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精神卫生保健中文化多样性的临床方法及法国跨文化咨询的特点:一项范围综述

Clinical Approaches to Cultural Diversity in Mental Health Care and Specificities of French Transcultural Consultations: A Scoping Review.

作者信息

Carballeira Carrera Laura, Lévesque-Daniel Sarah, Radjack Rahmeth, Moro Marie Rose, Lachal Jonathan

机构信息

Alicia Koplowitz Short-Term Fellowship, Madrid, Spain.

APHP, Hôpital Cochin, Maison de Solenn, Paris, France.

出版信息

Front Psychiatry. 2020 Oct 27;11:579147. doi: 10.3389/fpsyt.2020.579147. eCollection 2020.

Abstract

Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. We conducted a scoping review on psychiatric services adapted to cultural diversity, to compare these models of care to the French Transcultural Psychotherapy model. Systematic electronic search of databases (PubMed and PsycINFO), manual search of archives of journals dealing with transcultural psychiatry, and consultations with international experts, to identify all papers describing clinical models devoted to psychiatric care for migrants, published between January 1990 and October 2018. Narrative synthesis of the included articles. The study included 29 papers. The specificities of psychiatric services for migrant families are linked to the host country's migration patterns and citizenship model. In English-speaking countries, specialized services for ethnic minorities offer ethnic matching of the therapist and patient. In Canada, indirect transcultural consultation services have existed since the late 1990s. Australia emphasizes the networking of consultation services and professional training in cultural competence, while the Nordic countries (Sweden, Finland, Norway, and Denmark) focus management on trauma. In France, psychotherapy services, with flexible numbers of therapists involved according to the situation, have existed since 1990. Most initiatives place emphasis on training and supervision, in an indirect approach not specifically focused on the patient, or offer cultural matching of patient and therapist. The French transcultural approach, on the contrary, makes the family's culture and its cultural diversity an integral part of the therapy process.

摘要

文化背景在很大程度上影响精神疾病的体验和临床症状表现,同时文化因素也限制了获得医疗服务的机会以及医疗服务的效果,对于需要特定类型服务的移民家庭而言尤其如此。我们针对适应文化多样性的精神科服务开展了一项范围综述,以将这些照护模式与法国跨文化心理治疗模式进行比较。通过对数据库(PubMed和PsycINFO)进行系统的电子检索、人工检索涉及跨文化精神病学的期刊存档,并咨询国际专家,以识别1990年1月至2018年10月期间发表的所有描述针对移民精神科照护的临床模式的论文。对纳入文章进行叙述性综合分析。该研究纳入了29篇论文。移民家庭精神科服务的特殊性与东道国的移民模式和公民身份模式相关。在英语国家,为少数族裔提供的专门服务实现了治疗师与患者的种族匹配。在加拿大,自20世纪90年代末以来就存在间接跨文化咨询服务。澳大利亚强调咨询服务网络建设和文化能力方面的专业培训,而北欧国家(瑞典、芬兰、挪威和丹麦)则将管理重点放在创伤方面。在法国,自1990年以来就存在心理治疗服务,根据具体情况灵活安排参与的治疗师数量。大多数举措强调培训和督导,采用并非专门针对患者的间接方法,或者提供患者与治疗师的文化匹配。相反,法国的跨文化方法将家庭文化及其文化多样性作为治疗过程不可或缺的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5015/7652727/e08a06ebbb9a/fpsyt-11-579147-g0001.jpg

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