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Chapter 9. Counseling South American Immigrants 第9章。南美移民咨询
Pub Date : 2005-08-03 DOI: 10.1300/J191v03n01_09
Jairo N. Fuertes, V. Alfonso, J. T. Schultz
Abstract The Hispanic population in the United States is growing exponentially. There are a total of 1,506,654 South Americans in the United States who have come from Spanish-speaking countries. Most immigrants, if not all, experience difficulties triggered by migration, discrimination, acculturation, and second language acquisition. In this chapter, we briefly discuss major issues associated with migration and present literature and research on the construct of social support. We propose that integrating and utilizing social support during treatment will facilitate the adjustment process for the individual. We present interventions that allow the therapist to provide support while encouraging the client to seek support within him/herself and from other sources in the environment.
美国的西班牙裔人口呈指数级增长。美国共有1,506,654名来自西班牙语国家的南美人。大多数移民,如果不是全部,都会经历由移民、歧视、文化适应和第二语言习得引发的困难。在本章中,我们简要讨论了与移民相关的主要问题,并介绍了有关社会支持构建的文献和研究。我们建议在治疗过程中整合和利用社会支持将促进个体的适应过程。我们提出干预措施,允许治疗师提供支持,同时鼓励客户从他/她自己和环境中的其他来源寻求支持。
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引用次数: 2
Chapter 6. Psychosocial Stressors, Psychiatric Diagnoses and Utilization of Mental Health Services Among Undocumented Immigrant Latinos 第六章。无证移民拉丁美洲人的心理社会压力源、精神病诊断和心理健康服务的利用
Pub Date : 2005-08-03 DOI: 10.1300/J191v03n01_06
M. Pérez, L. Fortuna
Abstract The combined effects of minority status, specific ethnic group experiences (political, economic, trauma and immigration history), poverty, and illegal status pose a set of unique psychiatric risks for undocumented Latinos in the United States. Restrictive legislation and policy measures have limited access to health care, and other basic human services to undocumented immigrants and their children throughout the nation. However, little is known about the patterns of mental health care use, psychiatric diagnoses and psychosocial problems prevalent among the undocumented who do succeed in presenting to clinical settings and to the mental health sector. To begin to address the need for further understanding in this area, we completed a clinical chart review of 197 outpatient adult psychiatric charts in a Latino mental health outpatient treatment program located in an urban hospital system. We compared the diagnoses and mental health care use of undocumented Latino immigrants (15%) with that of documented (73%) and US born Latinos (12%) treated in this clinical setting. The undocumented Latinos in our study were more likely to have a diagnosis of anxiety, adjustment and alcohol abuse disorders. The undocumented also had a significantly greater mean number of concurrent psychosocial stressors (mean number = 5, p < .001) ascompared to documented immigrants and US born groups, which both had a mean number of 3 stressors identified at evaluation. The undocumented were more likely to have psychosocial problems related to occupation, access to healthcare and the legal system. However, the undocumented had a lower mean number of total mental health appointments attended (mean visits = 4.3, p < .001) in which to address these stressors as compared to documented immigrants (mean visits = 7.9) and US born (mean visits = 13.3). In terms of other previous mental health service use, the undocumented group had lower rates of lifetime inpatient and outpatient treatment use. The results of this study suggest the importance of early assessment of psychosocial stressors, substance use and barriers to care when treating undocumented immigrants. Although all Latino groups included in this investigation demonstrated numerable concurrent stressors, our investigation highlights the particular importance of accessible social services and supports for addressing psychosocial stressors in the lives of undocumented patients. Our results stress the importance of reexamining policies, that restrict access to social services and healthcare for the undocumented. Our results also suggest the importance of culturally appropriate evaluation and treatment of substance abuse disorders as well as addressing other psychological and behavioral responses to multiple stressors among undocumented individuals.
少数民族身份、特定族群经历(政治、经济、创伤和移民史)、贫困和非法身份的综合影响为美国无证拉美裔人带来了一系列独特的精神风险。限制性立法和政策措施限制了全国各地无证移民及其子女获得医疗保健和其他基本人类服务的机会。然而,对于那些成功地到临床机构和精神卫生部门就诊的无证件者普遍存在的心理保健使用模式、精神病诊断和社会心理问题,人们知之甚少。为了进一步了解这一领域的需要,我们完成了一项临床图表综述,其中包括位于城市医院系统的拉丁裔心理健康门诊治疗项目的197例成人门诊精神病学图表。我们比较了无证拉丁裔移民(15%)与有证拉丁裔(73%)和美国出生的拉丁裔(12%)在该临床环境中的诊断和精神保健使用情况。在我们的研究中,无证件的拉丁美洲人更有可能被诊断为焦虑、适应和酒精滥用障碍。与有证移民和美国出生的群体相比,无证移民同时存在的社会心理压力源的平均数量也显著增加(平均数量= 5,p < 0.001),后者在评估时平均有3个压力源。无证件者更有可能出现与职业、获得医疗保健和法律制度有关的社会心理问题。然而,与有证移民(平均访问= 7.9)和美国出生(平均访问= 13.3)相比,无证移民在解决这些压力源方面的平均总心理健康预约次数(平均访问= 4.3,p < .001)较低。在其他先前的精神卫生服务使用方面,无证件组的终身住院和门诊治疗使用率较低。本研究的结果表明,在治疗无证移民时,早期评估心理社会压力源、药物使用和护理障碍的重要性。尽管本调查中包括的所有拉丁裔群体都显示出许多并发的压力源,但我们的调查强调了无障碍社会服务和支持对解决无证患者生活中的社会心理压力源的特别重要性。我们的研究结果强调了重新审查限制无证移民获得社会服务和医疗保健的政策的重要性。我们的研究结果还表明,文化上适当的评估和治疗药物滥用障碍的重要性,以及解决无证个体对多重压力源的其他心理和行为反应。
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引用次数: 81
Appendix 附录
Pub Date : 2005-08-03 DOI: 10.1300/j191v03n01_12
[Haworth co-indexing entry note]: “Appendix.” Co-published simultaneously in Journal of Immigrant & Refugee Services (The Haworth Social Work Practice Press, an imprint of The Haworth Press, Inc.) Vol. 3, No. 1/2, 2005, pp. 199-209; and: Mental Health Care for New Hispanic Immigrants: Innovative Approaches in Contemporary Clinical Practice (ed: Manny J. González, and Gladys González-Ramos) The Haworth Social Work Practice Press, an imprint of The Haworth Press, Inc., 2005, pp. 199-209. Single or multiple copies of this article are available for a fee from The Haworth Document Delivery Service [1-800-HAWORTH, 9:00 a.m. 5:00 p.m. (EST). E-mail address: docdelivery@haworthpress.com].
[霍沃斯联合索引条目注释]:“附录。”《移民与难民服务杂志》(The Haworth Social Work Practice Press, The Haworth Press, Inc.的一个印记)第三卷,第1/2号,2005年,第199-209页;和:精神卫生保健新西班牙裔移民:创新的方法在当代临床实践(编:曼尼J. González和格拉迪斯González-Ramos)霍沃斯社会工作实践出版社,霍沃斯出版社,公司,2005年,第199-209页的印记。本文的单份或多份副本可在Haworth文件递送服务(1-800-HAWORTH,上午9点至下午5点(美国东部时间))收取费用。电子邮件地址:docdelivery@haworthpress.com]。
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引用次数: 0
Chapter 1. Health Disparities in the Hispanic Population 第1章。西班牙裔人口的健康差异
Pub Date : 2005-08-03 DOI: 10.1300/J191v03n01_01
G. González-Ramos, M. González
Abstract Closing the gap on health and mental health disparities has been receiving increasing attention, coming at a time of growing diversity in the U.S. population. There have been several reports, from the U.S. government and others, calling for increased focus on disparities and proposing the elimination of these (IOM, 2001, 2003; USDHHS, 2001). Despite all these efforts, health and mental health disparities are quite pronounced in the Hispanic population. There are a myriad of reasons for these inequalities that seem to include an interplay of social, personal, and environmental factors. This manuscript examines health and mental health disparities in the Hispanic population and suggests some future directions to be considered.
在美国人口日益多样化的背景下,缩小健康和心理健康差距已经受到越来越多的关注。来自美国政府和其他机构的几份报告呼吁加强对差距的关注,并建议消除这些差距(IOM, 2001,2003;USDHHS, 2001)。尽管做出了所有这些努力,但西班牙裔人口的健康和心理健康差距相当明显。造成这些不平等的原因有很多,其中似乎包括社会、个人和环境因素的相互作用。本文考察了西班牙裔人口的健康和心理健康差异,并提出了一些需要考虑的未来方向。
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引用次数: 5
Chapter 11. The Future of Culturally Competent Mental Health Care for Latino Immigrants 第十一章。拉丁裔移民文化胜任精神卫生保健的未来
Pub Date : 2005-08-03 DOI: 10.1300/J191v03n01_11
W. Vega
Abstract This chapter underscores the importance of cultural competence in the provision of effective mental health services to Latino immigrants. Culturally competent mental health care must be understood within the context of a social-political-economic framework that is changing on a continual basis. Health and mental health care reform for Latino immigrants must be linked to both practice-based research efforts and timely diffusion of best practice innovations. Cultural competence must be integrated as a valued component of the organizational structure of mental health systems of care.
摘要本章强调了文化能力在为拉丁裔移民提供有效心理健康服务中的重要性。必须在不断变化的社会-政治-经济框架的背景下理解具有文化能力的精神保健。拉丁裔移民的健康和精神保健改革必须与基于实践的研究工作和及时传播最佳实践创新联系起来。文化能力必须作为精神卫生保健系统组织结构的重要组成部分加以整合。
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引用次数: 1
Chapter 10. Central American Survivors of Political Violence 第十章。中美洲政治暴力幸存者
Pub Date : 2005-08-03 DOI: 10.1300/J191v03n01_10
D. Engstrom, Lissette M. Piedra
Abstract Despite compelling, well-documented findings on the levels of stress and trauma among Central American refugees, this group continues to be underserved. A host of issues contributes to this underservice, ranging from macro-level imposed obstacles, such as citizenship and health insurance as determining factors for accessing social and health services, to institutional factors that impede service utilization, such as an insufficient number of translators or a cumbersome and confusing bureaucracy. This chapter adopts a human rights framework as a strategy for working with groups of Central Americans who have experienced political violence. The ongoing effects of political violence on Central Americans, as they relate to mental and physical health problems, are reviewed and a case vignette is used to illustrate how political violence affects individuals and how macro-level forces and institutions create barriers to access and use of health care and social services. Treatment approaches for helping survivors of political violence in the context of a human rights framework are suggested.
尽管关于中美洲难民的压力和创伤程度的研究结果令人信服,但这一群体仍然得不到充分的服务。造成这种服务不足的原因有很多,从宏观层面强加的障碍,如公民身份和医疗保险作为获得社会和保健服务的决定因素,到阻碍服务利用的体制因素,如翻译人员数量不足或繁琐而令人困惑的官僚机构。本章采用了一个人权框架,作为与遭受政治暴力的中美洲群体合作的战略。审查了政治暴力对中美洲人的持续影响,因为这些影响涉及精神和身体健康问题,并使用了一个案例小品来说明政治暴力如何影响个人以及宏观层面的力量和机构如何为获得和使用保健和社会服务制造障碍。提出了在人权框架内帮助政治暴力幸存者的治疗办法。
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引用次数: 8
Developing a Model Intervention to Prevent Abuse in Relationships Among Caribbean and Caribbean-American Youth by Partnering with Schools 通过与学校合作,制定一项模范干预措施,以防止加勒比和加勒比裔青年之间的关系中的虐待行为
Pub Date : 2004-10-12 DOI: 10.1300/J191v02n03_07
K. Herman
SUMMARY This paper proposes a model intervention to prevent relationship abuse among Caribbean and Caribbean-American adolescents. Specifically, the model partners with a high school with a strong Caribbean student population and incorporates education, prevention and intervention, as the three core components. This paper highlights the importance of working with young people in a school setting, working with young people before they have fully tackled the developmental task of defining norms of and values in relationships, utilizing culturally competent staff and specialized programming, and emphasizing the need for early intervention in the instances of adolescent relationship violence before its evolution into adult domestic violence. The model proposed serves as an outline for further development of culturally-specific and competent interventions to prevent and address relationship violence among adolescents.
摘要本文提出了一个预防加勒比和加勒比裔青少年关系虐待的模型干预。具体而言,该模式与一所拥有大量加勒比学生的高中合作,并将教育、预防和干预作为三个核心组成部分。本文强调了在学校环境中与年轻人一起工作的重要性,在他们完全解决定义关系规范和价值观的发展任务之前与年轻人一起工作,利用文化上有能力的工作人员和专门的节目,并强调需要在青少年关系暴力演变为成人家庭暴力之前对其进行早期干预。所提出的模型是进一步发展针对具体文化的有效干预措施的大纲,以预防和处理青少年之间的关系暴力。
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引用次数: 0
Disparities in Infant Mortality Rates Among Immigrant Caribbean Groups in New York City 纽约市加勒比移民群体婴儿死亡率的差异
Pub Date : 2004-10-12 DOI: 10.1300/J191v02n03_03
M. Bayne-Smith, Yvonne Graham, Marco A. Mason, M. Drossman
SUMMARY This study examined infant mortality rates (IMR) in New York City (NYC) to identify those groups reporting higher IMR concentrations in recent years and to determine what factors and explanations are associated with this new trend. Analysis of data from NYC Department of Health (DOH) identified infant mortality patterns throughout the City by both maternal birthplace and NYC Health Districts. In addition, infant mortality rates for those NYC populations with the highest concentrations were compared to the most recently available IMR data from their countries of origin. Focus group sessions were conducted with women in the identified groups in New York City in an effort to obtain their perspectives on causality and other factors associated with the new trend. Strong patterns emerged from this study pointing to a concentration of the City's highest IMR among groups from the circum-Caribbean region. Results of focus group sessions with women in the identified population groups yielded a list of specific barriers faced by this population in the utilization of perinatal care services. In addition, the study resulted in some clearly delineated program and policy approaches that can help to address the disparities in IMR. Myriad causative factors contribute to the high rates of IMR among Caribbean immigrant groups. Expanding the availability of both successful program models and promising practices is critical to decreasing infant mortality in immigrant communities. Specific recommendations are for the development of a strategic set of interventions designed to eliminate this most serious challenge to the health of new immigrant groups in NYC. Any references to comparisons between data from NYC and data from the countries of origin were merely to serve as a reference point as it is not often possible to determine the level of scientific rigor applied to the collection and analysis of data external to the United States (U.S.). Implications for social work practice with immigrant populations include the need for delivery of culturally competent services in general and for cultural sensitivity to health beliefs surrounding maternal child health issues in particular.
本研究检查了纽约市(NYC)的婴儿死亡率(IMR),以确定近年来报告较高IMR浓度的人群,并确定与这一新趋势相关的因素和解释。纽约市卫生局(DOH)的数据分析确定了全市按产妇出生地和纽约市卫生区分列的婴儿死亡率模式。此外,还将纽约市人口密度最高的人群的婴儿死亡率与其原籍国最新可获得的婴儿死亡率死亡率数据进行了比较。在纽约市与已确定的群体中的妇女举行了焦点小组会议,以便了解她们对与新趋势有关的因果关系和其他因素的看法。从这项研究中得出的强有力的模式表明,伦敦金融城的最高IMR集中在加勒比海地区的群体中。与确定的人口群体中的妇女进行的焦点小组会议的结果列出了该群体在利用围产期护理服务方面面临的具体障碍。此外,该研究还得出了一些明确的方案和政策方法,有助于解决IMR方面的差异。无数的致病因素导致加勒比移民群体中高发病率。扩大成功的项目模式和有前途的做法的可用性对于降低移民社区的婴儿死亡率至关重要。具体建议是制定一套战略干预措施,旨在消除纽约市新移民群体健康面临的这一最严重挑战。任何将纽约市数据与原产国数据进行比较的参考都只是作为参考点,因为通常不可能确定用于收集和分析美国以外数据的科学严谨性水平。对移民人口社会工作实践的影响包括,需要提供总体上具有文化能力的服务,特别是对围绕妇幼保健问题的保健观念具有文化敏感性。
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引用次数: 2
Protecting Victims of Domestic Violence in Caribbean Communities 保护加勒比社区家庭暴力受害者
Pub Date : 2004-10-12 DOI: 10.1300/J191v02n03_08
Mary Spooner
SUMMARY A decade after the courts in many English-speaking Caribbean jurisdictions were granted the power to issue restraining orders to victims of domestic violence, battered women have not experienced the full benefits of such policy. Using the experiences of battered women in the English-speaking Caribbean state of Barbados, this study argues that there are significant challenges for victims, caused by cultural, social and economic factors that have not been appropriately addressed by domestic violence legislation. Marginalized by the court and legal system in the English-speaking Caribbean, many battered women seek out alternatives to the legal system for coping with domestic violence. Therefore when they migrate to countries like the United States where more accommodations are made for victims of domestic violence, they are unlikely to engage with the legal system and make their suffering known. Women might also be silenced by fears of violating immigration laws in the United States as well as risking personal loss due to the severe punishment of their partners when indicted by the legal system.
在许多讲英语的加勒比地区的法院被授予向家庭暴力受害者发布限制令的权力十年之后,被殴打的妇女并没有享受到这种政策的全部好处。本研究以加勒比海讲英语国家巴巴多斯受虐妇女的经历为例,认为家庭暴力立法没有适当解决文化、社会和经济因素对受害者造成的重大挑战。在讲英语的加勒比地区,许多受虐妇女被法院和法律制度边缘化,她们寻求法律制度之外的其他办法来处理家庭暴力。因此,当她们移居到像美国这样为家庭暴力受害者提供更多便利的国家时,她们不太可能诉诸法律体系,让人们知道她们的痛苦。在美国,女性可能会因为担心违反移民法而沉默,也可能会因为伴侣被法律起诉而受到严厉惩罚而面临个人损失的风险。
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引用次数: 3
Confronting the Reality 面对现实
Pub Date : 2004-10-12 DOI: 10.1300/J191v02n03_04
Mary Spooner, C. Daniel, A. Mahoney
SUMMARY The most recent UNAIDS report (December 2003) estimates that approximately 5 million persons became infected with the HIV virus globally in 2003 alone, while 3 million persons died as a result of HIV/AIDS. What do these staggering numbers mean for the Caribbean population? Is the impact of HIV/AIDS the same among Caribbean immigrants in the United States as among the Caribbean population in the countries of origin? If so, what are the factors that promote the spread of HIV/AIDS among this population regardless of their geographic location? Finally, what can be done to reverse the growing infection rate that has made the Caribbean the second largest population to suffer from HIV/AIDS globally? In this paper the authors explore sociocultural, attitudinal and gender-specific factors that place the Caribbean population at risk of the ongoing spread of HIV/AIDS. The authors make recommendations for a community involvement response to the HIV/AIDS epidemic that targets the individual, family and community to address the problem of HIV/AIDS in the Caribbean population. A community involvement model with its potential to reduce the negative impact of socio-structural factors, and attitudes towards victims of HIV/AIDS is recommended as a meaningful response to HIV/AIDS among the Caribbean population.
艾滋病规划署最近的报告(2003年12月)估计,仅2003年一年,全球约有500万人感染艾滋病毒,300万人死于艾滋病毒/艾滋病。这些惊人的数字对加勒比地区的人口意味着什么?HIV/AIDS在美国的加勒比移民和原籍国的加勒比人口中的影响是一样的吗?如果是这样,是什么因素促使艾滋病毒/艾滋病在这些人群中传播,而不管他们的地理位置如何?最后,可以做些什么来扭转日益增长的感染率,使加勒比成为全球第二大艾滋病毒/艾滋病患者群体?在这篇论文中,作者探讨了使加勒比人口面临艾滋病毒/艾滋病持续传播风险的社会文化、态度和性别因素。作者提出了社区参与应对艾滋病毒/艾滋病流行病的建议,以个人、家庭和社区为目标,解决加勒比人口中的艾滋病毒/艾滋病问题。建议采用一种社区参与模式,这种模式有可能减少社会结构因素的消极影响和对艾滋病毒/艾滋病受害者的态度,作为加勒比人口对艾滋病毒/艾滋病的有意义的反应。
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引用次数: 1
期刊
Journal of Immigrant & Refugee Services
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