정신건강의학과 의사가 문화적 역량을 갖추고 다양한 문화적 배경을 가진 소아청소년 환자와 가족을 면담하는 법

Abstract

Psychiatry is heavily influenced by culture with varying degrees of tolerance and stigma regarding mental illness. It is important to understand child and adolescent psychiatric patients in terms of cultural competence. Cultural competency is more important for psychiatrists since diagnoses are made and many treatments are delivered strictly based on verbal communication in mental healthcare. Culture provides the analytic frame to understanding patients’ expressions, behaviors, and symptoms based on language, norms, and values of community and family for psychiatric diagnoses. Difficulties in evaluating, diagnosing, and treating patients are escalated when psychiatrists have different cultural backgrounds. Korea faces a rapidly changing demographic and cultural landscape, with its population becoming increasingly multiracial and multicultural. Psychiatrists tend to have trouble stemming from children’s limited language and cognitive abilities for understanding other’s views and limited language fluency among multicultural families. Even with a family has the same cultural background, the increasing generational gap between children and their parents makes it difficult for parents to understand their children’s subcultures. The DSM-5 includes the ‘cultural formulation interview (CFI)’ for psychiatrists to better understand, diagnose, and treat psychiatric patients and families with diverse backgrounds. The author detail how to interview child and adolescent psychiatric patients as well as their families with cultural competency. Psychiatrists can be more culturally competent after practicing how to adapt the semi-structured CFI in a clinical setting in the Korean language. Moreover, it is time to introduce more culturally competent training for medical students and psychiatric trainees.