A neurofeedback protocol to improve mild anxiety and sleep quality.

strong family bonds can perceive mental disorders as something that would expose the family and affect its reputation. Structural-contextual barriers in Brazil include the lack of access to appropriate and culturally sensitive mental health services, due to the lack of staff members who understand and speak languages other than Portuguese, and the very small number of workers from minority groups or trained to work with people from different ethnic and cultural backgrounds. Brazil’s political and racial context could also affect the capacity of adults and children to trust the mental health system to help them, especially among undocumented immigrants. These barriers are even more complex in small municipalities and far from major centers. Reducing barriers to care and providing culturally appropriate mental health services is a significant challenge for professionals, policy makers, and migrant and refugee advocacy organizations. To cultivate best practices in assessment and diagnosis, clinicians could take various steps to examine consciously and take into consideration the extension of cultural and linguistic differences between patients and the predominant culture of Brazil. One way to do this is to recognize the dynamic nature of culture and incorporate cultural variables at all stages of the assessment process, e.g., by using culturally sensitive interviews or collecting data on acculturation, religious practices, racism/discrimination, and cultural values. The use of a contextual approach that takes the explanatory models of patients into account, and whereby patients could understand the medical hypothesis easily, would also be useful, as would assessment of the possibility of culture-related syndromes. Finally, for mental health professionals to have access to translators and work in partnership with the different cultural communities would greatly benefit the health services and help meet the needs of the growing number of immigrants and refugees in Brazil.