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精神病学中的微侵犯与文化冲突:将多元文化咨询取向扩展至精神科服务

Microaggressions and Cultural Ruptures in Psychiatry: Extending Multicultural Counseling Orientation to Psychiatric Services.

作者信息

Rudecindo Brendalisse, Kuo Patty, Smith William A, Tao Karen W, Imel Zachary E

机构信息

Department of Educational Psychology (Rudecindo, Tao, Imel) and Huntsman Mental Health Institute, Department of Education, Culture, & Society, and Ethnic Studies Program (Smith), University of Utah, Salt Lake City; Perelman School of Medicine, University of Pennsylvania, Philadelphia (Kuo).

出版信息

Focus (Am Psychiatr Publ). 2025 Jan;23(1):9-18. doi: 10.1176/appi.focus.20240034. Epub 2025 Jan 15.

Abstract

Racial microaggressions and cultural ruptures have a significant impact on mental health care for Black, Indigenous, and people of color (BIPOC) communities. This article reviews the application of the multicultural counseling orientation framework in psychiatry to address these challenges and improve therapeutic outcomes. The authors outline strategies to integrate cultural humility into psychiatric practice, with an emphasis on self-reflection, feedback, and the recognition of microaggressions. By fostering cultural humility, providers can create therapeutic spaces where patients feel safe and validated. The article also discusses cultural opportunities for exploring patients' identities and advocates for open dialogue that addresses these aspects early in treatment. Structural recommendations include enhancing training programs to incorporate equity-focused coursework, promoting recruitment and retention of BIPOC clinicians, and developing institutional policies to address systemic inequities. Adopting these approaches can reduce the adverse effects of microaggressions, build trust, and improve mental health outcomes for BIPOC patients. The authors suggest that future efforts should emphasize systemic changes in training, recruitment, and community engagement to create a more inclusive mental health care system.

摘要

种族微侵犯和文化冲突对黑人、原住民及有色人种(BIPOC)社区的心理健康护理有着重大影响。本文回顾了多元文化咨询取向框架在精神病学中的应用,以应对这些挑战并改善治疗效果。作者概述了将文化谦逊融入精神病学实践的策略,重点是自我反思、反馈以及对微侵犯的认识。通过培养文化谦逊,医疗服务提供者可以创造出让患者感到安全和被认可的治疗空间。本文还讨论了探索患者身份的文化契机,并倡导在治疗早期就开展涉及这些方面的开放对话。结构性建议包括加强培训项目,纳入以公平为重点的课程,促进BIPOC临床医生的招聘和留用,以及制定机构政策以解决系统性不平等问题。采用这些方法可以减少微侵犯的不利影响,建立信任,并改善BIPOC患者的心理健康状况。作者建议,未来的努力应强调在培训、招聘和社区参与方面的系统性变革,以创建一个更具包容性的心理健康护理系统。

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