Our case of the week demonstrates the usefulness of a culturally competent assessment in the treatment of an 11-year old biracial girl Julia. Julia’s father is a Latino while her mother is African American. At the moment of intake, Julia is struggling with depression related symptoms such as feelings of sadness, increased food intake, social isolation, and emotional dysregulation.
During the intake procedure with Julia’s parents, the therapist asks for cultural explanations for Julia’s symptoms with questions as “What do you think it has been like for Julia, growing up as a biracial child in a Latino family?”. The therapist also investigates the history of the cultural/ethnic identity in the parents themselves with questions as “How much did your parents talk with you about racism and prejudice when you were growing up?”.
The assessment leads to a case formulation which stresses that Julia’s biracial family had elected to emphasize one extended family culture over the other (Latino over Afro American ethnicity, catholic over other religions, and faith over ethnicity). Julia’s lack of embeddedness in her African American family tradition, culture, and identity was hence making it difficult for her to navigate a normally complex and tumultuous developmental period. She identified herself as a member of an oppressed minority group.
Treatment consequently focused on individual, family related, systemic as well as cultural factors. It consisted of 1) parental sessions, which focused on psycho-education and the creation of an open dialogue about racism and minority stress, 2) mother-daughter conjoint sessions, in which Julia and her mother opened up a conversation on their shared Afro American identity, history and experience, 3) family sessions, in which respect for each other’s ethnic identity and history was stressed, and 4) individual sessions with a focus on dealing with cognitive distortions and interpersonal stressors.
The case shows how a cultural-sensitive assessment influences case formulation and treatment strategy. It is very interesting for those who work with clients from an ethnic minority background.
Here you can find the link to the case in our Archive (registration is required): http://singlecasearchive.com/archive/the-impact-of-a-culture-sensitive-intake-assessment-on-the-treatment-of-a-depressed-biracial-child
To find our previous cases of the week, go to http://www.singlecasearchive.com/blog
The SCA team
minority, cultural-sensitive assessment, case formulation, depression,
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