Presenting Problem

Language issues aside there are other basic steps that are important in initiating all clinical interviews but are of greater importance in the early cross-cultural interview. One of these is deterimining "why is the patient here?" There are usually several components to this question with all patients: What is the reason this person gives for seeking help now, and more importantly, what is the real reason help is being sought? As reasonably good clinicians we know that there are often unspoken or unconscious reasons why persons seek help and that we should be alert for these. In the cross-cultural clinical setting this also occurs, but the fact that the patient is from a different cultural group may add other layers of complexity to the question. Depending on the type of clinical setting, patients may present their problems in different terms. For example, in a medical/psychiatric clinic type of setting the patient may describe the presenting problem in terms of physical symptoms or psychological complaints (i.e., insomnia, anxiety, etc.), or more general yet related terms (i.e., nervousness, stress). In a family social service environment the patient (or client in this case) may start with an emphasis on family, economic or other social problems. A patient may come for help with distressing symptoms which at first are attributed to one underlying process (medical illness, family problem), but which are really the result of another process (spousal abuse, serious depression).

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