Navigating Cultural Barriers in Brain Injury Rehabilitation

This neuropsychologist shares his experience and advice about culture, ethnicity, and brain injury rehab.

So how do I get a family or someone with a traumatic brain injury to buy into rehabilitation, if there are cultural barriers? Well, I start by buying into the family. I look at it the other way around. We're here collaboratively, and so that's why I start with their priorities and their goals and then look at how I can facilitate their goals and then perhaps add on ones that I've thought of that didn't occur to them or that they didn't notice yet, but I buy into them. That's the way I look at working on that. That's on a personal working-with-people level, but that's a much bigger issue, in terms of society as a whole. We have a lot of disparities in rehabilitation. That is to say that within the United States, people of various minority status generally receive fewer rehabilitation services than majority culture people. The barriers to that--probably the most important is healthcare funding, is that we have such a crazy quilt of healthcare funding that does not reach everybody, by any means, 46 million people without coverage and so on. And that's certainly a very important factor. Other factors are institutional barriers-- lack of awareness in the community of the services that may be available, lack of faith in those services, lack of appropriate outreach and language accessibility and so on. Fortunately, there is a government agency that has addressed all of those issues and has some very good guidelines. It's Cultural and Linguist Access to Services--I believe it's called CLASS. In the slides that accompany this interview, I'll list out some of those things of ways that institutions can look at making themselves more accessible to the ethnic minority communities that are in their catch-man area in their neighborhoods. There are a lot of things that keep people from even arriving at the office or the clinic or the rehabilitation facility or whatever it is. But once they've arrived, then other things having to do with those barriers are buying into them, working with their goals, finding out about their background, and those kinds of things. Again, as I said before, not just tolerance, but valuing and respecting that. Most of the things that I talk about, most of the things that I teach come from the people that I've worked with. They don't come so much from what I learned in graduate school or what I learned from the scientific literature.
Posted on BrainLine April 29, 2009.

Produced by Victoria Tilney McDonough and Brian Kin, BrainLine.