APS Grant enhances psychology training connections with Vietnam

The APS Grant for Intercultural and/or International Projects of up to $10,000 supports innovative projects that have an intercultural and/or international focus, particularly in countries where psychology is an emerging discipline. The 2013-14 Grant was awarded to Associate Professor Bernadette Moore MAPS MCCLP, Head of Program, Master of Clinical Psychology, Central Queensland University (CQU). Her project aimed to enhance professional relationships and connections between clinical psychology programs at CQU and the Vietnam National University – Hanoi, which hosts the first such program at postgraduate level in Vietnam. Bernadette shared her experiences and insights about the APS Grant project with InPsych.

How did you come to be involved with the project in Vietnam and what was your role?

In 2012 I decided to take a professional gap year. As a component of that year I wanted to utilise my skills as an educator and clinical psychologist to contribute to the development of psychology and more generally mental health services in low and middle income countries (LMIC) within the Asian region. This led me on an interesting journey to find a host organisation with whom I could build a sustainable partnership. This seemed quite challenging as I was uncertain of the value of my western ways of ‘knowing and doing’ in clinical psychology.

Via a very circuitous route I eventually made contact with Bahr Weiss, Associate Professor of Psychology and Human Development at Vanderbilt University and a Visiting Foreign Professor at Vietnam National University in Hanoi. Dr Weiss has a long history of working to build culturally appropriate mental health resources both in high income countries as well as low and middle income countries in Southeast Asia. A major component of his work has been the establishment and support of a research oriented Masters and PhD clinical psychology program in partnership with psychology staff at the Vietnamese National University (VNU), School of Education, in Hanoi. Following a number of preliminary skype discussions, Dr Weiss and I met in Hanoi to explore ways that I might contribute to this work. In that initial visit I was able to support the curriculum with some guest lectures and contribute to supervision of practicum case work and Masters thesis projects, which helped me begin to understand the philosophy and challenges of clinical psychology training within the Vietnamese context.

How did the APS Grant assist you in your collaboration with VNU?

The APS Grant provided an opportunity to continue to consolidate this relationship between myself and more generally Australia and the VNU program. The initial grant application had sought to support Dr Minh Dang, the Program Director at VNU, to visit the CQU clinical psychology program, in addition to myself providing some guest supervision and support at VNU. Unfortunately it ultimately was not possible for Dr Dang to travel to Australia because of other commitments, and I now understand more of the complexities of international professional development for staff working in Vietnam. Because of these unexpected difficulties, VNU requested I spend an extended period of time working within their program. This request was generously supported by CQU, which provided salary support during my time in Vietnam.

Through these activities the VNU program was able to identify a number of areas that they felt would be beneficial for me to support their graduate students and their staff. Having preparation time allowed for the lectures and PowerPoint presentations to be translated into Vietnamese for continued use within the program. I was able to contribute to individual and group clinical supervision and it was interesting to explore with students the clinical scenarios experienced within their mental health placements. The extended visit also allowed time for me to provide a curriculum review of several of their key courses.

What are some immediate or potential applications of your efforts to contribute to more global development of evidence-based practice and mental health workforces in low and middle income countries?

One of the immediate outcomes of the collaboration has been the successful application of one of the program graduates to come to Australia under an Australian Aid scholarship to work with me on his PhD program. I understand this is the first Vietnamese scholarship to be awarded under this grant scheme in the discipline of psychology. The recipient, Cao Minh Nguyen, is exploring the concept of bullying in Vietnam and is hoping to develop a culturally appropriate measure assessing bullying in high school students. As Vietnam becomes more westernised, bullying is rapidly becoming a serious social and mental health problem. Minh and I were able to work together initially in Vietnam, which, in conjunction with a developing professional relationship and my developing understanding of psychological practice in Vietnam, helped to facilitate this opportunity.

What did you learn from this exchange that might relate more generally to the development of psychology in Vietnam?

Perhaps the most challenging learning related to differences in how psychological knowledge can be valued. In 1986, Vietnam initiated Ðổi Mới, a major economic and social reform that moved Vietnam from a centrally controlled to a market-oriented economy. Although this reform has been associated with significant economic growth, it has resulted in the potential application of a business or market economy framework to health services and health knowledge. Psychological ‘expertise’ therefore has become an uncontrolled market economy with no oversight except the market, with untrained individuals providing psychological services, training, establishing fee paying therapy centres, etc. On several occasions I have been offered business opportunities in Vietnam and have had non-university based individuals attending my classes, all of which is a challenge to the development of psychology as a profession in Vietnam.

Access to written knowledge is also a significant barrier to students’ developing their clinical skills. Almost all clinical literature is written in English and although the training program is working on translating key articles into Vietnamese, access to the knowledge that we take for granted is limited. The VNU program does not assume that knowledge appropriate to western frameworks represents best practice in Vietnam. It does, however, seek to establish a research culture in parallel to the training program, so that students are also being trained as researchers to be constantly seeking to develop both evidence-based practice and practice-based evidence within Vietnam (Weiss et al., 2011). Because students have had minimal exposure to research training this must be a gradual developmental process. Opportunities for students to study overseas and develop these research skills are limited and the cost of international education prohibitive for most Vietnamese students. Students who do study successfully overseas may well decide to not return to Vietnam to work, so the economic investment in Vietnam psychology development is lost.

What kinds of personal qualities and professional skills have been most valuable to you in this project?

I think all partnerships must evolve gently and respectfully, with both partners valuing the contribution of the other. I strongly believe the quality of interpersonal relationships seem central to these collaborations. It has been important to work within the framework of the Vietnamese program and to be open to the learning that has been available to me. I am certainly far more mindful of the challenges inherent in developing and providing sustainable, culturally appropriate mental health services within the Vietnamese context after having spent time in the program in Hanoi.

On the other hand, the program has placed significant value on my own knowledge and experience – there seems substantial commonality in the educational and mental health work that we do whether in Vietnam or Australia. The clinical psychology curriculum is very closely aligned with our Masters training program in Australia. The nature and etiology of psychological distress, and the role of common and specific factors in responding to that distress, share many features. My experience is that Australian educators and clinicians have substantial skills to offer. As a profession, and, perhaps through our professional association, we should seek to find appropriate pathways to extend our practice beyond our Australian borders. The need is substantial; a survey of child mental health in Vietnam suggested that 20 per cent of children were above the screening threshold for mental health problems (Tran et al., 2003), while in Cambodia up to 35 per cent of adults may have diagnosable psychiatric illness (de Jong et al., 2001) with only 40 psychiatrists to respond to the population of 14 million people (Belford, 2010). It would seem important that Australian psychologists take a role in responding to this need in one of our close neighbouring countries.

The list of references can be accessed from the online version of the article

Thanks to Heather Gridley for arranging this interview.