Applying Nepali Ethnopsychology to Psychotherapy for the Treatment of Mental Illness and Prevention of Suicide Among Bhutanese Refugees

Abstract

Addressing mental health needs of 100,000 ethnic Nepali Bhutanese refugees relocated from Nepal is a new challenge for mental health clinicians in the receiving countries. A limitation of current services is the lack of knowledge about cultural understandings of mental health. Ethnopsychology is the study of emotions, suffering, the self, and social relationships from a cultural perspective. Nepali ethnopsychology can be used to develop and adapt mental health interventions for refugees. We discuss applying ethnopsychology to provide safe and effective mental healthcare for Bhutanese refugees, including cultural adaptation of cognitive behavior therapy, interpersonal therapy, and dialectical behavior therapy. Psychological interventions are proposed for the high rates of suicide among Bhutanese refugees. The contribution of ethnopsychology to applied anthropology and the growing field of neuroanthropology are discussed.

Psychological resilience and the gene regulatory impact of posttraumatic stress in Nepali child soldiers

“…These relationships were independent of demographic characteristics (age, sex, ethnic status, low caste, and education) and individual differences in leukocyte subset prevalence. They also emerged in a cultural context that is likely more collectively orientated than populations previously studied in social genomics literature (36)(37)(38). Despite this collective social orientation, individual self-perceptions of personal psychological resilience were associated with markedly lower CTRA gene expression profiles, to the extent that PTSDaffected former child soldiers with high levels of self-reported resilience showed molecular profiles comparable to those of PTSDfree civilian youth.…”

Therapist competence in global mental health: Development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale

“…Explanatory models include perceptions of symptoms, etiology, and treatment seeking behaviors. Use of explanatory models and ethnopsychology (local psychological concepts) is a crucial aspect of adapting PT across cultural settings (Hinton, Hofmann, Pollack, & Otto, 2009; Kohrt et al, 2012b). A recent meta-analysis of cultural adaptation of PT found that use of explanatory models, also known as “illness myths”, was the sole moderator of superior outcomes for culturally-adapted therapies (Benish, Quintana, & Wampold, 2011).…”

“…These concepts have been used in cultural adaptation of cognitive behavior therapy and other psychological treatments in Nepal and for ethnic Nepali Bhutanese refugees (Kohrt, Maharjan, Timsina, & Griffith, 2012b). …”

A Cultural Adaptation of Dialectical Behavior Therapy in Nepal

“…Individuals with prior attempts were viewed as having reduced potential for marriage, and, along with relatives, were likely to face discrimination in social and economic sectors. Local ethnopsychological models consider suicide to result from an imbalance or dysfunction of the dimaag (brain-mind), the rational apparatus that governs cognitions as well as proper social functioning (Kohrt, Maharjan, Timsina, & Griffith, 2012). Since dimaag -related problems are considered severe and permanent, they are often associated with profound stigma (Kohrt & Harper, 2008).…”