Barriers and challenges in the practice of multicultural counselling in Malaysia: A qualitative interview study

Counsellors face a lot of problems and stressors in their daily lives. As a person, counsellors may face challenges to deal with their personal expectations and responsibilities in life, work, family and community. As a professional, counsellors may face difficulties in dealing with professional issues and ethical dilemmas in their professional practice such as countertransference and value conflicts. These raise issues concerning their perceived multicultural competence and the adequacy of their training. Informed by a multicultural counselling perspective and drawing on semi-structured interviews with 12 professional counsellors in Malaysia, this study discusses the types of barriers and challenges faced by Malaysian counsellors and how these challenges were manifested and addressed in the cross-cultural counselling sessions. Results revealed five emerging themes based on participant counsellors’ responses on the barriers and challenges encountered in their practice of multicultural counselling in Malaysia. These were challenges related to counsellors’, clients’, presenting issues’, third-party and specific contexts’ characteristics. Research implications for the education and training of counsellors in the specific Malaysian socio-political context are also discussed.     

Intersectionality at Work: South Asian Muslim Women’s Experiences of Employment and Leadership in the United Kingdom

Drawing on qualitative interviews with 20 South Asian heritage, Muslim, female leaders, managers, and supervisors in the United Kingdom, we examine the multi-layered issues and challenges they face in pursuit of employment and leadership positions. The paper offers an intersectional perspective taking into account interconnected and overlapping factors (gender, ethnicity, religion, and family status) that affect not only the issues and challenges these women face in the labour market but also the individual agency and strategies they use to overcome any obstacles in the way of their employment and career. The results show that although Muslim women continue to face a myriad of challenges in the workplace, they are also able to tackle some of these issues through their individual strategies and networks, such as personal networks and further education. The study highlights the need for policymakers and employers to consider intersectionality to enable ethnic minority women’s inclusion and leadership within and outside the workplace.     

Evaluating Environmental Change Strategies: Challenges and Solutions

In this introductory article we define environmental change strategies (ECS), summarize the primary challenges associated with evaluating ECS, and provide an overview of the methods researchers have employed to begin to address these challenges. This special issue provides a range of examples, from researchers and practitioners in the field, of different approaches for addressing these challenges. These articles present new methods to understand and test how ECS are implemented and propose methods to evaluate their implementation. The content of the articles covers multiple public health issues, including substance abuse prevention, tobacco control, HIV prevention, and obesity prevention. This special issue is intended to build the evidence base for effective ECS, generate compelling discussion, critical analyses, and spur future research that will help improve the implementation and evaluation of ECS.     

Parent as Saboteur in the Therapeutic Treatment of Children

Children present some unique challenges to the therapist regarding treatment. Unlike adult patients, they are obviously still dependent upon the parent for transportation, the payment of fees, and the success or failure of treatment. Thus the parents make the ultimate decision to continue or terminate treatment. But sometimes a parent's characterological problems are activated by their child's treatment. These diagnostic problems can be classified as envy, jealousy, competition, and narcissism. When any or all of these unresolved parental issues are touched by the treatment of their child, some parents become determined to sabotage therapy, despite the necessity of the treatment for their child. The author's intent is to identify the parental characterological issues for sabotaging therapy through both a theoretical analysis and a discussion of the particular methods parents employ to achieve this end. Identification of the various strategies for handling hostile parents and elaboration of various methods that the therapist may employ are discussed when parental sabotaging of treatment becomes a problem. Recommendations for particular interventions are suggested to illuminate the challenges the therapist faces with those parents whose intent is to sabotage treatment.     

The Ethics of Conducting Community-Engaged Homelessness Research

This paper focuses on some of the ethical issues which may arise when conducting research in the context of homelessness. These issues are considered from the viewpoints of researchers, research coordinators and interviewers, drawing from their extensive real world experience. In addition to negotiating the complex context of homelessness, community-based homelessness researchers need to address a number of ethical issues in research conception, design, implementation and dissemination. Although these issues are commonly considered in community-engaged research, research with people who are homeless may raise exceptional challenges. Such challenges include determining the nature of informed consent; protecting research participants and researchers, and determining appropriate compensation for participation. Understanding the context of homelessness to conduct ethical research will require sharing information and joint decision-making, processes that must include members of communities within which the research participants live. Furthermore, researchers should be sensitive to the changing context of homelessness, and vigilant for new ethical challenges.     

Theory in Child Psychosocial Treatment Research: Have It or Had It? A Pragmatic Alternative

In the area of child psychosocial intervention research, substantial progress in addressing challenging methodological issues has been made. In this article we suggest that continued movement forward requires maintaining a balance between methodological and theoretical issues, and that it would be advantageous to begin to think about matching advances in methodological sophistication by similar advances in theoretical sophistication. The need to advance our understanding of theoretical issues is especially important in light of the challenges raised by postmodernism, particularly as these challenges relate to knowledge development. We discuss these challenges and describe how a pragmatic orientation may be a useful way to respond to them. We also describe how a pragmatic orientation has been useful in our work in developing, implementing and evaluating psychosocial interventions for children with phobic and anxiety disorders.     

Psychosomatic disorders: the canalization of mind into matter

Psychosomatic disorders represent a therapeutic conundrum. Despite compelling evidence to suggest the integrity of mind and body, humans are famously prone to experiencing them as separate. This paper explores the scientific challenges posed by psychosomatic disorders and how changing cultural notions contribute to their perplexing presentations. Excerpts of cases from patients with chronic pelvic pain, chronic fatigue, and a factitious disorder are presented as examples of the challenges that these patients pose in analysis. An explanatory model of mind/body interaction based on early maternal-infant interactions and the placebo response complex is proposed as the basis for how psychosomatic pathologies may develop. Finally, therapeutic approaches to the psychological treatment of patients with psychosomatic issues are considered.     

A Review of the Status,Challenges and Innovations Regarding Temporary Immigration of Labour in the Regional Economic Areas of Africa

The paper makes a desk review of the status, challenges and innovative ideas in the implementation of temporary labour immigration in African Regional Economic Communities, accompanied by an analysis of the underlying issues and challenges. Salient data are provided. African Regional Economic Communities are confronted with social, economic, political and security challenges which delay the ratification of relevant protocols and decisions. National high unemployment rates and low economic growth could make policy makers reluctant to potentially exacerbate their socio-economic situation by allowing the temporary entry of unskilled labour from neighbouring countries. There is lack of harmony and common standard in the education system, coupled with the concern that citizens of some states may dominate host country’s labour market. In this situation, they are committed to limited mobility of only certain categories of workers in the communities. A number of innovative ways of overcoming these challenges adopted by African Regional Economic Communities are discussed.     

Human and institutional transformations: Catholic hospitals becoming 'a light in the the darkness.

Catholic health care institutions in the United States and Canada face internal and external challenges to their continued existence. Confronted by these external and internal challenges, Catholic hospitals in the United States and Canada have been pressed to identify what is distinctive about the Catholic contribution to health care and to consider whether existing institutional structures and partnerships foster what is distinctive. The author looks at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman, and suggests that there is little agreement, even among Catholics, on such fundamental issues. The aim of this article is to highlight three important and often overlooked ideas raised by the authors, to relate them to the Canadian context by means of a story, and to pose questions for further discussion.     

Promoting reflection in pre-service teachers through problem-based learning: an example from Canada

This article discusses the process, benefits, challenges and recommendations associated with the adoption of the Problem-based Learning (PBL) approach to promote reflection for pre-service teachers. Drawing upon Schön’s concept of reflection, this article explains how a pre-service course in Canada aims to promote the participants’ ‘reflection in action’ of assessment content knowledge and professional competence through PBL. The article points out that PBL enables the pre-service teachers to critically reflect on assessment issues and make meaningful connections between their reflections and real-life teaching. The key challenges are the facilitators’ inadequate understanding of using PBL to promote reflection, as well as the pre-service teachers’ struggle with time constraint and juggling between their need for teacher guidance, group collaboration and self-directed study. To address these challenges, the article recommends formal professional development sessions for the PBL instructors, and the achievement of a balance between learner autonomy and teacher guidance.     

New work for a theory of ground*

There has been much recent interest in a distinctively metaphysical kind of determinative explanation: ground. This paper concerns various skeptical challenges to ground’s relevance to metaphysics, such as that it is an empty posit, that the work it is supposed to do is appropriated by other notions, and that it is inapt for specific issues it should serve. I argue against these challenges. My strategy is both critical and constructive. Critical because I argue that versions of these challenges raised by Elizabeth Barnes, Kathrin Koslicki, Mari Mikkola, and Jessica Wilson are not persuasive. Constructive because we may nevertheless learn from them new work for ground.     

What are the relationship experiences of in which one member identifies as transgender? A systematic review and meta-ethnography

Transgender individuals and their partners may face unique challenges that other couples do not. These unique challenges merit investigation, understanding and consideration by systemic practitioners in order to provide a culturally attuned service for transgender clients. A systematic review of the literature into the experiences of couples in which one member is transgender identified 22 qualitative papers. A translation and synthesis of constructs from these papers utilising a meta-ethnographic approach generated a number of third order constructs organised into nine overarching themes. These themes included experiences of stigma and discrimination, issues of power, privilege, visibility and identity, and experiences of dissonance and dysphoria that required adjustments and negotiations on the personal and relationship levels. Implications for practice and avenues for future research are discussed.     

Crisis, taboos and careers guidance

The relevance of the idea of 'crisis' for careers and careers guidance is examined, together with some of the critical responses that have been made to recent crises. It is argued that careers guidance generally responds to such challenges by seeing them as external problems rather than as changes which may alter its very assumptions and methods. Two particular taboos are noted in this context concerning the value of work and of working for an organisation. The questioning of these taboos leads to four models of alternative careers: the Uncareer, the Guerilla Career, the Cop-Out Career, and the Non-Career. These forms of career raise the broader issues of order and disorder within careers, with their associated implications for careers guidance.     

Care for the Caregiver: Clues for the Pastoral Care of Clergywomen

In this article, we report the results of a qualitative study on the special challenges faced by clergywomen: the impact of gender, work demands, and personal and professional stressors, and the positive and negative coping strategies these clergywomen employed. We include a discussion of the pastoral care issues that emerged from the study and make recommendations for ways pastoral counselors may care for their own.     

Identity,past and present,in an historical child-care setting

This article puts into context the service offered today to adults (former pupils) who grew up in the care of the Foundling Hospital. Key issues referred to are attachment, loss, identity and the urge to reconnect with one's personal history. Reflections on these issues are based on the experience of Coram Family social workers, who have for the past thirty years provided a birth-record service to the former pupils of the Foundling Hospital and their descendants. It is a moving experience to hear from this group of individuals something of what it has meant to have grown up in such particular circumstances. Although there are many echoes with adoption and fostering today, other significant issues are raised which do not apply in the work of family placement as it is now practised. Some historical background is given below in order to set the scene for this unique piece of child-care history, also to allow examination of the challenges faced by some 20,000 children over 200 years, in recognition of which the service to those former pupils and their families is still offered.     

Family Secrecy in Family Therapy Practice: An Explorative Focus Group Study

The aim of this focus group study was to explore the experiences of family therapists working with family secrecy. Our study highlights that family secrets present important and compelling challenges for family therapists. Furthermore, our study reveals that there seem to be some basic strategies family therapists use in dealing with these challenges in therapy sessions. One basic strategy is that family therapists try to guard their position of being a trustworthy therapist for each family member by avoiding becoming stuck in family secrecy. Furthermore, therapists explore ways to guide the family toward the disclosure of the secret in order to alleviate the toxicity of the secrecy. This highlights the importance of the systemic model and how influential this perspective is in family therapy practice. Some participants, however, have in addition a second strategy they sometimes use: talking with the family about secrecy without aiming to disclose the secret. In the discussion section of the article we reflect on the possibility that in the strategic choices family therapists make conceptual issues might be involved. Furthermore, we stress the importance of further research.     

Remarital Issues in Couple Therapy

Abstract

Remarriage and cohabitation after divorce are becoming societal norms. Given the increasing numbers of these couples, mental health professionals will encounter them in their clinical practice. There are unique issues associated with remarriage (e.g., role and boundary ambiguity, unrealistic expectations) that can hinder the family reorganization process and exacerbate typical communication problems experienced by couples. Therefore, therapists must have knowledge of these challenges to provide the most effective treatment. A brief overview of the remarriage and stepfamily literature, and recommendations for clinicians are presented.     

Disrupting the Luxury of Despair: Justice and Peace Education in Contexts of Relative Privilege

Abstract. The Iliff School of Theology established a justice and peace concentration within its curriculum to respond to the challenges of racism, class and economic exploitation, sexism, and militarism by fostering social analysis and attending to the contributions of religious thought and resources to the struggles of social change. Within an institution and with a student body who both tend to be relatively privileged in terms of class and racial or ethnic background, one of the persistent issues in teaching justice and peace studies has been addressing the emergence of guilt, anger, and despair as course content challenges students (and faculty) to relinquish self‐understandings, historical understandings of their religious tradition and national context, and inadequate theological and faith formation shaped by dominant narratives that ignore social realities of oppression. This pedagogical challenge has encouraged multiple professors to develop unique pedagogical approaches to educating students about justice issues in this context. This paper will draw on the insights of these approaches, in conversation with literature‐based analysis, to describe the temptations students experience when learning about justice and peace in contexts of privilege. This paper also describes the pedagogical practices that emerged in this particular context, and the failures and limitations of these practices for individual and institutional transformation.     

From Theory to Practice: Facing Ethical Challenges as a Clinical Intern

Although formal ethics classes provide a basic foundation in managing ethical dilemmas, professionals often point to their experiences on internship as an important training ground for consolidation of their ethical development. Clinical interns face many personal and professional transitions that can lead to a number of ethical dilemmas. Effective collaboration between administrative staff, supervisors, and interns can create a pragmatic model for negotiating these dilemmas. In this paper, issues related to balancing intern competency with training and patient/client needs, managing dual relationships with supervisory staff, and dealing with differences in orientation are addressed from the perspective of both the site and the intern. We also discuss ways in which problems can arise and how both sides can work together systematically to negotiate those problems. To illustrate this process, we discuss cases involving effective collaboration between interns and sites. Finally, the authors assert the need for formal, empirically supported training in classic ethical issues, but also in contemporary ethical issues arising from the ever-evolving field of mental health service delivery and unique challenges accompanying these advances.     

COVID-19 Interconnectedness: Health Inequity,the Climate Crisis,and Collective Trauma

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.