title: Culture-sensitive psychotraumatology.
abstract: BACKGROUND
  Although there is some evidence of the posttraumatic stress disorder (PTSD) construct's cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient's particular situation, to the nature of the patient's psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient's life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies.
  
  
  METHODS
  The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects.
  
  
  RESULTS
  As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-)stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping. When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure.
  
  
  CONCLUSIONS
  In summary, culture-sensitive psychotraumatology means assuming an empathic and non-judgmental attitude, trying to understand each individual's cultural background.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital, University of Zurich, Zurich, Switzerland; ulrich.schnyder@access.uzh.ch.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: School of Psychology, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.affiliation: Department of Experimental Psychology and Oxford Cognitive health NIHR Clinical Research Facility, University of Oxford, Oxford, UK.
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
authors.affiliation: Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
authors.affiliation: Centrum'45, Oegstgeest, The Netherlands.
authors.forename: Aram
authors.initials: A
authors.lastname: Hasan
authors.affiliation: Oasis Africa Center for Transformational Psychology & Trauma, Nairobi, Kenya.
authors.forename: Gladys
authors.initials: G
authors.lastname: Mwiti
authors.affiliation: Centre of Studies and Research in Traumatic Stress, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Christian H
authors.initials: CH
authors.lastname: Kristensen
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Neuner
authors.affiliation: Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Misari
authors.initials: M
authors.lastname: Oe
authors.affiliation: Department of Applied Child Psychology, King's College, London, UK.
authors.forename: William
authors.initials: W
authors.lastname: Yule
keywords: Culture; dissemination; evidence-based treatments; low and middle income countries; psychotraumatology; stigma