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Global Public Health
An International Journal for Research, Policy and Practice
Volume 9, 2014 - Issue 10
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Original Articles

A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy

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Pages 1211-1224 | Received 30 Oct 2013, Accepted 17 Jun 2014, Published online: 10 Sep 2014
 

Abstract

Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

Funding

This work was supported by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education; the University of Georgia Graduate School Deans Award, Social Sciences; University of Houston-Clear Lake Faculty Support Research Funds [grant number 1041].

Additional information

Funding

Funding: This work was supported by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education; the University of Georgia Graduate School Deans Award, Social Sciences; University of Houston-Clear Lake Faculty Support Research Funds [grant number 1041].

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