Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome are inevitable but eliminating global mental health disparities with indigenous healing is not.

SCIENTIFIC Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome exist. Greater awareness of this has resulted in many national and international initiatives, often framed in terms of moral responsibility or social justice, intended to eliminate these disparities. Such efforts include well-meant and sometimes effective attempts to culturally adapt counseling and psychotherapy. These efforts carry the implicit assumption that counseling and psychotherapy are scientifically sound, universal treatment practices with worldwide applicability that transcend national and cultural boundaries. However, according to the contextual model, individuals who are living in non-Western countries and those who are living in Western countries but are less acculturated to dominant Western norms may find the practices of counseling and psychotherapy, even when culturally adapted, to be culturally incongruent. The efficacy of these therapeutic practices is constrained by the extent to which individuals subscribe to the cultural meanings and moral visions underlying the Western institutions of counseling and psychotherapy. To the extent that they do not is the extent to which counseling and psychotherapy are not appropriate treatment strategies and to which such individuals would benefit from an alternative approach more in line with their cultural conditioning. In other words, these individuals may be no more likely to benefit from counseling or psychotherapy than a Western individual would be to benefit from a non-Western indigenous mental healing practice. Therefore, the best way to reduce mental health disparities globally is to promote indigenous healing practices in isolation and in collaboration with culturally adapted counseling and psychotherapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)