Clinical Manual of Cultural Psychiatry

In the past 20 years, therapists and educators have been encouraged to study the patient’s cultural and ethnic 

background as a way of understanding their problems. Ethnicity and religion can have a major influence on a patient’s habits, and the therapist needs to take it into account. This book is all about treating patients who come from different ethnic groups; African American, Asian, African, Native American, and various religious groups.

One of the great things about this book is that each chapter is illustrated with a video, which you can access online. Using actors, it shows what each session can be like. A most obvious issue discussed in this book is African American lifestyles. A chart is used to show the kinds of questions the therapist needs to ask the patient, particularly with regard to things like family life. Instead of open-ended questions about “what it’s like,” the therapist should read the patient’s body language when he answers, and probe deeper into comparisons. For example, if the patient is an African American man who has lost his job and is a stay-at-home parent, he might be feeling resentful, due to what he was taught about a man’s role. There might also be an underlying fear, inherited from his family, with regard to doctors. Perhaps he might think that going to therapy is a sign of weakness?

Another example in this book is a refugee from Ivory Coast, working as a cab driver, and having family problems. He says that he can’t adjust well to American life. But are there other factors? Are the gender roles rigid in his home country, and if so, would they be seen in the USA as abusive? Another case involves a middle-aged Asian, depressed by his lack of employment, and because his younger brother has taken his place as the favored son. Where he comes from, the oldest child is supposed to be favored, and the reversal of roles has left him confused and unhappy. As per the ethic he learned growing up, he is reluctant to talk to others about his problems.

A friend of mine, who taught English in China and Thailand, wrote a paper on the differences in social attitudes. She stressed, and even warned, that when working in Asia, you must never complain to coworkers about your commute. They will think you’re blaming it on them, and you will leave them feeling uneasy. It will also be seen as weakness. How Americans and foreigners deal with problems can be widely different.