Counselling, culture and communication for change

The contemporary landscape of mental health services is changing rapidly with a proliferation of training programmes in counseling and psychotherapy based primarily on North American/Eurocentric theories and cultures. With culture acting as an interpretive frame for behavior and given the multicultural nature of Caribbean society, there is therefore the need for a culturally relevant review of therapeutic communication if practitioners are to successfully engage Caribbean people in the therapeutic process. This chapter addresses some of the cultural factors in the Caribbean which influence this communication process, particularly, how people engage or avoid engaging in the process of counseling and therapy, and suggests strategies and skills for facilitating the needed engagement. Issues examined include clients' past experiences of helping relationships, belief about how change occurs, expectations of counseling/psychotherapy as providing a "quick fix", expectations that the therapist will play a primarily didactic role and that they will be passive learners, the impact of religious beliefs on clients' decisions whether or not to seek help and the challenges of dual relationships (circumstances whereby the therapist and the client interact with each other outside of the therapy context). Concepts are based on a series of presentations made at case conferences at the University Counselling Service at the UWI, Mona, and the authors' thirty-odd years of experience in various clinical settings. The University Counselling Service provides counseling and psychotherapy to a diverse range of clients within the university community, inclusive of students, staff at all levels, faculty members and administrators.

An assessment of stress among clinical medical students of the University of the West Indies, Mona Campus

This study looks at sources of stress amomg the medical students of the University of the West Indies at the Mona campus. Students of the classes 1993 through 1995 were asked to fill out a questionnaire which had been developed for a similar study at the University of Texas in 1983. The return rate was 66 percent. The results were compared for differences between males and females and between the different year groups. The two most stressful items were rated the same by men and women, i.e. 1) the amount of material to be learned, and 2) examinations and/or grades. There was no statistically significant difference between stress levels by gender in this study. The penultimate clinical year was most stressful. It is hoped that the findings of this study will be the basis for discussion about whether the identified stressors are inherent and necessary to the medical training experience and, if so, how students can be better prepared to cope with them.

An assessment of stress among clinical medical students of the University of the West Indies, Mona Campus

This study looks at sources of stress amomg the medical students of the University of the West Indies at the Mona campus. Students of the classes 1993 through 1995 were asked to fill out a questionnaire which had been developed for a similar study at the University of Texas in 1983. The return rate was 66 percent. The results were compared for differences between males and females and between the different year groups. The two most stressful items were rated the same by men and women, i.e. 1) the amount of material to be learned, and 2) examinations and/or grades. There was no statistically significant difference between stress levels by gender in this study. The penultimate clinical year was most stressful. It is hoped that the findings of this study will be the basis for discussion about whether the identified stressors are inherent and necessary to the medical training experience and, if so, how students can be better prepared to cope with them. (AU)