Understanding and Addressing Cultural and Multicultural Considerations in a Mental Health Assessment

by | Feb 25, 2024 | Psychology

 

Case Study
Sundeep is a 43-year-old male, married, with three children. He is from India and is currently living with his family in the United States on a work visa. Sundeep has entered your clinic for assessment and evaluation at the request of his wife and some family friends. He appears to be in a depressed mood, avoiding eye contact, and does not speak much in the first part of the assessment. Sundeep says that he has not been sleeping well lately and that he is experiencing high levels of stress related to his work and not meeting expectations within his job role. He is also studying at a local university part time, and he states that he is not performing as well as he had hoped he would. He has been experiencing extended sadness, feelings of hopelessness, lack of appetite, and extreme guilt about his emotions and thoughts. You notice that he avoids the use of the word “depression” and seems to replace it with “stress” during the conversation. Sundeep speaks to his father on a weekly basis and states that he dreads talking to him about how he is doing in both work and studies. As Sundeep begins to feel more comfortable, he shares that he has been thinking that if he fails here in the U.S., it will be even more difficult to go back to India and face his father, mother, and extended family. He shares that he has been thinking about harming himself, especially when the fear of failure is at higher levels throughout the day. Sundeep indicates that he has a plan for how he might take his own life and shares that he has the means to enact this plan as well.
In regard to strengths and supports, Sundeep identifies that he has two very close friends that he works with on a daily basis. He states that his wife is very supportive and that he does not know what he would do without his children, who are his source of motivation and strength each day.
Be sure to include the following components in your paper:
Part 1: Apply the four domains of the Cultural Formulation Interview.
• Apply the four domains of the Cultural Formulation Interview to the case study.
• Provide a thorough analysis of how information gathered in the Cultural Formulation Interview would apply to the diagnostic process with the individual in the case study.
• Discuss at least two ways cultural considerations may impact the diagnostic process with the individual in the case study.
Part 2: Examine the legal, ethical, sociocultural, and professional multicultural considerations associated with the case.
• Examine the legal standard for civil commitment. What are the cultural considerations that should be considered prior to a civil commitment? What specific cultural considerations related to the case should be considered related to civil commitment?
• Provide a rationale for why it is professionally and ethically imperative for the clinician to be aware of cultural considerations in the diagnostic process.
• Discuss at least two ways your own sociocultural/diversity perspectives may impact working with the client in the case study. { How might your own perspectives be applied or impact the diagnostic process?

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Answer

Sample Answer

 

Understanding and Addressing Cultural and Multicultural Considerations in a Mental Health Assessment

Part 1: Applying the Cultural Formulation Interview

In the case of Sundeep, a 43-year-old Indian male experiencing significant distress, it is crucial to apply the four domains of the Cultural Formulation Interview to gain a comprehensive understanding of his cultural background and the impact it may have on his mental health.

1. Cultural Definition of the Problem: Sundeep avoids directly mentioning “depression” and instead refers to his struggles as “stress.” This linguistic difference may stem from cultural beliefs that view mental health issues with stigma or shame, especially in certain South Asian cultures. Understanding this cultural perspective is essential for accurate diagnosis and treatment planning.

2. Cultural Perceptions of Cause, Context, and Support: Sundeep’s fear of failure and the pressure he feels from his family, particularly his father, are rooted in cultural expectations and norms prevalent in many Indian families. Exploring these cultural factors can provide insights into the unique stressors he faces and how they contribute to his current mental health challenges.

3. Cultural Factors Affecting Self-Coping and Past Help-Seeking: Sundeep’s reluctance to openly discuss his struggles with his father and his emphasis on self-harm as a coping mechanism may be influenced by cultural norms around masculinity, emotional expression, and help-seeking behaviors. Understanding how cultural beliefs shape his coping strategies is vital for developing an effective intervention plan.

4. Cultural Factors in the Therapeutic Relationship and Treatment: Recognizing Sundeep’s strong support network comprising close friends, a supportive wife, and children can guide treatment interventions that leverage these sources of strength within his cultural context. Incorporating culturally sensitive approaches, such as involving family members in therapy or drawing on culturally relevant coping mechanisms, can enhance the therapeutic alliance and treatment outcomes.

Part 2: Legal, Ethical, Sociocultural, and Professional Multicultural Considerations

1. Legal Standard for Civil Commitment: In considering civil commitment for Sundeep, it is crucial to recognize the cultural factors that may influence his perception of mental health treatment. In many South Asian cultures, seeking mental health care can be viewed as a sign of weakness or failure, which may impact his willingness to engage in treatment voluntarily. Understanding these cultural considerations is essential to ensure that any legal interventions respect his autonomy and cultural beliefs.

2. Professional and Ethical Imperatives: Clinicians must be aware of cultural considerations in the diagnostic process to provide culturally competent care that respects the individual’s values, beliefs, and practices. Failing to account for cultural factors can lead to misdiagnosis, ineffective treatment outcomes, and ethical breaches. By incorporating cultural competence into clinical practice, clinicians uphold ethical standards and promote positive therapeutic relationships with diverse clients like Sundeep.

3. Sociocultural/Diversity Perspectives: As a clinician with unique sociocultural perspectives, your own background may influence how you approach and understand Sundeep’s case. For instance, if you share a similar cultural background with Sundeep, you may have insights into the cultural nuances shaping his experiences and beliefs. Conversely, if your perspectives differ significantly from his, it is essential to remain open-minded, culturally humble, and willing to learn from Sundeep’s lived experiences to ensure a culturally responsive diagnostic process and treatment approach.

In conclusion, integrating cultural and multicultural considerations into mental health assessments like Sundeep’s case is vital for providing holistic and effective care that respects individual diversity and promotes positive mental health outcomes. By applying the Cultural Formulation Interview and recognizing the legal, ethical, sociocultural, and professional dimensions of multicultural considerations, clinicians can enhance diagnostic accuracy, treatment efficacy, and therapeutic rapport with diverse clients facing mental health challenges.

 

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