Cultural Competence in Trauma Therapy: Beyond the Flashback 1st Edition

I read this book in order to obtain CEUs from the APA. I found the book lacking. Firstly, this book has virtually nothing to do with actual treatment of Post-traumatic Stress Disorder in diverse populations. The author's definition of trauma is so broad that almost any negative life experience, not just those meeting criteria A, defines her traumatized populations. Therefore, the minority groups (to the US) she discusses are essentially traumatized simply by being members of those cohorts (social status, phenotype, religion, etc.). Really, it should just be titled "Diverse populations you may encounter as a therapist, and things that may bother them." Literally, I recall not one discussion of actual PTSD symptoms, e.g., flashbacks, intrusive memories, autonomic arousal, avoidance behaviors, being discussed as they may pertain to a diverse culture. (This is despite the sub-title of "beyond the flashback," which was ironic, since no flashback phenomena were once discussed in the entirety of the book.) The author's sociopolitical bend is glaring: for example, she goes so far as to criticize therapists who are not medicare providers for not offering more free or low cost services, as if the responsibility for population disparities should be born by the practitioners themselves. She describes the lack of universal healthcare in the US as being a source itself of trauma for individuals. She blames the "current political leadership" of the US for encouraging and supporting anti-immigrant sensibilities among Americans, instead of noting that they are simply exploiting them for their personal gain. This book would be irrelevant to anyone practicing outside the US, as her concerns and complaints entirely revolve around disparities in treatment provisions in the US, and in no way would assist any provider with understanding nuances of working with populations outside the US. Her writing is weak. She often will cite individual (anecdotal) cases to support her arguments, but in many cases, these examples have nothing to do with the point she just made, and in fact, worse, there are several instances when she seems to be directly ignorant that her example case may be malingering (in fact, in one, she directly admits they were diagnosed with malingering in a work comp case, and still continues on with describing the myriad ways that prejudice was responsible for the patient's care, rather than the individual issues in the case). And in the rare moments when this author gives concrete suggestions for clinical care, she can be woefully misled about how these ideas would play out in every day practice, such as by suggesting that the therapist should ask the patient curing an intake how they "feel" about belonging to their specific minority group. This is a rookie error that could have a disastrous impact on care. I think my greatest complaint with this book is that fact that it never once focuses on empowering patients from diverse backgrounds. While the list of difficulties in being from a minority background are clear, not once does the author really talk about how to empower these populations post-trauma, and focus on healing and efficacy. It just feels like most of the book is about having sympathy, without any focus on empowerment. And who needs pity? The book, for me, has only a limited number of strengths, one of which is that it offers a overall summary of working with non-privileged populations that could be helpful for students and providers who have themselves come from a privileged or insular background and have genuinely never worked with (or apparently met) others from diverse backgrounds. But if this book is an indication of the state of understanding of working with diverse populations in the field as a whole, then that's pretty sad.

I read this book during graduate school, and I found this to be a difficult title to swallow. As a non-white American in a clinical psychology program, I felt that the material did not really apply to me. The worst part is that the author doesn't create a space for other-raced service providers to be acknowledged. I'd be wrong to assume that any text relieves me of my own critical thought process while I taking the material. However, I had to do so much extrapolation from the provided examples to guess how my quite real racial profile might hypothetically factor into the white-based scenarios. As a person of color, I felt that the text unapologetically equated ethnic persons as the needing and unhealthy individual. Here is a fine line between worldview expansion and "othering"; and I don't feel the author always walked that line with Grace. Of course, this is all with the disclaimer that mindset and intent mean something. Part of my struggles may have stemmed from my graduate program. But even a prologue would have been appreciated. I would recommend other books for cultural expansion in terms of clinical treatment.

I took a couple chapters to get engaged but by the 3rd chapter...wow! I am half way through the book and finding it very useful and full of excellent clinical case examples. Fantatstic coverage of issues related to identity and privilege which intertwine with trauma. This book is important for any clinician doing trauma work!

Excellent book by an excellent processional. The ideas presented here are very important and timely.