Psychic retreats in other places: Clients who seek healing with traditional healers and psychotherapists1

Parental Perceptions of Autism Spectrum Disorder in Latinx and Black Sociocultural Contexts: A Systematic Review

Parents of children with autism spectrum disorder (ASD) face challenges in accessing diagnostic and treatment services; these challenges vary by race, ethnicity, and culture. This systematic review examines parental perceptions of ASD within Latinx and Black American communities. Findings indicate that interconnections with family and religious groups promoted positive coping and describe positive impacts of having a child with ASD. Relative to White families, community members reported reduced access to information and more inaccurate beliefs about ASD, higher levels of ASD-related stigma, and more negative experiences with healthcare providers, which serve to exacerbate healthcare disparities. Conclusions are limited by an underrepresentation of minority groups in research. We call for efforts to address the specific needs of racial and ethnic minorities.

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards.

Cultural competency in the treatment of obsessive-compulsive disorder: practitioner guidelines

This article provides clinical guidelines for basic knowledge and skills essential for successful work with clients who have obsessive-compulsive disorder (OCD) across ethnic, racial and religious differences. We emphasise multiculturalist and anti-racist approaches and the role of culture in shaping the presentation of OCD in clients. Several competencies are discussed to help clinicians differentiate between behaviour that is consistent with group norms versus behaviour that is excessive and psychopathological in nature. Symptom presentation, mental health literacy and explanatory models may differ across cultural groups. The article also highlights the possibility of violating client beliefs and values during cognitive behavioural therapy (CBT), and subsequently offers strategies to mitigate such problems, such as consulting community members, clergy, religious scholars and other authoritative sources. Finally, there is a discussion of how clinicians can help clients from diverse populations overcome a variety of obstacles and challenges faced in the therapeutic context, including stigma and cultural mistrust.

Key learning aims

(1)

"How Can We Help You": Mental Health Practitioners' Experiences of Service Provision in Northern Namibia

Although 12-13% of Namibians are reported to struggle with psychological distress, very few practitioners are available to provide mental health services in Namibia. Those practitioners who are available are often trained from Western counseling and psychiatric perspectives that may not readily align to beliefs about illness held constructed in Namibian cultures. Institutional effort is invested in the education and use of mental health practitioners, including counselors, social workers, nurses, psychologists, and psychiatrists. However, little is known about the experiences of these providers. Therefore, this study, a grounded theory ethnography, was undertaken as part of broader ethnographic work to understand how mental health practitioners (N = 7) in Northern Namibia view their work with Aawambo Namibians given that Namibian mental health practitioners are few but embedded in the country's health care system. Four categories were identified in analyses: Provision of Mental Health Services in the North, Practitioners' Conceptualizations of Psychological Distress: Western and Aawambo Influences, Beliefs about Mental Health Services in the North, and Integration of Traditional Treatment and Counseling. Results are discussed with respect to cultural competence in Namibian mental health practice and potential for integrating traditional practices and mental health services.

The meaning of acceptance (Thum-jai) in Thai people: Letting it go…so life goes on

The purpose of this qualitative study was to explore the meaning of acceptance (Thum-jai) as a culturally embedded coping strategy in the lives of Thai people who have experienced adversity that caused suffering. Thematic analysis was used to examine the responses of 47 participants to written, open-ended questions or face-to-face interviews. The EQUATOR's COREQ checklist for qualitative research was followed. Participants came from diverse religious' traditions and geographic regions throughout Thailand. Findings revealed seven themes: circumstance and emotion; thought and action; time, experience, and effort; social and moral support; religious and spiritual ethos; acceptance and hope; and survive and thrive. The adverse circumstance is central to the concept of acceptance. Before acceptance, there is often hope; yet Thai people reach an existential point whether to accept the reality of the situation or continue in distress. Purposeful approaches to deal with the event flow from the cultural contexts of spirituality and social support. Drawing upon psychological strength, Thai people undertake purposive thought and action to facilitate redirecting their lives for better mental health. Thum-jai brings release and peace of mind. Clinicians may find that people experiencing adverse life events are best served by nondirective approaches. Acceptance and change in thoughts and behaviours may come from meditation and therapeutic mindfulness practices that allow those in Western and non-Western cultures to use their own values, expressions, and societal expectations to cope with suffering and formulate effective decisions.

Help-seeking from indigenous healers among persons of African ancestry in the United States: Ethnic and racial disparities in mental and physical health

OBJECTIVE

Racial disparities in mental and physical health status are a persistent problem for people of African ancestry in the United States (U.S.). The current study seeks to determine whether indigenous help-seeking is related to ethnic and racial differences in health problems in persons of African ancestry.

METHODS/DESIGN

Complex sampling produced a nationally representative sample of 3570 African Americans, 1623 Caribbean Blacks, and 1006 non-Hispanic Whites. All 3750 African Americans, 1438 (88.6%) African Caribbeans, and 891(88.6%) European Americans had relevant data for the current study. Respondents to the National Survey of American Life (NSAL) were studied with structural equation modeling (SEM) to evaluate a model of help seeking from "faith healers," "herbalists or rootworkers," or "astrologists or psychics." Mental and physical health were predicted by this indigenous help-seeking.

RESULTS

Consistent with the hypothesis, SEM analyses indicated better model fit for African Americans with greater similarly to African Caribbean respondents (r = .901, p =  .001) than European Americans counterparts (r = -.332, p =  .382) in measurement models. These analyses also showed African Americans' indigenous help-seeking was negatively correlated with lifetime diagnoses of any DSM psychiatric disorders but positively correlated with burden of chronic diseases. The association between indigenous help-seeking and professional diagnoses of chronic diseases was negative for Caribbean Blacks.

CONCLUSION

Culturally competent psychological or medical services by Western practitioners to people in the U.S Black population require attention to indigenous healing systems.

Cross-Cultural Research on Psychotherapy: The Need for a Change

Psychotherapy models, some of which now have a history over a century, have been practiced worldwide. However, considering that the most prevalently applied psychotherapy models are the products of Western culture, questioning the extent of these models’ effectiveness and efficiency for people belonging to diverse cultural backgrounds is legitimate. No doubt, ethno-cultural groups living in Western multicultural societies will interact with Western culture more deeply compared with people living in non-Western countries; therefore, to also think that their needs will differ is reasonable. In this case, the quantity and quality of the required adaptations may also change. Although a promising number of studies exist on intercultural adaptations necessitated by the needs of multicultural societies, the literature on the effectiveness of these models in the non-Western world and the local psychotherapy models is quite limited. One important question is whether psychotherapy models can be adapted to address non-Western cultures without transforming their fundamental assumptions, and if so, can this be conducted efficiently? With these questions in mind, the aim is to review the current state of scientific studies on psychotherapy practices in various cultures. In addition, considering the large spectrum of cultural migration taking place in modern days and the difficulty of receiving mental health services in underdeveloped countries, the importance of adapted and local psychotherapy research has been emphasized and some suggestions for consideration in future research have been made.

Mental Health in Namibia

Psychological distress is inherently constructed within contexts and the unique, cultural meaning systems that have developed to understand mental illness. Moreover, cultures naturally develop their own systems of healing, grounded in traditional practices. Western psychology and psychiatry have, through globalisation and colonial histories, imposed systems of mental health care and definitions of mental illness. In doing so, local understandings and ways of being regarding mental health have often been eclipsed. This is no less true in Namibia. However, much of the existing mental health literature from Namibia explores mental illness from a Western lens of psychopathology. This article discusses the relevant research about mental illness in Namibia and situates this within related literature from other Southern African countries. Several cultural factors across diverse groups in Namibia are important to more fully understand what mental illness and treatment are throughout this country. The cultural role of diverse conceptualisations of mental illness is discussed in order to explore potential areas of growth in Namibian mental health and intervention. The nature of traditional healing in other Southern African contexts is also addressed, given that although traditional healing exists in Namibia, researchers have not yet explored it within the context of psychological distress. Recommendations for mental health and psychological treatment in Namibia are discussed.

Counterflows for mental well-being: what high-income countries can learn from low and middle-income countries

Global mental health is a comparatively new area of study and research that is concerned with addressing inequities and inequalities in mental health provision across the globe. In recent years concerted efforts have been made to scale up mental health services in low- and middle-income countries (LMIC). As such, there has been tendency to view LMIC as recipients of mental health-related knowledge, rather than providers of knowledge. Critics have referred to the prevailing flow of information from high-income countries (HIC) to LMIC as a form of medical imperialism. To redress the apparent imbalance in knowledge exchange, this paper reflects on valuable lessons that HIC can potentially learn from LMIC in terms of supporting mental well-being. Specifically, the paper reflects on how a greater willingness to embrace pluralism in HIC may facilitate people to engage with forms of support that they believe to be appropriate for them. The paper also explores examples of what are termed 'counterflows' of knowledge; ideas that have originated from LMIC that are influencing mental health-related practice in HIC. Barriers to potential counterflows are discussed.

Why breast cancer patients seek traditional healers

Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or "bomoh" at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.