Cross-cultural Adjustment

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Cross-cultural Adjustment Mental Illness

• Mei Liu, M.A.
• Certified Canadian Counsellor
• Canadian Counselling and psychotherapy association

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Workshop Objectives

• Understand the natural process and issues in
  cross-cultural adjustment
• Learn how to use self-validation for
  cross-cultural adjustment
• Recognize common mental illnesses
• Know when and how to seek professional help in
  the community

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PART ONE

• Cross Cultural adjustment
• Cultural Identity development
• Cultural Dislocations
• Cultural Conflicts
• Self-Validation

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Racial Identity Development

• Definition
• The process of developing rejection or/and
  acceptance toward own and dominant cultures, as
  well as other minority groups
• Not everyone will go through the same stages of
  development

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Cultural Identity Development

• Five Stages (Sue Sue, 1990)
• Conformity
• Dissonance
• Resistance and Immersion
• Introspection
• Integrative awareness

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Cultural Identity Development

• Conformity Stage
• Self-depreciating toward self own culture
• Appreciation toward dominant culture
• Discrimination toward other minority groups

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Cultural Identity Development

• Dissonance Stage
• Conflict between depreciation and appreciation
  toward self and own culture
• Conflict between depreciation and appreciation
  toward majority culture
• Conflict between dominate-held view of racial
  hierarchy toward other minority group

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Cultural Identity Development

• Resistance Immersion Stage
• Develop appreciation toward self and own culture
• Develop depreciation toward majority culture
• Developed empathy but also ethno-centrism toward
  other majority groups

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Cultural Identity Development

• Introspection Stage
• Examine basis of appreciation toward self and own
  culture
• Examine basis of depreciation toward majority
  group
• Examine own ethno-centrism toward other minority
  group

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Cultural Identity Development

• Integrative Awareness Stage
• Develop a positive attitude, sense of self, and
  confidence toward self own culture.
• Develop appreciation and openness to certain
  positive traits of majority culture
• Develop appreciation toward other minority group
  and willingness to reach out to them

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Cultural Conflicts

• Two types of Cultural Conflicts
• Conflict with the new culture
• Conflict arising with own culture after being
  exposed to new culture.

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Cultural Conflicts

• Four states of conflicts
• Low cultural conflict
• Host cultural conflict
• Home cultural conflict
• Bicultural conflict

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Cultural Dislocation

• A subjective experience of feeling displaced or
  not at home a in given socio-cultural environment
  
• (F. I. Ishiyama, 1995)
• Lack of validation or under-validation of self or
  the ethnic self in the host culture

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Cultural Dislocation

• Three Domains
• Unfamiliarity and disorientation in a new
  environment decreased social competency
• Uprooted-ness and homesickness
• Identity crisis

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Self-Validation in New Environment

• Based on Dr. Ishiyamas work
• A useful concept in helping self and others
  through the cross-cultural adjustment process
• Explore past and current sources of validation to
  grieve losses and establish new strength and
  identity

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Self-Validation in New Environment

• Themes of Validation
• Security, Comfort Support
• Self-Worth Self-acceptance
• Competence autonomy
• Identity belonging
• Love, Fulfillment and Meaning in life.

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Validationgram

• Sources of validations
• Relationships
• Places
• Things
• Activities

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Validationgram
Things
Relationships
Self
Increasing importance
Activities
Places
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PART TWO

• Mental Illness
• Schizophrenia
• Mood Disorders Depression Bipolar
• Anxiety Disorders
• Contributing Factors
• Mental Health Resources

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Mental illness

• Definition
• A diagnosable disorder that significantly
  interferes with ones thinking, emotion,
  behaviours, and social interactions.
• Diagnostic Standards
• North America DSM
• Europe ICD

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Mental illness Cultural Perspectives

• Different cultures might have different
  interpretations.
• A high degree of consensus about the diagnosis of
  mental illness among many countries.
• Diagnosis/label not as important
• How symptoms affect functioning is the best
  indication for intervention.

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Schizophrenia

• Positive symptoms
• Hallucinations
• Distortion in five senses/perceptions hearing
  voices, seeing things.
• Delusions
• Beliefs that is out of touch of the reality,
  especially paranoia. i.e. other are plotting to
  hurt them super power
• Disorganized speech

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Schizophrenia

• Negative Symptoms
• Withdrawal/isolation
• Lack of motivation
• Flat affect (dull expression)
• Neglect hygiene or personal care

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Schizophrenia

• Features
• Is not split or multiple personality
• 1 of population has schizophrenia
• Onset usually is around late teenage and early
  20s
• Females have a later onset
• No cure but can be treated

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Mood Disorders

• Normal mood fluctuations

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Two Major Types of Mood Disorders

• Mood episodes

Manic Episode
Depressive Episode
Depressive Episode
Major Depressive Disorder
Bipolar Disorder
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Major Depressive Disorder

• Symptoms (Depressive Episode)
• Depressed mood most of the day
• Markedly diminished interest or pleasure
• Significant changes in appetite and weight
• Sleep disturbance
• Fatigue of loss or energy
• Feeling of worthlessness or excessive guilt
• Poor concentration and memory
• Recurrent thoughts of death or suicidal ideation

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Major Depressive Disorder Intervention

• When symptom last for at least 6 weeks.
• Interfere with functioning, i.e. school, work and
  relationships
• Difficult to resolve with social support, rest,
  exercise, leisure or diet change.
• When there is suicidal ideation/plans

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Bipolar Disorder

• Features
• Mood swings between Manic and depressive
  episodes
• Depressive episodes lasts longer than Manic
  episodes
• Risk of suicide increases during a depressive
  episode
• Rule out drug use for an manic episode

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Bipolar Disorder

• Manic Episode symptoms
• Increased rate of speech and thought process
• Poor concentration easily distracted
• Decreased sleep and appetite
• Many projects begun but not completed
• Lack of self-control impulsive behaviour, i.e.
  increasing spending
• Boastful, arrogant, intrusive impatient
• Possible psychosis

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Bipolar Disorder Intervention

• Both episodes need medical intervention
• Sometimes hospitalization required
• Counselling or peer support alone is not
  sufficient
• Need to learn how to manage the illness

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Anxiety Disorders

• Anxiety is a normal reaction to stress
• Most of time anxiety will pass, and normal
  functioning is resumed
• Defined as a disorder when a certain group of
  symptoms are present
• Each disorder has dominant symptoms but they all
  are a form of anxiety.

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Common Anxiety Disorders

• Generalized anxiety disorder
• Panic attack
• Obsessive compulsive disorder (OCD)
• Phobia social or specific phobia
• Post-traumatic stress disorder (PTSD)

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Anxiety Disorder Intervention

• Is a problem when
• - Anxiety is out of proportion
• - Anxiety interfere with daily functioning
• - One starts avoid feared situations
• - One uses drugs alcohol to cope

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Mental illness

• Is not a personal weakness
• Can be treated
• Often caused by multiple factors
• Bio-psycho-social-spiritual model

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Bio-Psycho-Social-Spiritual Model

• Biological factors
• Genetics
• Heredity family history of mental illness
• Medical conditions, i.e. thyroid problems
• Brain chemicals, i.e. dopamine, serotonin
• Daylight exposure

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Bio-Psycho-Social-Spiritual Model

• Psychological Factors
• Coping styles
• Self-esteem self-worth
• Self-efficacy
• Attributions
• Attitudes

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Bio-Psycho-Social-Spiritual Model

• Social Factors
• Current stressors
• Financial difficulties/poverty
• Social network support
• Change in social environment and adjustment
• Social competency

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Bio-Psycho-Social-Spiritual Model

• Spiritual factors
• Spiritual beliefs
• Meaning/purpose in life
• Relationship with the greater world

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Mental Health Resources

• Family doctors (GP) Private psychiatrists
• School counsellors
• Community mental health teams Specialized
  programs
• Mental health emergency services
• Suicide prevention program
• 911

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Community Mental Health Teams

• Provide mental health treatment and
  rehabilitation outside of hospitals
• Consist of psychiatrists, nurses, social worker,
  counsellor, occupational therapist, vocational
  therapist, health care worker.
• Accept the most severe cases
• Accept direct referrals
• Free of charge

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Community Mental Health Programs

• Vancouver Coastal Health
• General Inquiry
• 604-736-2033
• www.vch.ca
• Adult Mental Health program
• Mental Health Emergency Services
• 604-874-7307

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Community Mental Health Programs

• Fraser Health
• General Inquiry
• 604-587-4600
• www.fraserhealth.ca
• Adult Mental Health program
• Mental Health Emergency Services
• 1-877-384-8062

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Urgent Mental Health Services

• 911
• Suicide Prevention Program 604-872-3311
• Crisis lines (Front of Yellow Pages)
• The Red Book 604-875-6381
• (Non-urgent resources)

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• Sometimes it is more important to know what
  kind of person has a disease that what kind of
  disease a person has
• Sir Wm. Osher