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10 - Explanatory models in psychiatry
- from Part II - Culture and mental health
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- By Mitchell G. Weiss, Department of Public Health and Epidemiology Swiss Tropical Institute Socinstrasse 57 CH-4002 Basel Switzerland, Daryl Somma, Department of Public Health and Epidemiology Swiss Tropical Institute Socinstrasse 57 CH-4002 Basel Switzerland
- Edited by Dinesh Bhugra, Institute of Psychiatry, London, Kamaldeep Bhui
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- Book:
- Textbook of Cultural Psychiatry
- Published online:
- 11 August 2009
- Print publication:
- 18 October 2007, pp 127-140
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- Chapter
- Export citation
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Summary
EDITORS' INTRODUCTION
Similar experiences of illness or distress are seen as being caused by different elements across different cultures. Feeling gutted and sinking heart are idioms of distress which are remarkably different across cultures, but their implications at an individual level are very similar. Furthermore, the causation of the distress will be seen as remarkably different. It is evident that, in traditional cultures, the locus of control may be seen as external which may be coloured by cultural expectations, whereas in others the locus of control may be internal. Within each culture, however, individuals may carry their own explanations which may or may not be strongly influenced by individual's culture. From a clinical perspective, it is crucial that clinicians are aware of explanatory models that patients bring to the therapeutic encounter so that engagement can begin.
Weiss and Somma examine the concepts of the explanatory model framework, its appeal to health professionals and social scientists as well as its limitations. The illness explanatory framework deals with notions about an episode of illness and its treatment by all who are engaged in the clinical process and understanding these models means that patients' views on their conditions are being acknowledged. Weiss and Somma emphasize that the model must be distinguished from other ways the term is used which may refer to the nature of health and other problems in general. They explain three formulations of illness explanatory models and describe conceptual underpinning of the illness explanatory framework. In the beginning of the illness explanatory model framework provided a means of bring cultural differences between patients and clinician (especially when they came from different ethnic and cultural backgrounds) in multicultural settings.