What Are Culturally Supported Interventions
The Book of Ethics
Ch. 5: Cultural and Spiritual
Dimensions of Addiction Treatment
Presented by: Joslynn A. Davis
Rapid Growth of an
Ethnic and Culturally Diverse
Clientele
As a result of a steadily increasing rate of racial and ethnic minorities in the U.S., the population that helping profession wants to assist has become very multicultural and diverse.
Some helping practitioners are unable to effectively help their clients due to the cultural boundaries between the client and the helper.
With so many cases like that on the rise in the helping profession, the American Psychiatric Association stated that in their guidelines that “helpers should be multiculturally competent and know their limitations in serving diverse
clients” …show more content…
(APA Ethical Guidelines; 1993,2003).
Multicultural Competence
To practice multicultural competence, it takes three aspects:
Awareness- the identification of one’s own biases and levels of openness to others, as well as awareness of other cultures.
Knowledge: includes both general cultural knowledge and information specific to various cultures.
Skills: the ability to address cultural issues and may involve empirically supported, adapted techniques for specific cultures, and other techniques that may have culture-based support.
10 Dimensions of Culture
When using the term “Culture” it is often associated and often limited to the 4 predominate ethnic minorities:
African American
Native American
Hispanics/Latinos
Asian Americans
However in ethical guidelines when referring to culture, there are ten dimensions that allow the helper to understand the various belief systems and worldviews on healing and illness.
Age
Gender
Race
Ethnicity
National Origin
Religion
Sexual Orientation
Disabilities
Language
Ethics in Relation to Culture
In the subject of Ethics, there is an array of beliefs that support Ethics being universal and independent of culture.
But on the opposite side of the debate, scholars also argue that ethical principles vary across cultures and contexts.
From these two opposing sides, there lies in the middle another view called “ethical multiculturalism” which takes into consideration cultural norms in ethical principles.
Virtue Ethics and Culture
Some practitioners ask helpers to adopt the view of Virtue Ethics, which asks for personal transformation and ongoing character development to pursue the highest form of multiculturalism.
Explanatory Models of Addiction
When working with clients of a different culture, it is crucial that the helper ask questions to guide the discovery of the patient’s understanding of the illness and treatment. Their responses will allow the helper to refer back to the Explanatory Models of
Addiction.
The helper will pose questions to gain answers to:
What the patient names the problem
Cause of the problem
Course, Mechanisms, and Effects of the problem
Patient’s fears of the problem
Patient’s fear of treatment
Explanatory Models of Addicition
Spirit Possession
Alcohol is evil; there’s a spirit of addiction that causes affliction
Witchcraft
Addiction is caused by magical practices of people with malign intent
Spiritual Affliction
Addiction is caused by alienation from God/Higher Power/Creator
Disharmony
Moral Weakness
Character Flaw
Biological Disease
Social Conditions
Developmental Experience
Intrapersonal Conflict
Addiction is caused by being out of harmony with self/nature/others
Substance use or addiction is viewed as a sin addicts lack impulse control, empathy, sense of responsibility
Addiction is caused by genetic factors/biological change in brain impulses Public Health Model
Addiction is caused by a traumatic experience/lack of adequate attachment and social learning
Psychoanalytic model: addiction is a symptom of underlying neurosis
Spirituality and Addiction
Treatment
Spiritual or religious concepts and practices have traditionally played a larger role in addiction treatment than in other areas of mental health or medicine. Research has found that
Spirituality in addiction has led to:
An inverse relationship between religiosity and substance use and abuse
Reduced use among those practicing meditation
Protective effects of Twelve Step group involvement during recovery
And when beginning to develop a treatment plan, keep these 4 guidelines in mind.
Asking about the patient’s spiritual belief.
Avoid expressing bias for or against spirituality/religion.
Include spiritual /religious aspects in treatment planning.
Address counter-therapeutic beliefs with factual information and respect.
Ethical Principles of Culture &
Spirituality in Addiction
Respect for Persons: implies respect for the cultural and spiritual beliefs, values, and experiences of persons in addiction treatment.
Helpers must make a good-faith effort to understand the beliefs and values of patients in order to provide care that is respectful of the patients perspective.
Justice: requires that culturally appropriate treatment options be available to all those in need of addiction treatment.
4 Treatment Interventions to refer to when working with patients from a different culture:
Transport evidence based treatment
Culturally adapt evidence based treatment
Culturally supported interventions
Developing new interventions
Ethical Principles of Culture &
Spirituality in Addiction
Personal responsibility and Voluntarism: Before developing a treatment plan, the patient needs to be informed of all information on all reasonable treatment options; regardless of the practitioners attitudes toward the interventions.
Coercion is minimized by having the patient input their own personal values to the information provided by the practitioner.
Therapeutic alliance: requires that cultural competence is critical to establishing an effective therapeutic relationship.
Beneficence/Nonmaleficence: to provide the best possible care, its necessary to incorporate cultural and spiritual dimensions into evaluation and treatment.
However keep in mind that some beliefs/practices are harmful, while others are therapeutic, so respect must be balanced with the obligation to help and prevent harm to the
patient.
Ch. 5: Cultural and Spiritual
Dimensions of Addiction Treatment
Presented by: Joslynn A. Davis
Rapid Growth of an
Ethnic and Culturally Diverse
Clientele
As a result of a steadily increasing rate of racial and ethnic minorities in the U.S., the population that helping profession wants to assist has become very multicultural and diverse.
Some helping practitioners are unable to effectively help their clients due to the cultural boundaries between the client and the helper.
With so many cases like that on the rise in the helping profession, the American Psychiatric Association stated that in their guidelines that “helpers should be multiculturally competent and know their limitations in serving diverse
clients” …show more content…
(APA Ethical Guidelines; 1993,2003).
Multicultural Competence
To practice multicultural competence, it takes three aspects:
Awareness- the identification of one’s own biases and levels of openness to others, as well as awareness of other cultures.
Knowledge: includes both general cultural knowledge and information specific to various cultures.
Skills: the ability to address cultural issues and may involve empirically supported, adapted techniques for specific cultures, and other techniques that may have culture-based support.
10 Dimensions of Culture
When using the term “Culture” it is often associated and often limited to the 4 predominate ethnic minorities:
African American
Native American
Hispanics/Latinos
Asian Americans
However in ethical guidelines when referring to culture, there are ten dimensions that allow the helper to understand the various belief systems and worldviews on healing and illness.
Age
Gender
Race
Ethnicity
National Origin
Religion
Sexual Orientation
Disabilities
Language
Ethics in Relation to Culture
In the subject of Ethics, there is an array of beliefs that support Ethics being universal and independent of culture.
But on the opposite side of the debate, scholars also argue that ethical principles vary across cultures and contexts.
From these two opposing sides, there lies in the middle another view called “ethical multiculturalism” which takes into consideration cultural norms in ethical principles.
Virtue Ethics and Culture
Some practitioners ask helpers to adopt the view of Virtue Ethics, which asks for personal transformation and ongoing character development to pursue the highest form of multiculturalism.
Explanatory Models of Addiction
When working with clients of a different culture, it is crucial that the helper ask questions to guide the discovery of the patient’s understanding of the illness and treatment. Their responses will allow the helper to refer back to the Explanatory Models of
Addiction.
The helper will pose questions to gain answers to:
What the patient names the problem
Cause of the problem
Course, Mechanisms, and Effects of the problem
Patient’s fears of the problem
Patient’s fear of treatment
Explanatory Models of Addicition
Spirit Possession
Alcohol is evil; there’s a spirit of addiction that causes affliction
Witchcraft
Addiction is caused by magical practices of people with malign intent
Spiritual Affliction
Addiction is caused by alienation from God/Higher Power/Creator
Disharmony
Moral Weakness
Character Flaw
Biological Disease
Social Conditions
Developmental Experience
Intrapersonal Conflict
Addiction is caused by being out of harmony with self/nature/others
Substance use or addiction is viewed as a sin addicts lack impulse control, empathy, sense of responsibility
Addiction is caused by genetic factors/biological change in brain impulses Public Health Model
Addiction is caused by a traumatic experience/lack of adequate attachment and social learning
Psychoanalytic model: addiction is a symptom of underlying neurosis
Spirituality and Addiction
Treatment
Spiritual or religious concepts and practices have traditionally played a larger role in addiction treatment than in other areas of mental health or medicine. Research has found that
Spirituality in addiction has led to:
An inverse relationship between religiosity and substance use and abuse
Reduced use among those practicing meditation
Protective effects of Twelve Step group involvement during recovery
And when beginning to develop a treatment plan, keep these 4 guidelines in mind.
Asking about the patient’s spiritual belief.
Avoid expressing bias for or against spirituality/religion.
Include spiritual /religious aspects in treatment planning.
Address counter-therapeutic beliefs with factual information and respect.
Ethical Principles of Culture &
Spirituality in Addiction
Respect for Persons: implies respect for the cultural and spiritual beliefs, values, and experiences of persons in addiction treatment.
Helpers must make a good-faith effort to understand the beliefs and values of patients in order to provide care that is respectful of the patients perspective.
Justice: requires that culturally appropriate treatment options be available to all those in need of addiction treatment.
4 Treatment Interventions to refer to when working with patients from a different culture:
Transport evidence based treatment
Culturally adapt evidence based treatment
Culturally supported interventions
Developing new interventions
Ethical Principles of Culture &
Spirituality in Addiction
Personal responsibility and Voluntarism: Before developing a treatment plan, the patient needs to be informed of all information on all reasonable treatment options; regardless of the practitioners attitudes toward the interventions.
Coercion is minimized by having the patient input their own personal values to the information provided by the practitioner.
Therapeutic alliance: requires that cultural competence is critical to establishing an effective therapeutic relationship.
Beneficence/Nonmaleficence: to provide the best possible care, its necessary to incorporate cultural and spiritual dimensions into evaluation and treatment.
However keep in mind that some beliefs/practices are harmful, while others are therapeutic, so respect must be balanced with the obligation to help and prevent harm to the
patient.