Clinician's Guide to Cultural Psychiatry

In recent years, increasingly diverse patient populations and culture gaps between mental health practitioners and patients have brought to the forefront the need for culturally competent care. Clinicians struggle to master the necessary competencies, and clinical instructors continually seek effective ways to impart those skills to trainees. Clinician's Guide to Cultural Psychiatry is the most welcome tool yet to help us in these endeavors.

No author is better qualified to produce such a book than Wen-Shing Tseng, whose wealth of research knowledge and teaching experience produced the well-respected Handbook of Cultural Psychiatry (1). Clinician's Guide to Cultural Psychiatry now provides much of that information in a more readable format, together with extensively updated sections pertaining specifically to clinical settings. In addition, Tseng has consulted with dozens of other respected authors and clinicians; names internationally well-known in the field of cultural psychiatry, such as Renato Alarcon, Ezra Griffith, Tsung-Yi Lin, Francis Lu, and Joseph Westermeyer. Their contributions to the text are in many cases specifically identified and add further cultural breadth.

The book opens with an introduction to concepts of culture and definitions of related terms, which should be required reading for psychiatric residents and students of all clinical social sciences. Tseng then explores the impact of culture on behavior, culture as it relates to pathology, and traditional cultural explanations for mental disorders. These opening sections are as readable as any novel and replete with interesting and relevant examples and photos.

As Tseng addresses specific disorders in more depth, he sometimes gets a little weighted down with descriptions of syndromes, producing chapters that contain important information but unfortunately read more like the original Handbook, a reference text rather than a clinician's guide. However, the focus soon turns back to direct clinical issues, and the author provides a useful guide to culturally competent clinical assessment, including relevant comments about language barriers and psychometric testing. Tseng addresses clinical care in virtually every setting and explores cultural components of psychopharmacology and psychotherapy. Later chapters examine specific subgroups, such as women, children, and the elderly, and also provide overviews of the major ethnic groups. I personally would have liked to see the urban subculture specifically addressed, with some discussion of the culture of gang violence, given that these issues are frequently encountered clinically in the United States. Nonetheless, the overall tone of the book lends itself to stimulation of lively discussion about topics that could not be covered at length.

Given the author's background as a researcher, the text is meticulously referenced in a most helpful format to encourage further reading on topics of interest. Case vignettes throughout keep the topics alive, as do the excellent illustrations. Clinician's Guide to Cultural Psychiatry will surely become a standard text for all psychiatric residency programs that are seeking to meet the cultural competency requirements of the Accreditation Council for Graduate Medical Education and should be an important addition to the library of every mental health clinician.

Dr. Beaubrun is assistant professor of psychiatry at Charles R. Drew University of Medicine and Science in Los Angeles and assistant clinical professor of psychiatry at the University of California, Los Angeles.