Navajo Youth and the Experience of Psychiatric Treatment

纳瓦霍青年与精神科治疗经验

• 批准号: 7097281
• 负责人: Thomas Csordas
• 金额: $ 56.29万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-20 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7097281
• 关键词: Native Americans; adolescence (12-20); behavioral /social science research tag; child psychology; clinical research; community; comprehension; culture; expectancy; health care personnel performance; human subject; human therapy evaluation; interpersonal relations; interview; longitudinal human study; patient care personnel relations; patient oriented research; psychological stressor; psychosocial separation; psychotherapy; religion; social psychology; therapy design /development

DESCRIPTION (provided by applicant): The proposed study is an examination of cultural meaning, social interaction, and individual experience in the encounter between 2 culturally distinct approaches to mental illness and its treatment: indigenous Navajo and conventional psychiatric. The study is designed as an ethnography of a new inpatient unit that for the first time will provide on-reservation residential psychiatric care for the most distressed among Navajo youth ages 12-18. Our long-term goal is to produce knowledge of broad use to those concerned with the treatment of adolescents suffering from mental illness in the context of significant cultural differences. The unique integrative nature of the new unit's treatment program suggests that it will be treated as a model for other such facilities in the future, and therefore through-going ethnographic description of the cultural processes relevant to its functioning is necessary and even urgent. Our specific aims are organized under 3 closely interrelated headings pertaining to the meanings that patients, families, and staff attach to the treatment of mental disorder: I.) Clinical Culture and Development of Treatment, tracing the development of a clinical culture and culturally sensitive treatment program in the context of staff, patient, and family expectations and levels of cultural competence among staff; II.) Definitions of Distress and Adolescent Development, comparing concepts of problem, illness, disorder, and stigma defined in psychiatric and indigenous terms, and examining Navajo concepts of adolescent development, growth, and maturity in the context of the contemporary Navajo social milieu; III.) Therapeutic Process and Perception of Treatment, describing patient, family, and staff experience of psychiatric treatment in relation to religious/ceremonial resources tapped by families on behalf of adolescent patients, identifying patterns of youth integration and into communities, and determining whether innovative on-reservation treatment makes a difference for troubled Navajo youth. The design includes a total of 307 participants: 1) patients in the new on-reservation facility, 2) patients drawn from off-reservation facilities, 3) students drawn from a public school on the Navajo Nation, 4) parents of these adolescents, 5) clinical staff, and 6) community advisors. Methods combine naturalistic observation, open-ended ethnographic interviews, and standardized instruments. Analysis emphasizes descriptive ethnography and comparison of narrative case accounts of participant experience and perception of treatment. Ethnography will be complemented by quantitative analyses to determine how youth in the 3 study groups differ on a variety of measures.

描述（由申请人提供）：拟议的研究是对两种文化含义的精神疾病及其治疗方法之间相遇的文化意义，社会互动和个人经验的检查：纳瓦霍原住民和常规精神病学。该研究被设计为新的住院单位的民族志，这首歌首次为12-18岁的纳瓦霍（Navajo）青年中最痛苦的人提供保留的住宅精神病护理。我们的长期目标是在具有重大文化差异的背景下对患有精神疾病的青少年治疗的人提供广泛使用的知识。新单位治疗计划的独特综合性质表明，将来它将被视为其他此类设施的模型，因此，对与其功能相关的文化过程进行了经过的民族志描述是必要的，甚至是紧迫的。我们的具体目标是在3个与患者，家庭和员工相关的精神障碍治疗的含义的3个紧密相互关联的标题下组织的： ii。）遇险和青少年发展的定义，比较了问题，疾病，疾病和污名的概念，并在当代纳瓦霍人社会环境的背景下研究了纳瓦霍人的青少年发展，成长和成熟度的概念； iii。）治疗过程和对治疗的看法，描述了与家人代表青少年患者挖掘的宗教/礼仪资源有关的患者，家庭和员工经验，并确定了青年融合和社区的模式，并确定创新的保留疗法是否可以使纳瓦纳霍（Navajo Navajo）青少年有所帮助。该设计总共包括307名参与者：1）新的保留设施中的患者，2）从放弃设施中得出的患者，3）从纳瓦霍（Navajo Nation）的公立学校中吸引的学生，4）这些青少年的父母，5）临床人员和6）社区顾问。方法结合了自然主义的观察，开放式人种学访谈和标准化工具。分析强调了描述性民族志和参与者经验和治疗感知的叙事案例的比较。人种志将通过定量分析来补充，以确定三个研究小组中的青年在各种措施上有何不同。