21st Century Psychology

Older approaches to clinical psychology don't cross cultures very well...
20 October 2023

Interview with 

Brigitte Khoury, American University of Beirut


Clinical psychology therapy session


Many argue that the world has shrunk, and as a population we’re now more mobile than we’ve ever been. One consequence of that is that the patients sitting down in front of healthcare practitioners will very often have originated from a very different culture or geography than the practitioner themselves, which can impact on the way the treatment needs to be approached. Particularly when it comes to clinical psychology, as Chris Smith hears from the American University of Beirut's Brigitte Khoury…

Brigitte - Education and training in psychology has been quite archaic and traditional and does not really meet the needs of the 21st Century. Meaning that what we think needs to happen is that there needs to be a revamping of psychology programmess, especially graduate programmes, people going for their Masters or their doctorate programs who will be practicing, or who will be teaching, or who will be working on policies. So the students who graduate from the more traditional programmes are not really equipped and have the skills required for what is needed now.

Chris - We could have just upset the people running courses in clinical psychology the world over with what you just said! What's the evidence, <laugh - we will> probably; what's the evidence that what you've just said is the case though? That the courses are not 21st Century ready?

Brigitte - Because the needs are different. I think many psychology programmes started 50 years ago, and I don't think they have really been updated and the needs are very different. For example, one of the main needs that we have now are social justice and human rights. We have global migrations everywhere in the world, and it is said that clinical psychologists or practitioners would at some point in their life be giving service for somebody from a different country. But many, many psychologists are not trained nor equipped to actually offer these services. And when you are trained in a certain theoretical and more or less western framework, because this is what most programmes are, even those in non-Western countries, they still rely on Western theories. Then we are not really preparing people to service people who are asking for help from other parts of the world.

Chris - Are you saying that the kinds of problems that a practitioner will encounter are going to be different because of the 21st Century, or are you saying that the patients present differently because they'll come from different backgrounds and people need to be equipped to handle that?

Brigitte - I think all of the above, partly is that yes, the problems that are faced now are different: disasters, violence, pandemics. So we have people who are coming in with different problems than, you know, what necessarily are the run of the mill usual you know, maybe mild anxiety, mild depression that people are trained in. But also we have people who come from different backgrounds, different cultures, which actually impact and affect how these problems present, but also how to treat these problems, which are not necessarily what psychologists or early, you know, early career psychologists are learning in their programmes.

Chris - So you're advocating for some kind of global framework then where people are made a bit more worldly with their clinical psychology training so that they can put themselves in the shoes of people from across the globe rather than just the nextdoor country.

Brigitte - Putting themselves in their shoes is a bit too much of an expectation, but at least being knowledgeable, being aware of different cultures and being open to actually learning about these cultures and being able to ask and say, you know, how can I help you best? But also there's another reason for that is that recently we have seen more a global movement of psychologists, meaning that more and more psychologists now are asking and wanting and interested to work outside their countries or where they trained, especially when there are areas of disasters or where more mental health services are needed. We see an influx of people who are interested to travel to these countries and offer their services. And it's coming from a very good place, of course, except that they arrive and they are not really equipped to offer these services.

Chris - Do you have any practical tips for how this should be implemented then? Because it, it sounds on the one hand pretty simple: we need to make sure people are more cognisant of more worldly of what's what's happening in different countries and to different people. But the devil's always in the detail with these sorts of initiatives and getting them to happen and getting everyone on board is really, really difficult.

Brigitte - Absolutely sounds very simple, but it's actually quite complicated. For example, one of the things that I always encourage my colleagues who want to travel to different countries, I always tell them, please try to read a bit about the history, the sociopolitical background of the country and the cultures and the religions and everything that makes that country what it is. I'm not saying, you know, they need to sit for a one year long course, but at least to be cognisant and aware of the different issues, problems, ethnicities, cultures that exist in that country. Or, and I always encourage that, I always say try to make connections with colleagues who are from the country you're interested in. There are many in universities that you can access now. Send some emails and say, look, I'm interested. I'd like to visit to how can I help? What can I do? And this is really a great segueway into that culture and that country because then you have a colleague who's on the same level and understands your lingo and, and where you're coming from. But at the same time as a mediator between the migrating or the traveling psychologist and the one who was in their home base.

Chris - How has this gone down with your colleagues and coworkers when you stand up and say this kind of thing? Are they receptive? Are they warm to the idea?

Brigitte - Absolutely. I mean, many, of course, not everyone, but many are very interested and many people who also work in global mental health and international psychology, they realise the shortcomings of the new generation of psychologists who are very interested, very open, kind of, you know, the world is their cocoon, but they are not equipped to be, be able to function in these capacities or in different places that they'd like to go to. So many are interested, many are willing to experiment in different ways and introducing different courses in their training programmes and possibly having maybe MOUs with training programmes outside their programme and send students three months, six months to experience different cultures and mental health. We've had that happen at our university. We've had MOUs from several universities and we've received their students at our programme. So some are very open, of course some resisted a bit more. And I understand they still believe that there needs to be the traditional training of psychology, which is as important of course, and is the basis of the learning and the teachings of psychology. But we cannot restrict ourselves only to that. And we need to start basically preparing psychologists for the 21st Century.


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