After the birth of her fourth child, a Puerto Rican woman is referred for depression by her family doctor. At the intake interview, her husband comes and answers all questions. He indicates that he will decide what she needs and what is to be done. The wife says very little and speaks only when she appears to feel her husband wants her to do so. 

Look at the culture of each client described in the following scenarios, and decide what might be the underlying issue. What are you thinking about the client as you read each description? What are your first ideas about what constitutes the client’s problem? Do you have a problem personally with the behavior of the client, and if so, in what way? The following brief explanations about cultural behaviors may help you answer the questions when you read the scenarios that follow: 

• In many Asian cultures, members do not talk about family problems, feeling that these are private. They may also pretend that no problems exist. 
• In most Asian cultures, crossing the legs and pointing the toe at another person is considered extremely rude. Because members of Asian cultures like to maintain harmony, they would not be likely to tell you directly that they were offended. In addition, in most Asian cultures, waving at another person or indicating that a person should join you by calling the person over with your hand or a finger is also considered extremely rude. 
• Asians are not likely to make changes in the family or to engage in discussions about the family unless the male head of the household is present or is consulted. Furthermore, they are likely to tell you things are all right in order to maintain harmony. Things may not be all right. They may also tell you that you were helpful to them because they assume that is what you want to hear, not because it is true. Telling you what they believe you want to hear will maintain harmony. 
• In most Asian cultures, group needs and considerations are more important than individual needs and considerations. 
• In most Hispanic families, the man makes the major decisions and expects to be consulted about anything affecting the family. He would not be likely to take his wife’s ideas or concerns into consideration. She would be expected to defer to the husband. 
• Many Hispanic families allow mental health problems to persist for a very long time rather than admit that there is a psychiatric problem. 
• In Hispanic culture, it is often believed that depression is due to a lack of religious faith. 
• In Hispanic culture, mental health problems are often attributed to sin.