M. Kagawasinger et Rcy. Chung, A PARADIGM FOR CULTURALLY BASED CARE IN ETHNIC-MINORITY POPULATIONS, Journal of community psychology, 22(2), 1994, pp. 192-208
Health care practitioners are encouraged to ''know the cultures'' of t
he multicultural client population they are serving in the United Stat
es. The premise behind this injunction is that the use of culturally s
ensitive techniques that are tailored to the cultural background of th
e client would result in effective therapy and produce positive outcom
es. However, as reflected in the plethora of terms used to describe th
e application of this knowledge, it is not made explicit why culture w
ould make a difference in therapy nor how it makes a difference, ultim
ately, in the outcome. The intent of this paper is to highlight one of
the fundamental sources of variation in cultural beliefs that affect
individual mental health. We propose a model that penetrates to the co
re of why culture makes a difference in how problems are perceived and
appropriate responses defined. Humans have three basic needs: safety
and security, integrity, and a sense of belonging. Yet each culture un
iquely frames each of these needs and prescribes the sanctioned means
to achieve them. In our struggle to define culturally competent or cul
turally based care, this fundamental aspect is often overlooked. Inste
ad, the Western worldview, structure, and definitions are used as the
template to assess dysfunction, diagnose a disorder, and prescribe app
ropriate care. The theoretical underpinnings of indigenous concepts of
self and symbolic interactionism are integrated to clarify these cult
ural misconceptions and to construct a new paradigm for providing effe
ctive and acceptable mental health care.