National Louis University Digital Commons@NLU Dissertations 7-2020 Psychotherapy Model for the Training of Counselors in India Vini Kalra Follow this and additional works at: https://digitalcommons.nl.edu/diss Part of the Clinical Psychology Commons Recommended Citation Kalra, Vini, "Psychotherapy Model for the Training of Counselors in India" (2020). Dissertations. 444. https://digitalcommons.nl.edu/diss/444 This Dissertation - Public Access is brought to you for free and open access by Digital Commons@NLU. It has been accepted for inclusion in Dissertations by an authorized administrator of Digital Commons@NLU. For more information, please contact [email protected]. Running head: PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS Psychotherapy Model for the Training of Counselors in India Vini Kalra Mudita Rastogi, PhD Chair Carolyn Gralewski, PhD Member A Clinical Research Project submitted to the faculty at the Illinois School of Professional Psychology/National Louis University, Chicago Campus in partial fulfillment of the requirements for the degree of the Doctor of Psychology in Clinical Psychology Schaumburg, Illinois June, 2019 ISPP/ARGOSYUNIVERSITY, SCHAUMBURG CAMPUS ClinicalResearch Project Approval/Tracking Form \/ l NI lc_At- ......;.(<It- StudentID . StudentName ________ _______ lr£� Titleof� E�--�a�-� · 1-:::r 1 �j,� Chairperson (printname) /vfud; fa.. t2._�5 1 V [,__ · JJ . A +-u� 1. � r� /Jt,__ li. {)Co/;:;,�1 Chairperson(signature) ' � j Date f · ep mp g st STOP (Acopy of this trackingform with st #1 co letedis due toClinical Trainin by Navember1 ofthe third academicyear) 2• p�� Pl-.. .b. 1e/2.111i1 /j• e 1 Cha_i:rperson(signa _ f) V J Dat � (-N -I fY 2ndt_��;mfunber �.(signature) Date 3rd Committee member(optional) Date (A f STOP copyo thistracki ngform with step #2 completedis due to ClinicalTraining by June 1 ofthe thirdacademic year) 3. InstitutionalReview Board Approved (submit tracking form withIRB app m d J InstitutionalReview Board pprover(signature) Date! STOP (Acopy of this tr ackingform with step #3 completed is due to Clinical Training by October Jst (or before) of thefourth year) 4. OralDefense P�?)lSed DraftApproved �t-1.,� �� 'Pl....1. orjo3/t4 Chairperson(signature) . 7 Date( 1 � 6r��Uy�, �r�. O:t/o'2.It q- f� r Date 2ndCoeemember(signa1ure) Jv1.!2..7) 1 I · e 3rd Committeemember (optional) Dat STOP (A copyof this tracking form withstep #4 completed is due to the registrarwho will discontmueCRP registration) 5. IRB Chair Receipt of AppendixH (IRB project completionreport) IRB Chair(signature) Date 6. E r's orial Changes {J: 3l}JfZZ 7/8/19 E� Date 7. JJ11al Appro al.,..»f CRPi· � rh0 -JJ\ O-:+-/oq/1 9 u�l;,J�_� Date 7 Chairperson(signature) / r f STOP (Acopy o thistrackin gform withstep #7 completedis due to the LeamerSupport Specialist, Janan Reynawho willissue the bowuicopy number____ _ 8. Bound Copy Accepted by School StudentServices (signature) *Date *Degreewill not be awardedwithout receipt ofbound CRP. PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS ii ACKNOWLEDGEMENTS I would like to show sincere gratitude towards my professor and advisor, Dr. Rastogi, without whom I would not have been able to do full justice to my clinical research model. I admire her genuine interest in field of global mental health that motivated me to pursue my research. I would also like to thank my committee member, Dr. Gralewski for her thoughtful advice that helped me improve my dissertation many folds. I am thankful for her time, effort and support throughout this process. I would also like to thank my parents for supporting my academic endeavors, without them this journey would have been impossible. They are my pillars of strength and the reason of my successful doctoral program journey thus far. Lastly, I would like to thank my fiancé Sagar who motivated me and provided emotional support during times when I could not see light at the end of the tunnel. PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS iii DEDICATION This project is dedicated to the millions of Indians suffering from mental illnesses who do not have access to mental healthcare services. PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS iv Abstract Common mental disorders in India are on the rise and are adding to the national burden of mental health care on a day-to-day basis. The demand for treatment of mental illnesses has risen considerably, though there is a shortage of mental health professionals who can deliver counseling services. The Indian government has made efforts to improve the scalability of services by training lay health counselors to diagnose and conduct brief counseling with the mentally ill and those involved with their care. Despite efforts to scale up services, the treatment gap still exists, as mental health services are not uniformly distributed. Considering that psychotherapy is based on Euro-American concepts of mental health care, but India is a complex amalgamation of cultures, there is a need for a culturally sensitive model of counseling. Thus, this clinical research project was geared toward creating a culturally sensitive model of counseling that can be used to train lay health counselors to conduct culturally appropriate therapy. Hence, this theoretical model of counseling uses sociocultural factors to conceptualize the mental health issues of Indian clients and indigenous methods along with an evidence-based approach to inform psychotherapy interventions. Finally, the Indian sociocultural aspect is integrated into the fundamentals of therapy to improve client retention and reduce the treatment gap. PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS v Table of Contents Chapter 1: Introduction ....................................................................................................... 1 Background of the Problem .......................................................................................... 1 Psychotherapy in India ............................................................................................ 1 Magnitude of Mental Health Burden ...................................................................... 3 Attitudes Toward the Mentally Ill ........................................................................... 3 Political History of Indian Mental Health ............................................................... 6 Bridging the Treatment Gap ................................................................................... 8 Purpose of the Study ..................................................................................................... 9 Chapter 2: Literature Review ............................................................................................ 12 Mental Health in India, Traditionally and Now .......................................................... 13 Understanding of Mind from an Indian Perspective ................................................... 15 Indian Culture and Mental Health ............................................................................... 18 Multiculturalism .................................................................................................... 18 Collectivism .......................................................................................................... 20 Casteism ................................................................................................................ 22 Religion ................................................................................................................. 23 Spirituality............................................................................................................. 24 Gender Inequality .................................................................................................. 25 Current Mental Health Needs in the Indian Population .............................................. 26 Common Mental Disorders in India ........................................................................... 27 Suicide ................................................................................................................... 27 Depression ............................................................................................................. 29 PSYCHOTHERAPY MODEL FOR INDIAN COUNSELORS vi Anxiety .................................................................................................................. 31 Schizophrenia ........................................................................................................ 32 Substance Abuse ................................................................................................... 34 Domestic Violence ................................................................................................ 36 Mass Trauma ......................................................................................................... 39 Alternatives to Psychotherapy in India ....................................................................... 42 Yoga ...................................................................................................................... 42 Meditation ............................................................................................................. 42 Ayurveda ............................................................................................................... 44 Naturopathy ........................................................................................................... 45 Euro-American Influence on India’s Mental Health .................................................