taxonomic approach to depression is intended for making clinical distinctions that separate depressive states from other possible disease conditions . . . That means the professional's task . . is to correctly identify clinically recognizable symptoms lurking beneath . . . personal idiosyncrasies and unique life experiences . . . Whatever the value of these categorizations in diagnosis, they can only serve as very preliminary guides to understanding . . . especially in individuals whose cultural history is different from that of the clinician or the authors of [the manual] (1995, p. 126).
The social worker must take care, especially when dealing with clients whose ethnic and cultural backgrounds differ from those of the white Anglo-Saxon majority, to consider ways in which that differing background may produce behavior that inadvertently fits a recognized diagnosis. The worker must also exercise caution in cases where the client's symptoms are not textbook examples of a given disorder that is, nevertheless, appropriate (see Austin, 1991).
Christopher S. is a 28-year-old African American male who has been diagnosed HIV positive. He has also been diagnosed as suffering from depression, and it is for this that he has come into treatment. Born and raised in a mid-sized southern city, Christopher's family is middle class. His father works as a mid-level manager for a major package delivery service. His mother is a registered nurse in one of the city's largest hospitals. Christopher is the youngest of three children. His older brother is a legal aide who lives near his parents. His sister, Janelle, works for an insurance company. She lives with her husband and son in Los Angeles, near her husband's family.
Christopher was a moderately good student in school, though something of a loner. His growing awareness of his homosexuality separated him from his peers at a crucial period in his adolescence, making him feel isolat...