Cultural Formulation
Cultural formulation is a process that educates people about their country and their common humanity while instilling moral and intellectual virtues in them (Fernandez, et al., 2014). Cultural formation does not occur overnight. It is a lengthy process that begins with birth and continues until an individual is cultured. Harry is now forty-three years old, and because he was born and raised in Japan, he was prepared and cultured in Japanese customs and values. Because of moving to the US when he was in his 20s, he has been exposed to new cultural expectations through interactions with the Americans which meant that he would be trained to adopt new beliefs and values. Harry is facing some challenges that may have been caused by his cultural formulation and therefore, he needs an intervention method.
Elements of a Cultural Formulation
Cultural Identity
Harry identifies himself as a Japanese and holds most of the Japanese cultural beliefs and values in high regard. Harry has lived in the US for more than twenty years already, but he still demonstrates the Japanese culture. For instance, although he has been facing challenges in his relationships and financial matters, Harry refuses to visit a counselor arguing that the Japanese culture opposes it. Moreover, when Harry was courting a Japanese-American lady, he felt that her fiancée was more Americanized than him. Harry holds this perception because he identifies himself as a Japanese.
Culture Acculturation
Cultural acculturation is the modification that individuals go through as they adapt or borrow traits from another culture (Mezzich, Caracci, & Fabrega, 2009). Harry is facing a lot of difficulties in adapting to the American culture, and this makes him irritable, lonely and nervous which leads him to experience social anxiety and tension in the relationships he has with other people. Moreover, due to these problems, Harry is unable to forgive the people who hurt him and he holds on to grudges for a long time. Harry upholds his dominant culture as he even refuses to seek counseling services. Although Harry eventually seeks counselling because his American friends keep insisting, he still feels weak and even thinks that his friends view him as a weak person. As Harry is trying to create a balance between his Japanese culture and the American one, he experiences a conflict because the two cultures vary greatly.
Cultural Explanation
Harry believes that his issues are caused by his culture which suggests that being manly is the ability of an individual to stand up for themselves when they are faced with challenges. When Harry was in high school, he was frequently bullied by other students which eventually resulted in physical injuries. Harry's father is a conservative Japanese who only suggested that Harry should stand up for himself and he did not offer any intervention. Due to this response, it became difficult for Harry to share his experiences with any of his family members. The bullying in the past continuously affects him as he often gets nightmares of friends and co-workers harassing him. As such, he experiences social anxiety as he prefers to stay alone, feels that people believe he is weak and he is even unable to move on from the breakup with his fiancée because he thinks that nobody else will accept him as he is.
Culture vs. Personality
The Japanese culture insists that a man should stand up for himself even when they feel they require help. As such, the Japanese oppose counseling services as they believe it is a sign of weakness. The cultural dynamics of the Japanese affect Harry, and that is why, he states that although he feels down most of the time, he is still able to go to work. He believes he must go to work to prove that he is not weak and that he can handle his issues as a man. However, his personality is different as he demonstrates low levels of self-confidence when presenting his case. He thinks that nobody understands him and that people think he is a not a smart person. Therefore, his character is entirely different from the one he tries to portray when living up to the expectations of his culture.
Culturally Sensitive Treatment
Culturally Sensitive Therapy
The use of therapy is one of the culturally sensitive treatments that can be used to deal with Harry's issues (Sperry, 2010). The therapist will incorporate cultural sensitivity in the treatment program by ensuring that the values, opinions, and attitudes that Harry holds in high regard due to his culture are respected. The therapist will only suggest intervention methods which Harry can appreciate without feeling that his Japanese values have been neglected. The use of therapy is the most effective approach because when Harry perceives that his culture is respected despite the fact that he now lives in America, he will become more open in sharing information and even become positive in receiving guidance (DeAngelis, 2015). As such, the intervention method will be an effective treatment method for Harry.
The Use of a Healing Circle
The use of healing circles is also another treatment method that may be used in Harry's case (Barnett & Bivings, 2010). Harry needs to be exposed to other individuals who after growing up in Japan, moved to the United States. These individuals will share their experiences with Harry and even explain to him how they dealt with challenges that came along when they were trying to fit into the American culture. Moreover, the circle would also include individuals who experienced bullying at some point in their life and how they were able to overcome it. The use of the healing circle will help Harry develop relationships with people who are facing challenges that are similar to his. Moreover, he will feel that these difficulties are common and that they are not only facing him because he is weak. The use of the healing circle will also make Harry more open to sharing information because it does not look so much like counseling which his culture opposes. Therefore, he will get a positive outcome from the interactions with individuals in the circle.
Conclusion
It is clear that the Japanese culture is more dominant in Harry's life even after living in the US for more than twenty years. Since he is facing a lot of difficulties as he tries to adopt the American culture, there is the need to seek treatment. The treatment will also help him deal with the psychological issues he suffered due to bullying during his high school days. The use of a healing circle coupled with culturally sensitive therapy will help Harry improve his social interaction skills which will reduce the loneliness, social anxiety and even the traumatic dreams that he experiences.
References
Barnett, J., & Bivings, N. (2010). Culturally Sensitive Treatment and Ethical Practice. Retrieved from www.apa.org: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwj40uu47I_XAhXG1xoKHeCJBVgQFggvMAE&url=http%3A%2F%2Fwww.apadivisions.org%2Fdivision-31%2Fpublications%2Farticles%2Fmaryland%2Fbarnett-ethical.pdf&usg=AOvVaw0UWEFFY4wp
DeAngelis, T. (2015). In Search of Cultural Competence. Retrieved from www.apa.org: http://www.apa.org/monitor/2015/03/cultural-competence.aspx
Fernandez, R. L., Neil, A., Baarnhielm, S., Kirmayer, L., Weiss, M., Hinton, L., & Collazos, F. (2014). Culture and Pyschiatric Evaluation: Operationalizing Cultural Formulation for DSM-5. Psychiatry, 77(2), 130-154.
Mezzich, J., Caracci, G., & Fabrega, H. (2009). Cultural Formulation Guidelines. Trancultural Psychiatry, 46(3), 23-36.
Sperry, L. (2010). Culture, Personality, Health and Family Dynamics: Cultural Competence in the Selection of Culturally Senstive Treatments. The Family Journal, 8(3), 1-16.
