Toolbox

Toolbox for assessing CALD clients in mental health

• Stigma, 'saving face', absence of Cartesian mind-body dichotomy, somatization, health-seeking pattern, language barrier and reframing are essential concepts to be aware of when doing assessments. Demonstrating an awareness and understanding of these will go a long way towards good rapport and trust with your client, as well as accessing the more subtle factors in a presentation.
• A distinction needs to be made between somatizing distress and how distress is reported to others. Explore how clients experience their psychological and emotional distress.
• Whether assessing adults or children, understanding their ethnocultural identity, migration experiences and acculturation levels, are essential. Ask about migration experiences and settlement challenges; these are often inextricably linked with the problem.
• Milestones can differ, depending on cultural norms and values. When assessing Asian children and adolescents, explore family expectations and perspectives on development and behaviour. Goals for treatment need to be congruent with family's and child's norms.
• Problems related to pre-migration trauma may present years after refugees have settled. Knowing your client's migration history can alert you to possible underlying issues at problem presentation. Be alert for cues and explore these sensitively, but do not push clients to speak about issues that may have been dormant for years.