Phrasing Questions for Relevancy Outside Mainstream American Culture

It is ethnocentric to think “western therapy dialogue” is somehow universally meaningful and effective. In fact, it often simply confuses people who expect a healthcare professional to act like an authority figure who instructs them to change their behavior. Being asked about “intrinsic motivation” and “levels of ambivalence” may not seem relevant even if simpler language is...
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Four Basic Interaction Skills for ALL Cultures

In order for a provider to be successful at motivational interviewing, four basic interaction skills should first be established. 2  An ability to ask open ended questions An ability to provide affirmations A capacity for reflective listening An ability to periodically provide summary statements to patients.   These basic skills are essential to all effective communication between providers and...
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Cross-cultural Use of the Edinburgh Postnatal Depression Scale

Although the cultural aspects of the pregnancy-related period in women’s lives have been studied extensively worldwide, the impact of cultural factors upon pregnancy-related depression has been investigated far less. Most research into pregnancy-related depression has been conducted in Western Europe, the U.S., Canada, and Australia. This research has been based primarily on studies of Western...
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Addressing Disparities In Mental Health Care For Latinos

Addressing disparities in mental health care for Latinos is of particular importance given their considerable population growth in the United States. The 2010 US Census reports: Latino Americans comprise the largest ethnic/racial minority group in the United States (50.5 million or 16.3%). Latinos are also the largest ethnic minority group of children (11.6 million) in the United States,1...
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Reading Between the Head Nods

It is important for U.S. healthcare providers to understand some key aspects of how language and culture can affect interactions with patients and families who have come to this country from other cultures―especially recent immigrants and refugees. Providers may not be prepared for the high context communication style that is normal in many societies. A lack of awareness of how this manifests in...
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What’s In a Frying Pan?

I recently visited a practice in Aurora, CO with a client base made up largely of immigrants and refugees. Dr. P.J.  Parmar, MD is doing some tremendous work with people from a variety of cultures who come to Colorado with limited English proficiency, limited understanding of western medicine, and low health literacy. I was seeking Dr. Parmar’s ideas about using motivational interviewing...
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Screening for Pregnancy-related Depression In Private Practice Settings: Cross-Cultural Considerations

  Although the cultural aspects of the pregnancy-related period have been studied extensively worldwide, the impact of cultural factors upon pregnancy-related depression ( also known as postpartum depression) has been less investigated. Most research into pregnancy-related depression has been conducted in Western, developed countries (see reviews by Kumar, 1994; O’Hara & Swain,...
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Effective Mental Health Referrals

Referrals to mental health services by medical providers are often problematic in cross-cultural encounters. Mental health services in the United States are based on cultural assumptions relevant to members of the mainstream society, but these assumptions may not be as relevant for people outside the dominant culture. Thus, clients from different cultural backgrounds may not understand what the...
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