On delicacy in clinical practice, or when the strange enchants 1-11 Original Paper – Renata Monteiro Buelau & Eliane Dias de Castro She wanted to draw houses. Twenty, thirty or so at each encounter. There were hundreds of them. Paper, lead pencil and nothing more. She wanted no other materials and said nothing, save for a few disconnected phrases, scarcely accessible to me. A triangle sitting on a rectangle, door, window and that was it. She would finish her drawing in five minutes, get up, leaving me alone in the room. I used to observe that strange presence with a mixture of amazement and enchantment. No word or thought could add anything more regarding those encounters.
Trauma, stress sensitization, culture, and psychotherapy: on reflexivity 12-17 Review Paper – Geert E. Smid Exposure to traumatic events may lead to increased susceptibility to new stressors, also called stress sensitization. Stress sensitization may manifest as interpersonal emotions, such as mistrust, anger, and alienation. Psychotherapy in sensitized trauma victims requires the therapist to adopt a reflexive attitude, in which the therapist’s thoughts and feelings evoked by the patient during the therapy are reviewed in the light of the patient’s history of trauma, losses, and cultural transitions.
Cultural psychiatry and transcultural implantation of psychotherapy in China 18-25 Original Paper – Xudong Zhao & Jie Qian Cultural psychiatry is a specific field of psychiatry dealing with cultural aspects of human behavior, mental health, psychopathology and treatment. Psychological services in the Chinese society require significant emphasis on the cultural sensitiveness and competence of the practioners regarding the unique cultural background of Chinese culture and its diversity of subcultures. Much needs to be explored about the transcultural implantation of psychotherapy in developing countries such as China and how it may influence the development of cultural psychiatry in the rapidly chaning society. We present a brief introduction of Chinese culture matrix of psyche and an overview of the development of psychological services in the Chinese society across the past 30 years based on multi-factor analysis of peer-reviewed articles, classical textbooks, personal oral history, interviews, and clinical experiences, and it discusses potential implications for culturally adaptive psychotherapy. We report that the modern Chinese culture matrix of psyche is a comphrehansive combination of Confucianism, Taoism, Buddism, Communism, and Socialism Market Economics as five dominant philosophies. The contemporary mainstream of the healing model of psychotherapy for Chinese patients includes 4 schools such as psychodynamic, cognitive and behavior, humanistic, and systematic models. The traditional Chinese medicine as well as the localized religions, superstition, and folk healing practices used to be the most common methods for ordinary Chinese people to deal with their psychological sufferings. We discuss how the comtemporary Chinese are carving modern psychotherapy with complex dynamics, and the general quantity, quality of effectiveness, and professionalism of the psychotherapists in China are still in distance with people’s expectations. Chinese culture matrix is profoundly comprehensive and each individual in psychotherapy presents his or her unique belief system and psychological needs within his or her own subcultural matrix. Contrasting the traditional healing pratices and modern trends in psychotherapy in China point towards the need of a new system of mental health service with more humane paradigm and techniques.
The Cultural Formulation Interview: Results from the international field trial in the Netherlands 26-37 Original Paper – Hans Rohlof, Rob C.J. van Dijk, Simon P.N. Groen, Neil K. Aggarwal, Roberto Lewis-Fernández The American Psychiatric Association’s DSM-5 Cross-Cultural Issues Subgroup developed the Cultural Formulation Interview (CFI) for routine use in the clinical assessment of any patient. The CFI has been tested in an international field trial in five countries. The aim of this study is to determine whether the CFI was perceived as feasible, acceptable, and clinically useful for patients (n=30) and clinicians (n=11) in the Netherlands. The study was conducted as part of an international field trial in five countries. Earlier studies have revealed that the ethnic diversity of the psychiatric population in the Netherlands may cause communication problems in mental health and reduce the accuracy of psychiatric diagnoses. Semi-structured interviews have been developed in the Netherlands to identify cultural issues in diagnostic assessment. In the Netherlands, 11 clinicians were trained in a structured program to administer the CFI. They conducted 30 interviews among patients of foreign and Dutch origin. The clinicians and patients used quantitative and qualitative questionnaires before and after the administration of the CFI. Patients as well as clinicians were positive about the feasibility, acceptability, and perceived utility of the CFI. Patients were slightly more positive than clinicians about its clinical utility. The CFI did not lead to diagnostic changes, possibly due to the characteristics of the mental health institutes. The CFI is a feasible, acceptable, and potentially clinically useful instrument in psychiatric practice. Its value may be greatest for patients among whom communication and diagnostic problems are expected.