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Abstract

Affirmative practice is an approach to health and behavioral health care that validates and supports the identities stated or expressed by those served. Affirmative care requires the practitioner to actively honor and celebrate identity while at the same time validating the oppression felt by individuals seeking services. Validation and empathy fundamentally result from increased understanding of individuals’ history, cultural context, and lived experiences. Origins of the approach honored the experience of those in LGBTQ+ communities; however, affirmative care should be valued across cultures, systems, and settings in which health and behavioral health care are offered. Affirmative care principles should be applied across cultures and communities while recognizing the worth of the individual and avoiding stereotyping. Along with delineating historical and demographic contexts, the authors offer recommendations for affirmative care in practice with African American, Asian, Indigenous, and Latinx individuals, as well as those living in rural communities.

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Information

Published In

History

Published in print: Winter 2020
Published online: 24 January 2020

Keywords

  1. affirmative care
  2. culture
  3. diversity and inclusion
  4. clinical practice, health and behavioral health care
  5. health care delivery

Authors

Details

Natasha S. Mendoza, M.S.W., Ph.D. [email protected]
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Francisco A. Moreno, M.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
G. Alexander Hishaw, M.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Albert C. Gaw, M.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Lisa R. Fortuna, M.D., M.P.H.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Anna Skubel, M.Ed.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Michelle V. Porche, Ed.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Mary Hasbah Roessel, M.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Jay Shore, M.D.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).
Anthony Gallegos, B.S.
Center for Applied Behavioral Health Policy, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix (Mendoza, Gallegos); College of Medicine, University of Arizona Health Sciences, Tucson and Phoenix (Moreno); College of Medicine, University of Arizona Health Sciences Center, Tucson (Hishaw); University of California, San Francisco, Medical School, San Francisco (Gaw); Boston Medical Center, School of Medicine (Fortuna), and Wheelock College of Education and Human Development (Skubel, Porche), all at Boston University, Boston; Caucus of American Indian, Alaska Native and Native Hawaiian Psychiatrists, American Psychiatric Association, Washington, DC (Roessel); Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora (Shore).

Notes

Send correspondence to Dr. Mendoza ([email protected]).

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