Book Review: Ethnocultural Perspectives on Disaster and Trauma

This paper will review the book: “Ethnocultural Perspectives on Disaster and Trauma’ by Anthony J. Marsella, Jeannette L. Johnson, Partricia Watson and Jan Gryczynski. Generally, this book discusses the issues concerning the recognition of diversity of the people’s groups during the disaster relief. It gives insights on the cultural context of working with ethnic minority communities during disasters, gives readers a framework for improving disaster policies and practices by “calling attention to the cultural background and personal uniqueness”. It paints a giant picture of disaster relief for humanitarian mental health workers and cross-cultural consultants.

Summary

The book can be served as a cultural information book for the front line humanitarian workers who may be encountered with cross-cultural counseling after disaster. As a cross cultural client hilariously speaking, I recommend all clinicians to read them before going into the field, it gives a very general idea about a behavior of the group of people and the reason of their certain behavior, and the authors interpreter the behavior in a respectful way.

This is the overview of the book content:

At the beginning book, Marsella analyzes the complexity of the disaster in the first chapter; as well as gives an in depth conception of culture. While giving a sharp insight of the potential conflict a cross-cultural communication may lead to, the author also argues that simply applying “western” relief may create more problems other than resolving them. Then it emphasizes the cultural consideration in six phases of disaster relief cycle. At the end, by quoting from The New South Wales Institute of Psychiatry’s Disaster Mental Health Response Handbook that a large range of victims need to be given consideration, it brings the awareness of the indirectly affected victims. In conclusion, it gives the seven symptoms of a disaster victim during the disaster cycle and raises the awareness of the complexity of disaster, and acknowledging and mediating variations rather than denying or distorting may help solve the problems. Here, by agreeing with the complexity of culture, I would like to share the iceberg culture model as a metaphor to understand a cultural is not to see the outlook, but to see through the under beneath the surface.

Picture 1. Cultural Iceberg (Princeton, NJ, 1992)

From raising the awareness of the diversity and complexity, Norris and Alegria give an overview of ethnic-minority individuals and communities in North America, and some difficult situations and stigma in mental health services. It argues that the data & the research from the past are helpful to understand the post traumatic stress disorder (PTSD) in the diversity group, but it’s also inadequate due to the complexity of diverse subgroup. The clinicians may also make impropriate medical decisions due to the bias or stereotyping (Takeuchi & Uehara, 1996) . Some studies show that the congruence between therapist and client plays a significant role in therapy (Sue, 1998) , and it quotes from Sue that when a clinician encounters a client from an uncertain cultural background, he/she is suggested to use hypotheses to test rather than make premature conclusions. Though there is no formulary to advise cross-cultural treatment, with the scientific mindedness as Sue suggested, the cross-cultural treatment programs need to address language needs, physical care as well as offering the mental health services with competent bilingual clinicians (Kinzei, 2001 ). Then, the authors show the emotional statues are related with socially engaged emotions (feeling of closeness), socially disengaged emotions (pride) and generic emotions (happiness), where the findings between Japan as an collectivism culture and United States as individualism culture are quite different (Kitayama, Markus, and Matsumoto, 1995), nevertheless, the treatment needs to be “embed the individual into a broader familial, interpersonal, and social context.” Finally, it gives the Solomon’s study that by minimizing the intervention for self-help while providing for basic needs, and empowering the victims to participate in their own recovery efforts so as to regain controlling over their lives and the future.

In the next nine chapters, it develops useful information concerning culture in different ethnocultural groups, which is list in the Table 1. As the author suggests, this is not the formulaic information but the references to assist the clinicians to make their own decision.

	African Americans	American Indians	Arab Americans	Asian Indians	Caribbean Island Black population	Chinese Americans	Hawaiians	Hispanic	Vietnamese
Population demographics
Historical events
Communication styles
Valid assessment instruments
Special disorder considerations
Special therapies and healing considerations
Medications and therapies
Disasters and trauma insights
Special recommendations for improving the services

Table 1. Chapter 3 – Chapter 11

In conclusion, the next chapter from Wilson offers an implication of the trauma experience, and again, some insights of the complexities of trauma across cultures. It finally raises serious questions about the cultural variations in trauma and “the necessity of using care and sensitivity when treating people from different cultural traditions”.

Critiques

All in all, it’s a very insightful book for mental health humanitarian workers in disaster relief and cross cultural consultants. Here are the bricks I think it’s important to be considered.

1. Application is very subtle in terms of groups. Though it gives a global view of application in the last chapter, the real applications in different minority groups looks as helpless as the situation of the minority groups. It might bring some social justice issue as well. Successfully addressing the problem, but to solve the problem, it's a long way to go.

2. Since the book is written by the psychology therapist (western), it will be good if it directly invite the therapist/healers/clinicians from different cultures, or even nations, countries, to share the similar disaster relief cases. (It actually did quite a lot of research and works in the book)

3. Other researches on the model of building a strong personality in each cultural tradition, to empower the victims recovering from PTSD as well as rebuilding the destroyed community.

4. Translation of the book, since it's cross culture and language.

5. Coordination and cooperation with other dimensions of disaster relief organizations, communities and programs. The disaster relief is not only humanitarian mental health service, but also the community re-building, society policy, facilities recovering and so forth. It will be great if the book can invite or cooperate with the different dimensions of the disaster relief.

6. Target on the trend indicator of each culture. Although, the philosophy of the people’s group is rooted from the history, as the economics developing and historical events happening, a trend indication is a very interesting topic to research into. From my perspective, in China, people go to counseling service is not a “wrong” thing to do, though the awareness of mental health is not high enough, the change of the value, the rapid civilization and the vanishing of the spirituality do make people go the counseling office.
7. Target on social justice issue + minority

8. Target on other international scholar and students are facing the cultural shock as well as not getting support from their own sub-cultural group; they are in need of the mental health support in a personal cultural disaster. To solving the problem: a. Selectively choose the international students and scholars in an authentic way. b. It’s not only to train the professional councilors and bring the awareness of mental health among this group of people, but also train those who understand the cultural disorder and cultural shocks, to counsel or help in a non-official level, as well as to offer the proper professional networks for this group of people.