• Immigrant Client

• Dominant-Culture Assessor

Homeland culture may differ from current country’s dominant culture

May misread culture-bound reactions as pathology

May have left homeland to escape war or oppression

May overlook client’s vulnerability to posttraumatic stress

May have weak support systems in this country

May overlook client’s heightened vulnerability to stressors

Lifestyle (wealth and occupation) in this country may fall below lifestyle in homeland

May overlook client’s sense of loss and frustration

May refuse or be unable to learn dominant language

May misunderstand client’s assessment responses, or may overlook or misdiagnose client’s symptoms

• Ethnic-Minority Client

• Dominant-Culture Assessor

May reject or distrust members of dominant culture, including assessor

May experience little rapport with client, or may misinterpret client’s distrust as pathology

May be uncomfortable with dominant culture’s values (e.g., assertiveness, confrontation) and so find it difficult to apply clinician’s recommendations

May view client as unmotivated

May manifest stress in culture-bound ways (e.g., somatic symptoms such as stomachaches)

May misinterpret symptom patterns

May hold cultural beliefs that seem strange to dominant culture (e.g., belief in communication with dead)

May misinterpret cultural responses as pathology (e.g., a delusion)

May be uncomfortable during assessment

May overlook and feed into client’s discomfort

• Dominant-Culture Assessor

• Ethnic-Minority Client

May be unknowledgeable or biased about ethnic-minority culture

Cultural differences may be pathologized, or symptoms may be overlooked

May nonverbally convey own discomfort to ethnic-minority client

May become tense and anxious

Information from: Rose et al., 2011; Bhattacharya et al., 2010; Dana, 2005, 2000; Westermeyer, 2004, 2001, 1993; López & Guarnaccia, 2005, 2000; Kirmayer, 2003, 2002, 2001; Sue & Sue, 2003; Tsai et al., 2001; Thakker & Ward, 1998.