Psychological Clinics

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The needs of Psychological Clinics in Malaysia 

The needs of Psychological Clinics in Malaysia
B.Sc(Hons) Community Health (UPM), MBA (UPM), DBA (UBI),  MMIM, MIHRM, MIM-CPT, CAHRP (Consultant), Certified E-Commerce Professional (Mal), Certified Professional Trainer (MIM, PSNB), Certified Stress Management (IACT, USA), Certificate Qualitative Research (Georgia, USA) Certificate in Homeopathy Medicine (Mal)

“I am stress, I don’t want to go to psychiatry, I will be labeled mad or insane. I would rather not to inform others. Let’s me suffer it myself” It is estimated that 70% of all patients who seek help from physicians for their “physical” complaints and illness are in fact suffering from stress, anxiety based on disorder and psychosomatic complaints. One study has even suggested that at least a third of all cardiology patients may have no real physical disorder but they suffer from panic attacks. Modern Western-trained doctors, because of their intensive training in looking for specific bodily symptoms in which they are tested in medical schools, get used to this outlook and take it with them in their medical practice. As the famous Harvard physician, Dr. Herbert Benson, says in his best-selling book, Timeless healing (Simon and Schuster, 1996), Western trained doctors are tested in their ability to remember and diagnose specifics far more than their ability to assess overall patients. They accordingly emphasise particular symptoms over wholeness and body over mind. For this reason, the 70% of patients whose core problem is psychological continue to receive drugs after drugs that can only help temporarily through suggestion. They may continue to see many doctors without finding one who recognizes their underlying emotional disturbance, their depression or their sexual dysfunction as the real etiological factor in their external illness Even patients who know that they are suffering from psychological problems such as anxiety based or mood disorders do not get the help they really need. Because of the stigma of “insanity”, many of them would not accept to see a psychiatrist. Besides, even those who do may not get the proper psychological therapy they need. Psychiatrists, as doctors who graduated from medical schools, prefer to prescribe drugs and other psychical therapies to long interviews and counseling Many of them had not even intensively trained in the modern psychotherapeutic method such as the use of systematic desensitization as behavioral therapy for phobic anxieties, sexual disorders and similar problems, the use of cognitive therapy for depression and the use of aversion therapy for addiction, tics and some forms of obsessive compulsive neuroses. Some psychiatrists who had been trained in the some of these behavioral and cognitive therapies may not have the time for their application. This is particularly true for those who work in private clinics. They can see more patients by briefly listening to their complaints and prescribing medicines. Patients who refuse to be referred to psychiatrists would be glad to see bomos and traditional healers. In research study presented by Badri to the Traditional Medical Practices Committee


Dr Leow Chee Seng 

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The needs of Psychological Clinics in Malaysia 

of the WHO in Geneva in 1973, has found that in most Islamic countries, the great majority of neurotic patients go to traditional healers. Many of them may get suggestive and spiritual help that are not available in modern hospitals and psychiatric clinics. However, they are also deprived from the modern psychotherapeutic techniques we just mentioned. From what has been said, the medical services in Malaysia is in great need for the establishment of psychological clinics in which trained therapists can offer their expertise to those who need it. General practitioners and even specialist should be informed about such psychological services and they should know when to refer some of the 70% of patients whose problems are either psychophysiological and downright anxiety or mood disorder. Since such patients can be cured or very such improved by psychotherapy, this may actually be economically cost effective. When such psychological clinics are set up, psychiatrists would be happy to refer suitable patients to the clinical psychologist who is also helped by a psychiatric social workers. On the other hand, patients who directly refer themselves to the psychological clinic and who need psychiatric drugs or more serious medical interventions are to be referred by the clinical psychologist to psychiatrists or physicians, Often, the patient who needs antidepressants or tranquillizers but who is afraid to go to a psychiatrists for fear of being stamped as “crazy”, can benefit from the therapy of the psychologist who convinces him to accept referral to the psychiatrist or physician. The co-operation between the psychologist and the doctors is very essential since at times purely organic disorder as hypoglycemia and hyperthyroidism can mimic anxiety symptoms and patient may unknowingly refer himself to psychologist or counselor. In modern countries that recognize the importance of psychological therapies to anxiety based and mood disorders such as the United States, it is estimated that specific phobias, which are the most common from the anxiety disorders, are more common than alcohol abuse, alcohol dependence, and major depression added together. It is reported in 1990, the United States spent 147.8billion mental health dollars. Of this amount such as $ 46.6 billion (32%) were spent on the treatment of anxiety disorders. Thus, it seems that in Malaysia and other Muslim and Afro-Asian countries the absence of such psychological services has ironically eclipsed the dire need for them.

It is clear from our statement of problem what services that psychological clinic can offer to its troubled patients and those who need minor therapy and counseling. However, the following list of services can be more illuminating. The Center provides three major services for the community: a) Counseling and psychotherapy Though counseling and psychotherapy were once considered two different forms of psychological intervention, the dividing line between them is becoming quite vague. In the paper title “counseling and psychotherapy from an Islamic prospective” (Ashajara, 1996, Vol. 1, No 1 & 2) Badri says: “ The “no man’s land” between the boundaries of counseling as speciality of educators and psychologists who offer guidance to normal people and students with mild emotional and academic problems, mainly practiced in educational institutions and that of psychotherapy as


Dr Leow Chee Seng 

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The needs of Psychological Clinics in Malaysia 

that of experts in clinical psychology and psychoanalysis, mainly practicing in clinics and hospitals, has already been so constricted that many references treat them as one subject.” Accordingly, the Yale psychological centre is expected to deal with all problems. These complaints range from mild educational adjustments of children and adults and marital problems that can be dealt with by counseling to severe symptoms of disorder like panic, agoraphobia, obsessive compulsive disorders, depression and sexual dysfunction that need indepth therapy and behavioral and cognitive interventions.

b) Education and professional training The centre of clinic can also be a place for the education and training of young counselors and aspiring psychotherapists. Special group therapeutic sessions can be arranged for patients who suffer form similar problems and these young counselors and psychotherapists to learn some of the skills of the profession may attend the therapeutic sessions. The centre can also organize special talks, TV shows and articles in daily papers to educate public about its service. In general, the centre that offers the service is contributing towards social responsibility. Besides, the concern of public on this issues increase the reputation of the centre indirectly. c) Research and consultancy services The centre is supposed to carry out research into adaptation of psychological tests and therapeutic methods to suit the rich cultural aspects of Malaysia. Most psychological assessment techniques are developed for use in Western countries. To be useful for the application in Malaysia, we need to adapt and standardized some of the instruments used in psychological testing. In doing so, the centre will co-operate with different departments of psychology in Malaysia. Also, the Malaysian Psychological Society can be of help in this issue. Another important service that centre can offer is perform research studies and consultations for Malaysia companies and other Institution interest in special psychological projects within the interest of the clinic. While the Centre accepts referrals from a wide range of other professionals and from both private and government sponsored agencies, clients are encourage to make direct contact.


Dr Leow Chee Seng 

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