Culturally Competent Family Therapy: A General Model

... I could not divorce her. I was ashamed. What would people say? They would say I'm no good. My mother also did not want me to divorce her. And then she cheated on me. She would really cheat on me like a hen. Later, I found out that, even before she married me, she had men. There was someone who had sex with her and took her to men. She had a taxi driver and she had an old man, a neighbor. People saw him going downstairs from her. My mother told me to take a private eye. I took one, and he found that she worked in it. I did not tell anybody. They would make fun of me that I did not kill her; just divorced her. In our community, we solve problems within the family. Here, I turned to other people. I went to a psychologist.

Shlomo: Why did you decide to do something unacceptable; turn to psychological help?

Nahum: My parents belittle me at home all the time. They call me Nahum Beduro, which means Nahum the No-Good. I could not rely on my family.

Shlomo: Why? You strike me as an intelligent man.

Nahum: Because I am the youngest, and I am a son and most of the family live in Bat-Yam. They want me to be their servant. Because they are old and sick. They don't want me to think: I am a big man, I am intelligent, I am strong, I'll marry an Israeli girl who is not a Georgian and I'll go away and leave my parents to die.

This chapter presents methods and techniques for collecting or eliciting data for an overall culturally competent diagnostic evaluation of a family. These include naturalistic observations in various settings (home, street, the clinic, etc.) and interviews. A method for transcribing the details of the family's verbal and nonverbal observed behavior is proposed. Interviews are the presenting-problems interview, designed to obtain a detailed behavioral description of the presenting symptoms, and the case-history interview. The purpose of the latter is to trace the development of the case. This involves: (1) Learning about the family's culture-bound information-processing pro grams of any of the types discussed in this book, at each stage of the family's development; (2) detecting adaptational transformations in these programs, in response to ecological and developmental changes; (3) locating bugs in these programs, as a result of the failure to restore simplicity. Interviewees are family members or people in the community who know the family. During the interviews, the interviewer forms hypotheses and asks leading questions. The readers are warned to use all these techniques with caution and flexibility, always bearing in mind the family's cultural sensitivities.

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