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Cultural Assessment in Clinical Psychiatry

Group for the Advancement of Psychiatry

  • ISBN 978-0-87318-144-0
  • Item #7144

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Culture permeates human activity the world over. In today's technological global village, people from very different cultures are interacting more closely and more often than ever—making it critical for clinicians to understand and incorporate cultural dimensions into their daily practices.

This volume offers a contemporary pragmatic understanding of how culture is inextricably intertwined with mental health and mental illness.

In Chapter 1, the 17-member GAP Committee on Cultural Psychiatry begins by discussing the history (particularly within the last two decades) and scope of culture in clinical psychiatry.

In Chapter 2, the authors describe 11 selected cultural variables that strongly influence clinical work: ethnic identity, race, gender and sexual orientations, age, religion, migration and country of origin, socioeconomic status, acculturation and acculturative processes, language, dietary influences, and education.

In Chapter 3, the authors present a brief history and detailed analysis of the Cultural Formulation, the newest instrument for ensuring thorough clinical assessments, explaining its clinical use based on DSM-IV guidelines.

In Chapter 4, the authors integrate the 11 cultural variables described in Chapter 2 with the use of the Cultural Formulation described in Chapter 3, producing an extraordinary cross-section of case vignettes:

  • How the son of Irish Catholic immigrants struggles to reconcile old-country traditions with life in modern American society
  • The sometimes painful and always complex process and outcomes of acculturation for a Pakistani Muslim family who had come to the United States for only a temporary period but ended up staying permanently
  • Diagnosing social phobia in an Asian American, whose traditional reticence must be viewed within the context of Asian culture
  • Loss of country of origin and family ties as catalysts leading to significant behavioral changes and severe depressive symptoms in an African immigrant tribesman from Kenya and the cultural context of his recovery
  • The interplay of gender, age, and religion with developmental issues, personality organization, and symptom development for a good Catholic girl
  • The existential, interpersonal, and clinical experiences of a Protestant minister from predominantly Catholic Ecuador, who came to the United States as pastor of an Hispanic church in a predominantly white city

In Chapter 5, the authors conclude with a summary and suggestions regarding the complex issues raised by a thorough cultural assessment.

Enhanced by a detailed index, this powerful work meets the significant—and rapidly growing—need for psychiatrists and other mental health professionals to understand the role of culture in psychiatry and to integrate this knowledge into their practice so that they can provide the most comprehensive and useful care to their patients.


  • Introduction
  • Chapter 1. Culture in clinical psychiatry: History and scope
  • Chapter 2. Cultural variables
  • Chapter 3. Cultural formulation: Description and clinical use
  • Chapter 4. DSM-IV-TR cultural formulation applied to six clinical cases
  • Chapter 5. Conclusions
  • GAP publications
  • Index

This outstanding volume has appeared at a most opportune time! Federal agencies, certification boards, professional organizations, and training programs are emphasizing the importance of cultural competence in clinical care. The recent 2000 Census has pointed up the importance of providing equitable, fair, and quality care to all of our citizens, regardless of ethnicity or sociocultural characteristics. This book guides the psychiatrist in achieving cultural competence in psychiatric practice. Topics include diagnostic guidelines, psychopharmacology, collaboration with translators, migration, and cultural factors that can influence diagnosis and treatment. Rich case examples emphasize clinical themes often encountered in psychiatric management. This book should appeal to the newest resident as well as the veteran psychiatrist keeping abreast of major developments in psychiatry.—Joseph Westermeyer, M.D., Ph.D., Chief of Psychiatry and Director of Mental Health Service, Minneapolis, VAMC, Professor of Psychiatry and Adjunct Professor of Anthropology, University of Minnesota

With a comprehensive review of the subject and nicely illustrated case examples, Cultural Assessment in Clinical Psychiatry shows how cultural information can be integrated into the biopsychosocial approach in psychiatric care and can enhance patient's recovery from mental illness. A must reading for students, teachers and clinicians interested in cross-cultural psychiatry.—Albert C. Gaw, M.D., F.A.P.A., Clinical Professor of Psychiatry, University of California School of Med, San Francisco; Medical Dir, San Francisco Mental Health Rehabilitaion Facility, San Francisco

Dr. Alarcon and the Committee on Cultural Psychiatry of the Group for the Advancement of Psychiatry have provided a superb overview of core concepts in cultural psychiatry for clinicians and educators. Upon a foundation of a comprehensive literature review and historical overview of each topic, they eloquently discuss the most important concepts in the field, linking theory with clinical practice. A number of detailed clinical case studies effectively illustrate the power of a comprehensive cultural formulation in assessment and treatment. This book will be a valuable resource for clinicians across a broad spectrum of experience and training.—James K. Boehnlein, M.D., Professor of Psychiatry, Oregon Health Sciences University; Director for Education, VA Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC)

[W]e believe that this book provides a useful guide to the historical and conceptual underpinnings of the DSM cultural formulation and in doing so, takes a step in the direction suggested by the Surgeon General. We recommend it to mental health clinicians as an introduction to cultural assessment in clinical psychiatry.—Alex Kopelowicz, M.D., and Steve Lopez, Ph.D., Journal of Clinical Psychiatry, 8/1/2003

In this book, the authors have all demonstrated expertise in cultural psychiatry as is shown by their impressively researched presentation of how culture intertwines with and affects mental health and illness. In addition, clinical values are well illustrated through consideration of specific cultural variables along with the application of DSM-IV-TR guidelines as they are used for cultural formulation of a series of clinical case examples.—Deborah L. Scuglik, M.D., Metapsychology Online Book Reviews, 8/1/2003

Cultural Assessment in Clinical Psychiatry works like an effective how-to-do manual. Interesting case examples add to the rich application of the cultural formulation. This is a must-read book for all trainees in mental health.—Lillian Comas-Diaz, Ph.D., The Journal of Nervous and Mental Disease, 8/1/2003

The Committee on Cultural Psychiatry of the Group for the Advancement of Psychiatry has written an excellent book, as one might expect from a group of individuals who have all had a major role in shaping our current understanding of cultural psychiatry.—Russell Lim, M.D., Psychiatric Services, 8/1/2003

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