12.7.4 Adding the biomedical model to indigenous beliefs.

The idea of utilizing culturally sensitive therapeutic approaches is to help the patient from a framework that the distressed person can understand. Although Western treatment modified with a cultural emphasis has not produced an extensive literature, most approaches that combine Western and indigenous treatments provide the patient with some form of spiritual counseling. However, little is known about the success of these blended services. In collectivistic societies where interdependence in relationships is significant and salient, it seems logical that individual therapy be combined with outreach to family and community. The efficacy of community based forms of treatment for emotional illness is supported by research (Miller & Rasco, 2004). A first step is the identification of health resources within the community that promote healing and adaptation. Most importantly community based solutions seek to mobilize other members of the cultural group to provide optimal solutions to stress and emotional disorder.

Community based interventions have proven useful in the treatment of mental health issues among refuges, immigrants or ethnic minorities who do not seek help within available medical structures. In Australia medical services were underutilized by Aborigines who felt unwelcome and anxious when seeking social assistance and counseling from medical facilities in the dominant society (Larsen, 1977, 1978a, 1981). One solution was to create a program of training of Aboriginal social workers within the structure of the Aboriginal and Islander Medical Center in Townsville, Northern Australia. The training program was offered to a group of young practitioners that successfully combined aspects of Western psychology and treatment approaches and these services were turn offered in a location administered by the indigenous population (Larsen, 1978b, 1979a, 1979b, 1980). The aforementioned program of training could be used as a model in other cultural settings since it blends Western approaches with cultural sensitivity.

Later studies have shown the validity of incorporating cultural sensitivity in delivering medical and mental health care to divergent cultures and ethnic minorities. For example a five year study of Asian American adolescents found that mental health services targeting ethnic minorities were more likely to achieve success. These findings have also found support in the experiences of other ethnic communities in the U.S., and the results show that targeting ethnic groups encouraged more patients to seek services (Takeuchi, Sue, & Yeh, 1995). The reason that ethnic specific services are more successful than mainstream approaches is rooted in the cultural differences between these groups and the majority society. Since different attributions for mental illness is common among ethnic groups cultural sensitivity is essential to any treatment approach. As noted earlier in some ethnic groups the beliefs that physiological factors are responsible for disorder dominate thinking, whereas patients in other ethnic groups are motivated to suppress thoughts related to psychological distress. The Western based medical services are not well prepared to deal with these culturally based beliefs and the scientific model does not know how to respond to mental illness thought to be a consequence of evil spirit possession or other extraterrestrial causes. However, employing bilingual staff sensitive to cultural values may contribute to greater use of existing health facilities (Snowden, Masland, Ma, & Ciemens, 2006).