Thailand

Summary

Counselling Associations

All Professional Bodies, National Associations (e.g. Mental Health, School, Guidance, Addiction, Faith-based etc.) and Accrediting Organisations.

PSI (Psychological Services International)

The Life Change People

Bangkok Counselling Service

Universities and Other Education and Training Institutes

Center for Psychological Wellness at Chulalongkorn University

Chulalongkorn University

Counselling Agencies, Services, Group Practices, Counselling Centres

Background & Context

Influenced by Western methods and systems, Thailand’s roots in the mental health care system stretches back 120 years (Tuicomepee, Romano & Pokaeo, 2012). Although counselling as a profession is new in Thailand, psychology as a subject isn’t a modern practice. The 1930’s marked the first time it was ever taught in the country’s teacher training curricula. From then, it has gone through quite the evolution with tertiary academies like Chulalongkorn University and Assumption University offering undergraduate and postgraduate programs in Psychology. 

With the late 1990s, came a period of globalization which, as a result of technological and economic advancements, brought about a dire need for mental health services. This was mostly due to instant cultural changes that influenced the average population’s lifestyle where it became more competitive and fast resulting in heightened stress levels and behavioral problems (Sangganjanavanich & Nolrajsuwat, 2015).

A study by the World Health Organization in 2016 showed that Thailand has one of the highest suicide rates in Southeast Asia at 14.4 suicides per 100,000 citizens. Despite the spike in such cases, there is a huge disparity in psychiatrists and psychosocial staff with only 7.29 mental health personnel for every 100,000 citizens, which are disproportionately concentrated in only the major cities, like Bangkok. Another study by Supanya and colleagues (2017), observed that the proportion of people diagnosed with depressive disorders accessing mental health services has grown exponentially from 2009 to 2016. The paper explored the success of Thailand’s development of a newer evidence-based surveillance and conceptual framework for suicide and depression. The system was based off five primary concepts: (i) to improve awareness of depression and depressive disorders and to reduce associated stigma through education; (ii) to reduce the progression to depressive illness in those at risk; (iii) to reduce the length of depressive episodes, with early, appropriate and effective interventions; (iv) to prevent suicide, an important comorbidity of major depressive disorder; and (v) to prevent relapse and recurrence of depression (Supanya, S., et al., 2017). 

Although Thailand started out with more of a Western modality when it comes to therapy, the country has eventually transitioned to approaches like logotherapy and mindfulness-based therapy that are more adjusted to the Thai culture. According to Chanpattana (2010), therapies such as person-centered therapy, which emphasizes the here-and-now concept which is heavily practiced in Buddhism sects, seem to work more effectively for the Thai population.

Current Regulatory Status / Level of Recognition:

Despite the introduction of this new evidence based system mentioned above, the overall statistics when it comes to the number of counsellors and their practices remain uncertain (Sangganjanavanich & Nolrajsuwat, 2015).The counselling “scene” in Thailand seems to operate from the interconnectedness among counsellors and other mental health professionals such as social workers and psychologists. Although it seems to be a good play on their part, there are also certain issues that stem from this situation. One of them includes difficulty in differentiating counsellors from other professionals. 

         Another point worth mentioning is that a majority of counsellors from social agencies tend to be trained in various forms of psychology, like social psychology and developmental psychology, as well as having experience in social work, which has ultimately led to undefined professional identities and undeveloped professional credentials and backgrounds. Overall, there is no professional association or standards that are set to ensure the quality of counselling services. The opposite seems to be the case when it comes to psychiatry and social work with associations like the Thai Psychological Association and the Social Workers Association of Thailand. 

Practice Settings

When it comes to counselling services there are numerous practice settings, some of which include: 

  • Schools & Universities
  • Private practices
  • Clinics & Hospitals
  • Retreats (this may come in the form of spiritual or counselling retreats for couples)

Interestingly, when it comes to group counselling and family counselling the settings in this country tend to differ from most. These types of counselling sessions and practices tend to be offered at hospitals and often reserved for psychiatrists to utilize not counsellors. This may be due to the Thai belief that family is sacred and oftentimes, the general population isn’t aware of such services and would not be interested due to the mental health stigma. 

Challenges & Trends

Thailand faces a number of challenges when it comes to counselling and mental healthcare. Listed here are a few of them: 

  1. Accessibility issues
  • Thailand has a disproportionate concentration of mental health personnel in the bigger cities compared to other smaller cities (WHO, 2016)
  1. Lack of standardization when it comes to licensing and regulations
  2. Lack of manpower in the mental health sector
  • According to Nimmawit and colleagues (2020), prevalence of high levels of burnout had increased dramatically from 17.1% to 49.3% among psychiatrists due to overwhelming workloads.  
  1. Lack of an association for counselling
  2. An overall lack of awareness and mental health stigma

Additional Information & References

For a deeper exploration of the counselling profession in the country, interested readers are recommended to read the following journal & website articles:

Thailand
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