"No matter what, we just work with the trauma…": Mental Health Therapists' Care of Diverse Sexual and Gender Identity Citizens in Cambodia

Julie E Bertram, Rachel Kryah, Roxanne Vandermause, Nil Ean, Robert Paul, Adam Carrico, Chhit Sophal, Steven Bruce, Kelly Gregory, Ellen Stein, Julie Mannarino, Julie E Bertram, Rachel Kryah, Roxanne Vandermause, Nil Ean, Robert Paul, Adam Carrico, Chhit Sophal, Steven Bruce, Kelly Gregory, Ellen Stein, Julie Mannarino

Abstract

The convergence of trauma symptomatology, mental health symptoms, family and social difficulties, and intersectionality of diverse sexual and gender minority (SGM) individual issues is complex, multi-faceted, and challenging for the individuals in Cambodia who suffer them and for the therapists in Cambodia who meet individuals in treatment. We documented and analyzed the perspectives of mental health therapists in the context of a randomized control trial (RCT) intervention within the Mekong Project in Cambodia. The research questions explored perceptions of therapists' care of mental health clients, therapist well-being, and experiences of navigating within a research environment in which SGM citizens with mental health concerns receive treatment. The larger study enrolled 150 Cambodian adults, among which 69 identified as SGM. Three key patterns emerged across our interpretations. Clients seek help when symptoms interfere with daily life, therapists care for clients and themselves, and integrated research and practice is integral yet sometimes paradoxical. Therapists did not identify differences in terms of how they work with SGM clients compared with non-SGM clients. Future studies are warranted to examine a reciprocal academic-research partnership in which we examine therapists' work alongside rural community members, evaluate the process of embedding and fortifying peer supports within educational systems, and study the wisdom of traditional and Buddhist healers to address the discrimination and violence that citizens who identify as SGM disproportionately suffer. National Library of Medicine (U.S.). (2020). Trauma Informed Treatment Algorithms for Novel Outcomes (TITAN). Identifier NCT04304378.

Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

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