examine the relationship between them and the Agonias Scale. Results Fifty-two percent of the participants reported having experienced some level of agonias during the past week. The family domain Krause suggests that family intervention can be useful if therapeutically appropriate and ethical. Method Borrowing theories of understanding culture knowledge from Anthropology, we undertook an ethnographic study in the Azorean Islands of Portugal, specifically on the islands of Sao Miguel and Terceira.

Results Our research indicated that in the Azores, suffering brings family and friends together by engaging the community to provide support to the entire family unit. One participant described how she and her mother decided to go to a curandeiro for their physical problems: The socio-cultural domain The cultural psychology framework Shweder, of intentional persons and intentional worlds reveals that there is interplay between the individual and his world that is consistently evolving, each a function of the other.

One Portuguese therapist related as cited in Harris, , If it makes my patient feel better, I have no reason to argue, you know. Results The Azorean ethnography revealed a number of new insights at the socio-cultural level. The religio-moral domain The religio-moral domain is part of the intentional world of the individual. Results The research identified five different types of healer in the community; herbalistas herbalist , endireitas bonesetter , as mulhers quem ler do livro the woman who reads the book , bruxas witch or medium , and curandeiros healer.

Barsness explains from a Christian tradition: Conclusion and Future Directions At the individual level, our findings provide evidence for the reliability and validity of the Agonias Scale for male Portuguese immigrants. At the religio-moral level, unanswered questions that would be worth further investigation include, for both Portuguese Canadians and Portuguese in the Azores, the following: Levels that can be addressed Questions that can be asked Individual What are the symptoms?

What are the cures?

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Are their culture specific disorders in that culture of origin? Who in the community suffer from culture specific disorders e. Are people being misdiagnosed? What family values are important to each family member? Do children speak language of origin? Do family members acculturate to home country at different rates?

How do all members of the family understand the cultures specific disorders? Do children marry people of their culture and how is that viewed by others in the family? Do children maintain the faith traditions of their family of origin? If not how is that? Socio-cultural What is the cultural history of the informants? What are the philosophical traditions of the culture of origin?

What is the historical context of informants? What is the socio-political context of the informants?

Cultural Psychotherapy: Working With Culture in the Clinical Encounter by Karen M. Seeley

What is the socio-economic status of informants? How does SES change from generation to generation? Are their ethical issues that arise? Koss-Chioino ; Journal Of Transcultural Psychiatry , 39 1 Through a series of illuminating case studies, Karen Seeley takes the unusual tack of looking at psychotherapy through the eyes of non-Western patients. The result is a powerful critique of the limits and biases of psychotherapeutic theory and practice in an increasingly multicultural and globalized world.

But the book goes beyond this negative critique to make a brilliant argument for a more ethnographic approach to clinical work, in which the therapist listens as much for relevant cultural meanings and values as for theoretically universal symptoms. Exploring the different ego functions necessary to function well in particular cultures, Seeley gives excellent case examples that show that a patient's cultural issues and the cultural differences between patients and therapists are best thought of as shaping psychology rather than as resistances to treatment.

Rich clinical material illustrates how the therapist can help clients bring cultural material into the treatment.