culture in psychiatric care
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Culture in Psychiatric Care. Albert C. Gaw, M.D., D.F.A.P.A. Clinical Professor of Psychiatry University of California San Francisco. Purposes of Presentation. To provide a clinically useful definition of culture To draw implications for mental health care. Culture. - PowerPoint PPT PresentationTRANSCRIPT
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Culture in Psychiatric Care
Albert C. Gaw, M.D., D.F.A.P.A.Clinical Professor of Psychiatry
University of CaliforniaSan Francisco
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Purposes of Presentation
• To provide a clinically useful definition of culture
• To draw implications for mental health care
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Culture
• A set of standard for behavior which a group of people attribute to those around them and which they used to orient their own behavior
Goodenough
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Culture…• Ideas that people carry around in their
heads about how other people, significant other people in their environment should act, standards that they attribute to others around them and which they used to guide their own behavior.
A. Harwood
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DSM-IV Definition• Meanings, values, and behavioral
norms that are learned and transmitted in the dominant society and within its social groups. Culture powerfully influences cognitions, feelings, and the “self” concept, as well as the diagnostic process and treatment decisions.
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Race• A number of broad divisions of the
human species, based on a common geographic origin, certain shared physical characteristics and distinguished from other such groups by a characteristic distribution of gene frequencies.
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Ethnicity
• Collectivity of people within a larger society defined on the basis of both common origins, shared symbols and standards for behavior.
Schermerhorn
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Essential Features of Culture
• Culture is learned• Culture refers to systems of meanings• Culture acts as a shaping template
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Essential Features of Culture…
• Culture is taught and reproduced• Culture exists in a constant state of
change• Culture includes patterns of both
subjective and objective components of human behavior
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Components of Culture
• 1. Percepts and concepts
– Percept: an impression in the mind of something perceived by the senses, viewed as the basic component in the formation of concepts.
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Association Areas of the Brain
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Components of Culture…
• Concept: a general idea or understanding; especially one derived from specific instances or occurrences.– A thought or notion
• E.g. anxiety, depression, schizophrenia
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Korean Concept
Luke Kim 1993
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Hwa-byung
Luke Kim 1993
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Components of Culture…
• 2. Proposition: ways in which percepts and concepts can be related to one another.– Location– Part/whole– Causal
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Components of Culture…
• 3. Beliefs: Propositions considered to be true.
– The world is round – God is almighty
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Components of Culture…
• 4. Values: Ways in which the world is organized into hierarchy of preferences.
– Life > death– Health > illness
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Components of Culture…
• 5. Operational procedures or recipe: ways in which people organized their effort to accomplish certain purposes.
– Taking a psychiatric history– Mental Status examination– ECT
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In Summary
1. Percepts and concepts2. Propositions3. Beliefs4. Values5. Operational Procedures or
Recipes
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Culture vs. Subculture
• Culture: involves very broad guideline or standards governing behavior in a wide variety of context, from cradle to grave.
• Subculture: narrower sets of standards which govern how one acts in a smaller range of behavior with a particular set of actors.
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Operating Culture
• Standards a person used at a particular time with significant others.
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Implications for Mental Health Care
• It enhances diagnosis and treatment.• It fosters clinician’s sensitivity towards
patients/clients.• It enriches psychiatric knowledge.
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Implications for Mental Health Care…
• It provides guidelines for judgment of “normality” versus “abnormality” of behavior.
• It provides a proper understanding of human beings, whether their behavior is normative or deviant.
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ReferenceReference
• Gaw AC: Concise Guide to Cross-Gaw AC: Concise Guide to Cross-Cultural Psychiatry. American Cultural Psychiatry. American Psychiatric Publishing, Inc., Psychiatric Publishing, Inc., Washington, DC, 2001Washington, DC, 2001
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Thank you !