CUSSW CLINICAL & COMMUNITY PRACTICE GRAND ROUNDS SERIES

Roberto Lewis-Fernandez, MD
Director, NYS Cultural Competence Center of Excellence and the Hispanic Treatment Program
New York State Psychiatric Institute and Associate Professor of Clinical Psychiatry at Columbia University

Cultural Formulation of Psychiatric Diagnoses: The Case of Ataques de Nervios

Wednesday, March 26, 2008
6:00 - 8:00pm (Room C03)

School of Social Work - 1255 Amsterdam Avenue
(between 121st & Morningside Drive)


RSVP: click here

Presentation
Dr. Lewis-Fernandez will discuss the cultural formulation, a systematic method for assessing cultural factors in the clinical encounter that is included in DSM-IV. Use of the formulation will be illustrated by the discussion of the evaluation and long-term treatment of a Puerto Rican woman suffering from nervios and ataques de nervios.

About the Presenter
Dr. Roberto Lewis-Fernández is Director of the NYS Cultural Competence Center of Excellence and the Hispanic Treatment Program at New York State Psychiatric Institute, Associate Professor of Clinical Psychiatry at Columbia University, and Lecturer on Social Medicine at Harvard University.  He received his B.A. from Harvard College in 1979, a Master’s Degree in comparative religion from Harvard Divinity School in 1982, and his M.D. from Yale Medical School in 1986.  He obtained his psychiatric training at The Cambridge Hospital (1986-90) and completed a Dupont-Warren psychiatric research fellowship (1990-91) and an NIMH-sponsored fellowship in clinically applied medical anthropology (1991-93) at Harvard Medical School.  From 1993 to 1995, Dr. Lewis-Fernández worked for the Puerto Rico Health Department implementing an innovative mental health consultation-liaison program for rural primary care clinics.

His research focuses on the socio-cultural determinants of illness experience, symptomatology, help-seeking behavior, and treatment outcome among U.S. Latinos diagnosed with anxiety, depressive, and dissociative disorders.  Specific interests include the relationship between psychiatric diagnoses and Latino popular syndromes; socio-cultural factors associated with treatment dropout; misdiagnosis of psychosis as a result of folk idioms of distress; symptom presentations of trauma-related disorders among Latino patients; and collaboration models between psychiatry and primary care medicine to increase access to mental health treatment.

Dr. Lewis-Fernández was on the DSM-IV Cross-Cultural Committee and the NIMH Study Group on Mental Health Services in Specialty Settings (2002-2007).  He is currently the chair of the Cultural Psychiatry Committee of the Group for the Advancement of Psychiatry, a member of the Anxiety Disorders Workgroup for DSM-V, and a member of the Community Services Board of the NYC Department of Health and Mental Hygiene.  From 1996 to 2007, he also served as Editor of the Cases Section of Culture, Medicine and Psychiatry, which publishes clinical cases illustrating the impact of culture on the symptoms, course, and outcome of psychiatric disorders and patients' help-seeking choices.

Suggested Readings

Lewis-Fernández R and Díaz N. The Cultural Formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 2002, 73:271-295.

Guarnaccia PJ, Lewis-Fernández R, Rivera M. Towards a Puerto Rican popular nosology: Nervios and ataques de nervios, Culture, Medicine and Psychiatry, 2003, 27:339-366.

Presentation
This presentation will describe the cultural formulation with Indigenous Peoples of the Americas. Brief case examples and audiovisual materials will illustrate the historical context of massive group trauma and cultural features for incorporation in culturally responsive assessment and interventions.

About the Presenter
Maria Yellow Horse Brave Heart, PhD (Hunkpapa/Oglala Lakota and Latina) is an Associate Professor at Columbia University School of Social Work and a research team member at the Hispanic Treatment Program, New York State Psychiatric Institute. From 1992 through 2006, Dr. Brave Heart was the President, Director, and Co-founder of the Takini Network as well as a faculty member at the University of Denver Graduate School of Social Work. As a tenured Associate Professor, Dr. Brave Heart was also Coordinator & Developer for the Native Peoples Curriculum Project & Certificate Program at the University of Denver Graduate School of Social Work and taught in the Four Corners Program in Durango, Colorado. She was also Core Faculty for the University of Denver?s Post-Graduate Trauma Response & Recovery Certificate Program.

Dr. Brave Heart specializes in trauma work for Indigenous communities and developed the theory of the American Indian historical trauma and unresolved grief. Currently, Dr. Brave Heart is developing research with Latin American Indians, expanding her focus on the traumatic responses, grief, and loss for massively traumatized Indigenous populations across all of the Americas.

Dr. Brave Heart received her Masters of Science in Social Work from Columbia University in 1976 and her PhD in clinical social work from Smith College in 1995. She served as: Vice President, American Indian Social Work Educators Association; Council on Social Work Education Board of Directors, Affilia Journal for Women in Social Work Editorial Board Member; and National Association of Rural Mental Health Board Member. Dr. Brave Heart directed the national Models for Healing Indigenous Survivors of Historical Trauma: A Multicultural Dialogue Among Allies Conference in 2001, 2003, and 2004, supported by SAMHSA. Dr. Brave Heart has been a consultant to the Center for Mental Health Services, the National Trauma Consortium Center on Women, Violence and Trauma, and the national Indian Country Child Trauma Center. She is also a member of the International Society for Traumatic Stress Studies. Dr. Brave Heart participates in traditional spiritual functions in Kyle at Pine Ridge and Sitting Bull camp at Standing Rock.

Suggested Readings

Brave Heart, M.Y.H. (2001) Clinical assessment with American Indians. In R.Fong & S. Furuto (Eds), Cultural competent social work practice: Practice skills, interventions, and evaluation (pp. 163-177). Reading, MA: Longman Publishers.

Brave Heart, M.Y.H. (2001) Clinical interventions with American Indians. In R. Fong & S. Furuto (Eds). Cultural competent social work practice: Practice skills, interventions, and evaluation (pp. 285-298). Reading, MA: Longman Publishers.

Brave Heart, M.Y.H. (1998) The return to the sacred path: Healing the historical trauma response among the Lakota. Smith College Studies in Social Work, 68(3), 287-305.

Brave Heart, M.Y.H. (2000) Wakiksuyapi: Carrying the historical trauma of the Lakota. Tulane Studies in Social Welfare, 21-22, 245-266.

Brave Heart, M.Y.H. (2003) The Historical Trauma Response Among Natives and Its Relationship with Substance Abuse: A Lakota Illustration, Journal of Psychoactive Drugs, 35 (1), 7-13.

THIS IS A PUBLIC EVENT

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To contact us: swevents@columbia.edu

The Clinical and Community Practice Grand Rounds is made possible through the generous support of the Hyman Grossbard Lectureship. Dr. Grossbard graduated from CUSSW in 1938, and was a member of the School's faculty from 1952 until his retirement in 1973. An eminent psychiatric social worker, Dr. Grossbard was highly regarded for his significant contributions to the field of child welfare.