August 2018: Racial, Ethnic, Cultural, and National Disparities in Counseling and Psychotherapy Outcome Are Inevitable but Eliminating Global Mental Health Disparities With Indigenous Healing Is Not



Bedi, R. P. (2018). Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome are inevitable but eliminating global mental health disparities with indigenous healing is not. Archives of Scientific Psychology, 6(1), 96-104.


SCIENTIFIC Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome exist. Greater awareness of this has resulted in many national and international initiatives, often framed in terms of moral responsibility or social justice, intended to eliminate these disparities. Such efforts include well-meant and sometimes effective attempts to culturally adapt counseling and psychotherapy. These efforts carry the implicit assumption that counseling and psychotherapy are scientifically sound, universal treatment practices with worldwide applicability that transcend national and cultural boundaries. However, according to the contextual model, individuals who are living in non-Western countries and those who are living in Western countries but are less acculturated to dominant Western norms may find the practices of counseling and psychotherapy, even when culturally adapted, to be culturally incongruent. The efficacy of these therapeutic practices is constrained by the extent to which individuals subscribe to the cultural meanings and moral visions underlying the Western institutions of counseling and psychotherapy. To the extent that they do not is the extent to which counseling and psychotherapy are not appropriate treatment strategies and to which such individuals would benefit from an alternative approach more in line with their cultural conditioning. In other words, these individuals may be no more likely to benefit from counseling or psychotherapy than a Western individual would be to benefit from a non-Western indigenous mental healing practice. Therefore, the best way to reduce mental health disparities globally is to promote indigenous healing practices in isolation and in collaboration with culturally adapted counseling and psychotherapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

Impact Statement

The professional practices of counseling and psychotherapy were developed in the Western world to address problems common in Western countries in a manner consistent with Western understandings. There is a small but growing awareness that (a) counseling and psychotherapy are cultural by-products rather than universal healing practices, and (b) counseling and psychotherapy share important therapeutic elements with many well-established indigenous healing practices from other countries. Despite these notions, counseling and psychotherapy are being exported to other countries at a high rate and often without enough scrutiny. Although this is generally done with good intentions to promote global mental health and to address differences in mental health across the world, these practices can be inconsistent with the societal values and collective beliefs of individuals in non-Western countries and can sometimes lead to more harm than good. Providing counseling and psychotherapy to such individuals would be equivalent to offering a westernized individual an indigenous healing practice from a different part of the world that does not fit within a Western belief structure. Therefore, counseling and psychotherapy may not be as effective as long-standing indigenous healing practices for individuals who do not subscribe to the assumptions, customs, cultural principles, and culturally promoted objectives that underlie the Western practices of counseling and psychotherapy. Therefore, these practices should not be always recommended in non-Western cultures. Instead, promoting traditional healers and indigenous healing practices and integrating them with culturally adapted counseling and psychotherapy is recommended to reduce international mental health disparities. (PsycINFO Database Record (c) 2018 APA, all rights reserved)