| INTRODUCTION
Culture is akin to being the
observer through the one-way mirror; everything
we see is from our own perspective. It is only
when we join the observed on the other side that
it is possible to seeourselves and others clearly--but
getting to the other side of the glass represents
many challenges (Lynch, 1992, p. 35).
Violence committed against and
committed by the youth of America is increasing
every day. In alarming rates, young people are turning
to violence to resolve their problems. One of their
conflict resolution solutions is homicide. The tragic
reality of several high profile shootings involving
multiple victims in our US schools supports the
premise that children are swimming in a "culture
of violence."
With the increasing diversity of the United States
population, there is a growing awareness of the
need for culturally specific responses to help survivors
of homicide victims (family members, close friends,
neighbors, schoolmates, and members of the community).
If mental health professionals are to provide and
link culturally sensitive support systems to homicide
victim survivors, they first need to be aware of
their own possible cultural biases and the fact
that others have widely varying responses to trauma.
Secondly, they need to identify and validate the
cultural background of the victim and survivors
in order to provide culturally appropriate services.
To be effective, mental health specialists need
to employ a cross-cultural perspective in their
service deliveries.
COMMONLY REPORTED CULTURAL BIASES
Mental health professionals in providing sensitive
and caring intervention services, need to be aware
of the ten most frequently encountered examples
of cultural bias about multicultural counseling
and development. For the intent of this article,
the ten will be only identified but not discussed.
According to Pedersen (1987), the misconceptions
are: (1) Normal Behavior Is Universal; (2) Emphasis
on Individualism; (3) Fragmentation by Academic
Disciplines; (4) Dependence on Abstract Words; (5)
Overemphasis on Independence; (6) Neglect of Client's
Support Systems; (7) Dependence on Linear Thinking;
(8) Focus on Changing Individual, Not System; (9)
Neglect of History; and (10) Dangers of Cultural
Encapsulation.
THE BACKGROUND FOR THE INFORMAL QUESTIONNAIRE
To help mental health professionals understand how
to intervene with homicide survivors in a multicultural
setting, the following information has been abstracted
from Irish, Lundquist, & Nelson (1993); McGoldrick,
Pearce, & Giordano (1996, 1982); Mitchell &
Everly (1995); National Victim Center (1992); Ogawa
(1998,1990); Poland & McCormick (1999); and
Young (1998, 1994). In addition, the author's presentations
in this area, experiences with assisting homicide
survivors in a large multicultural public school
community and experiences working with the American
Red Cross have also been integrated into information
within this questionnaire.
The questionnaire is organized into four categories:
(1) Community and Cultural Influences; (2) Survivors'
Characteristics; (3) Criminal/Juvenile Justice System;
and (4) Crisis Intervention/Therapy. Some of the
contents within the classifications occasionally
overlap. Each of the headings also has subcategories.
The areas are arranged into a question format that
mental health specialists can use as a starting
point for (a) cultural awareness and (b) trauma
intervention after a homicide. Prior to crisis and
during intervention following a homicide in a multicultural
setting, mental health professionals are encouraged
to ask themselves the following questions and to
seek answers to provide culturally sensitive service
deliveries to homicide survivors:
AN INFORMAL HOMICIDE AND MULTICULTURAL QUESTIONNAIRE
(1) COMMUNITY AND CULTURAL INFLUENCES
LIFE AND DEATH
- attitude toward death - What are the community's
beliefs and rituals toward death?
- life and death Does the culture perceive
life and death as polarities or as one process?
- life-death intermediate state Do survivors
believe in an "intermediate state"
between life and death where the spirits of
deceased loved ones are seen or sensed by them
and are released and free for reincarnation?
- bereavement and funeral practices How does
the culture, and especially the survivors, mourn
a death and specifically, a homicide?
CULTURE AND COMMUNITY
- history - What are the cultural literary,
folklore, myths, traditional ceremonies and
creative expressions? What is the meaning of
various oral and written traditions and cultural
expressions?
- type of community - Is the family and community
open or closed?
- society - Is the society patriarchal or other?
- context cultures Have the survivors been
socialized in a high context culture (where
much of the meaning is determined by the context
and where the survivors are more sensitive to
nonverbal messages), or have they been brought
up in a low context culture (where little of
the meaning is dependent on the environment
and where verbal messages are elaborate and
specific?).
- code of silence Is there a code of silence
among members of a minority group which prevents
them from sharing information with outsiders?
- community values - Are community members discouraged
from reporting crimes?
- gender roles - How do cultural expectations
control the role of females in reporting or
responding to crime?
INDIVIDUAL OR GROUP
- self-image - Do survivors judge themselves
as individuals or as a member of a group? Are
social relationships and group loyalty stressed
more than individuality?
- intragroup differences Are the survivors
perceived as displaying certain cultural characteristics
of their ethnic group as well as seen as manifesting
individual behaviors different from the group?
- obligations - Are there obligations to the
group and/or community that take precedence
and must be carried out?
STIGMA
- society's reaction Does the culture accept,
reject, or stigmatize the survivors?
- stigma - Is the family and/or community stigmatized
by the murder?
FEAR
- violent reprisals - In crime infected neighborhoods,
is the survivor or witness vulnerable to fearful
violent reprisals?
- retaliation - If a murder was committed by
a person of another ethnic background, do the
survivors fear repercussions against its people
by the other culture?
NONVERBAL COMMUNICATION
- communication Do survivors communicate detailed
verbalizations, or do they display sensitivity
to nonverbal messages?
- cultural behaviors Do the survivors avoid
displays of emotions and conduct that may appear
too aggressive, critical, or confrontational,
and do they preserve dignity and respect by
an ethic of modesty, an economy of physical
intrusions into the space of another person,
and sensitivity toward disturbing others by
one's words and behaviors?
- respect Have the survivors been socialized
to show respect through limited eye contact,
deference, and silence?
- proxemics How much physical space do the
members of a culture allow between themselves
and others? Do they physically get close, or
do they stand at a distance?
- chronemics How do the members use time?
Are they time conscious, or are they not? Do
they require rituals before they get down to
business, or do they get right to the task at
hand as hurried Westerners do?
- haptics Do the members use touch as a means
of communication, or do they avoid it?
PRIVACY
- humility Are the survivors culturally humble
and therefore uncomfortable with any public
demonstration that conveys that their own suffering
is greater or more serious than that of others?
- limelight shun Do survivors avoid the limelight
and the attention from the mass media?
TRAUMA
- type of threat What does the culture define
as a traumatic threat?
- interpretation How does the culture influence
the survivors' interpretation of a traumatic
event?
- religion How do religion and/or spirituality
impact the survivors' understanding, interpretation,
and reaction to trauma?
- expression and response How does the culture
influence how individuals and communities express
traumatic reactions?
- holistic approach Is trauma interpreted
by culture as afflicting the whole person and
not just one aspect of an individual's life?
- group suffering - What have the survivors'
social group suffered in the past, what traumas
has it endured, and what is it suffering at
present?
- idioms of distress - How do the survivors
communicate subjective discomfort associated
with their cultures?
- cultural time out Do survivors respond passively,
mimicking a depression, but are really culturally
manifesting "time out" to deal with
the stressful situation?
- health How does culture define healthy pathways
to new lives after trauma?
(2) SURVIVORS' CHARACTERISTICS
REACTIONS OF SURVIVORS
- symptoms and pain - What do the survivors
label as symptoms and pain, and how do they
communicate them?
- meaning and suffering - What is the survivors'
meaning (interpretation) for the homicide and
the aftermath of suffering?
- secondary victimization Are survivors experiencing
symptoms of secondary traumatization from the
agencies existing to assist them, and do they
show signs similar to those of their loved one
who was murdered?
- acute stress disorder reactions Are the
survivors expressing any acute stress symptoms?
Are you aware of the cultural idioms?
- other stressors Were the survivors experiencing
other life changes that were going on at the
time their loved one was murdered? What is their
past history with death and other major losses?
- resiliency - Are the survivors resilient?
- impact of homicide -What is the emotional,
physical and financial impact of the homicide
on the survivors and on the immediate and extended
family structure, including adherence to past
obligations and future relationships?
- fear and vulnerability Are survivors fearful
of further psychological or physical assaults
from others?
- complicated mourning Are the survivors unable
to mourn, are they grieving too long, or are
they unable to reach grief resolution?
COMMUNICATION
· language - Are the survivors
able to communicate effectively with service practitioners,
or are interpreters needed?
· non-verbal behavior-kinesics - What are
the survivors' non-verbal cues and body language,
body statements, gestures, and covert expressions
of moods and feelings?
PRIVACY AND CONCERN FOR OTHERS
· reluctance to share
intimacies - Are the survivors reluctant to share
private and shameful matters with others (cultural
strangers) and hesitant to come forward?
· shame - Are the survivors concerned with
privacy and confidentiality that causes them to
keep things to themselves, to avoid sharing what
they know with authorities, to refrain from bringing
shame on their families and communities, and to
refuse therapy?
· preventing discomfort - Have the survivors
been reared to avoid causing discomfort or trouble
for someone else?
RESPONSIBILITY AND GUILT
· "if only I had"
- Do the survivors accept unrealistic responsibility
for the homicide? Is there self-blame?
· "guilt of the survivors"
If the survivors experienced the same trauma but
lived, do they feel guilty that they survived
and that their loved one(s) didn't?
FOCUSED ATTENTION ON THE HOMICIDE AND/OR ITS
AFTERMATH
· search for details
Are the survivors searching endlessly for all
of the details of the victim's death: what happened,
when, how, where, who did something to someone,
and the unanswerable why?
· anger Are the survivors' rage at the
assailant an unending preoccupation, and do they
want to destroy the murderer and see him/her suffer?
· fixation - In their minds, are the survivors
stuck at the crime scene, the cemetery, or the
criminal justice system?
· loss of control Do the survivors feel
that the law enforcement and criminal justice
system are controlling their lives?
· flashbacks Are the survivors experiencing
flashbacks to the memory of receiving the death
notification or to the memory of, or an imagined
picture of, the crime itself?
· the media - How do survivors react when
viewing information about the murder in the mass
media?
(3) CRIMINAL/JUVENILE JUSTICE SYSTEM
POLICE AND CRIMINAL/JUVENILE JUSTICE SYSTEM INVOLVEMENT
· distrust - Is the community distrustful
(suspicious) of the police and other authority?
· unfairness - Do survivors fear they will
be treated unfairly by police and prosecutors?
· intruders - Are police and outsiders
viewed as intruders rather than peacemakers and
helpers?
· authority - Are the survivors taught
not to question authority even when a crime has
been committed?
· released on bail - Do survivors fear
reprisals and lack of police protection from criminals
on bail?
· concerns - Do survivors fear their needs
will be overlooked in favor of court trial techniques,
legal issues, and evidentiary concerns? Do they
fear exposure to intimidation or disparaging regard
by the majority culture?
· home visits - Do the survivors feel more
at ease at home to answer questions than in a
school, a police station, or court?
PAST TRAUMAS INFLUENCING THE SURVIVORS' PERCEPTION
OF THE CRIMINAL/JUVENILE JUSTICE SYSTEM
· perceptions - Are the
perceptions towards the criminal justice system
based upon the survivors' experiences with it
in their native land?
· refugees - Are the survivor refugees
who experienced certain forms of interrogation,
torture, or violence in their homeland, fearful
or resistant to procedures which appear similarly
intrusive in our criminal justice system?
· first contact Are the mainstream authorities
aware that the nature of their first contact with
the survivors may either confirm or dispel suspicion
regarding how the survivors feel they will be
treated?
· apprehension - Are the survivors overly
concerned about being incarcerated or hospitalized?
BARRIERS TO COMING FORWARD AS
SURVIVORS OR WITNESSES
· looked upon as suspects
- Are the survivors looked upon as suspects, which
sometimes may be the case?
· illegal status - Will illegal aliens
fear to come forward as survivors or witnesses
for fear of being deported?
· underreporting of crimes - Do lack of
knowledge, how to report, and to whom to report
influence an underreporting of crimes?
SERVICES FOR SURVIVORS
· outreach programs To help survivors,
is the criminal justice system developing appropriate
language, interactive skills, and comprehensive
outreach programs to serve multicultural populations?
· native language Are the survivors provided
interpreters and written materials in their native
language?
· restorative justice Is restorative
justice, responsive to the needs of victims, survivors,
offenders, and the community as equal citizens
being used as a new paradigm instead of the traditional
model which is just responsive to the state?
(4) CRISIS INTERVENTION/THERAPY
TAKING FIRST THINGS FIRST
· ethnocentrism Are
you aware that your ethnocentrism (the belief
that your race or culture is the standard by which
all others must be evaluated and judged) is not
the guide that should be used with minorities?
· request permission Did you request
permission from the survivors to communicate with
them and also to become involved in other activities
in their lives?
· fundamental needs Are you focusing
on the survivors' fundamental and everyday, basic
needs first since intervention may be more helpful
when focusing on immediate problems and practical
solutions than on psychosocial intervention?
CULTURAL HELPERS
· cultural doorkeeper
Have you identified a friend or colleague who
is a respected insider in the culture and who
can help make connections with the culture?
· survivors as guides Are you allowing
survivors to direct you through cultural protocols,
and are you following their directions?
CULTURAL SOCIAL SYSTEMS
· asking for help - Do
survivors ask for help or shy away from it and
accept other means in the culture for healing,
such as spirituality, religion, shamans, folk
wisdom, healers, superstitions, luck, acts of
God, the spirit world, and supernatural powers?
· the spirit world Are survivors allowed
to express their belief in the spirit realm, which
some ethnic groups accept as a faculty for discernment
and not as a deficit, --without having the validity
of their belief in the spirit world questioned
or diagnosed as pathological?
· definition of well-being - Do survivors
turn inward, not for personal benefit as in therapy,
but for other reasons such as through meditation,
asceticism, or self-reflection to restore harmonious
relationships?
· religion - How do religious beliefs and
support systems influence the survivors' attitudes
toward crime, trauma, and mental health concerns?
· help outside the family - Is outside
family or community assistance allowed?
· elastic households - Are there community
members ready to step in informally to take care
of the survivors' personal or economic circumstances?
· kin-structured networks - Are there close
and supportive relationships among the individuals
within a family and community regarding daily
living and crises?
· social supports - Do survivors have adequate
support systems as well as economic and legal
resources?
FEARS
· fear - Do the survivors fear and distrust
mental health professionals and clinics as a way
of controlling them through misdiagnoses, institutionalization,
and medication?
· medication Are you cognizant of the
reluctance of some survivors to verbalize underlying
fears and conflicts as well as to seek symptom
relief by medication?
THERAPY
· therapy - Are the survivors oriented
toward psychological therapy, or is disturbed
behavior in the culture viewed as the result of
a lack of will, supernatural causes, or physical
illness?
· type of therapy - Which modality of treatment
will you use? Individual, group, mutual peer support,
or other?
· the NOVA and CISD models Are you familiar
with the National Organization for Victim Assistance's
(NOVA's) Group Crisis Intervention design as well
as the Critical Incident Stress Debriefing (CISD)
paradigm (the Mitchell model)?
· therapist-client relationship
Are you of the same or different background
of the survivors?
· therapeutic orientation Are you keeping
in mind that Western European-based cultural values
of normality that govern our structure toward
minorities and that govern our interpretation
of trauma and suffering may not be appropriate
for survivor intervention?
· transcultural therapy Are the counseling
methods used culture-specific and readily transferable
between cultures?
· trust Did you establish trust with
the survivors? Murder causes survivors to lose
trust in the world that is no longer predictable
and secure.
· various cultural interventions Are
you including any of the following interventions:
reduction of isolation, relaxation techniques,
meditation, education about crisis and trauma
reactions, re-framing the crisis in culturally
relevant terms, helping the survivors to develop
control, or other?
· expressive arts Are you allowing the
survivors to express themselves through artwork,
language arts activities, music, drama, and/or
bodily-kinesthetics?
· being present Are you readily available
and compassionately present to the survivors to
help in any way possible?
· processing Are you asking survivors
to share their story?
· migration experiences - If the survivors
were refugees and experienced previous oppression,
are you aware of their trauma story that has been
imprinted on their memories?
· suicide potential Are you assessing
the survivors' risk for possible thoughts of suicide?
· intrusion caution Are you careful not
to ask intrusive questions?
· family members - Should family members
also be involved in therapy?
· expressing empathy As an intervener,
as appropriate, would you say, "I am so sorry
that this has happened to you;" "I can't
imagine how difficult that must have been for
you;" and/or "It must have been upsetting
to (hear, feel, smell, see, taste) that?"
ENTERING THE CULTURE OF THE SURVIVORS
· appropriate clothing
Are you wearing respectful clothes in order
not to offend the survivors?
· being respectful Did you say, "hello,"
"good-bye," and "thank you"
in the survivors' own language?
· access rituals Are you available to
participate in access rituals such as ceremonies,
food contexts, and religious services?
· rituals and routines Are you aware
of the survivors' scheduled times for eating,
dressing behaviors, and day to day routines in
order not to disturb their lifestyles?
· cultural obligations Do the survivors
have cultural other-directed obligations that
need to be known if they are to be helped adequately?
· body language Are you sensitive to
cues of body language and are you aware that nonverbal
communication in our culture can be interpreted
differently in and by another ethnic group?
· apologizing Are you willing to apologize
if you enact a cultural faux pas?
EDUCATING THE SURVIVORS ABOUT
WHAT TO EXPECT IN THE FUTURE
· trigger events - Are
the survivors aware that they will re-experience
crisis reactions during holidays and anniversaries
and also that they will go through them during
the criminal investigation and prosecution process?
· literature Are you providing the survivors
with literature in their language to help them
cope with their loss of their loved one?
· media Have you prepared the survivors
for the media intrusion?
TAKING CARE OF YOURSELF
· personal health Have
you been eating well, sleeping, exercising, and
taking breaks from your intensive crisis intervention?
· debriefing Are you willing to participate
in a debriefing after helping others?
CONCLUSION
Mental health personnel need to provide caring,
sensitive, cross-cultural competent and responsive
service deliveries. They need to intervene and to
link homicide survivors to support systems. Also,
they need to remember how diversity influences intervention
in an ethnic context. The informal questionnaire
is only a starting point for cultural awareness
and for intervening after a homicide. It may need
to be revised in the future. For now, the questionnaire
can be helpful to mental health professionals and
others to gain self-insight and to provide compassionate
services to trauma survivors and to others impacted
by the trauma.
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