What is therapy like in different countries?

January 27, 2018 7:16 PM

I think I have a pretty good grasp of US-based counseling/psychotherapy. However, I've been curious lately about how folks in other countries (excluding Europe, USA, and Canada) experience psychotherapy.

What modalities are popular? What is a session like? How are therapists trained? What is the relationship between the therapist and client like? Is religion ever integrated into mainstream psychotherapy? Maybe you have the unique ability to compare and contrast? These are just some questions off the top of my head but I'm really looking for any anecdotes at all. This is just out of pure curiosity so there is no wrong answer!

Thank you!

posted by eggs to Human Relations (12 answers total)

I've seen therapists in three countries, and to be honest with you, didn't notice much difference at all. US, Netherlands, and Hong Kong. This is besides the obvious language differences. Generally accredited by local standards body, and I prefer CBT so they were all trained in that method. Not sure what you are looking for.
posted by frumiousb at 7:45 PM on January 27, 2018

I hear that Freudian analysis is still popular in Argentina.
posted by thelonius at 10:59 PM on January 27, 2018

When I was idly looking about five years ago, there was all of one clinic specialising in CBT in the Polish capital, and my regular provider only offered psychoanalysis. It's better now, I researched it for a friend last year and CBT was offered in at least a dozen places.
posted by I claim sanctuary at 2:04 AM on January 28, 2018

I know next to nothing about it, but my impression is that psychotherapy is just not a thing in a lot of places outside of the West. And there’s a stigma attached to it. People just cope... or they don’t.

Frankly, it took joining Metafilter three years ago for me to see therapy and the associated vocabulary (anxiety, OCD, ADD, etc) talked about so much.
posted by Kwadeng at 5:10 AM on January 28, 2018 [8 favorites]

Response by poster: Good point Kwadeng. It would probably be helpful for me to decolonize my ideas around mental health help... maybe expanding this question to encompass any kind of mental health guidance or non-medical treatment is appropriate?
posted by eggs at 5:48 AM on January 28, 2018 [1 favorite]

In France, a psychiatrist is the only mental health service refunded by social security, therapist, psychoanalyst etc are not covered (but can be by private or work-provided health insurance).
posted by ellieBOA at 6:10 AM on January 28, 2018 [1 favorite]

Best answer: Somewhat anecdotal, but I have talked to people providing mental health services in India as well as people from the desi diaspora that have talked about not sharing serious negative diagnosis with patients and instead focusing on supporting the patient's caregiving network who then have a deeper understanding of how to support the patient. One specific example I was given was that someone experiencing psychosis (and in denial their reality was not a shared reality) would see the medical team for a bit of talk therapy, encouragement of nutrition/good sleep hygiene/exercise. And the wife and mother would be given medication to add to food or drink under the guise of "this is nutritional". The female members of the family would be given support in how to respond to statements and behaviours that validated the patient's feelings without encouraging them. Because of the stigma of mental illness the patient apparently recovered quicker without ruminating on a diagnosis of schizophrenia etc

This came up because when my husband was in (diagnosed) deep psychosis, with hallucinations and delusions, his medical team relied exclusively on his distorted self-reports, refused to accept any of my statements (even though I kept repeating I didn't need any feedback/them to violate patient privacy/i didn't need to recieve updates etc). When I FINALLY got a meeting with the head of his medical team after six weeks of inpatient care I discovered they were focused on minor events that were delusions and unaware of the trauma that contributed to his breakdown because he was too ashamed/in denial about it.

Covert medication and the impact of cultural ideas about individuality vs family collectivism are discussed in this paper.
posted by saucysault at 7:10 AM on January 28, 2018 [18 favorites]

Best answer: You may enjoy the book Crazy Like Us, which is about the globalization of American conceptions of mental illness. It includes lots of interesting info about how approaches to mental health vary/varied across cultures.
posted by introcosm at 10:06 AM on January 28, 2018 [5 favorites]

Spiritism and mental health has some useful descriptions.
posted by SyraCarol at 12:22 PM on January 28, 2018

Best answer: I asked a very similar question nearly a decade ago on the green!
posted by Keter at 10:16 PM on January 28, 2018 [1 favorite]

Yes, in France only psychiatrists are covered. That said, therapists and analysts are much, much less expensive than in the US. 50 euros for a 45-minute session with an experienced therapist who has a medical background and PhDs, for instance. Also, reimbursement is not diagnosis-based; diagnoses are much less fraught. My own therapist approaches treatment very holistically, which has been key in my healing and progress. She's never officially diagnosed me with anything (and nor have I asked her to), though of course we've talked about depression and trauma.

I haven't encountered much stigma in France. People talk about therapy rather openly – but admittedly I'm in a particular context filled with educated folk.
posted by fraula at 12:22 AM on January 29, 2018

The person I recently lived with in Russia told me that US-style medication and therapy for mild depression doesn't exist at all there. Hence she conceives her role as (private) teacher to include sympathetic listening and counseling. I don't know about the more severe cases.
posted by ck49 at 7:04 AM on January 29, 2018