In the first three chapters, the authors do an excellentjob of describing the emotional cycle of deployment,including predeployment, deployment, and postdeploy-ment. They also provide an excellent description of theimpact of multiple deployments, and the insertion ofrealistic vignettes of service members' experiencesthroughout the book is likely to hit home with manycombat veteran readers. Chapter 4 describes the Army's“Battlemind” program developed by Dr. Carl Castro andcolleagues at the Walter Reed Army Institute of Research.Battlemind is an acronym in which each letter refers to adifferent cognitive mindset that helps troops survive in awar zone, but can become disruptive and dysfunctionalwith continued use during the postdeployment period.Virtually every Army soldier who has recently returnedfrom deployment has been exposed to the Battlemindconcepts, so clinicians unfamiliar with this program wouldbenefit from reading the chapter and becoming intimate-ly familiar with it. Chapters 5–8 include descriptions ofthe common reactions to trauma, including anger, guilt,and grief. Additional chapters focus on reconnecting inpersonal relationships, overcoming barriers to care,community support, and PTSD.

The authors are complimented for the use of theproper terms to describe military service members fromeach of the branches of the armed services. Many authorstoday inappropriately refer to all military members as“soldiers,” which is often not appreciated by servicemembers who are not in the Army. Those familiar withthe military environment know it is filled with militaryterminology, abbreviations, and acronyms. The currentwars in Iraq and Afghanistan are no different, and theterms OIF, OEF, IED (improvised explosive device), andmany others are now part of the daily lexicon of almostevery OIF/OEF veteran. The authors include militaryterms throughout the book and include a glossary forthose readers less familiar with military jargon.

One of the most valuable aspects of the book is theemphasis on the “strong and brave” when referencingcombat veterans who may be experiencing symptoms ofcombat stress disorders. Because only a minority ofindividuals exposed to war zone trauma develops com-bat-related PTSD, there is the tendency for many troops,their commanders, and health care providers to interpretthis as a sign of personal weakness or a failure to cope.This interpretation does little to help combat warriorsnavigate their course to recovery. The authors handle thistopic adroitly and highlight that those troops who arestronger and braver are at a greater risk for combat-stressdisorders; they are more likely to place themselves inharm's way and may experience greater levels of combattrauma exposure.

This book alone may be sufficient to help some combatveterans recovery naturally from combat exposure with-

out any professional assistance. For others, it is hoped thatthe book will help encourage some to seek professionalassistance and reduce the barriers to seeking mentalhealth treatment in military, civilian, and VeteransAdministration settings. After the War Zone is a must-read, must-have book for any clinician or researcherworking with OIF/OEF veterans. I also highly recom-mended it as a bibliotherapy supplement to mental healthtreatment of combat-related stress disorders in OIF/OEFveterans.

Reference

Sloan, L. B., & Friedman, M. J. (2008). After the war zone: A practical guidefor returning troops and their families. Cambridge, MA: Da Capo Press.

Address correspondence to Alan L. Peterson, Ph.D., University ofTexas Health Science Center at San Antonio, Department ofPsychiatry, Mail Code 7793, San Antonio, TX 78229; e-mail:petersona3@uthscsa.edu.

Fontes, L. A.Interviewing Clients Across Cultures

New York: The Guilford Press

ReviewedbyLuanaMarques,MassachusettsGeneralHospital/Harvard Medical School

I nterviewing Clients Across Cultures (Fontes, 2008) is awell-written, timely book that is likely to be

helpful to clinicians and educators who are embark-ing on the journey of cultural competency. The bookis designed to familiarize the reader with severalcultural nuances involved in conducting a clinicalinterview with individuals from different ethnicminority backgrounds (i.e., Latinos, Asians, AfricanAmericans, etc.).

Sue (1998) suggests that “one is culturally compe-tent when one possesses the cultural knowledge andskills of a particular culture to deliver effective inter-ventions to members of that culture (p. 441). Atcurrent rates of growth, nearly 65% of the U.S.population will be comprised of ethnic minorities bythe year 2050 (United States Bureau of Census, 2000),thus it is becoming ever more essential for clinicians toeducate themselves about different cultures. There areseveral documented barriers of treatment assessmentand delivery for ethnic minorities that might interferewith a clinician’s ability to become more culturallycompetent, with one noteworthy barrier being thetopic of Interviewing Clients Across Cultures: culturalbarriers to assessment.

480 Book Reviews

From the outset, Fontes stresses how important it isthat clinicians educate themselves about their patients’cultures, thus becoming more culturally competent.While the author offers a culturally sensitive perspec-tive, she is also careful to acknowledge individualdifferences among people regardless of their ethnicity,thus encouraging the reader to avoid stereotypes.

The author provides a thorough description andevaluation of each step of conducting a culturally sen-sitive clinical interview, from preparing for the inter-view (Chapter 2) and awareness of biases (Chapter 3)to educating the reader about reports and properdocumentation (Chapter 10). The in-depth descriptionof each of these stages allows the reader to evaluate allcomponents of an interview from a multiculturalperspective.

One of the strengths of the book is the extensiveexpertise of the author, which is most apparent whenshe presents clinical vignettes. After describing a majortopic (i.e., the impact of language on personality,Chapter 6), the author often provides clinical vignettesthat illustrate the information presented (p. 122). Thisallows the reader to gain a better understanding of howto adapt a clinical interview to be more culturallysensitive. The abundance of ethnic idiomatic expres-sions and cultural beliefs sprinkled throughout thebook are helpful in familiarizing the reader withdifferent cultures as well as encouraging the reader toexplore alternative hypotheses for an interviewee’sbehavior. For example, the Spanish expression, la ropasucia se lava en casa (“to wash one’s dirty laundry athome,” p.168), may provide some cultural perspectivefor a Latino patient’s hesitation to share information.Without such knowledge, a clinician might assume thatthe patient is being guarded.

Interviewing Clients Across Cultures is also likely to beinstructive for an introductory multicultural class, as theauthor provides the information in an easily accessiblemanner to readers with different levels of expertise.Additionally, to facilitate group discussions or to furtherthe reader’s knowledge on the subject, the authorpresents several questions at the end of each chapter,which are well-formulated and thoughtful. Severaltables are also available, which summarize informationand suggest ways to address cultural issues while

interviewing patients (e.g., types of interview questionspp. 74-75).

Fontes does an excellent job broaching difficult topics,such as cultural norms for alcohol use, intimate partnerviolence, and sexual assault (Chapter 8). These topics arehighly sensitive, yet the author is able to discuss them in anopenmanner by highlighting howdifferent culturesmighthave particular stigmas toward disclosing these topics aswell as ways the interviewer can becomemore comfortablediscussing these topics (p. 193).

In addition to guiding the reader through the stagesof a clinical interview from beginning to end, the authoralso discusses adaptations that would be necessary forspecial populations such as children and adolescents(Chapter 9) or in unique situations (e.g., forensicsettings; Chapter 11). Finally, the author concludes withan excellent chapter describing common difficulties incross-cultural interviews (Chapter 12). This chapter willhelp clinicians increase their knowledge of culturalcustoms and alternative reasons for why people mightbehave in particular ways (i.e., reasons behind tardiness),which may be culturally appropriate but might be initiallymisinterpreted by a Western-trained clinician who is notknowledgeable about other cultures.

As mentioned by the author, “cultural competencemay be seen as a journey with a clear direction but nodistinct destination” (p. 280). This book serves as anoutstanding springboard to launch the reader intoincreased self-awareness and multicultural knowledgewhile conducting culturally sensitive interviews, with thecaveat that this is a continuous exploration.

References

Fontes, L. A. (2008). Interviewing clients across cultures. New York: TheGuilford Press.

Sue, S. (1998). In search of cultural competence in psychotherapyand counseling. American Psychologist, 53, 440–448.

United States Bureau of the Census, (2000). Census 2000 summary file 1.Available: http://www.census.gov/Press-Release/www/2001/sumfile1.html

Address correspondence to Luana Marques, Ph.D., MassachusettsGeneral Hospital/Harvard Medical School, Simches Research Building,2nd Floor, 185 Cambridge Street, Boston, MA 02114. e-mail:lmarques@partners.org.

Accepted: February 11, 2009

481Book Reviews