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Article Excerpt
Turkey and India are developing countries with unique cultural characteristics. The current state of mental health counseling in Turkey and India necessitates new laws, indigenous approaches, adaptations of culture-sensitive approaches, and research projects to validate such approaches. It is the job of mental health counselors to accomplish such complicated and trying tasks in the absence of social and financial resources.
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As globalization continues to bring the world closer, it is imperative to assess the usefulness of transferring Western counseling philosophies to cultures that are very different from the West (McGuiness, Alfred, Cohen, Hunt, & Robson, 2001). The notion that counseling theories and approaches can be transported across cultures is based on certain assumptions: that human beings are similar regardless of their race, ethnicity, or culture; that theories of counseling are fairly culture-free and can be applied to most individuals; and that if therapeutic strategies are used correctly, they can work for any individual (Pope-Davis & Coleman, 1997). Such incorrect assumptions led the authors to collaborate on this article to highlight how counseling works in countries that are very different from Western countries. Although Turkey and India are becoming more Westernized, they are still different from the Western countries in terms of their culture and the state of mental health counseling. Mental health counseling is relatively unknown in these countries and is in its early stages of development.
MENTAL HEALTH COUNSELING IN TURKEY
Turkey is considered a developing country and exemplifies several characteristics of other developing countries such as low levels of education and low income per capita. Only 41% of boys and 34% of girls were enrolled in secondary schools in 2000 (State Institute of Statistics, 2000). University graduates are approximately 1% of the population (Vassaf, 1983). Similarly, income level is low with the income per capita US$2,160 in 2000 (State Institute of Statistics). Given such socioeconomic circumstances, it is not surprising that mental health counseling does not receive the attention and resources it needs. For instance, in 2002, there were a total of 398 mental health units and psychiatric wards at the government hospitals (Health Ministry of Turkey, 2002); whereas in the United States, there were 4,546 mental health units and psychiatric wards in 2000 (National Center for Health Statistics, 2004). Based on these statistics, there is approximately 1 mental health unit per 168,000 people in Turkey, whereas in the United States there is 1 mental health unit per 61,000 people. Thus, the number of mental health units in Turkey is limited for a country of 67 million people (State Institute of Statistics).
Culture and Counseling
In addition to socioeconomic circumstances, cultural factors such as collectivism versus individualism and attitudes toward counseling also have a large influence on mental health counseling. According to Mocan-Aydm (2000), "Turkish people still seem to be close to the collectivism end while at the same time striving for individualism" (p. 282). Turkish people hold cultural values that promote respect toward authority figures and tend not to question or challenge authority. Mental health counseling as practiced in the West, however, requires the client to be independent and self-sufficient. Therefore, individual counseling, during which the client is expected to find his or her own answers and the counselor is not expected to give advice, can be quite foreign to Turkish clients.
Because of cultural values promoting respect toward authority figures, Turkish clients prefer directive, action-oriented counseling approaches such as cognitive-behavioral therapy (Mocan-Aydm, 2000). Other reports support the notion that Turkish clients, especially those from rural areas with a more traditional cultural background, prefer directive, group-based interventions. Vassaf (1983) indicated that 18% of students at a university campus in Turkey were from small towns and rural areas. He added that those students held more traditional values and came from a cultural background that was less Westernized than students from big cities. Vassaf indicated that, even though the students from rural backgrounds experienced more cultural conflicts and experienced identity crises, they were less likely to seek counseling services than students from urban areas. Additionally, students from rural areas preferred counselors with a similar cultural background as theirs and did not feel understood by counselors from an urban background. Vassaf concluded that directive behavioral approaches and preventive mental health interventions were more effective with clients of a rural background.
As Vassaf (1983) suggested, Demir and Aydm (1997) reported that, although there is a high prevalence of psychological problems in Turkey, there is a paucity of mental health...
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