In youth mental health services, practitioners are increasingly confronted with complex intercultural situations that require adjustments to their interventions. This may cause feelings of powerlessness and frustration, provoke defensive reactions, and negatively affect the quality of their work. To address this concern, the training of professionals is commonly cited as a solution, but often without unpacking what such initiatives entail and require. This thesis reports on findings from a qualitative study carried out on one such initiative: Montréal’s Transcultural Interdisciplinary and Interinstitutional Case Discussion Seminars.
This study’s objective was twofold: (1) to explore the lived experience of Transcultural Seminar participants; and (2) to examine the conditions and processes during Seminar meetings that contribute to improved intercultural competence. Over a five-year period of fieldwork (2013-2018), participant-observation of Transcultural Seminars was realized (61 meetings were audio-recorded), along with six focus groups and 26 semi-structured individual interviews. The data was analyzed qualitatively using thematic and narrative analyses. The theoretical frameworks that informed the analyses included the cultural safety paradigm, insights from game theory, the community of practice paradigm, and a politico-psychoanalytical perspective on representations and images.
Results showed that the term culture in practitioners’ and families’ discourse serves as a narrative strategy to mediate clinical interactions. These rhetorical moves can at times reify stereotypes and deflect personal responsibility, while at other times mobilize collective representations toward a common transformative goal (Article 1). Results also indicated that Transcultural Seminars operate under different rules than real-life clinical work, such as placing a high value on diversity and creativity, fostering a process of inclusive dialogue, and considering continuity over time. These rules allow participants to safely apprehend a situation from a different perspective and to negotiate power relationships (Article 2). The need to address local contextual elements in intercultural training was also documented, including the cultural identities of trainees and the local power differentials between groups. These sensitive elements can be addressed through supportive and reflexive group-based initiatives such as Transcultural Seminars, a form of Communities of Practice that brings together practitioners on a regular basis and provide them with a culturally safe enough space (Article 3). Finally, results indicated that the attention paid to images – mainly verbal and mental images – during Transcultural Seminars can enable practitioners to adopt a different way of looking at the families they work with. Results suggested that working with images in intercultural training is more productive for a transformation of the colonial gaze than the sole enunciation of general theoretical statements that can be experienced by trainees as judgmental (Article 4).
This study deepens our understanding of conditions and processes that are required to increase intercultural competence among youth mental health practitioners, without simplifying current anthropological knowledge. The results also warn against the danger of applying tools and protocols without proper training. Finally, with the aim to improve children’s and youth’s mental health and wellness, while supporting practitioners and protecting minority families from systemic discriminatory processes, this study calls for the adoption of reflexive, decolonial, and locally rooted approaches to intercultural training.