Kornwachs Gabriel, Hautzinger Martin, Kizilhan Jan
Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany.
Institute for Transcultural Health Science, DHBW, Stuttgart, Germany.
Front Psychiatry. 2024 Jul 25;15:1434670. doi: 10.3389/fpsyt.2024.1434670. eCollection 2024.
In post war regions, especially in low-income countries, the health care systems often require immediate support. For example, after the terror of the so-called Islamic State of Iraq and Syria (ISIS) in 2014, many internally displaced persons took refuge in the Kurdistan Region of Iraq (KRI). Those displaced by war have had to face the reality that psychotherapy did not exist as a service in the Kurdish health system. Many projects and Non-Government-Organizations (NGOs) that work in post-conflict regions focus on short term and quick response and/or basic psychological services. The implementation of the "Institute for Psychotherapy and Psychotraumatology" (IPP) at the University of Dohuk, follows a long-term approach. The 3-year-program teaches students to become professional psychotherapists, with respect to evidence-based and culturally adapted methods of psychotherapy. To achieve sustainability, the project is working towards handing over the teaching and organizational responsibilities into local hands. This article highlights the chances and challenges during this transition, as well as the importance of cultural understanding and realistic, practical solutions. An honest reflection on existing cultural challenges, e.g. inflexible hierarchical structures or an "old-fashioned" religious view of homosexuality, can then lead to practical solutions. These include winning over local authorities by including them in the process, culturally adapting to customs with the help of educated locals, demonstrating non-authoritarian forms of leadership, and explicitly promoting newly graduated young lecturers into positions of authority.
在战后地区,尤其是低收入国家,医疗保健系统往往需要立即得到支持。例如,在2014年所谓的伊拉克和叙利亚伊斯兰国(ISIS)制造恐怖事件之后,许多境内流离失所者在伊拉克库尔德地区(KRI)寻求庇护。那些因战争而流离失所的人不得不面对这样一个现实:库尔德卫生系统中不存在心理治疗服务。许多在冲突后地区开展工作的项目和非政府组织(NGO)侧重于短期和快速反应及/或基本心理服务。杜胡克大学“心理治疗与心理创伤研究所”(IPP)的实施采取了长期方法。这个为期三年的项目教授学生成为专业心理治疗师,采用基于证据且适应文化的心理治疗方法。为实现可持续性,该项目正努力将教学和组织责任移交给当地人。本文强调了这一过渡过程中的机遇和挑战,以及文化理解和切实可行的实际解决方案的重要性。对现有文化挑战进行坦诚反思,例如僵化的等级结构或对同性恋的“老式”宗教观点,进而能够得出实际解决方案。这些解决方案包括让地方当局参与进来以赢得他们的支持,借助受过教育的当地人在文化上适应习俗,展示非独裁的领导形式,以及明确提拔新毕业的年轻讲师担任领导职务。