Promoting the Culturally Sensitive Diagnosis of Mexican Americans: Some Personal Insights

Abstract

This article presents a series of personal guidelines for promoting the culturally sensitive psychiatric diagnosis of Mexican American/CNcano clients. These guidelines are primarily based on the authors' collective experiences in diagnosing and treating this population.Diagnostic assessment can be especially challenging when a clinician from one ethnic group uses the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-Tv; American Psychiatric As- sociation, 1994) to evaluate an individual from a different ethnic or cultural group. A clinician who is unfamiliar with the nuances of an individual's cultural frame of reference may incorrectly judge as psychopathology those normal variations in behavior, belief, or experiences that are particular to the individual's culture (DSM-N 1994). The purpose of this brief article is to present some of our personal insights into the psychiatric diagnosis of Mexican American or Chicano clients. These insights are intended to (a) supplement those made by other clinicians who have previously examined issues related to M g r a Gonzales is a doctoral student in counseling psychology at Michigan State University. Zdalia Castillo-Canez is a graduate student in clinical psychology at San Diego State University. Henry Tarke is regional manager of San Diego Mental Health Services. Fernando Soriano is a research associate for the Child and Family Research Group in San Diego. Piedad Garcia is regional manager for San Diego Comty Mental Health Services. Roberto J . Velasquez is an associate professor of Psychology at San Diego State University. Correspondence regarding this arlicle should be sent to Myra Gonzales, Michigan State University, 11 2 Paolucci Bldg., E. Lansing, MI 48824-1 11 0.

On machismo, grief abreactions, and mexican culture: The case of mr. x, the counselor, and the curandera

“…To the extent that a present time orientation is operative, and to the extent that this is a common trait in raza, resolution of psychological conflict may be synonymous with symptom abatement in clients-such as Mr. X-with a strong present orientation (APA, 1991; Gonzales et al, 1997;Sue & Sue, 1990).…”

“…In short, using anger to mask sadness-and the shame that Mr. X seemed to feel with that sadness-was "no longer working." Thus, the plan was to form a strong alliance with Mr. X, exploring the brother's death and his thoughts and feelings about it, in hopes of getting to the sadness in a "safe environment" (Gonzales et al, 1997;Teyber, 1992). After the fifth session, the client reported no change, After the sixth and seventh sessions as well, no change was reported, even with seemingly good rapport.…”

“…It appeared likely that the depressive symptomatology was not just reflective of a tragic loss. There is little doubt that suppressive elements arising from his take on machismo were the issue complicating his bereavement, feeding into and mirroring as depression (Gonzales et al, 1997).…”

“…It is also clear that we must accept the fact that, as psychologists and counselors, we are not viewed as group-sanctioned change agents in many cases. Finally, it is evident that a curandera may well use psychological interventions, through mingled with religious and ethnocultural artifacts, that can impact certain clients in ways that we now cannot (APA, 1991 ;Back-y-Rita, 1982;Gonzales et al, 1997).…”

Publishing in the Journal of College Counseling, Part 1: Disseminating College Counseling Knowledge Through Research Studies

“…Regardless of the quantitative or qualitative design used, researchers should consider diversity issues when conducting research studies. Counseling researchers are finding increasing evidence that some of the field's methods and models are inappropriate or insufficient for understanding the helping relationship (Lee & Mixson, 1995), problem assessment (Garretson, 1993;Gonzalez et al, 1997), and interventions (Pedersen, Draguns, Lonner, & Trimble, 2002) with populations who are diverse on the basis of race and ethnicity, gender, age, socioeconomic status, sexual orientation, or life conditions such as disabilities. This is of particular importance to counselors in the college setting, where professionals have been providing services for an ever increasingly diverse campus constituency (Bishop, 1990).…”