1. Multicultural Approach in Geriatric Mental Health Services for Refugees and Immigrants Agnes Hajek, ACSW Dr. Dixie Galapon Salwa Yalda

2. Session Objectives & Agenda Culture Self-Assessment EMASS Diversity Framework Multicultural Management Approach Sharing of community experience with Arabic speaking Refugees & Filipino Immigrants By the end of the 2-hour session, the participants will be able to: Identify the helpful strategies to reach out to refugees and immigrants seniors Describe the cost- efficiency and cost effectiveness of partnership and collaboration with other stakeholders Share the insights gained in working with the community where the CHW is also a member

3. Culture self assessment Have I been able to separate what is important to me, and what is important to my client?Have I been able to separate what is important to me, and what is important to my client? What do I know about the client’s cultural heritage?What do I know about the client’s cultural heritage? What is the client’s relationship with his/her culture from his/her perspective?What is the client’s relationship with his/her culture from his/her perspective? What are my stereotypes, beliefs and biases about this culture?What are my stereotypes, beliefs and biases about this culture? Have I appropriately consulted with other mental health professionals, members from this culture, and/or members of the client’s family or extended family?Have I appropriately consulted with other mental health professionals, members from this culture, and/or members of the client’s family or extended family? Have I incorporated culturally appropriate strategies/techniques with this client?Have I incorporated culturally appropriate strategies/techniques with this client? Adapted from the presentation of Dr. Erwin, Chika Asai, Jenny Durham, Amy Halvorson & Sarah Holte “Benefiting Multicultural Clients by Considering Acculturation” Counseling and Student Affairs Minnesota State University Moorhead North Dacota Counseling Conference Bismark, North Dakota February 6, 2006

4. Acculturation The process by which two cultures in constant contact engage in an exchange of ideas, traditions, and characteristics that ultimately alter both culturesThe process by which two cultures in constant contact engage in an exchange of ideas, traditions, and characteristics that ultimately alter both cultures The process can be emotionally and psychologically taxing, leading to mental distress and self-identity issues in individualsThe process can be emotionally and psychologically taxing, leading to mental distress and self-identity issues in individuals

5. Assessing Acculturation LanguageLanguage Religious beliefsReligious beliefs Educational statusEducational status EmploymentEmployment Societal normsSocietal norms Social status Media usage Social relations Gender roles Adapted from the presentation of Dr. Erwin, Chika Asai, Jenny Durham, Amy Halvorson & Sarah Holte “Benefiting Multicultural Clients by Considering Acculturation” Counseling and Student Affairs Minnesota State University Moorhead North Dacota Counseling Conference Bismark, North Dakota February 6, 2006

6. Individualism vs. Collectivism IndividualismIndividualism –World view that respects personal goals and individual uniqueness more than communal goals and social unity –Personal needs have priority over in-group needs Collectivism –A worldview that group members are connected with and interdependent between each other –In-group needs are placed before personal needs

7. Self-Concept IndividualismIndividualism –The self is independent from a group Collectivism –The self is a part of a group

8. Relationships IndividualismIndividualism –Autonomous in interpersonal relationships –Higher social skills in a starting new relationships –May give up unproductive social relationships easily Collectivism –Interpersonal harmony is the primal concern –Take time in forming new relationships –Relationships tend to be intimate and long-lasting –Make efforts to maintain relationships

9. Communication Style IndividualismIndividualism –Direct communication style –Focuses on content –Verbal communication is stressed Collectivism –Indirect communication style –Focuses on context –Non-verbal communication is important

10. Coping Strategies IndividualismIndividualism –Assertiveness –Expressing emotions –Confrontation Collectivism –Social support –Avoidance –Forbearance

11. Berry’s Model of Acculturation Cultural Maintenance YES NO Cultural Participation YESIntegrationAssimilation NO Separation/ Segregation Marginalization

12. Berry’s Acculturation Principles Cultural MaintenanceCultural Maintenance –The extent individuals value and wish to maintain their cultural identity Contact ParticipationContact Participation –The extent individuals value and seek out contact with those outside their own group, and wish to participate in the daily life of the larger society

13. Characteristics of Acculturation Integrated individualsIntegrated individuals –Individuals want to maintain their identity with home culture, but also wants to take on some characteristics of the new culture Assimilated individualsAssimilated individuals –These people do not want to keep their identity from their home culture, but would rather take on all of the characteristics of the new culture Separated individualsSeparated individuals –They want to separate themselves from the dominant culture –Can be called segregation if it forced separation Marginalized individualsMarginalized individuals –These individuals don’t want anything to do with either the new culture or the old culture

14. Factors Influential in Successful Coping with the impact of acculturation Amount of Exposure to the CultureAmount of Exposure to the Culture Intercultural CompetencyIntercultural Competency Ethnic Self-IdentityEthnic Self-Identity Social SupportSocial Support

16. Multicultural Management Approach

17. Outreach and Engagement Process

18. PEI Intervention Chart

20. Social & Recreational Day Program Spectrum

21. For more information, please contact: UPAC-EMASS Escondido office: 760-233-1984 UPAC-EMASS Escondido office: 760-233-1984 UPAC-EMASS El Cajon Site: 619-749-5560 Dr. Dixie Galapon Mental Health Director619-229-2999 Agnes Hajek, ASW, MSW619-208-4349 EMASS Program Manager Salwa Yalda619-206-6661 CHW & Site Coordinator African American CHW Stephanie Wilson 619-208-3016 Hispanic/Latina CHW Gina Osuna & Rosa Lopez Somali CHWs Fadumo Jama 619-208-6444 Lolita Gatmaitan 619-208-6669 Filipino CHW