This section highlights the need to be aware of the sociocultural diversity of populations in disaster situations. It will help mental health workers acquire the knowledge required to assist survivors from different cultural backgrounds. Content based on experience and knowledge should be incorporated into all the activities, depending on the region and the specific population affected by the disaster (Hispanic, Asian, etc.).
CONCEPTS FOR UNDERSTANDING BEHAVIOR WITHIN THE SOCIOCULTURAL MODEL
• Relationship of perceived behavior, expectations concerning behavior, and value level attached to it by survivors and workers.
• How behavior influences and is influenced by the perceived social status and associated role conferred on the individual by his community. Status and roles are symbols (concepts) of culturally defined expectations regarding patterns of relationships and behavior within a particular social system. Every person occupies multiple positions and each has an associated role with an array of role behaviors (role set), which are perceived differently by different individuals.
• It is through the "operation" of the role set that the person enacts, has access to, and interacts with his culture. The operation of the role set also serves to form his cultural identity, based on an internal consistency and sense of self through which he builds a self-image. After a disaster these operations may be modified for a period of time.
• Behavior develops out of many roles modified by individual differences and molded by social situations. After a disaster, distorted community situations affect behavior.
Mental health workers bring knowledge, attitudes and skills obtained in their previous experiences, coupled with their own cultural background. These characteristics strongly influence their communication style, approach to establishing relationships, and perception of survivors' responses. They also color their approach to accepting the suffering and pain of survivors. Understanding and respect for the cultural values of survivors are part of the knowledge needed in disaster assistance intervention programs.
Characteristics of the families affected - such as ethnicity, socioeconomic levels, acculturation, religion, and traditionally accepted approaches to dealing with stressors - will influence their recovery from a disaster. A specific value system is the relationship of human beings to nature, which can be critical in understanding differences in patterns of disaster response in diverse cultures. For example, the citizens of Managua, Nicaragua, believed that the 1972 earthquake that destroyed part of their city was a punishment by Mother Nature for their "wild" behaviors.
Numerous cultural issues will influence the interaction between the worker and the survivor from the first encounter at the disaster shelter or Red Cross Center. As individuals from different backgrounds are thrown together in groups overseen by an agency staff member who needs to organize schedules according to logistics, time, and personnel, the clashes in cultural approaches become evident. An understanding of the variations and sequences of emotions and behaviors, based on cultural traditions and values, is at the heart of disaster intervention. Transcultural approaches require different ways of addressing the factors that influence crisis resolution processes, which are well known in clinical practice when dealing with the majority population but which are manifested differently after a disaster.
In disaster assistance settings, where it is difficult to personalize living arrangements, the survivors' self-esteem may be easily wounded as conflicts arise when the survivors' need for help collides with workers' own beliefs about the way help should be delivered. This conflict may be accentuated when survivors perceive themselves as dependent on agency staff from a different culture. In catastrophic disasters, survivors who have lost most of their possessions may feel too humiliated to ask for basic necessities unless the worker uses strategies to help the survivors "save face." The worker will need to strive continually to be sensitive to the transcultural configuration of survivor-helper (dependency-authority/ power) relationships. Cultural attitudes cut across all situations, affecting the amount of help that can be accepted or offered.
INTEGRATING CULTURAL EXPERIENCE WITH POST-DISASTER COUNSELING SERVICE DELIVERY
The culture of a group is more than just a set of preferred behavior patterns and mazeways of social organization. Culture gives the individual a total vision of the universe, a conception and categorization of everything, as well as existential postulates regarding the nature of man and his ultimate destiny.
The worldview that individuals share with other members of a group reflects pragmatic knowledge, belief systems, attitudes, preconceived notions, and ranked value orientations. It is important for counselors to have an understanding of a survivor's culture and worldview in order to be able to plan, program, and deliver adequate and accessible services in consonance with the recipient's lifestyle.
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