Family Therapy in Iran: A Case Study of Obsessive-Compulsive Disorder

Article excerpt

Iranian clinical psychologists have devised family therapy methods that use cognitive behavior models that fit with their collectivist Islamic culture. The authors review Islamic-based strategies and describe family therapy with a culturally specific case of childhood obsessive-compulsive disorder. Family therapy, adapted to integrated, religious-based cognitive behavior therapy, seems appropriate for clients who are served in Iran.

Los psicologos clinicos iranies han ideado metodos de terapia de familia que emplean modelos cognitivo-conductuales que se ajustan a su cultura colectivista islamica. Los autores examinan estrategias basadas en el Islam y describen la terapia de familia con un caso culturalmente especificode trastorno obsesivo compulsivo en la ninez. La terapia de familia, adaptada a una terapia integrada cognitivo-conductual basada en la religion, parece apropiada para clientes tratados en Iran.

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Clinical observation and controlled experiments (Dobson & Dobson, 2009) have proven the effectiveness of cognitive behavior therapy (CBT). Clinical psychologists in the Islamic Republic of Iran have adapted CBT to fit their collectivist Islamic environment (Khodayarifard, Rehm, & Khodayarifard, 2007). We discuss these methods, exploring issues of cultural adaptation that are important to Western therapists. How do practices of Iranian therapists differ from those of therapists in the West? How might practices and findings from an Islamic collectivist society be of value to Western therapists? We hope to extend discussions regarding Islamic-based therapy (Ahmed & Reddy, 2007; Daneshpour, 1998; Erickson & Al-Timimi, 2001; Hamdan, 2008; Hedayat-Diba, 2000; Hodge & Nadir, 2008; Jafari, 1993) by reviewing strategies that have been found to be useful in Iran. We describe an Iranian therapist's treatment of a culturally specific form of childhood obsessive-compulsive disorder (OCD) to illustrate how CBT can be modified to fit a collectivist environment. Iranian methods differ from Western approaches in that Iranian therapists integrate family therapy, Islamic-based therapy, CBT, and strengths perspectives to fit clients' needs.

family therapy, islam, and cbt

Islamic therapists argue that the assumptions of Western psychotherapy are not universal and cannot be generalized to non-Western cultures (Al-Abdul Jabbar & Al-Issa, 2000; Alishah, 2001; Al-Issa, 2000; Jafari, 1993; Rahman, 1998). Western therapists are thought to overemphasize individual change, self-concern, assertiveness, self-growth, ego strengthening, and self-actualization, depending on their therapy orientation. Islamic-based therapists, on the other hand, focus on interdependence, self-restraint, perfection of self, integration, harmony, conformity, selflessness, and healthy altruism. Treatment focuses on group faith, prayer, hope, patience, and responsibility (A1-Abdul-Jabbar & Al-Issa, 2000;Jafari, 1993). Because of these differences, research conducted mainly on Western patients "may not be applicable to another environment" (Jafari, 1993, p. 329).

Islamic therapists believe that Muslim families have unique characteristics that require the use of special methods. They have argued that Western, Eurocentric models "do not account for non-Western criteria or cultural variations in family dynamics" (Daneshpour, 1998; Hall & Livingston, 2006, p. 140). Although variations exist among societies and social strata within societies, including the United States, Muslim families tend to prefer connectedness, less flexibility, and hierarchical relationships, and often use implicit communication styles. Generational family ties take precedence over individualistic orientation and behavior (Daneshpour, 1998).

Iranians have unique ways of interpreting emotional distress; sadness and melancholy, for example, are seen as indicating inner depth (Good, Good, & Moradi, 1985). …