Transcultural Psychology: An International Perspective of Clinical and Diagnostic Challenges in the Assessment and Treatment of Culturally Diverse Patients

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Course Information
Discipline(s): 
Psychology
Terms offered: 
Spring
Credits: 
3
Language of instruction: 
English
Prerequisites: 

Prior coursework in Psychology, Psychology Major or Minor, Pre-Med and Criminology students

Description: 

The course provides a theoretical framework and uses practical tools regarding the field of Transcultural Psychology. In addition, the course examines research work and clinical findings at an international level concerning the diagnostic procedures and models of treatment with culturally diverse patients. Case studies and field trips to research institutions are an essential part of the course.

Attendance policy: 

Regular class attendance is mandatory. Students are expected to attend classes each day, including course-related excursions.

IES Abroad Milano allows a maximum of TWO excused absences per semester. Each further absence will automatically result in a penalty of two points off (2/100) on the final grade. SEVEN absences per course (including 2 excused absences) will result in a failing grade for that course. Furthermore, an absence on the date of scheduled tests, presentations or quizzes does not entitle you to recover/reschedule such tests. Failure to attend your midterm and/or final exam will result in an F grade on that paper/exam.

Learning outcomes: 

By the end of the course, students are able to:

  • Use broader diagnostic tools and methods of assessment in a transcultural setting, including patterns of communication between patient and treater and methods of securing patient alliance in the therapeutic setting;
  • Recognize risk and protective factors for Adjustment Disorder and its correlation with other psychological disorders such as Depression and Psychosis;
  • Comprehend methods of assessment and profiling in addition to approaches to treatment in the legal/criminological sector with culturally diverse patients who have a double diagnosis (psychological disorder and criminal offense);
  • Apply clinical tools in a realistic setting.
Method of presentation: 

Lecture, group discussion and role plays, clinical case studies, guest speakers, field studies, review of research, video viewings, Power Point presentations

Required work and form of assessment: 

Class attendance and active class participation (20%);
term papers (30%);
mid-term exam (20%);
final exam (30%)

content: 

Session I: Introduction to the Transcultural Model
Influence of culture, background, language, emotions and perceptions on the process of acculturation and adjustment to new environment.
Required Reading: Erez & Gati, pp.583-598; Berry, et al, ch. 1 & 2
PowerPoint Presentation: Zaiontz, Arduini, Invernizzi. Psychiatry and Intercultural Globalization.

Session II: Theories of Transcultural Psychology
Main theories of Transcultural Psychology; definition of cultural psychiatry and psychology and theory of Migration Fluexes; timeline of historical definitions of culture, ethnicity, society, and minorities to current theories of the Psychological Selection of Bio-Cultural Information.
Required Reading: Tseng, ch. 1 & 2
Recommended Reading: Massimini

Session III: Culture and Psychopathology
Correlation between culture and the development of mental disorders; ways in which culture contributes to psychopathology from a Bio-Psycho-Social perspective.
Required Reading: Berry, et al, ch. 15; Tseng, ch. 11 & 12

Presentation of Psychodynamic Assessment based on Gabbard’s Bio-Psycho-Social model of diagnosis and treatment.
Required Reading: Gabbard, ch. 1 & 3; Kirmayer, pp. 232-257

Sessions V, VI & VII: Psychopathology and Multiculturalism
Theoretical and practical considerations on the creation of a transcultural clinical setting with culturally diverse patients; analysis of Adjustment Disorder and migration fluxes in a multicultural population of
ex-patriots; Adjustment Disorder and Psychosis – study of the correlation between Adjustment Disorder
and the onset of Depression with Incongruous Symptoms, Depersonalization and Dissociative
Phenomena, Psychosis.
Required Reading:
Session V - Giosan, et al, pp. 317-332; Ward & Kennedy
Session VI – Ward & Kennedy, pp. 474-476
Session VII – APA readings
Power Point Presentations:
Session V - Transcultural Setting: Theory and Practice; Transcultural Setting: The cultural formulation of the DSM IV-TR
Session VI - Zaiontz, Arduini, et al. Clinical Trends of the Anglophone Population in Milan: Pre- and Post
September 11, 2001; Zaiontz, et al. Adjustment Disorder: A Three-Year Study with a U.S. University
Population.
Session VII – Zaiontz, et al. Clinical Challenges of Multiculturalism of Psychotic Patients in a Private
Practice.

Session VIII: Testing in Transcultural Populations
Available assessment materials used for testing in transcultural populations; introduction to cultural competence and culturally sensitive intervention.
Required Reading: Terranova-Cecchini & Tognetti Bordogna

Sessions IX & X: Review & Midterm Exam

Sessions XI & XII: Culture-bound Syndromes
Patterns of psychological responses and factors that distinguish psychopathology from one culture to another; cross-cultural syndromes, such as Dhat (India) and Ataque de Nervios (Latin America), and why these syndromes are culturally linked; panic disorders and its manifestations in western (Anglo- American) societies and eastern counterparts (Cambodia); Hinton Cross-Cultural perspective. Required Reading: Fraser; Ranjith; Hinton, pp. 155-178; Hsia & Barlow, pp. 474-476

Session XIII: Social Implications: Globalization and Psychopathology
Social culture in relation to psychopathology; value dimensions of a society and its relation to tension;
cross-cultural approach – examination of Anglo-Saxon, Latin American and Italian cultures.
Required Reading: King, pp. 405-433; Lopez & Guarnaccia, pp. 571-598

Session XIV: Field Study to NAGA (Immigration and Refugee Center)
Field study providing students with experience in a social service setting dedicated to the challenges of immigrants and refugees in Milan.
Required Reading: Kinzie, pp. 577-591

Session XV: Criminology: Double Diagnosis
Exploration of double diagnosis; psychopathology and criminal offense; profiling culturally diverse individuals.
Required Reading: Parzen, pp. 131-155;
PowerPoint Presentation: Principles of the Italian Judicial System

Guest speaker in the field of psychiatry and criminology discusses how to provide an expert’s opinion and profiling in court cases.
Required Reading: McCloskey et al

Session XVII: Field Trip to San Vittore Prison
Guided tour of rehabilitation units within a confined setting.

Session XVIII: Approaches to Treatment: Patient-Treater Relational Model
Acquiring cultural sensitivity and competence within a clinical setting; working with culturally diverse patients.
Required Readings: Bolton, pp. 97-114
Recommended Reading: Tseng, ch. 33
PowerPoint Presentation: The Psycho-Educational Model by Julian Leff

Session XIX: Guest Speaker
Researcher in Genetics and Neuro-imaging discusses exploring a current and research-based perspective on how pharmacological medication interacts with ethnically diverse groups.
Required Reading: Tseng, ch. 31
PowerPoint Presentation: Current research in Ethnopsychopharmacology

Session XX: Prevention Models on the Early Identification of Psychological Discomfort within a
Multicultural Population
A research study at the International School of Milan
Required Reading: “Transcultural Psychiatry: Goals and Challenges”
PowerPoint Presentation: Zaiontz. Primary and Secondary Prevention of Mental Disorders within a
Multicultural School Setting.

Session XXI & XXII: Review and Final Exam

Required readings: 
  • American Psychiatric Association (APA). DSM IV – TR, Diagnostic and Statistical Manual of Mental Disorders. Trans. Milano: Masson, 2001.
  • Berry, John W, et al. Cross-Cultural Psychology: Research and Applications. Cambridge: Cambridge University Press, 1992.
  • Bolton, J. “The Third Presence: A Psychiatrist’s Experience of Working with Non-English Speaking Patients and Interpreters.” Transcultural Psychiatry 39 (2002): 97-114.
  • Erez, Miriam & Efrat Gati. “A Dynamic, Multi-Level Model of Culture: From the Micro Level of the Individual to the Macro Level of a Global Culture.” Applied Psychology: An International Review 53 (2004): 583-594.
  • Fraser, Miranda. “Culture-bound Syndromes: Initial Perspectives from Individual Psychology.” The Journal of Individual Psychology 58 (2002).
  • Gabbard, Glen. Psychodynamic Psychiatry in Clinical Practice: DSM IV Edition. American Psychiatric Press, 1994.
  • Giosan, Cezar, et al. “The Lay Concept of Mental Disorder: A Cross-Cultural Study.” Transcultural Psychiatry 38 (2001): 317-332.
  • Hinton, D. “Panic Disorder, Somatization, and the New Cross-Cultural Psychiatry: The Seven Bodies of a Medical Anthropology of Panic.” Culture, Medicine and Psychiatry 26 (2002): 155-178.
  • Hsia, Curtis & David Barlow. “On the Nature of Culturally Bound Syndromes in the Nosology of Mental Disorders.” Transcultural Psychiatry 12, vol 38 (2001): 474-476.
  • King, L. “Social and Cultural Influences on Psychopathology.” Annual Review of Psychology (2004): 405-433.
  • Kinzie, J.D. “Immigrants and Refugees: The Psychiatric Perspective.” Transcultural Psychiatry 43 (2006): 577-591.
  • Kirmayer, Laurence. “Psychotherapy and the Cultural Concept of the Person.” Transcultural Psychiatry 44 (2007): 232-257.
  • Lopez, S.R. & P.J. Guarnaccia. “Cultural Psychopathology: Uncovering the Social World of Mental Illness.” Annual Review of Psychology 51 (2000): 571-598.
  • McCloskey, L., M. Treviso, et al. “A Comparative Study of Battered Women and their Children in Italy and the United States.” Journal of Family Violence 17 (2002).
  • Parzen, M.D. “Toward a Culture-Bound Syndrome Insanity Defense.” Culture, Medicine and Psychiatry 27 (2003): 131-155.
  • Ranjith, R. Mohan. “Dhat Syndrome as a Functional Somatic Syndrome: Developing a Sociosomatic Model.” Psychiatry 69(2006).
  • “Transcultural Psychiatry: Goals and Challenges.” The Canadian Journal of Psychiatry 45 (2000): 429-430.
  • Tseng, Wen-Shing. Handbook for Cultural Psychiatry. Academic Press, 2001.
  • Ward, Colleen & Anthony Kennedy. “Coping with Cross-Cultural Transition.” Journal of Cross-Cultural Psychology (2001): 636-642.

The course packet includes excerpts from the following literature and a CD-Rom contains all the Power Point Presentations for the course.

The course also utilizes the following assessment tool:

  • Terranova-Cecchini, R. & M. Tognetti Bordogna. Cultural Identity: 1992.
Other Resources: 

PowerPoint Presentations:

  • Zaiontz, Caterina. Primary and Secondary Prevention of Mental Disorders within a Multicultural School Setting. International Congress on Schizophrenia and other Mental Disorders: A Transcultural Perspective. Stravanger: Norway, 2006.
  • Zaiontz, Caterina. A Six Year Study with the International School of Milan. In collaboration with ISM Professor Terry Haywood: 2006.
  • Zaiontz, Caterina, A. Arduini, L. Bartocetti, et al. Clinical Challenges of Multiculturalism of Psychotic Patients in a Private Practice. International Congress of the Psychological Therapies of Schizophrenias and other Psychosis. Madrid, 2006.
  • Zaiontz, Caterina, G. Invernizzi. Psychiatry and Intercultural Globalization. World Psychiatric Congress: Madrid, 2001.
  • Zaiontz, Caterina, A. Arduini, et al. Clinical Trends of the Anglophone Population in Milan: Pre- and Post September 11, 2001. International Congress, Volcanic Mind. University of Catania, 2004.
  • Zaiontz, Caterina, & A. Arduini. Adjustment Disorder: A Three-Year Study with a U.S. University Population. World Psychiatric Congress: Madrid, 2001.