PP WV Client Wellness

UnderstandingClient Culture in theWellness ContextThis 6 hours training is in compliance with SCVMHD Directive 2009-06 David Beckstein MFT : 

Open Minds Open Hearts Client Cultural Skills UnderstandingClient Culture in theWellness ContextThis 6 hours training is in compliance with SCVMHD Directive 2009-06 David Beckstein MFT

What’s in a Name Tag?How many do you have?Family, Religious, “Nick”, Professional, EndearmentNew Name, Others? : 

Open Minds Open Hearts Client Cultural Skills What’s in a Name Tag?How many do you have?Family, Religious, “Nick”, Professional, EndearmentNew Name, Others?

Learning Objectives: : 

Open Minds Open Hearts Client Cultural Skills Learning Objectives: You will have a chance to : Use critical thinking to examine bias and non strength based distortions in mental health . Increase knowledge about the complex web of needs and meanings that makes up cultural factors. Integrate recovery and wellness approaches with the inclusive appreciation of cultural variation. Explore some narratives that reflect the impact of power and intolerance pointing to justice healing.

Exercise #1 Discuss Jesse’s strengths, his cultural identity in terms of race, ethnicity. : 

Open Minds Open Hearts Client Cultural Skills Exercise #1 Discuss Jesse’s strengths, his cultural identity in terms of race, ethnicity.

Defining ideas- constructs: Race vs. EthnicityRace is a physical or biological aspect of a person’s appearance and genetic makeup.A racial group does develop a tradition whichis part of a historical expression known asEthnicity. This includes the peronsal and socially shared expression of a group “ethnos” or way of life. Ethnic culture is continually changing among subgroups, regions, and cultural fusion. : 

Open Minds Open Hearts Client Cultural Skills Defining ideas- constructs: Race vs. EthnicityRace is a physical or biological aspect of a person’s appearance and genetic makeup.A racial group does develop a tradition whichis part of a historical expression known asEthnicity. This includes the peronsal and socially shared expression of a group “ethnos” or way of life. Ethnic culture is continually changing among subgroups, regions, and cultural fusion.

What is Culture – the big C? Culture is a fluid and multiple set of patterned “components” which are taught in childhood and in adulthood, transformed, denied, and combined. Society and choice are key drivers of the ever changing formulations of this holistic concept. : 

DISTINCTIONS Open Minds Open Hearts Client Cultural Skills What is Culture – the big C? Culture is a fluid and multiple set of patterned “components” which are taught in childhood and in adulthood, transformed, denied, and combined. Society and choice are key drivers of the ever changing formulations of this holistic concept.

Culture Components? LanguageCustoms and RitualsBeliefs and ValuesArts and CraftsClothing and CuisineFamily and TribeShared History in Larger Society : 

Open Minds Open Hearts Client Cultural Skills Culture Components? LanguageCustoms and RitualsBeliefs and ValuesArts and CraftsClothing and CuisineFamily and TribeShared History in Larger Society The pieces of the Cultural whole

Parenting : Where do children sleep?Customs Arts and CraftsClothing Family Gender Economics/Class : 

Open Minds Open Hearts Client Cultural Skills Parenting : Where do children sleep?Customs Arts and CraftsClothing Family Gender Economics/Class The pieces of the Cultural whole Western Mono Tribe Cradle Basket huup

Political label = Culture? A label like “American”- citizenship Is “undocumented person” = “Alien”Regional identities or identities related to political ideologySouthern, mid-westerner, Belt wayRed state, right wing , Tea party-er : 

DISTINCTIONS Open Minds Open Hearts Client Cultural Skills Political label = Culture? A label like “American”- citizenship Is “undocumented person” = “Alien”Regional identities or identities related to political ideologySouthern, mid-westerner, Belt wayRed state, right wing , Tea party-er

Individuality vs. The WholeAn important and subtle distinction needs to be made by culturally competent staff.Just because persons have some of the characteristics of a sub culture, they probably don’t have all of them.Do not assume or generalize.“What is being ____ like for you?”Not “You probably like ______. “ : 

DISTINCTIONS Open Minds Open Hearts Client Cultural Skills Individuality vs. The WholeAn important and subtle distinction needs to be made by culturally competent staff.Just because persons have some of the characteristics of a sub culture, they probably don’t have all of them.Do not assume or generalize.“What is being ____ like for you?”Not “You probably like ______. “

Language : Word choice and biasPolitical correctness – is a superficial preoccupation with the most pure speech.Yet word choice makes a difference to find the words for each client that are acceptable and respectful. Standards in cultures change – relativeColored, Negro, black, African AmericanOriental , Asian , Pacific Islander, Korean AmericanRed man, Indian, Native American, Indigenous First Nations, Aboriginal Peoples : 

Open Minds Open Hearts Client Cultural Skills Language : Word choice and biasPolitical correctness – is a superficial preoccupation with the most pure speech.Yet word choice makes a difference to find the words for each client that are acceptable and respectful. Standards in cultures change – relativeColored, Negro, black, African AmericanOriental , Asian , Pacific Islander, Korean AmericanRed man, Indian, Native American, Indigenous First Nations, Aboriginal Peoples

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Open Minds Open Hearts Client Cultural Skills Is Race really that fixed?

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Open Minds Open Hearts Client Cultural Skills Skin colour changes ?

The Origins of Wellness ModelA set of values for, not against MHRecoveryStength Based ViewHolistic Consumer Voice/ChoicePractice Based Evidence : 

Open Minds Open Hearts Client Cultural Skills The Origins of Wellness ModelA set of values for, not against MHRecoveryStength Based ViewHolistic Consumer Voice/ChoicePractice Based Evidence

Exercise #2Bye Bye Illness, Hello Happiness : 

Open Minds Open Hearts Client Cultural Skills Exercise #2Bye Bye Illness, Hello Happiness

The Origins of Wellness Model : 

Open Minds Open Hearts Client Cultural Skills The Origins of Wellness Model Steve Hayes created new CBT school- Imagine a therapy that does not attempt to end or reduce symptoms (as a stated goal) Acceptance of “private experiences” but not attaching or identifying with these thoughts. Imagine a therapy that points people to see what values and satisfaction are possible in their lives and to commit to that path Acceptance model

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Open Minds Open Hearts Client Cultural Skills ACT radical departure from the Medical Model Things were call Symptoms do not really exist. Mental health problems are not from “illness” like an infection of a virus, or imbalance of insulin. People have “private experiences” positive or negative in reaction to situations, these are : Fleeting - changing (replicable, the next thought) Harmless – thoughts don’t hurt, uncomfortable Can be managed – do not have to take all attention. Consider how this open doors for engaging the client’s cultural and spiritual meanings? Acceptance model

Taking Resistance Seriously“I don’t like feeling bad about symptoms.”Identifying signs of illness can be itself a defeating task.The process of avoiding, reinforces the experience of harm, fear, and distress. (running from the bully)“I more I think about why I’m anxious, the more nervous I get, I’m such a loser.” ACT model says you can reframe and see your challenges in less black and white - disease terms and stigma. “I sometimes get tense, I’m going to take care of myself and find calmer ways to be.” : 

Open Minds Open Hearts Client Cultural Skills Taking Resistance Seriously“I don’t like feeling bad about symptoms.”Identifying signs of illness can be itself a defeating task.The process of avoiding, reinforces the experience of harm, fear, and distress. (running from the bully)“I more I think about why I’m anxious, the more nervous I get, I’m such a loser.” ACT model says you can reframe and see your challenges in less black and white - disease terms and stigma. “I sometimes get tense, I’m going to take care of myself and find calmer ways to be.”

“How do I find a place and role . . . in the cold, unequal world?” Acculturation Approaches IntegrationAssimilationSeparationMarginalization : 

Open Minds Open Hearts Client Cultural Skills “How do I find a place and role . . . in the cold, unequal world?” Acculturation Approaches IntegrationAssimilationSeparationMarginalization

AcculturationReceiving and accepting a culture, ethnosRooted in many contributing CONTEXTS:FAMILY, NEIGHBORHOOD , SEXUAL ORIENTATION GENDER SOCIALIZATION, SCHOOL, FAITH COMMUNITY PEER GROUP DISABILITY, CLASS, MEDIA WEB-WORLD Contributing CULTURAL BEHAVIORSLANGUAGE NORMS ROLES RITUALS NARRATIVES-MYTHS HEROS THREATSCOMING OUT, BEING HIDDEN, CHOICES : 

Open Minds Open Hearts Client Cultural Skills AcculturationReceiving and accepting a culture, ethnosRooted in many contributing CONTEXTS:FAMILY, NEIGHBORHOOD , SEXUAL ORIENTATION GENDER SOCIALIZATION, SCHOOL, FAITH COMMUNITY PEER GROUP DISABILITY, CLASS, MEDIA WEB-WORLD Contributing CULTURAL BEHAVIORSLANGUAGE NORMS ROLES RITUALS NARRATIVES-MYTHS HEROS THREATSCOMING OUT, BEING HIDDEN, CHOICES

Part II Culture under PowerAll persons treated equal?Behaviours of the Group in Power PROFILING - Presuming worst- PrejudgePRIVILEDGE- Access to resources, get to define the “norm”, expect assimilationINTERNALIZED OPPRESSION - self defeatSTIGMA- the use of negative labels and views about people with mental illness. Double Stigma- minorities : 

Open Minds Open Hearts Client Cultural Skills Part II Culture under PowerAll persons treated equal?Behaviours of the Group in Power PROFILING - Presuming worst- PrejudgePRIVILEDGE- Access to resources, get to define the “norm”, expect assimilationINTERNALIZED OPPRESSION - self defeatSTIGMA- the use of negative labels and views about people with mental illness. Double Stigma- minorities

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Open Minds Open Hearts Client Cultural Skills Being Japanese American in the 1940’s …

What is racism? 0 ….1…..2….3….4….5…..6….7….8….9….10Interest Confusion Discomfort Threat Hatred = Discomfort + Denial of IntolerantThoughts (supremacy of one over another)Institutional Racism- when a political system or institutions exclude or discriminate consciously or unconsciously. : 

Open Minds Open Hearts Client Cultural Skills What is racism? 0 ….1…..2….3….4….5…..6….7….8….9….10Interest Confusion Discomfort Threat Hatred = Discomfort + Denial of IntolerantThoughts (supremacy of one over another)Institutional Racism- when a political system or institutions exclude or discriminate consciously or unconsciously.

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Open Minds Open Hearts Client Cultural Skills Open talk about race 12.30

Ignorance and Fear : XenophobiaA natural response to difference?The unfamiliar ways of someone else will evoke interest and can move up the scale of rejection 0 ….1…..2….3….4….5…..6….7….8….9….10Interest Confusion Discomfort Threat HatredDiscomfort + Education=Capacity to respect and find commonality and shared value. : 

Open Minds Open Hearts Client Cultural Skills Ignorance and Fear : XenophobiaA natural response to difference?The unfamiliar ways of someone else will evoke interest and can move up the scale of rejection 0 ….1…..2….3….4….5…..6….7….8….9….10Interest Confusion Discomfort Threat HatredDiscomfort + Education=Capacity to respect and find commonality and shared value.

Culture is complexOversimplification offends and limits understandingEthnocentrism- naïve assumption that everybody is like the way you are.Stereotyping – attributing one behaviour, style, or characteristic to all people of that group often inflexibly- even when evidence is clearly contradictory of the biased view. Stereotyping erasing individuality and closes doors to seeing with open minds. : 

Open Minds Open Hearts Client Cultural Skills Culture is complexOversimplification offends and limits understandingEthnocentrism- naïve assumption that everybody is like the way you are.Stereotyping – attributing one behaviour, style, or characteristic to all people of that group often inflexibly- even when evidence is clearly contradictory of the biased view. Stereotyping erasing individuality and closes doors to seeing with open minds.

Stereotypes Simplistic generalizationsFrom the Outside : DiscriminationFrom the Inside: Internalized RacismStereotypic Satire and Humor?Acceptable by the inside group?Offensive if coming from outside?Commonality and Individuality areantidotes to Toxicity of Stereotyping : 

Open Minds Open Hearts Client Cultural Skills Stereotypes Simplistic generalizationsFrom the Outside : DiscriminationFrom the Inside: Internalized RacismStereotypic Satire and Humor?Acceptable by the inside group?Offensive if coming from outside?Commonality and Individuality areantidotes to Toxicity of Stereotyping

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A day “without Mexicans” Open Minds Open Hearts Client Cultural Skills

Part III Client Culture Mental HealthBias and blind spots in healing professions.ABSOLUTIST , UNIVERSALISTDominant Medical Model held assumptionsthat all illness was the same, biological.Another type of ethnocentrism – Western European concepts govern all peoples.RELATIVIST, CONTEXTUALAll meanings for human experiences are culturally patterned and culture is a key part of healing and “mental” health. : 

Open Minds Open Hearts Client Cultural Skills Part III Client Culture Mental HealthBias and blind spots in healing professions.ABSOLUTIST , UNIVERSALISTDominant Medical Model held assumptionsthat all illness was the same, biological.Another type of ethnocentrism – Western European concepts govern all peoples.RELATIVIST, CONTEXTUALAll meanings for human experiences are culturally patterned and culture is a key part of healing and “mental” health.

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Open Minds Open Hearts Client Cultural Skills Part III Client Culture

Different Lens of “Problem”?Three clinical portraits: a man from South east Asiaa man from North east Latin Americaa man from Western Europe.Different views of : causes level of the person’s control healing processes, “getting better.” : 

Open Minds Open Hearts Client Cultural Skills Different Lens of “Problem”?Three clinical portraits: a man from South east Asiaa man from North east Latin Americaa man from Western Europe.Different views of : causes level of the person’s control healing processes, “getting better.”

Part III Client Culture Really starts and ends with the CLIENT’s experience and world view.DSM IV diagnosis does not weigh every possible explanation or expressionPsychometric measurements are rooted in the one size fits all universalist view.Example of Chinese patients “Depressed”Their complaints were “headaches, sleep problems, dizziness.” shenjing shuairuo a lassitude, fatigue, weariness to culture. Western explanation: somatization : 

Open Minds Open Hearts Client Cultural Skills Part III Client Culture Really starts and ends with the CLIENT’s experience and world view.DSM IV diagnosis does not weigh every possible explanation or expressionPsychometric measurements are rooted in the one size fits all universalist view.Example of Chinese patients “Depressed”Their complaints were “headaches, sleep problems, dizziness.” shenjing shuairuo a lassitude, fatigue, weariness to culture. Western explanation: somatization

Part III Client’s Culturo-map. : 

Open Minds Open Hearts Client Cultural Skills Part III Client’s Culturo-map.

In conclusion about Client CultureThink Critically, Distinctions and Cultural “listening”an Open Mind1. What other explanations would your community have about this symptom?2. Where are there sources of healing for your child, family, community?3. What are your views about who is responsible for the problem, the healing?4. Who else might join in the healing team to help your family member? : 

Open Minds Open Hearts Client Cultural Skills In conclusion about Client CultureThink Critically, Distinctions and Cultural “listening”an Open Mind1. What other explanations would your community have about this symptom?2. Where are there sources of healing for your child, family, community?3. What are your views about who is responsible for the problem, the healing?4. Who else might join in the healing team to help your family member?

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Open Minds Open Hearts Client Cultural Skills

What is this families’ nationality? : 

Open Minds Open Hearts Client Cultural Skills What is this families’ nationality?

What is this families’ nationality? : 

Open Minds Open Hearts Client Cultural Skills What is this families’ nationality?

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Open Minds Open Hearts Client Cultural Skills Slaves had no legal marriages

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Open Minds Open Hearts Client Cultural Skills Text

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Open Minds Open Hearts Client Cultural Skills Text

E : 

E Open Minds Open Hearts Client Cultural Skills

Part III Client CultureLooking at the absolutist bias : 

Part III Client CultureLooking at the absolutist bias Open Minds Open Hearts Client Cultural Skills

E : 

E Open Minds Open Hearts Client Cultural Skills

UnCli : 

El El Superstar Open Minds Open Hearts Client Cultural Skills UnCli