University of Liverpool
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My researching multilingually experience started in February 2012 when I visited Sierra Leone to train health workers there in using psychosocial interventions to support the mental well-being of the population there. Sierra Leone is a country in West Africa with a population of just under 6 million people. Between 1991 and 2002 a brutal civil war occurred in the country. It is estimated that 40-50,000 people were killed and 500,000 civilians fled the country (Dufka, 1999). I visited Sierra Leone in conjunction with the organization commit and act which seeks to give people in areas of conflict access to psychotherapeutic support, regardless of religious, cultural or ethnic affiliation, especially in countries with little psychotherapeutic infrastructure. In February 2012, over 90 health staff working with local non-governmental organisations attended workshops that we facilitated. More recently, in February 2013, I returned to Sierra Leone with other Clinical Psychologists to conduct further training. As with the previous year, over 90 people attended workshops that were organized. Further information about relating to this visit is available online (www.rosswhiteblog.wordpress.com). Working in low and middle income countries (LMIC) such as Sierra Leone can provide important opportunities for Clinical Psychologists trained in high-income countries to look afresh at the assumptions that underlie their practice. The mental health systems and services that are well established in the UK and other high income countries may be the envy of many countries across the world, but it could be argued that these systems also bring rigidity to how distress is understood. Working in LMIC settings where biomedical systems of care may be less well established, provides a tantalizing glimpse into alternative explanatory models for the distress that people experience. Although the official language of Sierra Leone is English, the most widely spoken language is Krio. This is a corrupted dialect of English that has its origins in the English spoken by the freed slaves who travelled from the Caribbean to Sierra Leone in the 19th Century. There are also indigenous languages that reflect the tribal societies in Sierra Leone. The Temne and Mende languages are the most widely spoken. The tribal languages tend to be descriptive more than abstract. This can raise problems when discussing intra-psychic phenomena such as thoughts and feelings. This serves to emphasise the importance of tuning into local descriptions of distress and utilizing those phrases. We have learned much about how to engage with Leonean people through listening to the descriptions and metaphors that they use. We have conducted research to evaluate the effectiveness of the training packages that we deliver. Although there are increasing opportunities for mental health professionals to work globally, my research experience has highlighted the importance of speaking and thinking locally.
Ref: Dufka, C. (1999). Getting away with murder, mutilation and rape. New testimony from Sierra Leone. Human Rights Watch, 11, 3.
Dr Ross White (PhD, DClinPsy) is a Reader in Clinical Psychology at the University of Liverpool. He is the Research Director on the Doctorate of Clinical Psychology training programme. He is a former Director of the MSc Global Mental Health programme at the University of Glasgow and he is a co-investigator on this project. He is also involved in research collaborations with the World Health Organization and the United Nations High Commissioner for Refugee investigating the efficacy of psychological interventions in low- and middle-income countries – particularly in the context and/or aftermath of humanitarian crises. More information can be found here. This includes an interest in the processes involved in the linguistic/cultural adaptation of psychological therapies. Ross is a co-editor of the upcoming ‘Palgrave Handbook of Socio-cultural Perspectives on Global Mental Health .