Counseling cross-culturally

Just as in our home countries, in the fragile, central Asian country where I live and work, there is a growing realization of how important mental health is. Years of war and high levels of stressful life experiences like poverty and family violence mean more than 50% of the population here live with high levels of distress. Available services for mental health are in short supply: until recently there were very few trained counsellors and a handful of psychiatrists.

The need is huge, but what is it like for a counsellor or mental health professional to work in such a context?

The short answer is that there are many similarities to working in our home countries and a few added challenges. For example, communication skills remain key to effective counseling. However, there are obvious language barriers; slightly less obvious are the differences in style and content of communication. Where I work is a very indirect culture; people rarely say what they actually think or feel, which means workers here need to learn to pick up on the indirect cues and work hard to build trust so that people can share freely. Another area of challenge is adapting from working in a very individualistic culture to working in a very collective culture. This can raise issues of confidentiality and the need to work often with the wider family or in groups. A difference that I have noticed personally is the very high levels of traumatic incidents that people here have been exposed to. This has implications for the types of counseling that may be helpful, as well as meaning that it is vital that the counselor has a way of processing all the sad and awful stories they are exposed to in a typical day.

There are many other differences that can be discovered as you work, all of which make you a more effective cross-cultural communicator of the good news of Jesus as well as a more effective counsellor. My final point is that it is likely that as well as delivering counseling yourself, you will be expected to train and supervise local staff. It is a huge privilege and responsibility to influence the clinical practice of local mental health staff and gives an opportunity to lay good foundations that last long after you have left the country.

Counselor, Central Asia

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