ABSTRACT
The goal of this chapter is to provide a broad overview of some of the key issues involved in conducting culturally competent assessment of depression among American Indians and Alaska Natives. The approach to this task concentrates on three essential areas. First, we briefly sum marize some of the fundamental cultural issues regarding the way in which depression is expressed and experienced, as well as the social meaning it carries within local cultural settings. We then review the empirical literature regarding available instruments for assessing depres sion among Indian and Native clients. Finally, and perhaps most impor tant for the purposes of culturally competent assessment, we attempt to describe important clinical variations in the subjective aspects of the depressive experience among American Indians and Alaska Natives. Here we turn to the growing literature on the use of systematic cultural for mulations to inform and enrich clinical understanding of cultural identity, explanatory belief models, the influence of the psychosocial environment, and the relationship between the individual and clinician. In this regard, we are guided by the need for clinicians and clinical researchers to contextualize behavior and emotional experience as a means to avoid the imposition of one's own cultural categories onto another culture for which they lack validity (Lewis-Femandez & Kleinman, 1994).
