I think it is also important to educate on topics that people are not familiar with. Regarding psychoeducation P2 reported:
126
… I use that first session to just let them know what counselling is all about and what expectations are so that we are able to meet their needs.
P2 incorporates psychoeducation in the introductory session. In this regard P6 shared her ways of working further by saying:
… even within psychotherapy I teach. I also teach them about marriage,… I teach
them about life and understanding life.
This example about marriage implies that psychoeducation is an important part of psychotherapy. P7 indicated:
… when they come for therapy through the questioning they kind of find out that no I am the one who is supposed to take the ownership of the reason that they are here, and the expectations changes…
This means that psychoeducation is done at the beginning of the psychotherapy relationship and clients are made to realise that they are the ones who will act, become and change according to the goals of psychotherapy.
It seems as though amaXhosa psychotherapists use psychoeducation as a tool in their sessions. This could be due to the fact that most clients’ expectations of psychotherapy are reflective of an incorrect understanding of how psychotherapy must be conducted. Psycho- educating therefore may alleviate some of the misconceptions about psychotherapy that exist.
5.5.4 Fear of the law/HPCSA
In many of the examples given, the participants showed that they were fearful of consequences they may be faced with should they not follow the rules of doing
psychotherapy. Participants perceived HPCSA as the law and a body that is there to punish them. P3 illustrated this fear in:
I hope you are not going to contact Health Professions Council and then I’m put under discipline or whatever.
It is obvious that these amaXhosa psychotherapists were cautious about my motives and view HPCSA as an unapproachable authority that fails to understand people, but only implements
127
rules and regulations. Psychotherapists are clearly afraid of HPCSA. In this regard P7 indicated:
… during the CPD sessions we don’t talk about the economical issues of our clients in the CPD sessions we talk about many other things that are very good as well … Because people they actually they are blind folded they think that the ethics, yes the ethics are there to guide us, but sometimes other things are not there in the ethics…
Whilst this participant values some of the material presented when attending CPD, he shows frustrations about the lack of application of such material to everyday practise; where some aspects are not clarified and there is an implicit expectation that the professional needs to use judgement.
Some psychotherapeutic approaches do not emphasise considering the influences of the past, but this is important to the meaning-making of amaXhosa. P8 shared:
But I suppose you might call it a clash in a sense that in a Western or to a Western mind you would look especially in phenomenological settings you would look at a phenomenon as such and not look or you’d feel discouraged to look in past or draw from any wisdom or theories and look at the thing as is right now and the space and here and now.
It seems that amaXhosa psychotherapists are faced with clients who have expectations connected to their way of living and expect certain links to be made. Such approaches might include commentary about the spiritual world. However, our training as psychotherapists is Western, while we are Africans.
5.5.5 Psychotherapy and other systems
Suggestions and experiences of psychotherapists about South African universities and the psychology curriculum are made. Psychologists feel that their training should be designed such that it is relevant to a wider South African community and should prepare students for the real South African life for the majority. P6 reported:
… I do not know who develops curriculum for psychologists … make it relevant to
people and to the needs of society because we need to have lots of psychologists outside and inside. … for example… he is doing psychotherapy in his kombi and he
128
goes to the community and see people in that kombi. That’s how we should think. Sitting as we are sitting in the office not the same, in fact number 1 is it is accessible to the chosen few and few people can afford, these people out there do not have medical aid and we have to reach those people…[in class] there will be two Xhosa speakers and 8 English speakers, so it is not user friendly, … so they must take more Blacks so they are able to see a broader community.
During training, more emphasis should be put on the practicalities of applying psychotherapy skills to people. P7 noted that the teaching about ethical codes was more theoretical, before people had practice experience, so this led to anxieties about applications:
… when you are studying you are actually making sure that you comply with HPCSA as well as the academic department, and you don’t do much practicals, you are not trained to deal with practical issues in the department other than to understand policies, the code of ethics and how to actually implement modalities. But when I started my private practice … I was anxious…
However, P4 was supportive of the need for ethical guidelines and boundaries recognising the risks of not having such knowledge:
…because our work involves so much emotions it is sometimes easy for boundaries to blur and I sort of always feel that you need to establish so that by the time the process moves along and gets intense at least at the back of one’s mind… I am aware that there are rules that we still need to observe… because therapy is a formally structured scene so they (boundaries) are important, it does not always mean that they are actually always observed.
Again above, the participant notes that abstract guidelines might not always be applied. Her words above and below show that she emphasises her values and the need for warmth in relating. In addition, she appears to be more confident with her style of practice: P3 reported:
…how do I separate … who I am, the values I live my life… by with these therapeutic thingies, it’s part of who I am… that’s also the environment I am in of uBuntu. You know not being cold, having that cold relationship … and I don’t feel guilty about
129
anything, I mean I have helped my fellow human being and I would do it even if I was not counselling that person…
In summary, participants made suggestions of being culturally sensitive in universities when training psychotherapists and creating training programmes that will emphasise more
practical work and less emphasis on the rules of ethical codes and boundaries. Participants suggested that psychology curriculum in all South African universities could better integrate culture-sensitive diversity and ethics. amaXhosa psychotherapists feel excluded in the curriculum and practice of psychotherapy and this exclusion brings about dissonance to them as practitioners. Participants emphasised that although they may divert guidelines in order to bring good service and healing to their African clients, they were cognisant of the non- maleficence principle. This do no harm principle was perceived as guiding participants towards making sound decisions in certain situations.