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Cultural considerations in healthcare
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Assessment and treatments vary, and there are many outside influences that shape each process. One aspect that will be identified and explored will be the impact that culture has upon each. Questions explored will help understand how differences in culture can sometimes return varying degrees of either success or failure. Latino culture has its own defining characteristics and a very distinct set of values which have to be taken into consideration when trying to asses and treat alcohol or substance abuse.
The Role of Culture in Assessment and Treatment
There are many questions that require answers when exploring the reasons behind, or the circumstances surrounding a person with a AUD. One tool that aids in answering questions and connecting people with the proper resources is an assessment. A good assessment is critical to the process of helping individuals past the initial awkwardness of actually seeking professional help with an addiction. Assessments can cover a wide range of topics, such as gathering history related to prior substance abuse, medical, psychiatric, any pending legal issues, and family developmental issues. One aspect that assessors can gather much information from is the impact of social influences. Understanding social influences and more specifically, cultural
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At the onset of the assessment process, it was made clear that this was going to be a thorough undertaking. The client received, acknowledged his understanding of, and signed a release of information agreement. The client was made to understand that every bit of information gathered could have some relevance to the final assessment outcome. “Every assessment process is more than just a one-time paperwork procedure conducted at the onset of treatment to simply gather facts and secure a …diagnosis” (Juhnke, 2002). The following is an example of a test conducted to help establish baseline data.
1. Standardized testing.
a. Alcohol Use Disorders Inventory
With the growing population of minorities in the United States, it is reasonable to believe that at some point in a counselor or therapist career, there will be a session with a Latino/Hispanic client. From a cultural competence perspective, it is imperative that a counselor understands the Latino/Hispanic culture and their worldviews. Counseling Latinos offer to be discussed in the paper is the case of an Alberto and Angela a Mexican American couple married for 27 years. Alberto has recently lost his job. (
Some people only drink on the weekend, or just not at work. Some people attempt to hide their alcohol abuse while others demand company, or anything in between these various elements. Alcohol abuse or addiction is defined as an individual who a) needs to use alcohol every day to function, b) makes attempts to limit use to specific time with periods of sobriety between incidents of heavy drinking, c) have “binges” of continuous use for long periods of time interspersed with the aforementioned periods of abstinence, d) use in excess of the medical and social norms (Doweiko, 2015). To be diagnosed with an AUD requires the individual to meet 2 of eleven criteria laid out by the DSM-5 within a year, then severity is assessed on the basis of how many criteria are met (NIMH, n.d.). Severity is assessed as mild meeting 2-3 criteria, moderate meeting 4 to 5, and severe meaning meeting 6 or more criteria. These eleven criteria include factors such as having drank longer than intended, reduced interest in activities, increased risk behavior, and other factors that look at how drinking has affected you socially (NIAA,
A psychological assessment is defined as “the gathering and integration of psychology-related data for the purpose of making a psychological evaluation that is accomplished through the use of tools such as tests, interviews, case studies, behavioral observation, and specially designed apparatuses and measurement procedures” (Cohen, Swerdlik, &Sturman, 2013). Although examiners strive toward the assessment being good enough to be useful, they sometimes have to make decisions about what type of error is acceptable. There are many psychological assessments that have been used in the study of addictions, but we will take a look at the Addiction Severity Index.
Therefore, Mexican Americans typically take a passive role with regard to treatment options. For example, Mexican Americans seldom voice problems with pain while in the hospital due to a high value being placed on stoicism. Consequently, studies show that they receive inadequate analgesia more often than any other population. Life-sustaining measures may also be requested by family members if there is any hope that the ill loved one will survive. However, Mexican Americans believe that th...
Straussner, S.L.A., (2001). Ethnocultural Factors in Substance Abuse Treatment. (254 & 261). New York, NY: The Guilford Press.
Social problems include difficulties with family relationships, isolation, interpersonal conflicts, and pressures of social roles. The Latino culture tends to place a higher premium on the well-being of the family unit over that of any one family member, a concept termed familialism (Smith & Montilla, 2006). In general, familialism emphasizes interdependence and connectedness in the family, and often extends familial ties beyond the nuclear family (Falicov, 1998). Given these values, Latinos often describe depression in terms of social withdrawal and isolation (Letamendi, et al., 2013). Social roles also play an important role in mental health, traditional gender roles in particular are strongly enforced and can be a source of distress. In Latino culture, men and women are expected to fulfill the roles outlined in the traditions of Machismo and Marianismo respectively. Machismo indicates that the man is supposed to be strong and authoritative, while Marianismo designates the woman as the heart of the family both morally and emotionally (Dreby, 2006). Although there is little research on causal factors, adherence to these traditional gender roles can pose a psychological burden and has been found to be strong predictor of depression (Nuñez, et al., 2015). The centrality of social problems in the conceptualization of depression for Latinos may be reflective of the collectivistic values that are characteristic of the group. Although these values have the potential to contribute to depression, they also have the potential to serve as protective factors and promote mental health (Holleran & Waller, 2003). Therefore, it is imperative that the counselor carefully consider cultural values, both in terms of potential benefits and drawbacks, to provide appropriate counseling to the Latino
“Ultimately, diagnosis of a substance use disorder or PTSD relies on clinical assessment using DSM criteria. Screening instruments exist that can help uncover or point the way toward a potential diagnosis. For alcohol use disorders, the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-Consumption (AUDIT-C) have been widely validated as self-report screening measures. A single-item screening measure was recently validated for drug use disorders consisting of the single question, “How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?” A response of 1 time or more yields a positive screen.” -Returning Veterans With Addictions. (2011, July 11). Psychiatric Times. Retrieved Februa...
Robert s. Young, Jennie R. Joe. “ Some Thoughts About Epidemiology of Alcohol and Drug Use Among American Indian Population”. Journal of Ethnicity in Substance Abuse. Vol. 8 Iss 3:(2009) 223
This paper will discuss the Native American culture and briefly review their history, some beliefs and roles in society today. A short description into their culture with References will be used to show how Native Americans have been affected throughout hundreds of years. The trauma this culture endured has created many barriers, yet one often seen today is their extreme problem with the disease of Alcoholism. The Native American culture has gone through endless struggles, which has cost them to lose so much and still continues to impact them today. They are slowly moving back toward getting benefits that should have been available long ago, but in today’s world Native Americans still battle with many barriers not only in society, but in getting appropriate treatment for mental health or addiction issues.
(2012).Screening for alcohol risk in predominantly Hispanic youths: Positive rates and behavioral consequences. Journal of Child & Adolescent Substance Abuse, 21(3), 273-291. doi:10.1080/1067828x.2012.700851
In practice I would utilize The Genetic Model. The Genetic Model is a model focuses on the inheritable aspects of addiction in the individual (McNeece & DiNitto, 2012). Genetics can affect an individual with disease such as cancer or drug addictions. Inheritable aspects that can affect the individual are genetic mutations and mirrors behaviors by the individual of their environment. The genetic model will also allow the social worker or councilor to look in to the history of the client in potentially establishing the addiction.
The use of alcohol and substances are small among the Hispanic or Latino culture, but higher due to socioeconomic status. I have a better understanding of the triggers that could cause the Hispanic culture to become stressful and vulnerable even before living in the United States. This course has been a crucial weapon for social workers to be engage with Hispanic teens to combat the use of alcohol abuse by using the SBIRT tools. The SBIRT tools also provides theoretical frameworks that steps throughout the process to break free silence, shame, and uncover substance abuse.
in Strunin et al. 316). Mexican families allow the use of alcohol amongst their youth, this practice is often found not only in Mexico but in the U.S as well. Use of alcohol amongst teens is negligent behavior by both the parents adolescents. The study done by Strunin and other authors, also mentions the prominence of alcohol use amongst Hispanic/Latino youth. 16% of the U.S population consists of Hispanic/Latino immigrants, of that percentage, ⅔ identifies as Mexican. Of that majority, 40% is at risk of substance abuse. (Strunin et al. 309). Almost half of the of this population is prone to alcohol use amongst its youth. If substance abuse is a cultural value that is retained from a Hispanic/Latino family it is obvious that multiculturalism has developed a flaw that can lead communities into possible legal offenses. This retained cultural value is severe and should be attributed to negligent ideology that multiculturalism develops in our
Such as if the client needs information for living that is wheelchair accessible or community activity centers, this information could be provided shortly after the assessment to help the client get motivated towards their discharge goals. Giving them information early allows the client to process the information and be able to communicate with the TRS if this is helpful or if they need other material. Another example could be if the client was in pain, an immediate action could be for the TRS to contact someone to that could help with the client’s
The cause of alcoholism is a combination of biological, psychological, and cultural factors that may contribute to the development of...