
Contents
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Introduction: patients and clinicians as migrants Introduction: patients and clinicians as migrants
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Background Background
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Handling cultural differences in clinical contexts: some examples Handling cultural differences in clinical contexts: some examples
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Negotiating the psychiatric encounter Negotiating the psychiatric encounter
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Dreams and nightmares Dreams and nightmares
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Social units as patient, pathogen, and resource Social units as patient, pathogen, and resource
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Theories of psychiatric disorders Theories of psychiatric disorders
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Organic causes Organic causes
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Clinician versus patient perspectives Clinician versus patient perspectives
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Culture-related attitudes and beliefs Culture-related attitudes and beliefs
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Being in spiritually safe places Being in spiritually safe places
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Concepts of propriety, morality, and legality Concepts of propriety, morality, and legality
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Learning the idioms for psychiatric constructs Learning the idioms for psychiatric constructs
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Assessing treatment compliance Assessing treatment compliance
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The 150% person The 150% person
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Conclusion Conclusion
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Acknowledgements Acknowledgements
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References References
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54 Handling cultural differences between patient and clinician
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Published:January 2021
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Abstract
This chapter proposes to aid clinicians in handling cultural differences encountered by patients and clinicians. Our overarching emphasis involves ‘migratory psychiatry’—a context in which patients may have migrated to an unfamiliar culture. We also include contexts in which clinicians have migrated to the patient’s culture, as this situation can produce similar problems that the clinician must manage. From innumerable possible topics, we have selected seven areas owing to their frequency and/or clinical importance: negotiated psychiatric encounters, dreams, and nightmares, social units as patient/pathogen/therapeutic resource, theories of psychiatric disorder, organic causes, managing differences, and culture-related attitudes and beliefs. Although this list does not cover all potential challenges, it does provide the reader with a format for handling other dilemmas arising between patient and clinician in psychiatric settings. The ‘Methods’ section specifies the means by which the reviewers and authors have approached such matters in their careers. The latter include being thoughtful in learning from their own experiences, benefitting vicariously from the experiences of teachers and colleagues, and reading journals and books on related topics.
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