Group counseling and psychotherapy across the cultural divide: the case of Ethiopian Jewish immigrants in Israel

Cultural Aspects of Health care for Ethiopian Jewish Immigrants in Israel: A Literature Review

The unique health-related traditions, perceptions, and communication patterns of Ethiopian immigrants are challenging to Israeli healthcare providers who are trained in western medicine. The aim of this review was to conduct a survey of traditions, beliefs, and symptom reporting by Ethiopian immigrants and culturally oriented interventions to improve the care of Ethiopian immigrants. We used the keywords "Ethiopian immigrants Israel" and "Ethiopian Jews." Of 418 articles initially retrieved, 35 satisfied the inclusion and exclusion criteria. We described health-related traditions and their possible complications. Possession syndrome was frequently misdiagnosed as a neurological or psychiatric disorder. The medical staff was unfamiliar with these health and illness beliefs, somatization patterns, and the communication style of Ethiopian immigrants. There were successful interventions that involved liaisons from the Ethiopian community and community-based educational activities. Medical professionals working with African immigrants worldwide can use the Israeli experience to develop effective, culturally oriented interventions to optimize the health care for these immigrants.

Psychodynamic psychotherapy and global health

This study surveys and examines the literature about psychodynamic psychotherapy in low and middle income countries. Although much has been written on this topic, the literature remains disjointed, unsystematic, and lacks randomized controlled trials. This trend is in stark contrast with a growing body of systematic literature and randomized controlled trials that exist in other types of psychotherapy used in low and middle income countries. While there is evidence that other types of psychotherapy are useful in these countries, questions remain regarding the implementation of psychodynamic psychotherapy. Is psychodynamic psychotherapy relevant to non-Western cultures? Are changes necessary to make it relevant? Is psychodynamic psychotherapy economically feasible in low and middle income countries? Although definitive answers to these questions do not yet exist, as psychodynamic psychotherapy is open-ended and client-centered, it is likely to be flexible across a wide range of cultures.

From Winnicott's potential space to mutual creative space: a principle for intercultural psychotherapy

This paper suggests that elaborating Winnicott's idea of "potential space" can provide a conceptual approach to psychotherapy across the cultural divide. The first part of the paper discusses the general problematic of intercultural psychotherapy. This is illustrated with an account of therapeutic work with Ethiopian Jews who have migrated to Israel. There is a significant gap between the Ethiopian cultural codes relevant to psychotherapy and those of the Israeli therapist, who is usually trained in the Western psychotherapeutic tradition. A meaningful and effective therapeutic process can take place if psychotherapist and client cocreate a "mutual creative space."

Psychotropic drug use in Israel: results from the national health survey

BACKGROUND

Despite increasing psychotropic drug prescriptions worldwide, little is known about utilization of these medications in the general population in Israel. We examined psychotropic drug use in the general population of Israel and the patterns of use among individuals with different DSM-IV diagnoses of 12-month mental disorders.

METHOD

A representative sample was derived from the National Population Register of noninstitutionalized residents aged 21 and older. Face-to-face interviews were conducted from May 2003 to April 2004. Individuals were asked about any psychotropic drug use in the past 12 months. DSM-IV disorders were assessed using a revised version of the World Health Organization's Composite International Diagnostic Interview.

RESULTS

Psychotropic drug utilization was observed in 6.9% of the general population and in 19.6% of individuals with any 12-month psychiatric disorder. The extent of use varied according to sociodemographic variables and the specific DSM-IV diagnostic categories. Among individuals with a 12-month diagnosis of pure major depression, only 13.6% received any antidepressants within the same period; exclusive use of antidepressants was 5.7%, while 3.3% of the individuals used only anxiolytics.

CONCLUSION

Similar to findings in other European countries, our findings suggest that the majority of individuals diagnosed with a common mental disorder are not being treated with psychotropic drugs or are being inappropriately treated.