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While physiological reactions to trauma seem to be universal, manifestations of responses may differ significantly.

Culture forms a context through which the traumatized individuals or communities view and judge their own response.7

Traumatic incidents could include violent attacks such as: mugging, rape, war, torture or sexual abuse; being kidnapped or held captive; child abuse; domestic violence, serious accidents such as car or train wrecks; and natural disasters such as floods or earthquakes. Or it could be something witnessed, such as massive death and destruction after a building is bombed or a plane crashes.

Social Networks Social networks consist of the social ties or interactions an individual has with family, friends, neighbors, community members or others. Social ties have a functional aspect that is referred to as social support that may provide financial and emotional support.8 Social support from families, friends and communities is a key determinant of mental health, and greatly influences an individuals health-seeking behavior. It should be acknowledged that not all ties are supportive in nature. For example, it should not be assumed that if son or daughter lives in close proximity to an elderly parent or another aged family member that the elderly parent receives adequate support. Emotional support may come from a neighbor or friend.

Cultural Assessment Guide


1. Language What is your primary language? Is that the language you speak at home? What language are you most comfortable speaking? 2. Migration Where were you born? Your parents born? Where were your children born? When did you come to the United States? What state? Where do you live? What did you find to be the most challenging adjustment when you arrive to the US? What are your challenges today? 3. Ethnic and Cultural background How would you describe yourself ethnically or culturally? How would you describe your cultural background? 4. Familys role Who raised you? Who do you regard as the person that impacted your life the most? Tell me about the members of your family. 164
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NOTES

Do they all live close to you? Do you want your family (not) included in treatment? Which member of your family offers you the most support in times of hardship? What do you do for family that makes you feel the best? 5. Religious and/or spiritual beliefs and practices NOTES Is religion or spiritually important to you? Are you comfortable talking about your beliefs with me? Do you believe in any other forms of healing? (i.e. herbal remedies, traditional healing practices)? Is there religious leader/healer who you might find helpful? 6. Experiences of trauma

Did you experience any forms of social, religious, or political or ethnic-based intolerance/ discrimination at any time that you may want to share with me? Have you experienced any traumatic losses (loss of home, family, employment) that changed the way you think and or feel about yourself, people, family, friends, etc.? How? 7. Social networks Who would you view as your most important source of support? What kinds of activities do you enjoy? Do you have any community connections that would help in the treatment process? Do you know what types of social supports are available to you? 8. Understanding of presenting problems Do you understand why you are in the hospital? Does your family/support network understand why you are here? What would you like us to know about you, your culture, beliefs, or traditions that would to help us care for you better? Is there anything or any situation that you are afraid of or fear? NOTES

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9. Clients perceptions of cross-cultural barriers to treatment

Have you experienced any barriers when using some of the services that is available to you? Is anything that we do not offer that would helpful to you? 10. General Service Delivery Are you in need of any financial assistance? Have your financial status change as a result of your illness? Do you have a restrictive diet due to your illness or belief? (Example low salt, low cholesterol, no beef, no pork etc.) What is your favorite kind of food? Is food or preparation of food an important part of your daily routine? If you like to watch movies and TV, how much do you watch on a daily basis? In what language do you prefer to watch TV? How is work/school/ day program? Any issues that that I should be aware of or could help you? Where do you like to spend your time? How do you like to spend your time? Are you taking your medication as prescribed? When did you last speak with your family/significant other? How they are doing? How is your relationship with them? Do you have any plans for social outings, or a vacation? Based on the information gathered in the assessment guide and/or any other culturalbased information that you have learned about this client during the your assessment, how would you modify your plan of care? Develop related interventions based on this information learned through this assessment.

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3. Are there program and/or organizational barriers that need to be addressed based upon this assessment?

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