Working with individuals

Effective communication
Cross-cultural communication needs to consider a variety of customs and ways of doing business. It is important to try and establish early in the process what the expectations are for both parties from the consultation and what can be realistically achieved. Effective communication of information is a major concern for families. In many cases the language used is difficult to understand and too often families are given too little information and assumptions are made about understanding that may be incorrect. Do not make assumptions from your previous experience with Aboriginal or Torres Strait Islander clients. There also may be a number of sensitive or taboo subjects that present problems in interview. Even if these issues are acknowledged, clients may still not be able to discuss these openly. Fear about "payback" can cause significant anxiety and prevent the patient from returning home or elaborating further. Practitioners need to be aware of sensitive and highly emotional issues and use alternative means of gathering information or consult with Aboriginal or Torres Strait Islander mental health workers.

Language
Use of language can be problematic, especially where Aboriginal English and traditional languages are used extensively. The use of interpreters can be useful especially where English is the second or third language. Direct translations are not always possible and understanding what is meant may require further exploration. It is likely that continued explanations will be required so that the person being interviewed understands what you are doing and is not made to look foolish or shamed by the questions. Language form and content must be assessed against the cultural norms for the group, for example, use of a narrative or story-telling style may be appropriate.

Body Language
Body language is also an important part of communication for both professional and client. Be relaxed, calm and interested rather than authoritarian. Aboriginal and Torres Strait Islander peoples will be aware of your body language throughout the interview and make their own assessment of the integrity of the process.

Eye contact
In general, eye contact is averted as a mark of respect or as part of cultural behaviour however this varies enormously between groups. It may be considered extremely impolite to look someone directly in the eye whom one does not know. Avoidance of direct eye contact should not be over-interpreted. Gazing together in the same direction may give an indication of social connection.

Gender
Gender and age are also important issues. It may be inappropriate for a young female doctor to examine or ask personal questions of a male client and vice versa. However when there is no alternative and in emergency situations, the professional should acknowledge that the client may feel uncomfortable about the questions you are asking and may need to give their consent for the interview to proceed.