Multicultural Issues

Multicultural Issues entail a wide range of topics and challenges stemming from similarities and differences found in race, religion, ethnicity, culture, sexual orientation, and/or disability. Culture is shared patterns of behaviors and interactions, beliefs, and emotional understanding that are learned through a process of socialization. 

Although this is not an exhaustive list of all the cultural frameworks, this list illustrates a way to begin to understand cultural influences Hays (2001, 2009):

• Age and generational influences

• Developmental disabilities

• Acquired disabilities

• Religion and spiritual orientation

• Ethnicity (and Race)

• Socioeconomic status

• Sexual orientation

• Indigenous heritage

• National origin (and generational status)

• Gender

There are a number of culturally specific stressors which is a system of oppression that produces inequities on the basis of a cultural factor:

• • Heterosexism (sexual orientation)

  • Ableism (dis/ability)

  • Ageism (age) 

  • Religion (religious beliefs, practices, and/or affiliations; e.g., Islamophobia, Anti-Semitism) 

  • Cissexism (gender identity)

  • Colonialism (practice of domination involving subjugation of a people; e.g., Indigenous people in Canada)

  • Classism (class, socioeconomic status, education, wealth) 

  • Sexism (sex and/or gender) 

  • Racism (race)

  • Immigration Status (citizenship and/or immigration status) 

Each of the cultural stressors are systemic, structural, interpersonal, and internalized. People from different cultural groups may be negatively stereotyped or heavily discriminated against because of their differences from a main culture. We live in a society that brings together people of various cultures and sometimes this may or may not result in tension or friction between people. Regardless of one’s background or heritage, healthy social environments can depend on tolerance, compassion, and a willingness to learn about and celebrate the  differences and similarities within us. 

HOW DO MULTICULTURAL ISSUES AFFECT HEALTH?

Culture, customs, or beliefs can greatly influence how people interact and how we see one another in different ways. Culture plays a number of roles in one’s well-being and such roles include: coping styles, help-seeking behaviors and attitudes, understanding or views of behavioral health symptoms and disorders, ways to express one’s emotion and define health, and protective or risk factors. For instance, race or heritage can play a role in health as some health conditions (e.g., cardiovascular diseases, osteoporosis) are more likely to occur in marginalized populations. Some people of color are also shown to be more susceptible to other concerns such as eating or food issues. 

In addition, people’s perspectives on health and health problems vary by their cultural views, which in turn influences their medical treatment seeking actions. Sometimes one’s cultural views and practices can enhance their overall health or be beneficial for certain health issues, but can lead to maladaptive or problematic dynamic in medical treatments. Studies have illustrated that various minority groups may be less likely to seek both medical and mental health treatment and some of the main reasons include fear, stigma, discrimination experienced in the healthcare system, or lack of access and resources.  

Ever-changing societies rely on refraining from negative stereotyping and discrimination. Everyday experiences of discrimination can increase stress and negatively impact mental health and one’s self esteem. Along with the obvious impact of outright discrimination and violence, the effects of implicit bias and microaggressions can accumulate over time and lead to chronic stress and health issues. I recognize the harmful effects of such discriminations and other experiences that individuals encounter sometimes or on a daily basis and provide support to those who go through the negative health consequences of such experiences. 

Because culture and life contexts significantly influence the manifestation, course, and expression of mental health difficulties, it is crucial to examine and appropriately reflect on these contexts in the assessment, diagnosis, intervention, and prevention effort. 

IMMIGRATION CONCERNS

Many individuals and families relocate for an array of reasons across the world (e.g., escaping from terrorism and crimes, seeking better living situations). As some studies suggest, when they secure safe environments and more resources in the new country they settled, their overall rates of mental well-being tends to improve compared to those who were born in the U.S. with a different country of family origin.  

However, immigration concerns often expose those who landed and settled in a new country to extreme risks to mental health and threaten people’s access to proper medical and mental healthcare. The immigration policies (duration of stay, rights upon arrival, detention facility stay, etc.) in each country differ and can significantly impact individuals’ access and resources in a timely manner. For example, individuals with temporary visas often report developing mental health concerns (anxiety, stress, discrimination, loneliness, isolation, etc.) that did not exist or became worse through the process or the results of their immigration. 

These effects are more damaging for individuals who were detained. Detained refugees often report pervasive stress, symptoms of depression and anxiety, as well as posttraumatic stress with painful flashbacks, nightmares, reliving the event, and sadness. Despite the general success rate of escaping traumatizing and terrorizing environments in their home country, the likelihood of experiencing even more trauma during detention can lead to higher risks of negative mental health outcomes. The lack of or limited access to basic needs that one requires for their well-being, such as work, housing, education, or healthcare services, can exacerbate any mental health issues and prior traumas that many immigrant individuals and families face.    

HOW THERAPY CAN HELP WITH MULTICULTURAL ISSUES

Culture plays a crucial role in psychotherapy and other psychological work. Research has shown that often therapy patients prematurely terminate their treatment or do not seek treatment at all due to negative perspectives (i.e., stigma) on mental health treatment, lack of support and/or resources in their environment, cultural mistrust and lack of cultural responsiveness in therapy (Lester et al., 2010 ; Roberts, Gilman, Breslau, Breslau, & Koenen , 2011; Paramesh , Cockbain , Hillyard , & Price, 2017).

I believe that understanding the worldviews and values of patients as well as the modal experience of the cultural groups while acknowledging the unique lived experience of each patient is pivotal in my treatment when it comes to multicultural concerns. In therapeutic relationships with patients, a unique dynamic is formed by the culture of both therapist and patient. Even when multicultural issues may not be the immediate focus of the therapy work, it is very important for a mental health provider to be aware of any possible cultural differences found in the relationships.

I am passionate about addressing the health disparities in many different cultural groups. Instead of looking at individuals’ problems through the lens of deficit, generalizing or pathologizing aspects, I adopt the lens of strength-based, socio-political, and systems focus to promote and support health equity. I love assisting people to recognize and utilize their own resilience while addressing problems that are heavily influenced by ongoing historical trauma as well as socioeconomic and sociopolitical problems.

In my clinical work, I take an approach of being culturally humble and conscious, systems and trauma-informed, and strength-based when serving many individuals from different cultural backgrounds to promote authentic engagements with them. I carefully learn and examine one’s cultural contexts and how it affects individuals struggles and their effort to cope. When making diagnoses and providing treatment as well as recommendations, I strive to stay mindful and informed of the role and impact of one’s culture including my own biases of which I may not be aware. Since I am also a product of culture and do not have all the knowledge and experiences of every single culture that exist in human history, I relentlessly pursue continuous education and training in order to stay as a culturally informed and responsive psychologist in my work. 

To learn more about my approaches in multicultural issues and discuss your problems, please schedule a free 15 minute consultation with me.