From Ancestral Knowledge to Clinical Practice: The Case of \u3cem\u3eAgonias\u3c/em\u3e and Portuguese Clinicians in America

Cultures have varying notions about symptom expression and the treatment of mental health issues. Consequently, clients and psychotherapists may or may not share a similar worldview. In the psychotherapy literature there has been increased attention to these complex processes. This survey descriptive study aims to understand how therapists working with culturally diverse clients incorporate sensitivity to cultural differences. Fifteen culturally sensitive mental health care providers working with the Portuguese immigrant community were interviewed about their practices. Specifically, we investigated their understanding of the symptoms, causes and cures for agonias, a culture specific phenomenon. It was found that even though the providers are all Portuguese themselves, the meaning that they ascribed to agonias (anxiety and/or depression) was very different than the meaning ascribed to agonias by community members. The community member’s meanings ranged from indigestion to being on the brink of death. A cluster analysis revealed that clinicians who stated that agonias is anxiety, conducted cognitive behavioral therapy or psychopharmacology, and those that stated agonias had a depressive component tended to use family therapy or psychoanalysis

From ancestral knowledge to clinical practice: the case of agonias and Portuguese clinicians in America

Cultures have varying notions about symptom expression and the treatment of mental health issues. Consequently, clients and psychotherapists may or may not share a similar worldview. In the psychotherapy literature there has been increased attention to these complex processes. This survey descriptive study aims to understand how therapists working with culturally diverse clients incorporate sensitivity to cultural differences. Fifteen culturally sensitive mental health care providers working with the Portuguese immigrant community were interviewed about their practices. Specifically, we investigated their understanding of the symptoms, causes and cures for agonias, a culture specific phenomenon. It was found that even though the providers are all Portuguese themselves, the meaning that they ascribed to agonias (anxiety and/or depression) was very different than the meaning ascribed to agonias by community members. The community member¿s meanings ranged from indigestion to being on the brink of death. A cluster analysis revealed that clinicians who stated that agonias is anxiety, conducted cognitive behavioral therapy or psychopharmacology, and those that stated agonias had a depressive component tended to use family therapy or psychoanalysis.Este estudio descriptivo mediante encuestas trata de conocer como los terapeutas que trabajan con clientes de diferentes culturas incorporan a su práctica profesional la sensibilidad a estas diferencias culturales. Con este objetivo, se entrevistaron quince profesionales del área de salud mental considerados hábiles con respecto a cuestiones culturales, los cuales trabajaban con la comunidad de inmigrantes portugueses. En concreto, se trata de identificar el conocimiento de estos profesionales sobre los síntomas, posibles causas y tratamientos del fenómeno ¿agonias¿, específico de la comunidad de inmigrantes portugueses. Incluso tratándose de profesionales de nacionalidad portuguesa, se identificó que el significado que le atribuyen al fenómeno ¿agonías¿ (como sinónimo de ansiedad y depresión) es diferente al descrito por los individuos de la comunidad de inmigrantes. El significado que estos le atribuyen varía entre el término de indigestión a una denominación que indica proximidad de la muerte. Un análisis global revela que los clínicos que identifican ¿agonías¿ con ansiedad habían aplicado terapia de conducta cognitiva o psicofarmacológica; por su parte, los que identifican las ¿agonías¿ como un componente de la depresión habían empleado la terapia familiar o el psicoanálisis