Cultural and ethnic differences in psychopathology must be examined more closely. Unfortunately, the cultural and ethnic biases that can creep into clinical assessment do not necessarily yield to efforts to compensate for them. There is no simple answer. The DSM-5’s emphasis on cultural factors in the discussion of every category of disorder may well sensitize clinicians to the issue, a necessary first step. When practitioners were surveyed, they overwhelmingly reported taking culture into account in their clinical work (Lopez, 1994), so it appears that the problem, if not the solution, is clearly in focus. Strategies for Avoiding Cultural Bias in Assessment
Clinicians can—and do—use various methods to minimize the negative effects of cultural biases when assessing patients. Perhaps the place to begin is with graduate training programs. Lopez (2002) has noted three important issues that should be taught to graduate students in clinical psychology programs. First, students must learn about basic issues in assessment, such as reliability and validity. Second, students must become informed about the specific ways in which culture or ethnicity may impact assessment rather than relying on more global stereotypes about a particular cultural or ethnic group. Third, students must consider that culture or ethnicity may not impact assessment in every individual case. Assessment procedures can also be modified to ensure that the person truly understands the requirements of the task. For example, suppose that a Native American child performed poorly on a test measuring psychomotor speed. The examiner’s hunch is that the child did not understand the importance of working quickly and was overly concerned with accuracy instead. The test could be administered again after a more thorough explanation of the importance of working quickly without worrying about mistakes. If the child’s performance improves, the examiner has gained an important understanding of the child’s test-taking strategy and avoids diagnosing psychomotor speed deficits. Finally, when the examiner and client have different ethnic backgrounds, the examiner may need to make an extra effort to establish a rapport that will result in the person’s best performance. For example, when testing a shy Hispanic preschooler, one of the authors was unable to obtain a verbal response to test questions. However, the boy was overheard talking in an animated and articulate manner to his mother in the waiting room, leading to a judgment that the test results did not represent a valid assessment of the child’s language skills. When testing was repeated in the child’s home with his mother present, advanced verbal abilities were observed. As Lopez (1994) points out, however, “the distance between cultural responsiveness and cultural stereotyping can be short” (p. 123). To minimize such problems, clinicians are encouraged to be particularly tentative about drawing conclusions regarding patients from different cultural and ethnic backgrounds. Rather,
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