Cross-Cultural Complexities in Psychological Diagnosis and Treatment: A Qualitative Exploration among Psychologists

Abstract

The psychological diagnosis and treatment process is influenced by social norms, belief systems, and the contextual meanings of distress and is not treated as a culturally neutral process. The purpose of this qualitative study was to gain an understanding of the ways psychologists working within Pakistan have perceived and dealt with the cross-cultural complexities associated with psychological diagnosis and treatment. The research utilized an interpretative qualitative methodology, where semi-structured interviews were carried out with (n=12) psychologists currently practicing in different types of clinical settings including hospitals, private practice clinics, universities, NGOs, and rehabilitation centers. The collected data were analyzed based on thematic analysis to identify common themes. The results of the study indicate there are three main themes: cultural difference in diagnostic criteria, socio-cultural factors in the therapeutic relationship, adaptive and negotiated ways in which clinical psychologists practice. Psychologists reported that there were many difficulties within the ability to diagnose clients because of the conflict between Western diagnostic criteria and the clients' somatic, spiritual, and culturally based signs of distress. Family control over decisions for treatment, use of faith as a means of coping and the stigma surrounding mental illness, honor-related issues etc, all had a significant effect on the disclosure, diagnosis, and treatment engagement process of their clients. Psychologists used adaptive strategies such as disclosing diagnoses to their clients over time, using clients' cultural and religious values, and using an ongoing ethical negotiation process between cultural sensitivity and professional responsibility to help resolve these issues.