Problem: After reading the following TEDx Talk, Challenges and Rewards of a culturally-informed approach to mental health By Jessica Dere, answer the following three (3) questions from the point of view of a licensed professional counselor in training.
1. What could be an initial assumption about Pat? Need Assignment Help?
2. Was there something that was hard to understand about the video?
3. What was a key takeaway from this talk?
TEDx Talk Challenges and Rewards of a culturally-informed approach to mental health By Jessica Dere.
It's truly an honor to be here. I would like to start my talk today with a little exercise introducing you to a person named Pat. Pat is 31 years old and lives at home with one sibling and their parents. Pat has always lived in the family home and would not consider moving out to live alone except after getting married. Todd's parents always play a significant role in making decisions about all aspects of Pat's life, including education, work decisions, past friendships, and romantic life. This has been the case since Pat was a child. Pat really makes decisions without consulting family members and rarely expresses disagreement with others out of fear of disapproval or loss of support. Pat feels very uncomfortable when alone and tends to cling to others out of fear of being abandoned. Now take a moment to picture Pat. Are you picturing a young man? A young woman. Are you picturing a person of a particular ethnic or cultural background? Maybe similar to your own or different? And consider for a moment whether such information would make a difference in how you think about that, and whether or not you think that Pat might have some kind of mental health concerns. Now what if I added the following information? Specifying that Pat is Patricia Lee and that she and her family immigrated to Canada from China when she was five years old. Or the following, where Kat is Patrick Smith, whose maternal and paternal grandparents immigrated to Canada from the United Kingdom, and his parents grew up in the Toronto area. Judging from some faces that I can see, is information indeed makes a difference in how you think about that. Simply adding some basic demographic information can significantly shift how we think about the very same behaviors. This exercise is elicited similar responses in my classroom when I have used it in teaching about personality disorders, which offer a particularly striking example of the need to consider cultural factors when defining mental illness, since they are themselves defined by patterns of behavior that deviate from cultural expectations. I use it to exercise, to introduce the role of cultural factors in thinking about mental health and illness, and to introduce the central idea that culture matters. In my experience, once introduced to this idea, people seem to intuitively know that culture makes a difference when thinking about mental health and mental illness. Without specifically talking about cultural differences in things like parent child relationships, independence and interdependence or assertiveness, we seem to just know that it makes a difference if we're talking about Patricia or Patrick. But not only does culture matter, when it comes to mental health, it is fundamental. Many people, including myself, argue that a culturally informed approach is really critical to effective healthcare, and that only by including cultural factors in our discussions of this field will be truly make advances. Recently, a group of medical and social scientists writing in one of the world's most prestigious medical journals stated the following. At the systematic neglect of culture in health and Healthcare is the single biggest barrier to the advancement of the highest standard of health worldwide. A pretty powerful statement. So this is great. I see a number of you nodding, and you seem to be in agreement that reflecting on Pat illustrates for you, at least at a basic level, the importance of considering cultural questions when it comes to mental health. But stopping here would be problematic for a number of reasons. First of all, I still have 15 minutes and 52 seconds left on the clock. But more importantly, stopping here could serve to reinforce certain cultural stereotypes. Contrasting the leads versus the Smiths, and would not really leave you with any idea of how to actually go about considering cultural factors. Or worse, it might leave you with an overly simplistic idea of how to do this, suggesting perhaps that simply knowing a person's ethnic background or immigration history provides enough information to really understand the meaning of their behaviors and relationships. So acknowledging the culture matters is a crucial initial step, sort of like the first piece of a puzzle. But we need to go much further. So knowing Pat's cultural background is like having a first piece of the puzzle. Much more needs to be learned before getting even close to a complete picture. For example, based on common cultural ideas, you may have had the sense that the description of Pat's behavior became somehow more acceptable when it was Patricia, a young woman of Chinese Canadian background, compared to Patrick, a young man and 2nd generation Canadian of British descent. However, although interdependence and social harmony our values more commonly endorsed among people of China's background compared to Western European background. Is it necessarily the case that Patricia's parents are happy with her level of dependence upon them? Maybe their migration to Canada was partially driven by their own traits of independence and they are really quite concerned that their daughter has not developed greater autonomy or self reliance. Maybe Patricia has never felt that you fitted among her peers and really feels incapable of attaining the level of independence as encouraged by her parents. On the other hand, although independence and autonomy are commonly endorsed, values in North America make its normative within Patrick's family to defer to one's parents and to view life decisions as communal endeavors. These examples illustrate that we cannot simply make sweeping assumptions about people purely based on their cultural background. Nor can we make simple comparisons or distinctions between people similar because they're from different contents. Now this might suggest to you then that cultural information is of not much use at all, and that we should simply focus on the individual and their unique experiences. But this would also be problematic and incomplete. Because to truly understand Patricia Lee's experience, we must know that her parents level of emphasis on independence may be relatively uncommon, uncommon within their cultural community. And on the other hand, or similarly, Patrick Smith's experience of his level of dependence upon his family would likely carry different meaning if he and his family were from a cultural community that particularly emphasized family. So in other words, in order to really develop a full understanding of mental health, we must develop an understanding of individuals in context. So this discussion illustrates one of the key challenges of a culturally informed approach to mental health. And in teaching this field to undergraduate students, I have the privileged opportunity of working with them as they wrestle with these very types of challenges. The path that I often see my students take is one of initial excitement. And they engage with the idea that culture matters and often tend to appreciate the in-depth discussion of a topic that tends to be lacking or minimized in teachings about mental health. His initial excitement, though, then turns often to some level of viewing, overwhelmed as they begin to really grapple with the complexity of culture and begin to recognize the number of different factors to consider and questions to pose. In helping my students to navigate these questions, it has helped me to distill my own thinking about this field and how best to teach it. I recognize that dealing with cultural matters can indeed be daunting, and I also have some concern that feeling overwhelmed can sometimes lead to the avoidance of new ideas or experiences. So with that in mind, I propose two related suggestions that I believe can help people to engage with a culturally informed approach to mental health rather than avoid it. And these are to take the stance of informed curiosity and to ask different questions and ask questions differently. So a stance of informed curiosity stands in contrast to some models of culture and mental health, which suggests that one needs to be an expert in a particular cultural group in order to work with or understand the experiences of a member of that group. For example, many articles in book chapters talk about working with Asian clients or working with Hispanics clients. Although well intentioned, that type of approach can inadvertently lead to the perpetuation of cultural stereotypes. There's the assumption, at least at at some level, that members of a given group share values, beliefs, and experiences simply based on group membership, so that can be the case. It is certainly not necessarily true. A clinician working from such a perspective may have easily assumed that Patricia Lee's level of dependence upon her family was encouraged or supported. I've also always found the more expertise based approach problematic from a personal perspective. As the daughter of a tiny Canadian father and Anglo Canadian mother, born and raised in bilingual Montreal, English was a first language. There is unlikely to ever be a book texture devoted to working with people of my particular cultural makeup. I think my own lived experience as a person of mixed cultural heritage informs my thinking about culture and how it plays a role in mental health. And my experience also plays a role in my emphasis on a stance of informed curiosity rather than expertise. I believe that such a stance promotes an attitude of humility and really encourages 1 to develop hypothesis and questions rather than make assumptions. So one of the key ways that I worked to promote a stance and form curiosity among my students is by helping them to ask different questions and ask questions differently about mental health. My own passion for the area of culture and mental health really began when I took a course an introductory course in medical anthropology in the second year of my undergraduate studies. This course proved to be a key turning point in my academic path, and looking back, I think that one of its lasting effects was that it forced me to ask different questions about health and mental health, questions to which I have not previously been exposed in my psychology courses. Working with a different discipline, with its own set of theories and frameworks. Also instilling me the value of asking questions differently. In many ways, that course forced me to re evaluate ideas I had previously taken for granted, and that type of experience is often at the heart of cultural discussions about mental health. The interdisciplinary nature of my early experience also corresponds to the interdisciplinarity that often characterizes discussions of culture and mental health. Taking back to that image of the complex set of puzzle pieces. A cultural approach to mental health truly benefits things from the integration of different perspectives, each offering their own sets and types of questions. Now, taking a stance and inform curiosity by no means minimizes the importance of developing in depth knowledge in cultural matters. Rather, the emphasis is on how to engage with this knowledge. With a focus really on gaining awareness of the wide range of cultural differences that exist in human experience so as to be equipped to pose informed questions. We know from cultural psychology research that there are significant cultural differences across the spectrum of psychological domains. Including in cognitive perceptual processes regarded as basic and therefore often assumed to be universal. For example, we know that there are significant cultural differences in how people perceive the world, such as to what extent they focus on background information when examining a photograph versus focusing on the photographs essential figure. We also know that there are significant differences in how people think about the world, such as to what extent they use contextual information when grouping different objects together. These types of differences suggest that some of you may be viewing the slide behind me as a single holistic image, whereas others may be more focused on specific constituent parts. More directly relevant to mental health, we also know that cultural context plays a profound role in what types of emotions people most value and want to feel, and how and with whom they express those emotions. In some cultural context, feeling proud is closely associated with generally feeling good, whereas in other contexts the individual focus that pride entails makes it less desirable. And there's a large literature demonstrating important cultural differences in how people define the very notion of the self. For some, of the cell was truly an autonomous and individual entity, whereas for others, their ideas about the self include close into personal connections. So cultural differences in domains such as these should directly inform our thinking about mental health and illness. If culture plays such a profound role when things are going right, it must surely play similar role when things go awry. How people experience profound shift in their emotional life is deeply influenced by their values and beliefs about emotions and when and whom it is appropriate to share their emotions. In some cultural context, physical symptoms of major depression tend to be more strongly emphasized compared to psychological symptoms. And this may be linked to cultural differences in values about emotion. So at this point I have likely convinced you of a number of the challenges of taking A Culturally informed approach to mental health, and I bothered some suggestions about how to engage with these challenges. But hopefully I have also at least planted the seed that there are rewards to be had as well. Not surprisingly, I personally believe that the rewards at the level of research, clinical care and teaching about mental health are numerous and profound, and ultimately far outweigh the challenges. At a research level, in order to build a comprehensive understanding of mental illness, we must integrate cultural factors, as suggested by the quote you. To start with my talk, we neglect culture at our own peril. If what it means to be sad and to share the sadness with others is profoundly impacted by our values and beliefs about emotion, and we will never develop a complete understanding of severe sadness or depression without a cultural approach. From a clinical perspective, integrated cultural factors into our assessment of a person's distress is crucial to really understand their experience and can contribute to improve treatment. We know from research that treatments that integrate a person's own cultural beliefs about the causes of their distress are more effective than treatments that do not. How best to integrate cultural factors into treatment is an area of ongoing investigation and debate, but begins with the arguments that culture makes a difference. And thirdly, at the level of learning about mental health for students and the general public more broadly, the rewards of a culturally formed approach include greater open mindedness, increased understanding of experience is different from ones own, and less stereotyping. This approach also offers new perspectives about ideas already learned about mental health. These are all rewards that my own students have specifically talked about when discussing the benefits of learning about this field. So I hope then for today is that you walk away with some of this increased open mindedness curiosity. And an interest in asking different questions about mental health. All rooted in the central premise that culture matters.