The Cultural Context of Trauma Recovery: Considering the Posttraumatic Stress Disorder Practice Guideline and Intersectionality

The American Psychological Association's (2017) Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults endorsed by the American Psychological Association notes that attention to cultural context is a required component of trauma-informed mental health care provision. Despite the inclusion of this statement, the Treatment of PTSD Guideline does not give adequate attention to culture in the defining of trauma, review of the trauma literature, the criteria adopted for evaluation of PTSD treatments. and, resultantly, the determination of treatment recommendations. Culture plays a significant role in the vulnerability to, experience of, and recovery from mental health sources of distress, including interpersonal trauma (Bryant-Davis, 2005). Approaches to trauma-focused psychotherapy that are ethically sound call for a prioritizing of cultural competence (awareness, knowledge, and skills), as well as cultural humility (Harvey & Tammala-Nara. 2007). Trauma survivors, however, hold multiple identities simultaneously that influence their conceptualizations of trauma, therapy, and the recovery process (Brown, 2008). Intersectionality refers to the way in which a multiply marginalized person experiences cultural identity and oppression that is qualitatively different than the experience of trauma survivors from dominant cultural groups (Crenshaw, 2005). The realities of racism, sexism, heterosexism, and classism, as well as their influence on the trauma recovery process. are examined, while noting the minimal attention that has been given to additional forms of oppression such as religious intolerance and able-bodyism. This critical review of the literature will examine the theoretical and empirical literature, which has examined the framework and strategies that have been cultivated in service to trauma survivors who have been traditionally underserved. Attention will be given in particular to benefits, limitations, and critiques of evidence-based interventions, as well as benefits, limitations, and future research needs of both culturally modified interventions and culturally emergent trauma interventions.