What is it about?
Therapists trained in Western countries like North America, Europe, and Oceania often face difficult ethical challenges when they start practicing in countries across Asia, Africa, Latin America, and the Middle East. The cultural values, legal systems, and healthcare structures in these regions can be very different from what they were trained in. For instance, the way therapy is regulated, how clients access mental health care, and whether insurance covers services can all work differently. This article challenges the assumption that Western ethical guidelines apply everywhere and introduces a new framework that empowers therapists to challenge Western ethics and adapt their practice to local realities.
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Perspectives
My inspiration for this article initially came from the concept of “reverse culture shock", a term I first encountered in discussions with therapists who trained in the U.S. and later returned to practice in Asian countries and other regions. However, as I delved deeper, I realized that what they were experiencing wasn’t simply a “shock from cultural differences.” After all, many of these therapists are from those countries—they know the culture well! The real issue lies in how we are conditioned to see Western training as THE standard, the way things “should be.” When this belief is ingrained in us, any social reality that differs from what we were taught can feel "wrong" or "inferior. Beyond this, I’ve also long questioned the role of Western “experts” who are invited—often at high fees—to the Majority World to promote what they deem to be the “best psychology.” This unquestioned authority of Western models over local knowledge has always puzzled me. These two threads—our internalized assumptions about Western psychology and the systemic privileging of Western expertise—led me to explore the ethical foundations of our field and how they have been shaped. That’s what this paper is about. I truly hope you enjoy reading this article. Even more than that, I welcome critique! I’d love to hear your thoughts and ideas for further exploration.
Yiheng Zhou
University of Iowa
Read the Original
This page is a summary of: Ethical practice in the majority world: A framework for psychotherapists trained in the minority world., American Psychologist, March 2025, American Psychological Association (APA),
DOI: 10.1037/amp0001511.
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