Family Systems in Cultural Consultation

Abstract

The chapter introduces the importance of a systemic orientation and the use of family systems theory and therapy and as interpretive frameworks and a set of tools for cultural consultation work. A systemic orientation emphasizes (1) accessing the social context of the patient to understand their personal predicaments and options as well as resources for resilience or healing; (2) promoting a working alliance in the context of clinical engagement, treatment and problem solving with key members of the patient’s family system; and, (3) uncovering family system issues which may constitute core clinical problems that need attention in intervention planning. Systemic agendas may also involve culturally or institutionally embedded structural issues, which are key to understanding intra-psychic, social or health care related issues. A rich family therapy literature offers tools and paradigms to pursue dialogue with patients and their families while acknowledging the complex and often hybrid cultural underpinnings of identity and illness experience. To promote flexibility of cultural imagination and problem solving, the systemically oriented consultant and therapist acknowledges the impact of multiple actors and dynamics and pursues modes of engagement to validate systemic realities and facilitate options for change. Clinical case examples are used to illustrate intervention planning which acknowledging the multiple realities of the systems of the dominant or host society and the cultures of origin of migrant or minority groups.