This part refers to Part D of the DSM V – Cultural Elements of the Relationship Between Client and Clinician.
The clinician should:
- Have awareness of their own cultural background, values and preferences.
- Be self-reflective about their attitudes to the cultural group of the client and the potential areas of bias or prejudice.
- Maintain awareness of transference and counter-transference, and whether these are inter-ethnic, throughout the process.
- Have awareness of potential areas for misunderstanding and ultimately misdiagnosis (ethno-cultural identity of client, differences in Western and non-Western values, differences in conceptions of normality and self, differences in cultural expressions of distress and coping strategies, differences in the professional service delivery models (especially for substance abuse/dependence treatment services), explanatory models of illness, multicultural exposure and the possibility of culture-bound syndromes).
- Have some knowledge of the client’s culture. Build rapport by talking or asking about the client’s country/culture. (A quick internet search will usually reveal enough information to start a conversation).
- Seek consultation if difficulties with engagement, follow-up or adherence are experienced or if there are negative transference and counter-transference issues. If there are any cultural factors that could adversely affect the therapeutic relationship and the treatment phase, these MUST be addressed or an alternative referral for the client made.
- Have a dialogue with the client about their treatment experience and needs:
- What is their motivation for seeking treatment? (Have they come under pressure from someone else?)
- What do they expect from the clinician? Do they feel they can speak freely? Do they feel able to make their own decisions in collaboration with the clinician?
Is there a preference/need for a particular gender of practitioner or for a practitioner of a similar cultural background?
- Are they comfortable with the clinician/therapist?