Psychological Clinics

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The needs of Psychological Clinics in Malaysia

D r L e o w C h e e S e n g Page1

The needs of Psychological Clinics in MalaysiaB.Sc(Hons)CommunityHealth(UPM),MBA(UPM),DBA(UBI),

MMIM, MIHRM,

MIM-CPT, CAHRP (Consultant),

Certified E-Commerce Professional (Mal),

Certified Professional Trainer (MIM, PSNB),

Certified Stress Management (IACT, USA),

Certificate Qualitative Research (Georgia, USA)

Certificate in Homeopathy Medicine (Mal)

I am stress, I dont want to go to psychiatry, I will be labeled mad or insane. I would rathernot to inform others. Lets me suffer it myself

It is estimated that 70% of all patients who seek help from physicians for their physicalcomplaints and illness are in fact suffering from stress, anxiety based on disorder and

psychosomatic complaints. One study has even suggested that at least a third of all cardiologypatients may have no real physical disorder but they suffer from panic attacks. ModernWestern-trained doctors, because of their intensive training in looking for specific bodilysymptoms in which they are tested in medical schools, get used to this outlook and take itwith them in their medical practice. As the famous Harvard physician, Dr. Herbert Benson,says in his best-selling book, Timeless healing (Simon and Schuster, 1996), Western traineddoctors are tested in their ability to remember and diagnose specifics far more than theirability to assess overall patients. They accordingly emphasise particular symptoms overwholeness and body over mind.

For this reason, the 70% of patients whose core problem is psychological continue to receive

drugs after drugs that can only help temporarily through suggestion. They may continue tosee many doctors without finding one who recognizes their underlying emotional disturbance,their depression or their sexual dysfunction as the real etiological factor in their externalillness

Even patients who know that they are suffering from psychological problems such as anxietybased or mood disorders do not get the help they really need. Because of the stigma ofinsanity, many of them would not accept to see a psychiatrist. Besides, even those who domay not get the proper psychological therapy they need. Psychiatrists, as doctors whograduated from medical schools, prefer to prescribe drugs and other psychical therapies tolong interviews and counseling

Many of them had not even intensively trained in the modern psychotherapeutic method suchas the use of systematic desensitization as behavioral therapy for phobic anxieties, sexualdisorders and similar problems, the use of cognitive therapy for depression and the use ofaversion therapy for addiction, tics and some forms of obsessive compulsive neuroses. Somepsychiatrists who had been trained in the some of these behavioral and cognitive therapiesmay not have the time for their application. This is particularly true for those who work inprivate clinics. They can see more patients by briefly listening to their complaints andprescribing medicines.

Patients who refuse to be referred to psychiatrists would be glad to see bomos and traditionalhealers. In research study presented by Badri to the Traditional Medical Practices Committee


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of the WHO in Geneva in 1973, has found that in most Islamic countries, the great majorityof neurotic patients go to traditional healers. Many of them may get suggestive and spiritualhelp that are not available in modern hospitals and psychiatric clinics. However, they are alsodeprived from the modern psychotherapeutic techniques we just mentioned.

From what has been said, the medical services in Malaysia is in great need for theestablishment of psychological clinics in which trained therapists can offer their expertise tothose who need it. General practitioners and even specialist should be informed about suchpsychological services and they should know when to refer some of the 70% of patientswhose problems are either psychophysiological and downright anxiety or mood disorder.Since such patients can be cured or very such improved by psychotherapy, this may actuallybe economically cost effective.

When such psychological clinics are set up, psychiatrists would be happy to refer suitablepatients to the clinical psychologist who is also helped by a psychiatric social workers. On theother hand, patients who directly refer themselves to the psychological clinic and who need

psychiatric drugs or more serious medical interventions are to be referred by the clinicalpsychologist to psychiatrists or physicians, Often, the patient who needs antidepressants ortranquillizers but who is afraid to go to a psychiatrists for fear of being stamped as crazy,can benefit from the therapy of the psychologist who convinces him to accept referral to thepsychiatrist or physician. The co-operation between the psychologist and the doctors is veryessential since at times purely organic disorder as hypoglycemia and hyperthyroidism canmimic anxiety symptoms and patient may unknowingly refer himself to psychologist orcounselor.

In modern countries that recognize the importance of psychological therapies to anxietybased and mood disorders such as the United States, it is estimated that specific phobias,which are the most common from the anxiety disorders, are more common than alcohol abuse,alcohol dependence, and major depression added together. It is reported in 1990, the UnitedStates spent 147.8billion mental health dollars. Of this amount such as $ 46.6 billion (32%)were spent on the treatment of anxiety disorders. Thus, it seems that in Malaysia and otherMuslim and Afro-Asian countries the absence of such psychological services has ironicallyeclipsed the dire need for them.

It is clear from our statement of problem what services that psychological clinic can offer toits troubled patients and those who need minor therapy and counseling. However, the

following list of services can be more illuminating. The Center provides three major servicesfor the community:

a) Counseling and psychotherapy

Though counseling and psychotherapy were once considered two different forms ofpsychological intervention, the dividing line between them is becoming quite vague. In thepaper title counseling and psychotherapy from an Islamic prospective (Ashajara, 1996, Vol.1, No 1 & 2) Badri says:

The no mans land between the boundaries of counseling as speciality of educators and

psychologists who offer guidance to normal people and students with mild emotional andacademic problems, mainly practiced in educational institutions and that of psychotherapy as


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that of experts in clinical psychology and psychoanalysis, mainly practicing in clinics andhospitals, has already been so constricted that many references treat them as one subject.

Accordingly, the Yale psychological centre is expected to deal with all problems. Thesecomplaints range from mild educational adjustments of children and adults and marital

problems that can be dealt with by counseling to severe symptoms of disorder like panic,agoraphobia, obsessive compulsive disorders, depression and sexual dysfunction that need in-depth therapy and behavioral and cognitive interventions.

b) Education and professional training

The centre of clinic can also be a place for the education and training of young counselorsand aspiring psychotherapists. Special group therapeutic sessions can be arranged for patients

who suffer form similar problems and these young counselors and psychotherapists to learnsome of the skills of the profession may attend the therapeutic sessions. The centre can alsoorganize special talks, TV shows and articles in daily papers to educate public about itsservice.

In general, the centre that offers the service is contributing towards social responsibility.Besides, the concern of public on this issues increase the reputation of the centre indirectly.

c) Research and consultancy services

The centre is supposed to carry out research into adaptation of psychological tests andtherapeutic methods to suit the rich cultural aspects of Malaysia. Most psychologicalassessment techniques are developed for use in Western countries. To be useful for theapplication in Malaysia, we need to adapt and standardized some of the instruments used inpsychological testing. In doing so, the centre will co-operate with different departments ofpsychology in Malaysia. Also, the Malaysian Psychological Society can be of help in thisissue. Another important service that centre can offer is perform research studies andconsultations for Malaysia companies and other Institution interest in special psychologicalprojects within the interest of the clinic.

While the Centre accepts referrals from a wide range of other professionals and from both

private and government sponsored agencies, clients are encourage to make direct contact.

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Psychological Clinics