Implementing culturally congruent trauma-informed care requires knowledge of acculturation factors.
Scenario: A monolingual Chinese-speaking young 26-year-old Chinese female recently emigrated from rural China appears in the emergency room with a broken arm and a sprained wrist. She keeps her eye contact minimal and alternately looks at the floor and then the door. Her posture is slumped and turned inward making her appear much smaller than her 5’2 frame. With the assistance of a bi-lingual hospital translator, the patient states her husband brought her in after she “fell into a door” and injured herself. When asked how she “fell into the door” she stated she wasn’t moving fast enough and her husband “helped to move faster.” She anxiously asks one question: “Can you fix me fast, my husband will get upset if this takes too long? I don’t want to upset him.”
Provider considerations: Are your staff and clinical model of care prepared to assess this patient for domestic violence in a culturally congruent and effective manner to better enhance patient engagement and treatment outcome? To do so, what are the stereotypes and cultural norms that must be acknowledged? What would the culturally effective trauma-informed care look like for this patient?
An ability to sensitively and accurately assess cultural norms is essential in detecting cultural expressions of distress and trauma as well as to accurately evaluate gender specific and cultural/social norms that influence patient communication and self-presentation. Treatment interventions that are trauma-informed must also be guided by congruent cultural practices to build culturally authentic resiliency care and to yield better engagement and treatment outcomes among culturally diverse communities. Otherwise, marginalizing culturally intrinsic social and personal norms prolong the experience of victimization and keeps the violence “invisible’ and the victim “powerless.”