Choosing the right mix: lessons on culturally relevant treatment from the evaluation of the Drug and Alcohol Multicultural Education Centre's Counselling Service

Abstract

Understanding and engaging with cultural perspectives can enhance treatment for substance use issues and co-occurring mental health issues among culturally and linguistically diverse (CALD) communities. As not many services document the way they provide services to CALD clients, this research sought to investigate the ways in which alcohol and other drug counsellors at a specialist service balance cultural relevance with fidelity to a combination of psychosocial interventions. Semi-structured, in-depth interviews were conducted with counsellors and clients at the Drug and Alcohol Multicultural Education Centre's Counselling Service in a major Australian city. Interviews employed screening questions to explore the combination of brief solution focused therapy, cognitive behavioural therapy and narrative therapy as well as bilingual counselling roles and information provided to clients about the service. Interviews were conducted in the four major languages spoken by clients of the service: Arabic, English, Mandarin and Vietnamese. The findings highlight 10 strategies for culturally relevant treatment. These include addressing clients' understanding of counselling, offering bicultural and bilingual counsellors, enquiring about the importance of cultural identity to each client, responding to cues from clients about taboos or sensitive topics, and expectations about social roles and communication patterns. Furthermore, counsellors reflected upon the interpretability of psychosocial interventions in particular languages, and explained flexible and creative responses which integrate elements of cultural philosophy and communication styles into their practice of counselling.

Keywords:

• culturally and linguistically diverse
• psychosocial interventions
• counselling
• cultural diversity

Acknowledgements

The author wishes to especially thank the participants in this study. The author is also grateful to Connie Donato-Hunt, Ian Flaherty, John Howard and Helen Sowey for their valuable comments on earlier versions of this article; and Julaine Allan and Rod Macqueen for their input regarding aboriginal AOD services and related research. Approval for this research design and publication was granted by the NSW Population and Health Services Ethics Committee on 2 August 2011.