The last prerequisite for profesional competence in multicultural mental health is that each provider of service integrate research-based knowledge with knowledge gained from practice. Whether interventions are directed toward individuals, groups, or institutions, scientific practices dictate a feedback loop in which practice knowledge is evaluated to modify existing practices where deemed necessary and to modify theory, as well as research, when required. At the individual level this means that service providers change their service to be more consistent with the latest more efficient and effective practices. At the ecological level, this may mean that the basic structure of the culture, such as its institution(s) or its educational and parenting practices, require modification. Socioeconomic status is a particularly potent cultural force in human behavior, including prevalence of disorders, manifestations of illness, health status, physical illness (particularly infectious illnesses), mental illness, and treatment.
Understanding multiculturalism with all its immense ramifications for society at all levels is an implicit objective of this handbook. Multiculturalism as a force in psychology appears to be growing, and its theoretical and professional underpinnings are examined in several chapters. It is clear that a new multicultural worldview is in the making, with profound implications for identity, relations with others, health, illness, and adjustment.
In summary, this handbook is unique in its theoretical and thematic approach in which the role of culture is viewed as central, not peripheral, to mental health and to mental illness. It assigns to culture the potential of influencing the etiology, manifestations, and treatment of mental disorders. This handbook is unique in that it integrates DSM-1V cultural conceptualizations, criteria, and formulations. It goes far beyond cultural awareness and provides meaningful knowledge that bears directly on the assessment and treatment of diverse populations. Culture in the context of multicultural assessment and treatment practices is viewed as not just another variable or set of variables, but rather as a multitude of variables that constitute the context for the operation of all other variables. This prominence assigned to culture gives to both the experienced and the beginning mental health provider an array of conceptual tools and knowledge gained from both research and practice for delivering better mental health services for diverse populations.
Our minds are formed from our cultural experiences in interaction with our physiological development. Our perceptions, our values, our beliefs, and our emotions are formed and shaped by the cultures in which we are born and raised. Just as a ball of clay is shaped not only by the hands but also by the mind (in interaction, of course, with our physiology), the mind is shaped by cultural experiences and forces. Unlike the ball of clay, however, the mind has a dynamic quality, thanks to its computer and learning capabilities. As more than one writer has noted, we are each born into a story, but we also can make our own story. The mind thus has the ability to create its own story and to learn from others' stories as well. We are formed by our culture, but we have the potential of changing our culture as well, and in doing so, change ourselves or transcend our culture. No matter how far we take our own story, its roots always remain in our cultural experiences.
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