Black South Africans’ Perceptions of Psychotherapy and Counselling
Abstract
The public health issue of mental health is a concern in South Africa. However, studies indicate that only a minority of Black South Africans pursue psychotherapy and/or counselling, while most, around eighty percent, rely on traditional healers for mental health issues, unlike their white counterparts. This qualitative study, grounded in social constructivism and phenomenological design, examined the perceptions of psychotherapy and/or counselling among Black South Africans in the Soweto township of Gauteng Province, South Africa. It aimed to understand this conundrum and discrepancy. Data was generated through individual face-to-face semi-structured interviews and analysed through thematic analysis. The analysis uncovered different themes and sub-themes. The findings revealed that Black individuals have a reasonable understanding of psychotherapy and/or counselling. Furthermore, the study demonstrated a shift in perception among Black South Africans, as they expressed a combination of negative and positive opinions on psychotherapy and/or counselling. The results of this study emphasise the need for heightened awareness campaigns to address, clarify and demystify negative perceptions. Additionally, there is a need for targeted interventions that are relatable, relevant, context-specific, and sensitive to the needs of Black South Africans. Future studies should consider conducting a longitudinal study to monitor the trajectory of the perceptions of Black South Africans over time.
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References
Bantjes, J., Kagee, A. & Young, C. (2016). Counseling psychology in South Africa. Counseling Psychology Quarterly, 29(2), 171–183. https://doi.org/10.1080/09515070.2015.1128401
Bhardwaj, P. (2019). Types of Sampling in Research. Journal of the Practice of Cardiovascular Sciences, 157-163. https://doi.org/10.4103/jpcs.jpcs_62_19
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Chen, M. (2008, November). Address at the WHO Congress on Traditional Medicine. https://www.who.int/director-general/speeches/detail/address-at-the-who-congress-on-traditional-medicine
Connell, R. W. (2005). Masculinities. University of California Press. https://books.google.co.za/books?id=XuCxQgAACAAJ
Employee Assistance Professionals Association of South Africa. (2023). The State of Mental Health in South Africa. https://www.eapasa.co.za/the-state-of-mental-health-in-south-africa/
Francis, D., & Webster, E. (2019). Poverty and inequality in South Africa: critical reflections. Development Southern Africa, 36(6), 788–802. https://doi.org/10.1080/0376835X.2019.1666703
Futshane, V. (2021). Recovering from Covid-19 and Inequality: The Experience of South Africa. https://docslib.org/doc/13592362/recovering-from-covid-19-and-inequality-the-experience-of-south-africa-vuyokazi-futshane-25-may-2021
Gonzalez, E., Tomaszewski, L.E. & Zarestky J. (2020). Planning Qualitative Research: Design and Decision Making for New Researchers. International Journal of Qualitative Methods, 1-7.
Gumede, W. (2021, October 28). Untreated mental illnesses impact SA’s economy, social and family stability. https://www.wits.ac.za
Harriman, N. W., Williams, D. R., Morgan, J. W., Sewpaul, R., Manyaapelo, T., Sifunda, S., Mabaso, M., Mbewu, A. D., & Reddy, S. P. (2021). Racial disparities in psychological distress in post-apartheid South Africa: results from the SANHANES-1 survey. Social psychiatry and psychiatric epidemiology, 57(4), 843–857. https://doi.org/10.1007/s00127-021-02175-w
Jackson, P. B., Williams, D. R., Stein, D. J., Herman, A., Williams, S. L., & Redmond, D. L. (2010). Race and psychological distress: the South African stress and health study. Journal of health and social behavior, 51(4), 458–477. https://doi.org/10.1177/0022146510386795
Lawal, S. (2024, April 27). South Africa: 30 years after apartheid, what has changed? https://www.aljazeera.com
Lund, C., Kleintjes, S., Cooper, S., Petersen, I., Bhana, A., & Flisher, A. J. (2011). Challenges facing South Africa’s mental health care system: Stakeholders’ perceptions of causes and potential solutions. International Journal of Culture and Mental Health, 4(1), 23–38. https://doi.org/10.1080/17542863.2010.503039
Luthada, N. V., & Netshandama, V. O. (2019). An investigation into the trend of domestic violence on men: Re-visiting the Sepedi adage “Monna ke nku o llela teng.” Gender and Behaviour, 17(3). https://www.ajol.info/index.php/gab/article/view/191230
Mashamaite, P. G. (2015). An exploration of the treatment of mental illness by indigenous healers in Moletjie, Capricorn district, Limpopo Province [Master’s dissertation, University of Limpopo]. http://ulspace.ul.ac.za/handle/10386/1533
Mendu, E., & Ross, E. (2019). Biomedical healthcare and African traditional healing in the management of HIV and AIDS: complimentary or competing cosmologies? African journal of AIDS research: AJAR, 18(2), 104–114. https://doi.org/10.2989/16085906.2019.1619600
Mngoma, N. F., & Ayonrinde, O. A. (2023). Mental distress and substance use among rural Black South African youth who are not in employment, education or training (NEET). The International journal of social psychiatry, 69(3), 532–542. https://doi.org/10.1177/00207640221114252
Mothibe, M.E., & Sibanda, M. (2019). African traditional medicine: South African perspective (pp. 1-27). IntechOpen. https://doi:10.5772/intechopen.83790. https://www.intechopen.com/books/traditional-and-complementary-medicine/african-traditional-medicine-south-african-perspective
Neubauer, B. E., Witkop, C. T., & Varpio, L. (2019). How phenomenology can help us learn from the experiences of others. Perspect Medical Education, 8(2), 90-97. https://doi.org/10.1007/s40037-019-0509-2
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic Analysis: Striving to Meet the Trustworthiness Criteria. International Journal of Qualitative Methods, 16(1). https://doi.org/10.1177/1609406917733847
Olugbile, O., Zachariah, N. P., & Isichei, B. (2007). Nosology and modalities for deciding on the management of patients with psychiatric illness among traditional healers in Lagos, Nigeria. International psychiatry: bulletin of the Board of International Affairs of the Royal College of Psychiatrists, 4(4), 83–84.
Omolayo, B.O., & Osagu, J. (2013). Counseling and Psychotherapy: Is there any difference? Department Of Psychology, 1-8. https://hdl.handle.net/10520/EJC138729
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and policy in mental health and mental health services research, 42(5), 533-544. https://doi.org/10.1007/s10488-013-0528-y
Pawlak, A., & Kacprzyk-Straszak, A. (2020). What is psychotherapy today? Overview of psychotherapeutic concepts. Journal of Education, Health and Sport, 10(5), 19. https://doi.org/10.12775/jehs.2020.10.05.002
Ross, E. (2007). Traditional Healing in South Africa. Social Work in Health Care, 46(2), 15–33. https://doi.org/10.1300/j010v46n02_02
Ruane, I. (2010). Obstacles to the Utilisation of Psychological Resources in a South African Township Community. South African Journal of Psychology, 40(2), 214–225. https://doi.org/10.1177/008124631004000211
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & quantity, 52(4), 1893-1907. https://doi.org/10.1007/s11135-017-0574-8
Semenya, S. S., & Potgieter, M. J. (2014). Bapedi traditional healers in the Limpopo Province, South Africa: Their socio-cultural profile and traditional healing practice. Journal of Ethnobiology and Ethnomedicine, 10(4). https://doi.org/10.1186/1746-4269-10-4
Shange, S., & Ross, E. (2022). “The Question Is Not How but Why Things Happen”: South African Traditional Healers’ Explanatory Model of Mental Illness, Its Diagnosis and Treatment. Journal of Cross-Cultural Psychology, 53(5), 503-521. https://doi.org/10.1177/00220221221077361
South African Depression and Anxiety Group. (2021). World Mental Health Day 2021. https://www.sadag.org/index.php?option=com_content&view=article&id=3091&Itemid=483.
South African Medical and Education Foundation. (2022). Mental health in South Africa. Mental health: A Growing condition in healthcare for South Africa, https://www.samefoundation.org.za/mental-health-a-growing-condition-in-healthcare-for-south-africa/
Tenny, S., Brannan, J. M., & Brannan, G. D. (2022). Qualitative Study. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/29262162/
University of Witwatersrand. (2022). Mental health in SA is at shocking levels but people are not seeking help. https://www.wits.ac.za/news/latest-news/research-news/2022/2022-11/mental-health-in-sa-is-at-shocking-levels-but-people-are-not-seeking-help-.html
World Bank Group. (2024, August 01). The World Bank in South Africa, https://www.worldbank.org/en/country/southafrica/overview
World Health Organization. (2024). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
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