A third meta-analysis, published in the Annual Review of Clinical Psychology in 2014, came to a more conservative conclusion. In a summary of 10 recent meta-analyses — including those by Smith and Benish — Stanley J. Huey Jr., PhD, of the University of Southern California, and colleagues, found that maladaptive psychotherapy was generally effective in ethnic minority clients — a finding that partly counteracts criticisms that individual Western therapy is not the best choice for many ethnic minorities. Commonly used cultural adaptations include recognition of family involvement and the role of the extended family, as well as the use of culturally relevant metaphors or interactive visual intervention resources.7 Staffing a study with local researchers and front-line staff that reflects the participating population or community diversity can help ensure that the research is accepted by participants.12 At FHI Clinical, we found that it was particularly useful to have staff on the ground to conduct research to engage communities. “PREVAIL`s Social Mobilization and Communications Unit is a unique group of people who engage directly with communities through social science research or clinical trials. They help engage the community and explain what the program is – the benefits and risks – in language the community will understand. In addition, funding for this type of research has generally been low (see “Institute focuses on patients, including ethnicity”). The National Institutes of Health generally requires a biomedical aspect in most mental health research, including that involving cultural literacy. And the only NIH institute that deals with ethnic minority health issues, the National Institute of Minority Health and Health Disparities, is one of the least funded NIH agencies and tends to invest more money in education than research, say leaders on the ground. “Psychologists of my generation are working collaboratively with those of previous generations to further integrate science into cultural literacy and culturally competent treatment,” she says. “We`re not saying we need a cultural adjustment for Mexican Americans that includes excessive emotional involvement,” he says. “It`s too static, too fixed, too stereotyped and it doesn`t take into account the individual.” Bernal helped launch this type of research in the 1990s, when he realized that he was informally adapting evidence-based treatments to his clients anyway. The goal of much of the health research and the researchers behind it is to improve the health of the population affected by the targeted disease.
However, many research studies do not reach the communities that would benefit most from their intervention. While there are many reasons for this (including unequal places, which our Vice President of Global Strategy, Ghiorghis Belai, discussed in a recent article), research has shown that despite community members` willingness to participate and the use of study materials translated into local languages, non-compliance with negative consequences has a negative impact on engagement and therefore recruitment:3 Burchum, J. L. R. (2002, October). Cultural competence: an evolving perspective. In: Pflegeforum: (Jg. 37, nr. 4, s. 5). Blackwell Publishing Ltd. Betancourt, J.
R. (2004). Cultural competence – marginal or mainstream movement? New England Journal of Medicine, 351(10), 953-955. In the first study to use this framework, University of Puerto Rico psychologist Jeannette Rosello and Bernal compared how Puerto Rican adolescents with depression responded to culturally appropriate versions of cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) versus their peers on a waiting list. Both adapted treatments were effective and both were superior to the control group`s results, they found (Journal of Consulting and Clinical Psychology, 1999). Carpenter-Song, E. A., Schwallie, M. N., & Longhofer, J. (2007). Cultural competence reconsidered: criticism and directions for the future. Psychiatric Services, 58(10), 1362-1365.
Muzychenko, O. (2008). Intercultural entrepreneurial competence in identifying international business opportunities. European Management Journal, 26(6), 366-377. Developing cultural literacy helps us understand, communicate and interact effectively with people of all cultures. This gives us the opportunity to compare different cultures with our own and better understand the differences. Unconsciously, we bring our own cultural framework of interpretation into each situation. This is not to say that culture alone determines how a situation is interpreted. Their own history and personality also play an important role (Hofstede, 2002). Borchum (2002) described cultural competence as “a dynamic, non-linear process that never ends and continues to expand. It is based on an increase in the development of knowledge and skills in relation to its characteristics” p.
5. We synthesized and adopted the studies of Williams (2001) and Martin and Vaughns (2007) that can contribute to a better understanding of the components of cultural competence. These attributes will guide you in developing cultural competence: “We started very consciously to look at the protocols of these treatments and deconstruct them in terms of cultural metaphors, hypotheses and language,” he says. Because of this complexity, the science of culturally competent processing has tended to fail, many say. But thanks to a series of research efforts, that has changed, according to an expert in the field, psychology professor Melanie Domenech Rodriguez, PhD. at Utah State University. But it was not easy to define, understand and apply cultural competence in treatment. On the one hand, researchers are still discussing the basic ingredients of cultural competence and culturally competent care. What makes a particular therapist, practice or protocol culturally competent? While there is much speculation on this topic, the answers to these questions are far from clear. Martin, M. and Vaughn, B. (2007).
Cultural competency: Diversity and inclusion literacy.
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