The Diagnostic Window: Culture‐ and Gender‐Sensitive Diagnosis and Training

Abstract

This article presents a gender and culturally sensitive clinical interview and diagnostic model for use with all clients and a method for training students in its use.

Trauma Outcome Process Assessment (TOPA) Model: An Ecological Paradigm for Treating Traumatized Sexually Abusive Youth

“…Ecological risk factors include: (a) cultural factors that covertly support abuse and violence and indirectly blame victims for their own abuse (Brown & Rasmussen, 1994;Rasmussen, 1999Rasmussen, , 2004Sinacore-Guinn, 1995), (b) violence in the community (e.g., gang violence, war, terrorism; Moin, Sharlin, & Yahav, 2007;Rasmussen, 2002Rasmussen, , 2007, and (c) inadequate environmental support and lack of resources (Friedrich, 2002;Gray & Pithers, 1993;Katz, 1997;Rasmussen, 2004Rasmussen, , 2007. The TOPA model accommodates to the family system and cultural background of the child, with parallel treatment for the parents and interventions targeting the family's dynamics as salient components of the treatment (Brown & Rasmussen, 1994;Burton et al, 1998;Rasmussen, 2007).…”

The Pros and Cons of Viewing Formal Diagnosis From a Social Constructionist Perspective

“…For example, Aderibigbe and Pandurangi (1995) wrote with regard to diagnosis that "many behavioral disorders do not conform to a finite set of taxa; significant differences are seen in them across cultures" (p. 229) and added that "in part, this is due to different beliefs about self and reality" (p. 229). As can be seen, such a view fits much better not only within social constructionism but also within counseling's core humanism and the value that counseling places on honoring diversity (Hansen, 2003(Hansen, , 2004Kelly, 1997;Sinacore-Guinn, 1995;Smart & Smart, 1997).…”

“…The other side, however, argues that the field studies in fact show just the opposite because the cited field studies are badly flawed (Kirk & Kutchins, 1992). However, diagnosis is still touted as aiding official communication, despite the lack of clear proof that it in fact does so (Fong, 1993;Hohenshil, 1993;Horowitz, 2002;Sinacore-Guinn, 1995).…”

“…What this means is that there is a great deal of proof that mental disorder is not evoked only by inner disorder, as an objective view of diagnosis leads one to believe, but also by social stressors and circumstances (Horowitz, 2002;Kutchins & Kirk, 1997;Levine, Perkins, & Perkins, 2005;McLaughlin, 2002). A further lasting criticism of an objective view of diagnosis is that it blurs the effects of ethnic and cultural variety on ideas of mental health and disorder (Cook, Warnke, & Dupuy, 1993;Sinacore-Guinn, 1995;Smart & Smart, 1997;Townsend, 1995). As a case in point, whereas the frequency of some diagnoses in some groups is proportional to that of the general population, the frequency for other groups is disproportionately high-hinting at bias in the diagnostic system (Horowitz, 2002;Levine et al, 2005;McLaughlin, 2002).…”

DSM—IV and Culturally Sensitive Diagnosis: Some Observations for Counselors

“…Indeed, the term idiographic means "relating to, involving, or dealing with the individual or the unique" (Webster's Third New International Dictionary, 1965, p. 1123, and the inclusion of such information is essential to arrive at a fully descriptive profile of the client. Numerous authors (Dana, 1993;Das, 1995;Hays, 1996;Keitel, Kopala, & Adamson, 1996;Kleinman, 1988;Konner, 1995;Morrison, 1995;Seligman & Moore, 1995;Sinacore-Guinn, 1995;Strauss, 1977) have noted the need to gather personal, family, and other contextual information that at first glance may seem secondary, even incidental, but which, on further consideration, begins to tell the client's story in a more fully formed manner.…”