Cultural consensus theory and cultural models theory present distinct perspectives about the nature of individual and cultural knowledge. Anthropologists have not really explored the implications of these differences, nor have they examined these differing perspectives in situations where both are plausible alternatives. Through an analysis of patterns in how individuals diagnosed with diabetes and living in an Anishinaabe (Ojibway) community talked about diabetes and the judgments they made about the relevancy of culturally plausible illness causes, I find, for this data set at least, that cultural models theory provides a better fit. Nevertheless, cultural consensus analysis played a critical role in this determination. Some ideas about the nature of collective memory are examined in light of my findings.

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The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman's (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor's (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups. Keywordsculture; psychotherapy; cultural competence; narratives; autism Mental health services have historically not been responsive to the mental health needs of racial and ethnic minority groups in the United States (U.S. Department of Health & Human Services, 2001). Minority group members with diagnosable disorders are less likely than majority group members to use mental health services (e.g., Barrio et al., 2003) and to receive quality mental health care (e.g., Melfi, Croghan, Hanna, & Robinson, 2000). As one effort to address these noted disparities, numerous clinical scholars and researchers have argued that mental health systems and practitioners need to integrate a cultural perspective in providing services to these communities (e.g., Hall, 2001). Generally speaking, initiatives aimed at increasing cultural competence take two basic forms. At the institutional level, hiring practitioners who are knowledgeable of the communities they serve and who speak the languages of those communities are examples of ways institutions can move in the direction of cultural competence (Betancourt, Green, Carrillo, Ananeh-Firempong, 2003;Guarnaccia, Vega, & Bonner, 2006). At the clinical level, clinicians are encouraged to integrate cultural matters in their assessments and interventions (e.g., cultural formulation, Lewis-Fernandez & Diaz, 2002 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptDespite the acknowledged need for mental health care to incorporate a cultural perspective, there are significant empirical and conceptual limitations to the study of cultural competence. Currently, there is no evidence that clinicians who adhere to a given culturally competent approach provide better mental health care than those clinicians who do not adhere to such an approach. Perhaps the best evidence in support of cultural competence concerns ethnic and linguistic match. Sue and colleagues (1991) indicate that Mexican-and Asian-origin patients in a public mental health system who receive services from clinicians who are ethnically and linguistically matched are likely to drop out less, receive more services, and improve in functioning more than patients who receive services from clinicians who are not ethnically or linguistically matched. Although these d...

This paper investigates variation in folk medical beliefs in a Tarascan community in west‐central Mexico. The data are from a structured interview completed with ten traditional curers and a like‐sized comparison group of noncurers. Three possible patterns of interinformant agreement are described and tested using the quadratic assignment program. The results suggest that although curers and noncurers do differ, the differences are not so great that they represent two variant systems of medical beliefs. Rather, there is a single system of beliefs common to both groups, but with curers showing higher agreement among themselves in expressing this system than noncurers. This finding, and a related one showing higher agreement among older informants, are explained in terms of culture learning. Curers and older people share more knowledge about illness because of their greater experience in both dealing with and communicating about illness. A model of folk medical knowledge is then presented and systematic variation from this model examined.

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