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The International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) publishes a volume following each world congress of the IACAPAP. It has done so since 1970, and the current volume recaps the work of the 2008 Congress that took place in Istanbul, Turkey. These conferences and publications have provided expressive forums for different professional groups, examining issues that child and adolescent practitioners and researchers face each day in different cultural settings.
In this compilation of papers, the focus is on an extraordinarily wide range of transcultural issues, such as the effects of an on-going war in the Middle East, the burden of stigma on limiting access for care, international adoptions, and work with immigrant groups and torture. These are included in the first section of the volume. The authors speak to the developmental challenges that are faced by families within the context of military conflict. It is the authors' perspective that while war will interfere with optimal development, there may indeed be ways to mitigate the effects. Namely, the research highlights how a supportive and cohesive atmosphere within the family system can aid in the child's adjustment to the persistent trauma.
Ethnographic work carried out in Cambodia -- in conjunction with the Buddhist community - offers a fascinating look at the possibility of educating locals in child psychiatry under incredibly different circumstances. The monks and the traditional healers work within the context of their religious beliefs as they minister to the childhood disorders -- oftentimes regarding some symptoms, such as convulsions, as links with their previous life and their mother -- ties with whom need to be severed in order for the child to move healthily into adulthood.
In the second section, cultural aspects of specific disorders of child and adolescent concern are addressed, including the clinical aspects of conversion disorder in Turkey. Emotional problems may not be taken seriously by the child's family or the physician. Coincident with the comparative lack of words to express emotions, body language may instead be used. Mythical beliefs may play a role, one example being the common belief that "djinnies" exist and that patients may indeed be possessed by these harmful djinnies, causing, for example, the symptoms of hysteria.
The incidence of depression and suicide in Japan has been linked to family and interpersonal conflict in more recent studies, and is focused on in an illustrative chapter. Similarly, Swedish studies have focused on parental mental health and the effect of their traumatic experiences on the mental health of their children. The effects of stress and torture are also addressed in reported studies, e.g., in immigrants settling in Greece.
The final section details the need for understanding the cultural aspects of the work by the training institutions preparing workers such as child psychiatrists. The need for coordination between government agencies in developing and implementing treatment programs -- programs that will be effective in these challenging circumstances.
This volume of papers from the IACAPAP conference give the reader a flavor of critical, provocative and challenging work going on globally in the field of child and adolescent mental health. It is a fascinating account of the research, the setting up of programs, and the attempts to train workers in cultural areas far outside our usual zones of comfort.
© 2009 Rudy Oldeschulte
Rudy Oldeschulte trained in psychoanalysis with Anna Freud, and now teaches ethics, psychology, and sociology. [email protected]
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