| 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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