Saturday, April 13, 2013

Culture and treatment, a reaction

Culture and Treatment
To think that the whole idea of psychotherapy could be culturally irrelevant outside of the western world is a large chunk of cookie to swallow. And due to the current lack of research, it is a very possible fact. I hadn't given much thought to it, that since psychotherapy was created within the western world that it could possibly not be applicable to cultures in other parts of the world. I am not sure that therapy could be completely ineffective in other cultures, but . However, I have always been somewhat skeptical about all of the schools of therapy and their limitations. I eventually want to be a therapist. The idea of psychotherapy being culturally bound may not have occurred to me before, but I have noticed a similar phenomenon. Every person has a slightly (and sometimes dramatically) different view of the world, which comes out when they make statements about how things are, or how they see things. I have witnessed this throughout my life. It seems that really every theorist's view on psychology is an extension of their outward projection. That makes sense, and what also goes along with that is the fact that one person's solution to life's issues will not always another person. This is especially true because most people tend to project themselves all over the people around them.
This idea of psychotherapy being somewhat culturally bound is further confirmed when the text looks at two studies in two different large US cities that that show higher dropout rates, poorer treatment outcomes, and lower rates of utilization of psychological services by minorities groups than by European American groups. These findings were for adults only. Studies of adolescents showed greater variation. This may be because young people typically are less resistant to social change than are adults who have lived in a specific culture for a longer period of time.
I have a hard time believing the actual purpose of therapy is culturally bound. Therapy's goal, through any school, is to help the client become more happy, whole and functional. This is done  basically by bringing the subconscious into the conscious so that the client is more aware. This seems pretty universal. I can only see this goal of therapy being inapplicable perhaps to a very hierarchical culture where  unconscious drives are shameful and not supposed to be discussed. But studies have shown for years that pushing back the unconscious likely causes psychological problems. Then again, I am not sure if these studies were cross-cultural.
I have mixed feelings about ethnic-specific treatments. The idea makes sense, especially when backed up with evidence that ethnic minorities are more likely to return for services when the services are ethnically based. The text cites that an important determinant of the effectiveness of mental health services is the length of treatment. If a person is likely to return for more treatment, they are more likely to become healthy. I am very optimistic about this research. However, ethnic-specific services don't sound too far off from segregation of services, and the United States has a dark history of segregation. Going to an extreme of separation cannot be the healthiest alternative. In order for a system of ethnic-specific treatment to be truly successful, it should all exist under the same umbrella of service organizations, so that true segregation cannot be allowed occur. Also, I think a helpful aim within ethnic-specific services might be to learn to function better within the current sociocultural context.

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