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Handbook of race and development in mental health PDF

403 Pages·2012·3.9 MB·English
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Handbook of Race and Development in Mental Health Edward C. Chang • Christina A. Downey Editors Handbook of Race and Development in Mental Health 1 3 Editors Ph. D. Edward C. Chang Ph. D. Christina A. Downey University of Michigan Indiana University Kokomo Department of Psychology Department of Psychology 2263 East Hall 2300 S. Washington St. 530 Church St. Kokomo Indiana 46904 Ann Arbor Michigan 48109 USA USA I would like to dedicate this work to my parents, Tae Myung-Sook and Chang Suk- Choon. As immigrants, they sacrificed their life paths so that my journey to becoming a Korean American would be fruitful and bright. I will always keep close, in my heart and in my head, the pride I have of being their child, and make sure to offer my own path to my always remarkable child, Chang Olivia Dae. E.C.C. This volume is dedicated to every mental health researcher and practitioner who seeks to understand context, history, and the best qualities of each individual and culture. In addition, I offer sincere grati- tude to my family, friends, colleagues, and mentors, for always showing me the best in myself and in you. C. A. D. v Foreword A systematic understanding of positive human development and behavior did not th st originate with Western psychology of the 20 and 21 centuries. A rich source of well-formulated positive psychology is found in Asian religions that go back more than 2500 yrs. Most major Asian religions have at their core a psychology little known to the millions of their followers, but articulated well by monks, gurus, yo- gis, erudite people, and health professionals (e.g., Nikhilananda, 1942). Two Asian psychological principles of virtuous ways of life are presented here briefly. First, a most complex laid-out psychology is classical Buddhism, called Abhidharma (San- skrit word), which lays out the principle that every action is motivated by under- lying mental factors that are positive and negative (Govinda, 1961); this system could be linked today to the stress-diathesis model of protective and risk factors (Benard, 1995). Second, in Hinduism, the notion of dependency in human develop- ment is viewed positively through the constructs of bond, bondship, and kinship (Sinha, 1968). Using Seligman’s (2002) theory of positive psychology, the exercise of bonding may be interpreted as interpersonal and social signature strengths, lead- ing to positive emotions, engagement, and meaning, and resulting in happiness and the promotion of well-being. In Buddhism (Narada, 1968), factors in adulthood that interfere with medita- tion in spiritual practice or concentration in occupational work are unhealthy, while those that facilitate the mind’s focus are healthy. This means that to attain a healthy mental state, unhealthy mental states are replaced with their corresponding polar opposites. In the hierarchy of healthy factors, cognitive factors come first. Insight is the central healthy state that suppresses delusion, the fundamental unhealthy fac- tor. The essential partner of insight is mindfulness, and the presence of these two factors is sufficient to suppress all unhealthy factors. When there is a thought of a negative action, the twin factors of modesty (opposite of shamelessness) and discre- tion (opposite of remorselessness) act as preventative forces, both always connected with good judgment (called rectitude). Confidence is self-belief based on correct perception. The configuration of healthy cognitive factors of modesty, discretion, rectitude, and confidence together produce good behaviors, as judged by both per- sonal and social standards. vii viii Foreword The configuration of healthy affective factors of nonattachment (opposite of greed/egoism), connectivity (opposite of aversion), impartiality (opposite of envy), and composure (opposite of frustration) together replaces an acquisitive or reject- ing attitude with an even-mindedness toward whatever object might arise in one’s awareness. Another cluster of positive factors have both physical and psychologi- cal effects and are: buoyancy (opposite of pessimism), pliancy (opposite of inflex- ibility), adaptability (opposite of tightening/contraction), and proficiency (opposite of low mental and physical energy) prevent depression and make one adapt physi- cally and mentally to changing conditions, meeting whatever challenges that may arise. Peterson and Seligman (2004) stated, “missing in the resilience literature is any discussion about which protective factors are relevant for whom, under what stressful circumstances, and with respect to what desirable outcomes” (pp. 79–80). It appears that Abhidharma of Gautama Buddha (536–438 B.C) identified the pro- tective factors of resilience for common, everyday folks who are challenged by the limits of the body, senses, and mind that when overcome attain liberation from limits. In Hinduism, another major Asian religion, the ideal of lifespan development emphasizes continuous dependency relations. In the extended/joint family, young children occupy a special status of spiritual innocence and are rarely exposed to prolonged frustration. They are continuously gratified bodily and reassured emo- tionally, especially by their mother. Through such parental dynamic, children are conditioned in the dependency relationship. The early permissiveness instills a foundation of belonging, self-worth, and safety. Subsequently, at the start of school, severe discipline follows to instill self-restraint, social harmony with siblings and classmates, and above all, commitment to the family. Discipline also teaches the control of anger and aggression. Particular social relations are observed with par- ents, aunts, uncles, grandparents, siblings, and cousins. Each relative is addressed with a respectful title based on the relative’s birth order or kinship through mar- riage. Each stage of a person’s development marks a new network of dependency relations. Each dependency relation is chracterized by a more or less rigid inherent relational status. Old age prescribes dependency on children, who are morally obligated to pay back their parents. Filial piety is mutual exchange and ensures the full cycle of reciprocity. The goals of human development are satisfying and continuous depen- dency. Sons and daughters realize their social identity in a lifespan prolongation of their original state of dependency. Relationships among family members provide a model of positive interactions in all areas of life, work, and society, including lead- ership, as well as rationales with inherently religious meanings. As these examples illustrate, positive psychology can be traced to the ancient re- th ligions of Buddhism and Hinduism, just as it can be located in the early 20 century existentialism and humanism, in counseling psychology’s prevention approach, and in postmodernism, each with its own constructs of wellness. The credit, however, st goes to Seligman in the 1990’s and early 21 century for branding it and placing it within the American Psychological Association’s (APA) policy (2006) of evidence- Foreword ix based practice. It’s exciting to read psychologists in this book, influenced by Selig- man, to be focusing on strengths of racial, ethnic, and other marginalized people, which make them resilient against challenges. The authors resist explanations of psychopathology related to “cultural deficits/disadvantages” and/or low environ- mental resources of minority children, adults, and the elderly. The universalistic assumption within American positive psychology is a sweeping generalization and has been corrected by the chapter authors with their understandings of group- and development-specific positive factors. With regard to multicultural psychology, whose goal is the empowerment of racial, ethnic, and diversely identified minorities, Leong, Pickren, and Tang’s chap- ter, A History of Cross-Cultural Clinical Psychology (in this book), brought to my mind Martin Luther King, Jr.’s Invited Distinguished Address at the 1967 Annual Convention of the American Psychological Associations. King said that psycholo- gists who do individual therapy treat clients diagnosed with “Adjustment Disorder” (defined as the development of clinically significant emotional or behavioral symp- toms in response to an identifiable psychosocial stressor or stressors [American Psychiatric Association, 2000]). However, King challenged that the goal of therapy is to help clients become “well-adjusted” to the social world around them. As King (1967) put it: You who are in the field of psychology have given us a great word. It is the word “malad- justed.” This word is probably used more than any other word in psychology. It is a good word; certainly it is good that in dealing with what the word implies you are declaring that destructive maladjustment should be eradicated. You are saying that all must seek the well- adjusted life in order to avoid neurotic and schizophrenic personalities. But on the other hand, I am sure that we all recognize that there are some things in our society, some things in our world, to which we should never be adjusted….We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism and the self-defeating effects of physical violence. (pp. 9–10) King argued that for psychologists to make a meaningful contribution to people’s mental health, they would have to find ways to help ordinary citizens develop their capacity for what King called “creative maladjustment nonconformity” (King as cited by Carson, 1995, p. 319). King’s fundamental argument was that psycholo- gists who are actively engaged in healing society are themselves creatively malad- justed, who model creative nonconforming behaviors to their clients to cope with racism. Like King, Michael Lerner (1998) said, “Most therapists don’t understand the social conditions which lead to so much pain in personal life, so they are unlikely to be able to uncover meaningful ways for individuals to deal with those social conditions” (p. 325). Clinical psychology is symptom-focused than etiologically- focused, which can discount the impact of context and social inequities on a client’s life. While Lerner admits that therapy can help people be less self-destructive, he also points out that “these benefits mostly fit into the category of ‘learning to cope with an oppressive reality’” (p. 329). Like King, Lerner argued that most psycholo- x Foreword gists unwittingly play a restraining/repressive role in society because they squander the opportunity to foster the strength of social justice advocacy in their clients, col- leagues, and the organizations they serve. As Lerner put it: Lacking a sense of social causality, most therapists interpret the frustrations of family and personal life as individual failings. Instead of bringing their clients to an understanding of the larger social forces that shape their individual experiences, therapists implicitly suggest that the problems are individual in scope, and can be adequately solved by changes in indi- vidual psyches or through changes in their family systems. (p. 323) In the present book, I found chapter authors refer to common strengths across American cultural minorities that are context-based, e.g., social network support, extended family composition, watchful parents and older relatives, religiousness or spiritual practice, guidance of cultural traditions and beliefs, and preference for racial, ethnic, or cultural identity. Group-specific strengths have also been identified by the authors. Group specific strengths for African Americans include the enduring self-esteem and resilience of children and adolescents (see also APA, 2008) and the religious coping of the elderly. Respect for tribe/nation membership, spiritual practice, and cultural elements of healthcare are strengths of American Indian and Alaska Na- tive adults. For Asian Americans, children’s strengths include the maintenance of group harmony, parental engagement, educational values for achievement, and bi- culturalism that is inclusive of ethnic identity; adults abide by their collectivistic worldview, and the elderly feel secure in their family cohesion and peer support. For European Americans, children have a strong sense of purpose, an internal locus of control, social privilege, and the security of having membership in the domi- nant society; adults are cognitively involved, productive, and directed by positive help-seeking attitudes; the elderly are change-oriented, adaptable, educated, and engaged, and, therefore, have many resilience factors. For Latinos, their children’s strengths are familismo values, bicultural competence that is inclusive of ethnic identification, and bilingualism; these strengths continue through adulthood, while for the elderly, who are first-generation immigrants, Hispanic cultural values and religion play important roles. Both common and group-specific cultural strengths need to be utilized in treat- ments with racial, ethnic, and cultural groups to increase their general life satisfac- tion and mental health. The adaptation of mainstream therapies to specific cultural groups will increase the treatment efficacy of particular mental disorder presenta- tions (e.g., Jackson et al. 2006; Shen et al. 2006). In a meta-analysis, Griner and Smith (2006) found that interventions that were based on a theory and on research of a specific culture were found to be almost twice as effective as interventions that did not consider race and/or culture. The word “particular” in the previous paragraph is added emphasis because the individual, who varies in abiding by his or her culture owing to acculturation and/ or personal temperament is given as much importance as the individual’s universal humanity and membership in a race, ethnicity, culture, or local context. Accord- ing to Sue (1998), clinicians who are multiculturally competent are scientifically Foreword xi minded and have skills in dynamic sizing. In other words, they are in the practice of making cultural hypotheses on the status of a particular client, including know- ing when to generalize and when to exclude the experience of others in client case conceptualization and treatment. Thus clinicians are able to adopt treatment models to be sensible and acceptable to their individual minority clients. Professor of Clinical Psychology Gargi Roysircar, EdD. Director, Multicultural Center for Research and Practice Antioch University New England References American Psychiatric Association (2000). Diagnostic and statistical manual-IV-text revision (DSM-IV-TR). Washington: Author. APA Presidential Task Force on Evidence-Based Practice (2006). Evidence-based practice in psy- chology. American Psychologist, 61, 271–285. APATask Force on Resilience and Strength in Black Children and Adolescents (2008). Resilience in African American children and adolescents: A vision for optimal development. Retrieved July 1, 2011, from http://www.apa.org/pi/cyf/resilience.html. Benard, B. (1995). Fostering resilience in children. Urbana, IL: ERIC Clearinghouse on Early Childhood Education. (ERIC Document Reproduction Service No. ED386327). Retrieved June 29, 2011, from http://chiron.valdosta.edu/whuitt/files/resilience.html. Carson, C. (1995). Martin Luther King, Jr.: Charismatic leadership in a mass struggle. In J. T. Wren (Ed.), Leader’s companion: Insights on leadership through the ages (pp. 318–324). New York: The Free Press. Govinda, L. A. (1961). The psychological attitude of early Buddhist philosophy. London: Rider. Griner, D., & Smith, T. (2006). Culturally adapted mental health interventions: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531–548. Jackson, L. C., Schmutzer, P. A., Wenzel, A., & Tyler, J. D. (2006). Applicability of cognitive–be- havior therapy with American Indian individuals. Psychotherapy: Theory, Research, Training, 43(4), 506–517. doi:10.1037/0033–3204.43.4.380. Kakar, S. (1971). The theme of authority in social relations in India. Journal of Social Psychology, 84, 93–101. King, M. L., Jr. (1967). The role of the behavioral scientist in the Civil Rights Movement. In- vited Distinguished Address at the annual meeting of the American Psychological Association, Washington, DC. Retrieved July 12, 2011, from http://www.apa.org/monitor/jan99/king.html. Lerner, M. (1998). Surplus powerlessness: The psychodynamics of everyday life and the psychol- ogy of individual and social transformation. Amherst: HB Publications. Narada, M. (1968). A manual of Abhidhamma. Kandy, Sri Lanka: Buddhist Publication Society. Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and clas- sification. New York: Oxford University Press. Seligman, M. E. P. (2002). Using the new positive psychology to realize your potential for lasting fulfillment: Authentic happiness. New York: Free Press. Shen, E. K., Alden, L. E., Söchting, I., & Tsang, P. (2006). Clinical observations of a Cantonese cognitive–behavioral treatment program for Chinese immigrants. Psychotherapy: Theory, Re- search, Training, 43(4), 518–530. doi:10.1037/0033–3204.43.4.380. xii Foreword Sinha, J. B. P. (1968). The construct of dependence proneness. Journal of Social Psychology, 76, 129–131. Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psy- chologist, 53, 440–448. Nikhilananda, S. (1942). The gospel of Sri Ramakrishna. New York: Ramakrishna-Vivekananda Center.

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