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Dudley, J. R. (2020). Social work evaluation: Enhancing…
Dudley, J. R. (2020). Social work evaluation: Enhancing what we do (3rd ed.). Oxford University Press.
Chapter 10, “Analyzing Evaluation Data” (pp. 255-275)
Fennig, M. (2021). Cultural adaptations of evidence-based mental health interventions for refugees: Implications for clinical social work Links to an external site.. The British Journal of Social Work, 51(3), 964-981. https://doi.org/10.1093/bjsw/bcaa024
Marsiglia, F. F., Medina-Mora, M. E., Gonzalvez, A., Alderson, G., Harthun, M., Ayers, S., Gutiérrez, B. N., Corona, M. D., Melendez, M. A. M., & Kulis, S. (2019). Binational cultural adaptation of the keepin’ it REAL substance use prevention program for adolescents in Mexico Links to an external site.. Prevention Science, 20(7), 1125-1135. https://doi.org/10.1007/s11121-019-01034-0
Matheson, F. I., Hamilton-Wright, S., Hahmann, T., McLuhan, A., Tacchini, G., Wendaferew, A., & Dastoori, P. (2022). Filling the GAP: Integrating a gambling addiction program into a shelter setting for people experiencing poverty and homelessness Links to an external site.. PLoS ONE, 17(3), 1-19. https://doi.org/10.1371/journal.pone.0264922
List the main themes found in the Content Analysis of Focus Groups. Based on the data, provide a thorough analysis of the current barriers to services (found in each theme).
Select one barrier to service and create two social work recommendations to address that specific barrier. Use literature to support your recommendations.
Discuss how you would collaborate with other service providers and key community members to ensure that they understand the need for a culturally appropriate intervention.
Critically reflect on your own culture and explain how your cultural values and beliefs may have influenced how you interpreted the focus group data. What specific strategies would you undertake to become more culturally competent to practice or conduct research with this group?
Content Analysis of Focus Groups
Research Question 1: What are the barriers in implementing mental health services in
the Asian American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Participants: Healthcare providers
Patient-Related Barriers
Social Stigma Associated With Mental Illness
“. . . but also a lot of my patients have a fear of going to psychiatrists because of
the social stigma . . .”(RT, pg. 1)
“Because of the stigma it is hard to get patients to ask for help and . . .” (AW,
pg. 2)
Financial Difficulties
“. . .and many have financial difficulty and have to pay an additional fee for
psychiatry.” (RT, pg. 1)
Cultural Differences in Help-Seeking
“It is easier sometimes to refer patients to someone else because a lot of
times I find that the Chinese patients I see are unwilling to open up or
trust.” (AW, pg. 2)
“We have to see why Asians go to see a health care provider, forget about
whether it’s in the mental health profession, or even a regular clinician.
Why does the patient see the provider . . . is it because they have
seen a Chinese herbalist and have failed and have used their last
efforts to see a Western doctor, that will put tremendous expectations
on this relationship, as opposed to someone who comes to see the doctor
for the first time and has faith [in] the Western doctor?” (CTS, pg. 7)
Service Provider-Related Barriers
“Despite all the training, I have found that working with Chinese populations there are a
lot of barriers.” (AW, pg. 2)
“Pass the Buck” Theme
“It is easier sometimes to refer patients to someone else because a lot of
times I find that the Chinese patients I see are unwilling to open up or trust.” (AW,
pg. 2)
Lack of Training/Skills/Expertise
“. . . and I find that I struggle with my own skills. I am trying to get some help
in being a better primary care provider and getting my skills more fine-
tuned for the population that I work with.” (AW, pg. 2)
“On the Western provider side, we noticed that when a provider is confronted
with a non-Western patient, they are reluctant to enter areas because they are
not really sure if that behavior is natural to that culture. So that while they
know pathology on the one hand, they are not sure if what they are seeing
is pathological. I remember one Indian psychiatrist said that someone with
schizophrenia in India has the same symptoms in New York, but you know, there
are excuses sometimes and avoidance, so educating the general provider
concerning what really can be expected is very important.” (RN, pg. 8)
“My comment is very similar, there are very big knowledge gaps for providers
and what providers bring to the situation . . .” (FA, pg. 8)
Cultural Assumptions
“Well, what you have to think about is other areas, our own cultural biases.
There are certain things that I make assumptions on without even knowing it
just because of what I knew growing up, and I think these are areas we need to
address.” (JG, pg. 7)
Systems Barriers
Primary Care Is the Access Point for Patients With Mental Health
Conditions
“. . . primary care as sort of the gatekeeper. Those are the guys that are
picking up the symptoms and so I sort of see that this is a good project to
enhance our understanding of this population.” (MM, pg. 2)
Changing Financial Systems
“Another issue is that there are financial issues that primary physicians often
see that there is cost shifting going on where psychiatry or whomever else is
telling us to do a new activity that is really shifting a responsibility.” (JS, pg. 4)
Changing of Responsibilities
“Another issue is that there are financial issues that primary physicians often see
that there is cost shifting going on where psychiatry or whomever else is telling
us to do a new activity that is really shifting a responsibility.” (JS, pg. 4)
Professional Medical/Psychiatry Culture
Differing Cultures and Ideologies Within Medical Profession
“One major barrier is that there is a difference in physician culture. An
internalist perceives a different way of treating a patient than a family care doctor,
and the pediatrician looks at it differently than an internalist, and that certain
cultures when they have certain specialty referral systems will feel differently
when the specialty referral system is used less frequently, and we have found
them being treated much differently.” (JS, pg. 4)
Miscellaneous
“We tend to forget that mental health problems are a spectrum; they may
not be necessarily psychosis or dementia, manic depression, they may not
be a DSM diagnosis, they may be lifestyle related. They are a state of flux; it is
a spectrum. When a woman is having infertility, when a woman loses a
pregnancy, when a woman delivers a baby and it is another girl, but she wanted
a boy, or when she delivers a baby that she wanted, but the burden is too much.
So it can be gyn issues, it could be ob issues, but they are not DSM categories,
and I think that a barrier is that we do not acknowledge the existence of these
kinds of things . . .” (PRF, pg. 6)
“The other big thing that I think of is . . . when we do see these patients and when
we do have the luxuries of identifying these issues that I have just outlined, that
we try to squeeze these people into the diagnoses that I just described. So
we make it into an anxiety disorder, or we make it into a depression when it could
be just lifestyle related or culture related . . . ” (PRF, pg. 6)
