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Culture Brokers, Clinically Applied Ethnography, and Cultural Mediation

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Cultural Consultation

Part of the book series: International and Cultural Psychology ((ICUP))

Abstract

This chapter looks at the practice of cultural mediation and the role of culture broker in medical settings with a focus on the cultural consultation service (CCS) of the Jewish General Hospital in Montreal and ethnopsychiatric consultation clinics in France and Italy. We first provide an overview of the concept of culture broker and culture in anthropology and its introduction into the medical settings of underserved communities, especially Aboriginals and immigrants. We then explore the most recent cultural mediation models emerging in the last 20 years in Europe, focusing on a few examples of implementation and policies. The culture broker is a go-between who sensitizes clinical practitioners to patients’ belief systems and encourages patients to “trust” the institutional system. Definitions of culture brokers, their professional recognition, and the roles they play in mediation vary cross-nationally and depend on different ideologies of citizenship and power relations. In practice, culture brokers are usually situated between two approaches: one, aimed at assimilating the immigrant’s point of view to the healthcare system and larger society, and the other, a more inclusive two-way exchange that offers space for each participant to understand the other’s point of view through providing opportunities for negotiation and empowerment strategies. We illustrate the complex and challenging role of culture broker at the CCS service through significant vignettes. They aim to show how culture brokering practices are context-based, depending on the embodied ability to recognize, tolerate, and mediate between diverging regimes of interpretation.

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Notes

  1. 1.

    1 In communication studies and related disciplines, many terms have emerged to point to the process of communication between culturally diverse parties, including cross-cultural, intercultural, and interdiscourse communication. Although they often are used as synonyms, they imply distinct concepts of culture. Cross-cultural communication implies that there are distinct cultural groups and looks at their interaction comparatively. Intercultural communication starts from the assumption that there are distinct cultural groups but studies their communicative practices in interaction with each other. Finally, interdiscourse communication sets aside any a priori notion of group membership and identity to investigate how and in what circumstances concepts such as culture are produced. The interdiscourse perspective, therefore, looks at the context of communication and interaction as relational process.

  2. 2.

    2 This case is discussed in further detail in Chapter 14 (Vignette 14-9).

References

  • Abu-Lughod, L. (1991). Writing against culture. In R. G. Fox (Ed.), Recapturing anthropology: Working in the present. Santa Fe, NM: School of American Research Press.

    Google Scholar 

  • Adams, K. M. (1997). Ethnic tourism and the renegotiation of tradition in Tana Toraja (Sulawesi, Indonesia). Ethnology, 36, 309–320.

    Article  Google Scholar 

  • Amit, V. (Ed.). (2007). Going first class? New approaches towards privileged travel and movement. London, England: Berghahn Press.

    Google Scholar 

  • Andoche, J. (2001). Sante mentale et culture. Les avatars français de l’ethnopsychiatrie. In J. P. Dozon & D. Fassin (Eds.), Critique de la santé publique. Paris, France: Balland.

    Google Scholar 

  • Appadurai, A. (1996). Modernity at large: Cultural dimensions of globalization. Minneapolis, MN: University of Minnesota Press.

    Google Scholar 

  • Augusti-Panareda, J. (2006). Cross-culture brokering in the legal, institutional and normative domains: Intercultural mediators managing immigration in Catalonia. Social and Legal Studies, 15, 409–433.

    Article  Google Scholar 

  • Barbee, E. (1986). Biomedical resistance to ethnomedicine in Botswana. Social Science Medicine, 22, 75–80.

    Article  PubMed  Google Scholar 

  • Barbee, E. (1987). Tensions in the brokerage role: Nurses in Botswana. Western Journal of Nursing Research, 9, 244–256.

    Article  PubMed  Google Scholar 

  • Barnes, J. A. (1954). Class and committees in a Norwegian island parish. Human Relations, 7, 39–58.

    Article  Google Scholar 

  • Beneduce, R. (1999). Luoghi e strategie di un’etnopsichiatria critica. In POL. it.

    Google Scholar 

  • Beneduce, R., Costa, G., & Favretto, A. R. (1994). la salute straniera. Napoli, Italy: Edizioni Scientifiche Italiane.

    Google Scholar 

  • Bibeau, G. (1997). Cultural psychiatry in a creolizing world: Questions for a new research agenda. Transcultural Psychiatry, 34(1), 9–41.

    Article  Google Scholar 

  • Bischoff, A. (2003). Caring for migrant and minority patients in European hospitals. A review of effective interventions. Vienna, Austria: Ludwig Boltzmann Institute for the Sociology of Health and Medicine.

    Google Scholar 

  • Bischoff, A. (2006). Intercultural mediation: Does it contribute to inclusion? Comparing policies and practices in the sectors of health, education, social and legal services: National Research Programme PNR 51: “Integration or Exclusion?” National Swiss Fond.

    Google Scholar 

  • Boissevain, J. (1974). Friends of friends: Networks, manipulators and coalitions. Oxford, England: Blackwell.

    Google Scholar 

  • Bott, E. (1957). Family and social networks. London, England: Tavistock.

    Google Scholar 

  • Brown, N. (1992). Beachboys as culture brokers in Bakau town, the Gambia. Community Development Journal, 27, 361–370.

    Google Scholar 

  • Burgess, W., Herring, J., & Young, T. K. (1995). Aboriginal health in Canada: Historical, cultural, and epidemiological perspectives. Toronto, Ontario, Canada: University of Toronto Press.

    Google Scholar 

  • Chambers, E. (2000). Native tours: The anthropology and travel and tourism. Long Grove, IL: Waveland Press.

    Google Scholar 

  • Clifford, J., & Marcus, G. E. (Eds.). (1986). Writing culture: The poetics and politics of ethnography. Berkeley, CA: California University Press.

    Google Scholar 

  • Cohen-Emerique, M. (2004). Positionnement et compétences spécifiques des médiateurs. Hommes et Migrations, 1249, 36–52.

    Google Scholar 

  • Corin, E. (1997). Playing with limits: Tobie Nathan’s evolving paradigm in ethnopsychiatry. Transcultural Psychiatry, 34(3), 345–358.

    Article  Google Scholar 

  • Dinh, M. H., Groleau, D., Kirmayer, L. J., Rodriguez, C., & Bibeau, G. (2012). Influence of the DSM-IV outline for cultural formulation on multidisciplinary case conferences in mental health. Anthropology & Medicine, 19(2), 261–276.

    Article  Google Scholar 

  • Fassin, D., & Rechtman, R. (2005). An anthropological hybrid: The pragmatic arrangement of universalism and culturalism in French mental health. Transcultural Psychiatry, 42(3), 347–366.

    Article  PubMed  Google Scholar 

  • Fernando, S. (Ed.). (1995). Mental health in a multi-ethnic society: A multidisciplinary handbook. New York, NY: Routledge.

    Google Scholar 

  • Fernando, S. (2002). Mental health, race and culture (2nd ed.). New York, NY: Palgrave.

    Google Scholar 

  • Fernando, S. (2003). Cultural diversity, mental health and psychiatry: The struggle against racism. New York, NY: Routledge.

    Book  Google Scholar 

  • Fiorucci, M. (2007). Dossier: la Mediazione Interculturale e le sue Forme: Contesti, Esperienze e Proposte. Introduzione [Intercultural mediation and its forms: Contexts, experiences and proposals. Introduction]. Rome, Italy: Studi Emigrazione, Centro Studi Emigrazione Morcelliana.

    Google Scholar 

  • Fossi, A. (2004). La médiation interculturelle au milieu hospitalier, in: La médiation interculturelle au débat. Les Cahiers du Carrefour Interculturel Wallon, 1, 28–37.

    Google Scholar 

  • Freeman, P. (1997). Ethnopsychiatry in France. Transcultural Psychiatry, 34(3), 313–319.

    Article  Google Scholar 

  • Gadamer, H. G. (1987). The problem of historical consciousness. In P. Rabinow & W. Sullivan (Eds.), Interpretive social science: A second look. Berkeley, CA: University of California Press.

    Google Scholar 

  • Geertz, C. (1960). The Javanese Kijaji: The changing role of a culture broker. Comparative Studies in Sociology and History, 2, 228–249.

    Article  Google Scholar 

  • Gentile, E., & Caponio, T. (2006). Dossier mediazione. La mediazione interculturale nei servizi. Il caso della provincia di Bologna. Osservatorio delle Immigrazioni, Special Issue, 1–40.

    Google Scholar 

  • Gershon, I. (2006). When culture is not a system: Why Samoan culture brokers can not do their job. Ethnos, 71, 533–558.

    Article  Google Scholar 

  • Giordano, C. (2006). Translating the other: An ethnography of migrant encounters with the police, nuns, and ethno-psychiatrists in contemporary Italy. Doctoral dissertation, University of California, Berkeley, CA.

    Google Scholar 

  • Giordano, C. (2008). Practices of translation and the making of migrant subjectivities in contemporary Italy. American Ethnologist, 35(4), 588–606.

    Article  Google Scholar 

  • Giordano, C. (2011). Translating Fanon in the Italian context: Rethinking the ethics of treatment in psychiatry. Transcultural Psychiatry, 48(3).

    Google Scholar 

  • Gobbo, F. (2004). Cultural intersections: The life story of a Roma cultural mediator. European Educational Research Journal, 3, 626–641.

    Article  Google Scholar 

  • Gregg, J., & Saha, S. (2006). Losing culture on the way to competence: The use and misuse of culture in medical education. Academic Medicine, 81, 542–547.

    Article  PubMed  Google Scholar 

  • Halba, B. (2009). T.I.P.S for intercultural dialogue: T-learning to improve professional skills for intercultural dialogue. Paris, France: Institut de Recherche et d’Information sur le Volontariat (IRIV).

    Google Scholar 

  • Hannerz, U. (1992). Cultural complexity. New York, NY: Columbia University Press.

    Google Scholar 

  • Jackson, L., Graham, E., & Jackson, J. C. (1998 [1995]). Beyond medical interpretation: The role of interpreter cultural mediators (ICMs) in building bridges between ethnic communities and health institutions. Seattle, WA: Harborview Medical Center.

    Google Scholar 

  • Jezewski, M. A. (1990). Culture brokering in migrant farmworker health care. Western Journal of Nursing Research, 12, 497–513.

    Article  PubMed  Google Scholar 

  • Kahn, M., & Kelly, K. (2001). Cultural tensions in psychiatric nursing: Managing the interface between western mental health and the Xhosa traditional healing in South Africa. Transcultural Psychiatry, 38, 35–50.

    Article  Google Scholar 

  • Kareem, J. (1992). The Nafsiyat intercultural therapy centre: Ideas and experience in intercultural therapy. In J. Kareem & R. Littlewood (Eds.), Intercultural therapy: Themes, interpretations and practice (pp. 14–37). Oxford, England: Blackwell Scientific.

    Google Scholar 

  • Kaufert, P. (1990). The ‘boxification’ of culture: The role of the social scientist. Santé Culture Health, 7, 139–148.

    Google Scholar 

  • Kaufert, J. M., & Koolage, W. W. (1984). Role conflict among ‘culture brokers’: The experience of native Canadian medical interpreters. Social Science & Medicine, 18(3), 283–286.

    Article  Google Scholar 

  • Kaufert, J. M., & O’Neil, J. D. (1998). Culture, power and informed consent: The impact of Aboriginal health interpreters on decision-making. In D. Coburn, C. D’Arcy, P. New, & G. Torrance (Eds.), Health and Canadian society: Sociological perspectives. Toronto, Ontario, Canada: Univeristy of Toronto Press.

    Google Scholar 

  • Kaufert, J. M., Putsch, R. W., & Lavallée, M. (1998). Experience of Aboriginal health interpreters in mediation of conflicting values in end-of-life decision making. International Journal of Circumpolar Health, 57, 43–48.

    PubMed  Google Scholar 

  • Kirmayer, L. J., Groleau, D., Guzder, J., Blake, C., & Jarvis, E. (2003). Cultural consultation: A model of mental health service for multicultural societies. Canadian Journal of Psychiatry, 48(2), 145–153.

    Google Scholar 

  • Kirmayer, L. J., & Minas, H. (2000). The future of cultural psychiatry: An international perspective. Cannadian Journal of Psychiatry, 45(5), 438–446.

    Google Scholar 

  • Kirmayer, L. J., Rousseau, C., & Lashley, M. (2007). The place of culture in forensic psychiatry. The Journal of the American Academy of Psychiatry and the Law, 35(1), 98–102.

    Google Scholar 

  • Kleinman, A. (1987). Anthropology and psychiatry: The role of culture in cross-cultural research on illness. The British Journal of Psychiatry, 151, 447–454.

    Article  PubMed  Google Scholar 

  • Kleinman, A., & Benson, P. (2006). Anthropology in the clinic: The problem of cultural competency and how to fix it. PLoS Medicine, 3(10), e294.

    Article  PubMed  Google Scholar 

  • Krajic, K., Strassmayr, C., Karl-Trummer, U., Novak-Zezula, S., & Pelikan, J. (2005). Improving ethnocultural competence of hospital staff by trainwing: Experiences from the European ‘Migrant-friendly Hospitals’ project. Diversity in Health and Social Care 2, 279–290.

    Google Scholar 

  • Marcus, G. E. (Ed.). (1992). Rereading cultural anthropology. Durham, England: Duke University Press.

    Google Scholar 

  • Marks, S. (1997). The legacy of the history of nursing for post-apartheid South Africa. In A. Rafferty, J. Robinson, & R. Elkan (Eds.), Nursing history and the politicsof welfare. London, England: Routledge.

    Google Scholar 

  • Minervino, S., & Martin, M. C. (2007). Cultural competence and cultural mediation: Diversity strategies and practices in health care. Translocations: The Irish Migration, Race and Social Transformation Review, 1, 190–198.

    Google Scholar 

  • Minore, B., & Boone, M. (2002). Realizing potential: Improving interdisciplinary professional/paraprofessional health care teams in Canada’s northern Aboriginal communities through education. Journal of Interprofessional Care, 16, 139–147.

    Article  PubMed  Google Scholar 

  • Molina, I., Gailly, A. G., Romero, C., & Guest, B. (Eds.). (2001). Social linkworking and inter-cultural mediation in Europe. Pilot project TPL transnational partnership for linkworking, Sweden. Stockholm, Sweden: Partnersap for Multietnisk Integration.

    Google Scholar 

  • Moro, M. R., & Real, I. (2006). La consultation transculturelle d’Avicenne. In M. R. Moro & Y. Mouchenick (Eds.), Manuel de psychiatrie transculturelle. Grenoble, France: La Pensée Sauvage.

    Google Scholar 

  • Narayan, K. (1993). How native is a “native” anthropologist? American Anthropologist, 95(3), 671–686.

    Article  Google Scholar 

  • Nathan, T. (1994a). L’influence qui guérit. Paris, France: Éditions Odile Jacob.

    Google Scholar 

  • Nathan, T. (1994b). Les bienfaits des thérapies sauvages. Thérapie scientifique et thérapie sauvage. Nouvelle Revue d’Ethnopsychiatrie, 27, 37–54.

    Google Scholar 

  • Ng, J., Popova, S., Yau, M., & Sulman, J. (2007). Do culturally sensitive services for Chinese in-patients make a difference? Social Work in Health Care, 44, 129–143.

    Article  PubMed  Google Scholar 

  • Paine, R. (1971). Theory of patronage and brokerage. In R. Paine (Ed.), Patrons and brokers in the East Arctic. Toronto, Ontario, Canada: University of Toronto Press.

    Google Scholar 

  • Pandolfi, M., & Bibeau, G. (2006). Suffering, politics, nation: A cartography of Italian medical anthropology. In F. Saillant & S. Genest (Eds.), Medical anthropology: Regional perspectives and shared concerns. London, England: Blackwell.

    Google Scholar 

  • Pöchhacker, F. (2008). Interpreting as mediation. In C. Valero-Garces & A. Martin (Eds.), Crossing borders in community interpreting definitions and dilemmas. Philadelphia, PA: John Benjamins Publishing Company.

    Google Scholar 

  • Press, I. (1969). Ambiguity and innovation: Implications for the genesis of the culture broker. American Anthropologist, 71, 205–217.

    Article  Google Scholar 

  • Santiago-Irizarry, V. (2001). Medicalizing ethnicity: The construction of Latino identity in psychiatric settings. Ithaca, NY: Cornell University Press.

    Google Scholar 

  • Sargent, C., & Larchanche, S. (2009). The construction of “cultural difference” and its therapeutic significance in immigrant mental health services in France. Culture, Medicine and Psychiatry, 33(1), 2–20.

    Article  PubMed  Google Scholar 

  • Singh, N. N., McKay, J. D., & Singh, A. N. (1999). The need for culture brokers in mental health services. Journal of Child and Family Studies, 8, 1–10.

    Article  Google Scholar 

  • Soong, F. S. (1983). The role of Aboriginal health workers as culture brokers: Some findings and their implications. Australian Journal of Social Issues, 18, 268–274.

    Google Scholar 

  • Streit, U. (1997). Nathan’s ethnopsychoanalytic therapy: Characteristics, discoveries and challenges to western psychotherapy. Transcultural Psychiatry, 34(3), 321–343.

    Article  Google Scholar 

  • Sturm, G., Heidenreich, F., & Moro, M. R. (2008). Transcultural clinical work with immigrants, asylum seekers and refugees at Avicenne Hospital, France. International Journal of Migration, Health and Social Care, 4, 33–40.

    Article  Google Scholar 

  • Sturm, G., Nadig, M., & Moro, M. R. (2011). Current developments in French ethnopsychoanalysis. Transcultural Psychiatry, 48(3), 205–227.

    Article  PubMed  Google Scholar 

  • Szasz, M. C. (1994). Introduction. In M. C. Szasz (Ed.), Between Indian and White worlds: The culture broker. Norman, OK: University of Oklahoma Press.

    Google Scholar 

  • Taylor, J. S. (2003a). The story catches you and you fall down: Tragedy, ethnography, and “cultural competence”. Medical Anthropology Quarterly, 17(2), 159–181.

    Article  PubMed  Google Scholar 

  • Taylor, J. S. (2003b). Confronting “culture” in medicine’s culture of no culture. Academic Medicine, 78, 555–559.

    Article  PubMed  Google Scholar 

  • Trudgen, R. (2000). Why warriors lie down and die. Darwin, NT: Aboriginal Resources and Development Services.

    Google Scholar 

  • Turner, V. W. (1974). Dramas, fields and metaphors: Symbolic actions in human society. Ithaca, NY: Cornell University.

    Google Scholar 

  • Van Willigen, J. (2002). Applied anthropology. An introduction. Westport, CT: Bergin & Garvey.

    Google Scholar 

  • Verrept, H. (2008). Intercultural mediation: An answer to health care disparities? In C. Valero-Garcés & A. Martin (Eds.), Crossing borders in community interpreting. Definitions and dilemmas. Amsterdam, Netherlands: Benjamins.

    Google Scholar 

  • Weidman, H. (1975). Concepts as strategies for change. Psychiatric Annals, 5, 312–314.

    Google Scholar 

  • Willis, E. (1999). From culture brokers to shared care: The changing position of literacy for Aboriginal health workers in Central Australia. Studies in Continuing Education, 21, 163–175.

    Article  Google Scholar 

  • Wolf, E. (1956). Aspects of group relations in a complex society: Mexico. American Anthropologist, 56, 1065–1078.

    Article  Google Scholar 

  • Zajde, N. (2011). Psychotherapy with immigrant patients in France: An ethnopsychiatric perspective. Transcultural Psychiatry, 48(3), 187–204.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Research Centre, St. Mary’s Hospital Center, 3830, Avenue Lacombe, Montreal, QC, Canada, H3T 1M5

    Alessandra Miklavcic Ph.D.

  2. Département de Sociologie, Université du Québec à Montréal, Case Postale 8888, Succursale Centre-Ville, Montréal, QC, Canada, H3C 3P8

    Marie Nathalie LeBlanc Ph.D.

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  1. Alessandra Miklavcic Ph.D.
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Correspondence to Alessandra Miklavcic Ph.D. .

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Editors and Affiliations

  1. Jewish General Hospital Inst. Community & Family Psychiatry, Montreal, Québec, Canada

    Laurence J. Kirmayer

  2. Jewish General Hospital Inst. Community & Family Psychiatry, Montreal, Québec, Canada

    Jaswant Guzder

  3. McGill University Div. Social & Transcultural Psychiatry, Montreal, Québec, Canada

    Cécile Rousseau

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Miklavcic, A., LeBlanc, M.N. (2014). Culture Brokers, Clinically Applied Ethnography, and Cultural Mediation. In: Kirmayer, L., Guzder, J., Rousseau, C. (eds) Cultural Consultation. International and Cultural Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7615-3_6

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