Mental health counseling is gaining worldwide popularity. It is, therefore, important to critically examine the appropriateness of direct importation of Western psychological interventions into non-Western countries. This article reviews the state of counseling in Taiwan and Ghana. It highlights the heterogeneous nature of counseling services in the face of cultural similarities. In addition, it demonstrates the importance of considering the interplay of culture and religion in assessment, case conceptualization, and treatment.
Example 1: Because he had been experiencing nightmares for about a year, a 45-year-old Taiwanese male sought a Buddhist Master's advice. He told the Master that he dreamed about being chased by a man every night. He added that, on occasion, his wife was awakened at night by his heavy breathing during his nightmares. In addition, he told the Master that he was afraid of the dark and slept with lights on. The Master asked him what it felt like for him to have those dreams. The man replied that he suspected that he may have been a murderer in a previous life and that the spirits of his victims came to his dream to get even. The Master advised him to recite sutras and give the merits he gained from reciting sutras to those whom he had hurt in his previous life, which the man followed diligently. Six months later, he no longer has those nightmares and can sleep in the dark.
Example 2: TC, an 11-year-old female, has been living with a foster aunt (Mrs. H) in a suburb of a large city in Ghana for financial reasons after her mother's death. Mrs. H recently observed that TC had been forgetting to do her homework and chores, stealing and drinking alcohol, not eating, spending a lot of time by herself, and refusing to go to church. When confronted, TC said she wanted to live with her father. Mrs. H refused to do this, pointing out that TC's father could not provide for TC financially. An hour later, Mrs. H did not feel well and had to see a doctor the next day. That day, according to Mrs. H, TC appeared happier than she had been all month. In consultation with some relatives and church members, Mrs. H decided that TC's rebellious behavior meant that she was a witch, and she sent TC to a prayer camp. Together, they would talk to the Master and pray for deliverance.
Taiwan and Ghana are two non-Western countries considered to be relatively similar culturally in terms of the importance of collectivism, religion, and gender roles. In both, as the above examples illustrate, the family and religious resources are used to resolve psychological distress. The Taiwanese man's decision to talk to the Master is somewhat similar to counseling-seeking behaviors in the United States (i.e., seeking face-to-face help from a mental health professional for diagnosis and treatment). The Ghanaian case showcases a communal diagnosis that occurred in the absence of the troubled one and a communal intervention of exorcism through religious ritual. Albeit with the same label of Talking to the Master, the above examples, by no means representative of all people in each of these countries, highlight the existence of differences in help-seeking behavior for mental health difficulties. This article explores the influence of cultural practices and religious worldviews on the state of counseling in Ghana and Taiwan and proposes an Ideal Master approach to counseling that integrates cultural values, religious worldviews, and Western psychology theory.
BACKGROUND ON TAIWAN AND GHANA
Taiwan and Ghana have experienced significant socioeconomic change in the past century and increased contact with Western and Eastern countries by means of the media, the entertainment industry, commercial products, business, and education. Both societies strive to preserve their traditions in the face of these changes. Profiles of the two countries are summarized in Table 1.
Strongly influenced by Confucianism, Taiwanese tradition emphasizes filial piety (Lee, 2002), which shapes the family structure, interpersonal relationships, and gender roles. …