Transcript Cross-cultural adjustment & mental illness

Cross-cultural
Adjustment
&
Mental Illness
Mei Liu, M.A.
Certified Canadian Counsellor
Canadian Counselling and psychotherapy
association
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Workshop Objectives
• Understand the natural process and
issues in cross-cultural adjustment
• Learn how to use self-validation for
cross-cultural adjustment
• Recognize common mental illnesses
• Know when and how to seek
professional help in the community
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PART ONE
Cross Cultural adjustment
• Cultural Identity development
• Cultural Dislocations
• Cultural Conflicts
• Self-Validation
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Racial Identity Development
Definition:
The process of developing rejection
or/and acceptance toward own and
dominant cultures, as well as other
minority groups
• Not everyone will go through the
same stages of development
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Cultural Identity
Development
Five Stages: (Sue & Sue, 1990)
• Conformity
• Dissonance
• Resistance and Immersion
• Introspection
• Integrative awareness
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Cultural Identity
Development
Conformity Stage:
• Self-depreciating toward self & own
culture
• Appreciation toward dominant
culture
• Discrimination toward other minority
groups
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Cultural Identity
Development
Dissonance Stage:
• Conflict between depreciation and
appreciation toward self and own
culture
• Conflict between depreciation and
appreciation toward majority culture
• Conflict between dominate-held view
of racial hierarchy toward other
minority group
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Cultural Identity
Development
Resistance & Immersion Stage
• Develop appreciation toward self and
own culture
• Develop depreciation toward majority
culture
• Developed empathy but also ethnocentrism toward other majority
groups
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Cultural Identity
Development
Introspection Stage:
• Examine basis of appreciation toward
self and own culture
• Examine basis of depreciation toward
majority group
• Examine own ethno-centrism toward
other minority group
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Cultural Identity
Development
Integrative Awareness Stage:
• Develop a positive attitude, sense of
self, and confidence toward self &
own culture.
• Develop appreciation and openness
to certain positive traits of majority
culture
• Develop appreciation toward other
minority group and willingness to
reach out to them
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Cultural Conflicts
Two types of Cultural Conflicts
• Conflict with the new culture
• Conflict arising with own culture after
being exposed to new culture.
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Cultural Conflicts
Four states of conflicts:
• Low cultural conflict
• Host cultural conflict
• Home cultural conflict
• Bicultural conflict
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Cultural Dislocation
• A subjective experience of feeling
displaced or not at home a in given
socio-cultural environment
(F. I. Ishiyama, 1995)
• Lack of validation or under-validation
of self or the ethnic self in the host
culture
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Cultural Dislocation
Three Domains:
• Unfamiliarity and disorientation in a
new environment – decreased social
competency
• Uprooted-ness and homesickness
• Identity crisis
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Self-Validation in New
Environment
• Based on Dr. Ishiyama’s work
• A useful concept in helping self and
others through the cross-cultural
adjustment process
• Explore past and current sources of
validation to grieve losses and
establish new strength and identity
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Self-Validation in New
Environment
Themes of Validation
• Security, Comfort & Support
• Self-Worth & Self-acceptance
• Competence & autonomy
• Identity & belonging
• Love, Fulfillment and Meaning in life.
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Validationgram
Sources of validations:
• Relationships
• Places
• Things
• Activities
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Validationgram
Things
Relationships
Self
Increasing
importance
Activities
Places
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PART TWO
Mental Illness
• Schizophrenia
• Mood Disorders – Depression &
Bipolar
• Anxiety Disorders
Contributing Factors
Mental Health Resources
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Mental illness
Definition:
• A diagnosable disorder that
significantly interferes with one’s
thinking, emotion, behaviours, and
social interactions.
Diagnostic Standards:
• North America: DSM
• Europe: ICD
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Mental illness &
Cultural Perspectives
• Different cultures might have
different interpretations.
• A high degree of consensus about
the diagnosis of mental illness
among many countries.
• Diagnosis/label not as important
• How symptoms affect functioning is
the best indication for intervention.
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Schizophrenia
Positive symptoms:
• Hallucinations:
Distortion in five senses/perceptions:
hearing voices, seeing things.
• Delusions:
Beliefs that is out of touch of the
reality, especially paranoia. i.e.
other are plotting to hurt them;
super power
• Disorganized speech
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Schizophrenia
Negative Symptoms:
• Withdrawal/isolation
• Lack of motivation
• Flat affect (dull expression)
• Neglect hygiene or personal care
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Schizophrenia
Features
• Is not split or multiple personality
• 1% of population has schizophrenia
• Onset usually is around late teenage
and early 20s
• Females have a later onset
• No cure but can be treated
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Mood Disorders
• Normal mood fluctuations
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Two Major Types of
Mood Disorders
Mood episodes
Manic Episode
Depressive
Episode
Major Depressive
Disorder
Depressive
Episode
Bipolar
Disorder
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Major Depressive Disorder
Symptoms (Depressive Episode):
• Depressed mood most of the day
• Markedly diminished interest or pleasure
• Significant changes in appetite and weight
• Sleep disturbance
• Fatigue of loss or energy
• Feeling of worthlessness or excessive guilt
• Poor concentration and memory
• Recurrent thoughts of death or suicidal
ideation
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Major Depressive Disorder
Intervention
• When symptom last for at least 6
weeks.
• Interfere with functioning, i.e.
school, work and relationships
• Difficult to resolve with social
support, rest, exercise, leisure or
diet change.
• When there is suicidal ideation/plans
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Bipolar Disorder
Features:
• Mood swings – between Manic and
depressive episodes
• Depressive episodes lasts longer
than Manic episodes
• Risk of suicide increases during a
depressive episode
• Rule out drug use for an manic
episode
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Bipolar Disorder
Manic Episode symptoms:
• Increased rate of speech and thought
process
• Poor concentration; easily distracted
• Decreased sleep and appetite
• Many projects begun but not
completed
• Lack of self-control; impulsive
behaviour, i.e. increasing spending
• Boastful, arrogant, intrusive;
impatient
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Bipolar Disorder Intervention
• Both episodes need medical
intervention
• Sometimes hospitalization required
• Counselling or peer support alone is
not sufficient
• Need to learn how to manage the
illness
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Anxiety Disorders
• Anxiety is a normal reaction to stress
• Most of time anxiety will pass, and
normal functioning is resumed
• Defined as a disorder when a certain
group of symptoms are present
• Each disorder has dominant
symptoms but they all are a form of
anxiety.
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Common Anxiety Disorders
• Generalized anxiety disorder
• Panic attack
• Obsessive compulsive disorder (OCD)
• Phobia: social or specific phobia
• Post-traumatic stress disorder
(PTSD)
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Anxiety Disorder
Intervention
• Is a problem when:
- Anxiety is out of proportion
- Anxiety interfere with daily
functioning
- One starts avoid feared situations
- One uses drugs & alcohol to cope
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Mental illness
• Is not a personal weakness
• Can be treated
• Often caused by multiple factors
• Bio-psycho-social-spiritual model
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Bio-Psycho-Social-Spiritual
Model
Biological factors:
Genetics
Heredity: family history of mental
illness
Medical conditions, i.e. thyroid
problems
Brain chemicals, i.e. dopamine,
serotonin
Daylight exposure
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Bio-Psycho-Social-Spiritual
Model
Psychological Factors:
• Coping styles
• Self-esteem & self-worth
• Self-efficacy
• Attributions
• Attitudes
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Bio-Psycho-Social-Spiritual
Model
Social Factors:
• Current stressors
• Financial difficulties/poverty
• Social network & support
• Change in social environment and
adjustment
• Social competency
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Bio-Psycho-Social-Spiritual
Model
Spiritual factors:
• Spiritual beliefs
• Meaning/purpose in life
• Relationship with the greater world
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Mental Health Resources
• Family doctors (GP) & Private
psychiatrists
• School counsellors
• Community mental health teams &
Specialized programs
• Mental health emergency services
• Suicide prevention program
• 911
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Community Mental Health
Teams
• Provide mental health treatment and
rehabilitation outside of hospitals
• Consist of psychiatrists, nurses,
social worker, counsellor,
occupational therapist, vocational
therapist, health care worker.
• Accept the most severe cases
• Accept direct referrals
• Free of charge
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Community Mental Health
Programs
Vancouver Coastal Health
• General Inquiry:
604-736-2033
www.vch.ca
“Adult Mental Health program”
• Mental Health Emergency Services
604-874-7307
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Community Mental Health
Programs
Fraser Health:
• General Inquiry:
604-587-4600
www.fraserhealth.ca
“Adult Mental Health program”
• Mental Health Emergency Services
1-877-384-8062
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Urgent Mental Health
Services
• 911
• Suicide Prevention Program 604872-3311
• Crisis lines (Front of Yellow Pages)
• The Red Book 604-875-6381
(Non-urgent resources)
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“
Sometimes it is more
important to know what kind
of person has a disease that
what kind of disease a person
has”
Sir Wm. Osher
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