Transcultural skills for early childhood professionals.

Context: Transcultural skills are especially useful for those involved in the perinatal period, when parents and babies must adapt to one another in a setting of migration a long a focus of transcultural clinical practice. Objective: The aim of this article is to provide useful transcultural skills for any health care worker (e.g., psychologists, child psychiatrists, midwives, family doctors, pediatricians, specialized child-care attendants, and social workers) who provide care or support to families during the perinatal period. It highlights the cultural aspects requiring attention in relation to representations of pregnancy, children's needs, obstetric complications, and postnatal problems. Taking into account the impact of culture on clinical evaluation and treatment can enable professionals to distinguish what involves cultural representations of pregnancy, babies, and sometimes of disease from what is associated with interaction disorders or maternal psychopathology. Methods: After explaining the relevance of transcultural clinical practices to provide migrant mothers with better support, we describe 9 themes useful to explore from a transcultural perspective. This choice is based on the transcultural clinical practice in our specialized department. Results: The description of these 9 themes is intended to aid in their pragmatic application and is illustrated with short clinical vignettes for specific concepts. We describe situations that are extreme but often encountered in liaison transcultural clinical practice for maternity wards: perinatal mourning with cultural coding, mediation in refusal of care, cultural misunderstandings, situations of complex trauma and of multiple contextual vulnerabilities, and difficulties associated with acculturation. Discussion: The transcultural levers described here make it possible to limit cultural misunderstandings and to promote the therapeutic alliance. It presupposes the professionals will concomitantly analyze their cultural countertransference and acquire both the knowledge and know-how needed to understand the elements of cultural, political, and social issues needed to develop clinical finesse. Conclusion: This combined theoretical-clinical article is intended to be pedagogical. It provides guidelines for conducting transcultural child psychiatry/psychological interviews in the perinatal period aimed at both assessment and therapy.

[From the cultural cradle to the empty cradle, accompanying perinatal mourning]. / Du berceau culturel au berceau vide : accompagner le deuil périnatal.

In all societies, births and deaths are important moments that call upon the intimate and collective representations of each person. When death occurs during the perinatal period, bereaved couples may feel the need to refer to the cultural representations they have internalized, and thus re-affiliate themselves with a group to which they belong, likely to accompany them in making sense of what they have experienced. A clinical situation allows us to understand the psychological support of couples from elsewhere who are confronted with perinatal mourning.

[Clinical approach to linguistic plurality in a mother and infant welfare protection centre]. / Travail clinique autour de la pluralité linguistique en protection maternelle et infantile.

Many children supported by professionals from the mother and infant welfare protection centre grow up in a plurilingual environment. Taking into account this plurilingualism provides better understanding of the relationships which the children establish with their environment. This can also help them to engage in a transgenerational transmission as well as in multiple cultural affiliations.

[Culture in initial interactions]. / La culture dans les interactions précoces.

Communication between infants and their parents is established through the initial interactions which begin at birth. These are unique to each parent-infant dyad and are structured both on the basis of the reactions, behaviour and characteristics specific to the babies as well as on the images, sensations, projections and representations of the parents. Culture and language are important elements in this context.