ROCKY MOUNTAIN REGION DISASTER MENTAL HEALTH NEWSLETTER

Learning From The Past and Planning For The Future


MENTAL HEALTH MOMENT
December 7, 2001

"You can make your world so much larger simply by acknowledging everyone else's"
- Jeanne Marie Laskas

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PARENTAL DISCORD AFFECTS OFFSPRING MARRIAGES

 Parents who are jealous, moody, inclined to fly off the handle,
 critical and prone to dominate their spouse have a far worse effect
 on their children's marriage than does parental divorce or poor
 parent-child relations, according to a Penn State study. Alan Booth,
 distinguished professor of sociology and human development, and Paul
 R. Amato, professor of sociology, analyzed a sample of 297 parents,
 comparing the quality of their marriages in 1980 with that of their
 children in 1997. They found that parental divorce by itself does not
 substantially mar the matrimonial happiness of children. Neither is
 the children's marital quality necessarily lessened by poor
 relationships with their parents during adolescence; psychological
 distress resulting from parental discord; or deficits in their
 parents' socio-economic status and their levels of education. The
 researchers published their conclusions in the October issue of the
 Journal of Personality and Social Psychology. For the full story by
 Paul Blaum, visit http://www.psu.edu/ur/2001/parentmarriage.html
.
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                   RED CROSS PROVIDES HOPE IN LIBERIA

The Liberian Red Cross has managed to harness the power of humanity to
help displaced people on the road back to both dignity and independence.
Red Cross-run 'TV Tower camp' was set up after virtually the entire
population of Lofa province fled renewed civil conflict earlier this year.

"When the fighting started around our village, my daughter Nyapu and I
decided it was time to leave," Kedeh recalled. Her eyes wander, betraying
nervousness as she speaks. "We carried what little food we had with us,"
she adds.

More at: http://www.ifrc/Docs/News/01/102902/

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                                         FLOODS IN NORTH KOREA

"This village used to be famous for its honey and chestnuts and beautiful
scenery. People would come from all over the country to see it. But now it
has all been reduced to rubble," says 42 year-old Ryu Mi Ok, a farmer in
Ryongchon-Ri in Tongchon county, in the Democratic People's Republic of
Korea's (DPRK) south eastern coastal province of Kangwon. Tongchon is
one of eight counties in the province which was hit by a combination of
severe storms, rains and sea surges over two days on 9-10 October,
making about 12,000 people homeless.

Ryu now lives with three other members of her family in a 1.5 square metre
vinyl hut that provides only the most rudimentary shelter.

More at:http://www.ifrc.org/Docs/News/01/102601/

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Cross-cultural Counseling/Therapy

Responses to disasters (natural and man-made) are handled initially by those in the area immediately 
affected. When there are insufficient local resources available or the extent of the disaster is 
overwhelmingly large, outside assistance is usually called for. Developed countries like the United 
States and Canada have prepared disaster response plans that address the situation and help people 
affected through a national response (Lystad, 1990). Within countries having pluralistic populations 
such as Canada and the United States, disaster workers need to be aware of, and sensitive to, cultural 
mores and differences. When disaster workers from these and/or other countries seek to assist with 
disasters in another country, it is essential that they have an understanding of the cultural norms and 
expectations of the population they hope to assist (Marsella, Friedman, & Gerrity, 1996). This is 
especially true for disaster mental health professionals. How different cultural groups handle stress and 
deal with stressors, their abilities, needs and desires for certain types of assistance, their motivations, 
their senses of honor and pride, their religious orientations and beliefs, their political systems and 
leadership, and their ways of handling and dealing with grief and loss are just some of the variables 
which are affected by cultural differences (Mak & Nadelson, 1996). Another one is communication - 
not just language differences, but also the nuances of specific words, phrases, slogans, proverbs, and
colloguialisms. Well-intentioned attempts to help can easily be at risk for being misunderstood as 
meddling, interference or even as political attempts to influence and/or control. 

There has been a powerful development of comprehensive mental health services throughout 
the world. Much of the literature in this field has been devoted to the maladaptation and stress 
of the culture contact situation (Draguns, 1981; Higginbotham, 1976, 1979a, 1979b); Diop, 
Collignon and Gueye, 1976; Pedersen, Lonner and Draguns, 1976; Taft, 1977; Pinter, 1969).
The problems of people removed from their cultural roots through migration, sojourn or involuntary 
displacement occupy the work of a great many culturally-oriented mental health professionals. 

There is a considerable amount of information available on how to help people who are casualties 
of intercultural mobility. Some examples include distraught college students, confused immigrants, 
traumatized expellees and refugees, discouraged and dissatisfied Peace Corps volunteers. Pinter 
(1969) reported a number of attempts to sketch a composite portrait of an individual who is least or 
most likely to succumb to such stress. Characteristics of host environments have also been scrutinized
in attempts to identify those features which contribute to making such an environment particularly 
stressful or unusually stress-free for newcomers (Pinter, 1978). 

There is a sizeable background of literature which deals with psychotherapy and counseling with 
individuals who have been transplanted to a new cultural setting (Szapocznik, Scopetta, Arondale 
& Kurtines, 1978; David, 1976). This body of writing provides practical relevant information for the 
professional involved in extending services to immigrants, sojourners or returnees from intensive 
cross-cultural encounters. 

All people respond to stimuli and situations by either changing themselves or the environment and 
by combining these two operations in various proportions. Historically, the implicit goal of counseling 
and psychotherapy has been to bring about a greater degree of conformity to the norms of the dominant 
majority group. The contemporary cross-cultural counselor or therapist faces a choice. He/she can 
prepare the client for changing obstacles in the environment, or he/she can equip the client for a greater 
degree of accommodation to the social structure in its current state. The increase in the individual's 
options also involves choices on the extent and nature of one's relationships, reference groups, and 
identity, especially in relation to one's ethnic or cultural group. 

Wrenn (1962) was among the first to sensitize counselors to the problem of cultural encapsulation and 
warned against the imposition of culturally alien goals, values and practices upon clients across cultural 
lines. Pedersen (1976) took the position that, at least in a multicultural setting like the United States, 
crossing the cultural gulf in the mental health field is the rule rather than the exception. 

The Vail Conference on Clinical Psychology which was sponsored by the American Psychological 
Association elevated the knowledge of the cultures of one's clients to an ethical imperative (Korman, 
1974). As a result, doing therapy or counseling without cultural sensitivity, knowledge or awareness is 
not just problematic. It has been declared unethical. The implication of these recommendations is that 
the knowledge on therapy and culture has ceased to be an esoteric field. Instead, it has become a 
matter of direct and practical concern for those who provide services across cultures. 

What features of a culture are reflected in its therapeutic services? What kinds of models are implicitly 
emulated in the conduct of psychotherapy? One can only point to statements placing psychotherapy in 
its respective cultural context and relating it to the needs, expectations, models and opportunities 
experienced in that culture (Draguns, 1975; Neki, 1973; Wittkower & Warnes, 1974). Does addition of 
healers of one's own cultural tradition result in the enhancement of effectiveness of mental health services? 
One area where such an investigation has been made was about the efficacy of Morita Therapy (Miura 
and Usa, 1970; Reynolds, 1976) and Naikan Therapy (Tanaka-Matsumi, 1979) in Japan. These are two 
procedures indigenous to their culture, yet developed and practiced by modern mental health professionals. 

In Japan, the two indigenously developed therapies, Naikan and Morita, are based on guilt induction and 
control and on suppression of communication respectively. In the Naikan system, the client is admonished 
to think of all the ways in which he has wronged his mother (Tanaka-Matsumi, 1979). In the course of 
Morita therapy, what the client may say and when and how it is said is elaborately restricted and 
ritualized (Reynolds, 1976). The contrast between Western expectations and Japanese therapy is stark. 
Documentation on Morita therapy indicates that this therapy works in a substantial proportion of cases 
on its home grounds. As Sue (1977) has pointed out, therapy and counseling services geared to a 
culturally distinct group have to be appropriate in process and in goals to be acceptable and effective. 

One of the things that therapists of different orientations and cultures share is the ability to generate 
perceptions of competence and concern in their clients (Torrey, 1972). The role of the therapist, regardless 
of technique, is catalytic, enabling the client to make use of his/her existing assets and strengths 
(Prince, 1976, 1980). Non-western cultures have tended to rely to a greater extent than the West upon 
the induction of altered states of consciousness to bring about these catalytic effects. 

Jilek-Aal (1978) noted the effectiveness of the Salish Indian spirit dance in promoting therapeutic change 
in that cultural group. It induces regression through an altered state of consciousness, promotes the 
experience of death and rebirth, and provides the participant with a new identity reoriented toward 
the ideal of the Salish culture. The rationale and the procedure appear to be reminiscent of the fixed-role 
therapy of George Kelly (1955) with the exception of greater reliance on affective and regressive 
processes, and on altered states of consciousness. 


                               Working outside the cultural milieu 

Collomb (1973) attempted to answer the question: What impels a mental health professional to offer 
services outside his or her usual geographic and cultural milieu, and how may these motives interfere 
with his or her optimal functioning as a therapist? He presented a provisional typology of what might 
be called the cultural distortions of counter-transference. On the basis of his observations, he distinguished 
three attitudes that could be described as those of universalism, cultural uniqueness, and rejection of 
one's own culture of origin. One prerequisite with which it is difficult to disagree is that the therapist, 
as part of his/her expertise and competence, should know the culture within which he/she operates. 
Devereux (1969), for example, applied himself to a thorough study of the "Plains Indians", preparatory 
and concurrent to conducting psychotherapy with one of them. 

Therapists working in a cross-cultural setting should approach this task with a maximum of self-awareness 
and be prepared to deal with their own distortions of the therapy experience and relationship. In her 
work with members of other cultures in Miami, Florida, Weidman (1975) pioneered the concept of culture-
broker - a well-informed intermediary whose inputs are brought to bear on the therapy process. The client 
remains the major source of information about those features of his/her cultural experience which might 
otherwise baffle the therapist. The limit of this mode of inquiry is that the individual, not the culture, is the 
focus of all therapy (Draguns, 1981). Sessions should not deteriorate into ethnographic data-gathering in 
its own right and for its own purpose nor to satisfy the therapist's curiosity. Rather, the referent should be: 
Is this information needed for therapy, and, if so, how? 

In summary, counselors should have knowledge of the culture they work in as part of their expertise and 
competence. Giordano and Giordano (1976) provided some very valuable and specific information to 
keep in mind when initiating and maintaining contact with clients of another culture. The knowledge of 
the culture of one's clients provides the counselor with an entree and/or point of departure. The experience 
of the counselor with a cultural group or the information on it in the relevant professional literature serves 
as a source of hypotheses, to be verified, discarded and/or modified based on acquisition of further 
information. Working together with a counselor/healer from the culture could vastly improve the probability 
of success in appropriate interventions. This would be of special concern in a disaster or major crisis 
situation. 

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REFERENCES

Collomb, H.(1973). L'avenir de la psychiatrie en Afrique. Psychopathologie Africaine, 9, 343-370. 

David, K.H. (1976). The use of social learning theory in preventing intercultural adjustment problems. 
In Pedersen, P., Lonner, W.J. & Draguns, J.G. (Eds.), Counseling across cultures. Honolulu: University 
of Hawaii Press. 

Deveraux, G. (1969). Reality and the dream: Psychotherapy of a Plains Indian. Garden City, NY: 
Doubleday. 

Diop, B., Collignon, R. & Gueye, E. (1976). Presentation de l'etude concertee de I'O.M.S. sur les 
strategies pour l'extension pes soins de sante mentale. Psychopathologie Africaine, 12, 173-188. 

Draguns, J.G. (1975). Resocialization into culture: The complexities of taking a worldwide view of 
psychotherapy. In Brislin, R.W., Bochner, S. & Lonner, W.J. (Eds.), Cross-cultural perspectives 
on learning. New York: Sage Publications. 

Draguns, J.G. (1981). Cross-cultural counseling and psychotherapy: History, issues, current status. 
In Marsella, A.J. & Pedersen, P.B. (Eds.), Cross-cultural counseling and psychotherapy. New York: 
Pergamon Press. 

Giordano, J. & Giordano, G.P. (1976). Ethnicity and community mental health. Community Mental Health 
Review, 3, 4-14, 15. 

Higginbotham, H.N. (1976). A conceptual model for the delivery of psychological services in non-western 
settings. Topics in Culture Learning, 4, 44-52. 

Higginbotham, H.N. (1979a). Culture and the delivery of psychological services in developing nations. 
Transcultural Psychiatric Research Review, 16, 7-27. 

Higginbotham, H.N. (1979b). Culture and mental health services in developing countries. In A.J. Marsella, 
Ciborowski, T. & Tharp, R. (Eds.), Perspectives in cross-cultural psychology. New York: Academic Press.

Jilek-Aal, W. (1978). Native renaissance: The survival and revival of indigenous therapeutic 
ceremonials among North American Indians. Transcultural Psychiatric Research Review, 15, 117-148. 

Kelly, G. (1955). The psychology of personal constructs. New York: Norton. 

Korman, M. (1974). National conference on levels and patterns of professional training in psychology:
Major themes. American Psychologist, 29, 441-449. 

Lystad, M. (1990). United States programs in disaster mental health. International Journal of 
Mental Health, 19: 80-88. 

Mak, F.L. & Nadelson, C.C. (Ed.) (1996). International review of psychiatry, Vol 2. Washington, DC, USA: 
American Psychiatric Press, Inc. 

Marsella, A.J., Friedman, M.J. & Gerrity, E.T. (1996). Ethnocultural aspects of posttraumatic stress 
disorder: Issues, research, and clinical applications. Washington, DC, USA: American Psychological 
Association. 

Miura, M. & Usa, S. (1970). A psychotherapy of neurosis: Morita therapy. Psychologia, 13, 18-34. 

Neki, J.S. (1973). Guru-chepa relationship: The possibility of a therapeutic paradigm. American Journal of 
Orthopsychiatry, 43, 755-766. 

Pedersen, P. (1976). The cultural inclusiveness of counseling. In Pedersen, P., Draguns, J.G., Lonner, W.J. 
& Trimble, J. (Eds.), Counseling across cultures. 2nd ed Honolulu: University Press of Hawaii. 

Pedersen, P., Lonner, W.J. & Draguns, J.G. (Eds.) (1976). Counseling across cultures. Honolulu: University 
Press of Hawaii. 

Pinter, E. (1978). Immigrant status and psychic disturbances. Schweizer Archiv fuer Neurologie, 
Neurochirurgie und Psychiatrie; 122: 75-82. 

Pinter, E. (1969). Wohlstandfluchtlinge. Eine sozialpsychiatrische studie an ungarischen Fluchtlingen in 
der Schweiz. Bibliotheca Psychiatrica et Neurologica, No. 138. 

Prince, R.H. (1976). Psychotherapy as the manipulation of endogenous healing mechanisms: A 
transcultural survey. Transcultural Psychiatric Research Review, 13, 115-134. 

Prince, R.H. (1980). Variations in psychotherapeutic experience. In H.C. Triandis & J.G. Draguns (Eds.), 
Handbook of cross-cultural psychology. Vol. 6. Psychopathology. Boston: Allyn & Bacon. 

Reynolds, D.K. (1976). Morita psychotherapy. Berkeley: University of California Press. 

Sue, D.W. (1977). Counseling the culturally different: A conceptual analysis. Personnel and Guidance 
Journal, 55, 422-425.

Szapocznik, J., Scopetta, M.A., Arandale, M.A. & Kurtines, W. (1978). Cuban value structure: Treatment 
implications. Journal of Consulting and Clinical Psychology, 46: 961-970. 

Taft, R. (1977). Coping with unfamiliar environments. in Warren, N. (Ed.), Studies of cross-cultural 
psychology. Vol. 1. London: Academic Press. 

Tanaka-Matsumi, J. (1979). Cultural factors and social influence techniques in Naikan therapy: A Japanese 
self-observation method. Psychotherapy: Theory, Research and Practice 16, 385-390. 

Torrey, E.F. (1972). What western psychotherapists can learn from witchdoctors. American Journal of 
Orthopsychiatry 42, 69-76b. 

Weidman, H. (1975). Concepts as strategies for change. Psychiatric Annals, 5, 312-314. 

Wittkower, E.D. & Warnes, H. (1974). Cultural aspects of psychotherapy. American Journal of 
Psychotherapy, 28, 566-573. 

Wrenn, G.C (1962). The culturally encapsulated counselor. Harvard Educational Review, 32, 444-449. 

To search for books on disasters and disaster mental health topics and purchase them online,
go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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               Contact your local Mental Health Center or   
               check the yellow pages for counselors, psychologists,   
               therapists, and other Mental health Professionals in   
               your area for further information.
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                        George W. Doherty
                        O'Dochartaigh Associates
                        Box 786
                        Laramie, WY 82073-0786

MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news