Use the term, expression, or briefdescription elicited MEDICAL DIAGNOSIS, PROBE: in question 1 to identify the problem in subsequent People often understand problems in their questions (e.g., ”her conﬂict with her son”). own way, which may be similar or differ- ent from how doctors describe the prob- lem. How would you describe [INDIVIDUAL’S] problem?
Ask how informantframes the problem for members 3. Sometimes people have different ways of of the social network. describing the problem to family, friends, or others in their community. How would them?
Focus on the aspects of the problem that matter most 4. What troubles you most about [INDIVID- to the informant. UAL’S] problem?
GUIDE TO INTERVIEWER ITALICIZED.
CULTURAL PERCEPTIONS OF CAUSE, CONTEXT, AND SUPPORT
This question indicates the meaning of the condition 5. Why do you think this is happening to for the informant, which may be relevant for clini— [INDIVIDUAL]? What do you think are the cal care. causes of his / her [PROBLEM]?
Note that informants may identify multiple causes PROMPT FURTHER IF REQUIRED: depending on the facet of the problem they are con- Some people may explajn the problem as the sidering. result of bad things that happen in their life, problems with others, a physical illness, a spiritual reason, or many other causes.
Focus on the views of members of the individual's 6. What do others in [INDIVIDUAL’S] fam- social network. These may be diverse and vary ily, his/her friends, or others in the com- from the informant's. munity think is causing [INDIVIDUAL’S] [PROBLEM]?
Elicit information on the individual’s life context, 7. Are there any kinds of supports that make focusing on resources, social supports, and resil— his/her [PROBLEM] better, such as from ience. May also probe other supports ( e.g., from co- family, friends, or others?
workers, from participation in religion or spiritu- ality).
Focus on stressful aspects of the individual's environ— 8. Are there any kinds of stresses that make ment. Can also probe, e.g., relationship problems, dlf- his/her [PROBLEM] worse, such as diffi- ficulties at work or school, or discrimination. culties with money, or family problems?
Sometimes, aspects of people’s background or identity can make the [PROBLEM] better or worse. By background or identity, I mean, for example, the communities you belong to, the languages you speak, where you or your family are from, your race or ethnic back- ground, your gender or sexual orientation, and your faith or religion.
Ask the informant to reflect on the most salient ele— 9. For you, what are the most important ments of the individual’s cultural identity. Use this aspects of [INDIVIDUAL’S] background or information to tailor questions 10—11 as needed. identity?
Elicit aspects of identity that make the problem bet- 104 Are there any aspects of [INDIVIDUAL’S] ter or worse. background or identity that make a differ—
Probe as needed (e.g., clinical worsening as a result ence to his/her [PROBLEM]?
of discrimination due to migration status, race/ ethnicity, or sexual orientation).
Probe as needed (erg., migration-related problems; 11. Are there any aspects of [INDIVIDUAL’S] conﬂict across generations or due to gender roles). background or identity that are causing other concerns or difficulties for him/her?
GUIDE TO INTERVIEWER ITALICIZED.
Clarify individual's self-coping for the problem.
12. Sometimes people have various ways of dealing with problems like [PROBLEM].
own to cope with his/her [PROBLEM]?
Elicit various sources of help (e.g., medical care, mental health treatment, support groups, work— based counseling,folk healing, religious or spiri- tual counseling, other alternative healing).