Culturally informed case conceptualisation: Developing a clinical psychology approach to treatment planning for non‐Indigenous psychologists working with Aboriginal and Torres Strait Islander clients

Abstract

Background In the context of the Australian Psychological Society's formal apology and the increasing awareness of the need to develop interventions that improve the social and emotional wellbeing of clients who identify from Aboriginal and Torres Strait Islander cultural backgrounds, this article considers the clinical psychology case conceptualisation. The primary aim of any case conceptualisation is to inform intervention and, in the initial stages of treatment, is considered important in helping the psychologists to develop a stronger therapeutic relationship whilst also providing a reference point from which to evaluate treatment progress. In other words, it enables practitioners to develop a coherent set of explanatory inferences—based in theory—that describe and explain why the person has a particular problem at a particular time. Method The model draws together mainstream case formulation processes with culturally specific understandings of social and emotional health and wellbeing. A worked case example is used in this article to illustrate how the non‐Indigenous psychologist can integrate influence of the broader social and cultural context into the case conceptualisation to enhance culturally responsive practice. Results The proposed model provides the psychologist with an entry point for understanding an individual's experience within a broader socio‐historical–political context. The model may help the practitioner to identify areas in which he or she needs to develop their cultural intelligence. Conclusions Developing and enhancing culturally responsive practice is a practical way in which clinical psychologists can meaningfully participate in “active reconciliation” within a clinical psychology encounter.

Non‐Indigenous Psychologists Working with Aboriginal and Torres Strait Islander People: Towards Clinical and Cultural Competence

“…In terms of case formulation and diagnosis, researchers (Kilcullen & Day, ; Parker & Milroy, ; Westerman, ) have called for Aboriginal and Torres Strait Islander people to be assessed within their community and cultural context, in the presence of family members and Aboriginal and Torres Strait Islander mental health workers, and to consider cultural explanations for their symptoms to reduce problems associated with the misdiagnosis, under‐diagnosis, and over‐diagnosis of mental health conditions. Westerman () has described “culture‐bound syndromes” specific to Aboriginal and Torres Strait Islander people that if not understood, may be confused with depression, anxiety, or psychosis.…”