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The relevance of psychology in South Africa has been scrutinised, due to the fact that dominant psychological theories and practices in this country are rooted in western, Eurocentric ideas about mental health. This means that the mental health services provided via mainstream psychology is only beneficial to the white, middle class, and ultimately inappropriate and irrelevant to the needs of the majority black population in South Africa (Hickson & Kriegler, 2001) Western psychology tends to be “culture-bound and culture-blind; alien to the thinking of Africans; irrelevant for the spiritual dimension in the lives of many black people; as well as uncharacteristic of the behaviour of blacks and often detrimental to the helping process.
(Hickson & Kriegler, 2001, p. 784)
Psychologists who operate using theories based on this monocultural perspective, assume that it can be applied to all populations, which has been referred to as the assumption of universality, whereby the Eurocentric view is regarded as the only view (Naidoo, 1996) In order to redress this issue and implement some sort of positive, lasting change, Western psychology should be analysed, starting from a theoretical perspective.
When it comes to the theories that psychology in South Africa is based on, it is evident that those theories subscribe to international trends, such as feminism and post-structuralism, yet we have been unable to create any of our own that are unique to South Africa and that can be applied to this socio-political context (De la rey & Ipser, 2004) Psychological theory is too deeply imbedded within ‘hard’ science frameworks such as psychometric, psychiatric and neuropsychological (Macleod, 2004) It is also predominantly curative and stems from individual-focused theories.
This conceptualisation of psychological distress as an illness occurring within an individual, overlooks any external or environmental factors that may have contributed to that distress (Ahmed & Pillay, 2004) In a country that is struggling with poverty, violence and HIV/AIDS, this notion seems completely illogical. It is evident that psychological theories have been decontextualized in this regard. Professional Issues South Africa has a population of over 40 million people, 90% of which are blacks.
The lack of skilled, black psychologists is problematic in this regard, due to the assumption that black patients need black psychologists. Another issue here is language diversity. English and Afrikaans have a much higher profile than any other language in this country, despite the fact that there are eleven official languages. This poses a problem, because not only are there a lack of black psychologists, but only a marginal number of psychologists are able to consult in any of the nine African languages.
This language barrier could potentially leave a significant amount of people without access to psychological services, due to psychologists either consulting in their language of preference or avoiding consultations with non-English speaking patients (Ahmed & Pillay, 2004) Ethical issues have also arisen about universities finding it acceptable to implement training programs, where their clinical psychology graduates will go on to provide services to a majority that will require the use of translators (Pillay & Siyothula, 2008) Hence, recruiting first-language African language speakers into psychology training programs is essential (Ahmed & Pillay, 2004) Training Issues It is evident that more black psychologists need to be trained in South Africa.
African students have been historically disadvantaged, and as a result have encountered difficulties in entering not only the field of psychology, but other areas as well. In order to cater for majority of the population, people who speak African languages need to be recruited. During apartheid, training programmes were reserved almost exclusively for whites (Pillay & Siyothula, 2008) Of course no action was taken at the time to rectify this, which resulted in psychology inadvertently playing a role in apartheid policy. It is suggested that this may still persist today, to a certain degree, considering the very small number of black clinical psychologists that are registered with the Health Professions Council of South Africa.
The list of registered clinical psychologists indicated that 307 were black, out of a total of 2295 (Pillay & Siyothula, 2008) Some tertiary institutions have trained more black clinical psychologists than others, in order to understand the reasons behind this; we need to look at the institutions themselves. Universities’ selection and training of black students must be looked at from a contextual perspective, namely that of South Africa’s social, political and educational history. According to Pillay & Siyothula (2008) there are three broad groupings which encompass the universities in the country – the traditionally English-speaking universities, the traditionally Afrikaans-speaking universities, and the historically black universities. These institutions have selected and trained clinical psychology students accordingly, based on their social and political agendas.
So we can assume that most of the black students were selected by the historically black universities, and it is these types of selection policies that reinforce existing inequities (Pillay & Siyothula, 2008) especially when one considers the fact that all university programs were expected to aim to ensure that at least 50% of any class is black (Eagle, 2005) Research Issues When it comes to research in psychology in South Africa, the issues that are primarily responsible for the distress of most of the majority population in our country, is simply overlooked. Many professionals have remained indifferent about the issues surrounding race, poverty and HIV/AIDS, which seems rather ludicrous when one lives in a country that is crippled by these issues.
During the 1980s, when the relevance of psychological theory and practice was first called into question, the South African Journal of Psychology contained the lowest proportion of articles that dealt with race (Macleod, 2004) The field of psychology has undergone many changes since then, however some problems continue to persist in the post-apartheid era. Psychological research appears to be dominated by quantitative research, based primary on ‘hard’ science theoretical resources and scientific objectivity (Macleod, 2004) Only a small proportion of studies have shed some light on the complex relationship between the individual and their socio-political context. A situational analysis was conducted to determine what type of research was being conducted within the field of psychology. It revealed rather interesting results.
When juxtaposing the articles found in PsycINFO, with the articles found in the South African Journal of Psychology, it was found that HIV/AIDS had the highest profile in the international arena, but a relatively low one in South Africa. Also, violence, crime and trauma appear in the international forum but are not found in the SAJP (Macleod, 2004) The low percentage of articles on race and racism illustrates that mainstream psychology has taken on an apolitical stance in this country, with authors regarding race as an unproblematic category, therefore critical assessment of this issue is seen as unnecessary (Macleod, 2004) Furthermore, the actual research being conducted for the SAJP has been found to be somewhat skewed, with 64. 3% of studies being conducted in the three wealthiest provinces in the country – Western Cape, Kwazulu-Natal and Gauteng.
The research also appeared to be biased in terms of socioeconomic status and class, with 56. 8% using only middle-class participants, 25% from a range of socioeconomic backgrounds, and only 18. 2% from working class or poor backgrounds. This is highly problematic, considering the fact that 48. 5% of the South African population are below the national poverty line. When looking at the figures, it indicates that authors tend to remain indifferent about the socioeconomic issues and the way in which it impacts people’s lives, seeing as the individuals who are most affected by these issues, are exceedingly underrepresented in the studies that are being conducted (Macleod, 2004) Critical Evaluation
As I mentioned earlier, psychological theory has been regarded as Eurocentric, culture-blind and a service provision that is only appropriate for the needs of the white minority in South Africa. In order to redress this issue, theories need to be evaluated and innovative strategies implemented, with the aim of developing theories that are more accustomed to dealing with the sociocultural issues in this country. A sort of indigenization of psychological theory in South Africa is paramount to improving the mental health of the disadvantaged majority. Mental health services for black people in this country are inferior and characterised by inequality (Hickson & Kriegler, 2001) and in order to address this, psychology has to be tailored to suit their needs, starting with the theoretical framework that it is based on.
There is a call for the development of theories that will challenge and transform the existing mainstream ones (Ahmed & Pillay, 2004) There is a need for South African researchers to have a critical understanding of the applicability of their theories, in light of the sociohistorical context of South Africa, which will enable them to adapt and modify their approaches accordingly. Furthermore, the unique socio-political context in South Africa creates an avenue to not only contribute to theoretical debates locally, but globally as well (Macleod, 2004) The theories being utilised by practitioners need to be critically analysed, in order to determine how it translates into the reality of their specific practice (Watson & Fouche, 2007) When one thinks about the majority black population in South Africa, a significant factor that always tends to arise is culture. And the question at hand is whether or not cultural sensitivity should be integrated into existing theoretical frameworks, and if so, to what extent?
The problem here is that it may perpetuate the difference between black and white people and the integration of culture into psychological theories may in fact serve as a means of ‘othering’ the black client. Culture will then be seen as something that is in opposition to that which is the norm, which in this case would be the white minority (Eagle, 2005) It would also mean that psychologists would be encouraged to directly associate cultural differences with race differences, and this reductionist view is ultimately unrealistic. Yet it remains an integral part of mainstream thinking, and not only in the mental health field. As I mentioned earlier, the assumption is that black patients need black psychologists.
One would assume that this is not only for the purpose of providing mental health services in the mother tongue of the client, but to also provide the client with someone that they can easily relate to and someone that they can regard as their equal. I also mentioned previously that culture within a South African context is often associated with race differences, namely Black culture. But in this country it is also associated with the sort of socioeconomic background that many black people in South Africa come from, and in this sense culture can sometimes be linked to poverty or material deprivation (Eagle, 2005) When working with economically and socially deprived clients, is simply providing them with someone of their own race, going to efficiently assist them with their mental health issues?
The fact that black clients will relate better to black practitioners is a given, and according to Ahmed and Pillay (2004) strategies should be implemented with the aim of providing mental health care in a language that the client understands and speaks fairly well. However, apart from the language factor, the nature of the interaction itself may perpetuate the sense of inequality between the client and practitioner, as opposed to eradicating it. “Clinical practice concerns about this kind of ‘culture’ centre around whether clinical interventions are suitable at all” (Eagle, 2005, p. 51) Around the same time that the relevance debate arose, some psychologists turned to community psychology as a means of redressing the lack of access that the majority had with regards to mental health services.
This systemic approach that is focused on prevention strategies as opposed to curative strategies, may be able to assist the disadvantaged majority on a much larger scale and will enable psychologists to address the social ills that the country is presently facing (Watson & Fouche, 2007) Another strategy would be for psychologists to collaborate with traditional healers, since many members of the black population tend to opt for the services of traditional healers and sangomas, as opposed to mainstream mental health services. Clinicians may have to come to terms with the limitations that their methods and practices may have in a South African context.
Not only have clinicians often referred their tradition orientated clients to traditional healers, but some have even trained to become traditional healers themselves (Eagle, 2005) Although this may be with good intentions, it can also be problematic when one has to grapple with the concepts of both traditional and clinical practices, which ultimately can create confusion for both the client as well as the practitioner (Eagle, 2005) There also may be tensions between traditional healers and mainstream mental health workers, as both may be struggling to establish how they can exist alongside each other within the same field. But finding some sort of common ground may be beneficial for their clientele base and create a collaborative avenue that can be easily accessed by anyone seeking mental health services (Stead, 2002) Training in psychology continues to reflect a predominantly white membership.
The need for recruiting those that are historically disadvantaged into training programs is consistently echoed (Ahmed & Pillay, 2004) Yet enormous constraints are imposed on those from disadvantaged backgrounds that want to enter into training programs. This can be traced back to the primary and secondary education sectors, whereby a lack of resources in schools, produced students that were ill prepared and unable to meet the strict demands and criteria of tertiary education. Therefore, efforts to rectify these issues should focus primarily on secondary and primary education levels, as opposed to attempting to address it at a tertiary level, where it is most likely to lead to a case of being too little, too late.
Equipping students with the kills to bridge the gap between their schooling systems and higher education is essential in this regard (Pillay & Siyothula, 2008) “Psychological training in South Africa needs to reflect the needs inherent in a traumatised society, and the vast problems presented by a Third World community” (Hickson & Kriegler, 2001, p. 787) Yet the focus of these training programs still seems to be on individual, curative work that is based predominantly on Western values. The inability to engage with the socio-political issues facing the country, will ultimately impact the way in which they will eventually treat their clients (Ahmed & Pillay, 2004) It has been suggested that in order for students to be able to fully the grasp the severity of the issues at hand, they need to have experienced it themselves to some extent.
But what constitutes ‘life experience’? This brings us back to culture, whereby experiential knowledge may take precedence over other types of knowledge production, as it enables those individuals to produce knowledge via their position within that sociocultural context, and use it in a way in which it will add to their learning experience in a positive way. However this could be problematic in the sense that white students may not be in a position to make useful contributions of knowledge, due to the fact that they may be seen as lacking this “life experience” which may in fact perpetuate the racial division between black and white students (Eagle, 2005)
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