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Our cities are increasingly multi-cultural and multi-racial yet this diversity is not reflected in the psychotherapy profession nor in its patient population. In addition, there is a perception that the western-trained therapist is ill equipped to undertake therapy with members of ethnic/cultural minorities (hereafter ‘blacks’). The importance of this book lies in its attempt to place these issues squarely on the agenda. The book is a fitting tribute to the memory of Jafar Kareem - pioneer and campaigner in this field, and founder of Nafsiyat, the intercultural therapy centre - who died unexpectedly a few months after its publication.
The book is made up of twelve thoughtful chapters grouped into three sections - themes, interpretations and practice. It has an appendix of nearly sixty pages of case material for teaching purposes, including suggestions for how it might be used to illuminate the effect of clinicians' stereotypes on clinical thinking. Unfortunately there are no therapy session transcripts. The book ends with an extensive bibliography.
In the first of three ‘themes’ chapters Roland Littlewood presents a historical overview that makes a very good case for taking seriously the provision of psychotherapy services for blacks. Jafar Kareem follows with an account of the orientation of Nafsiyat, giving examples of the sort of patients seen and work done there. His is an approach that takes into account not only the inner world, but also the patient's context and the effect of life in a racist society (the societal transference). Littlewood's second chapter in this section brings a refreshing anthropological perspective to the debate. He shows that although ‘psychological’ distress is recognised and treated universally, its conceptualisation as psychological, and treatment by psycho-therapy, are peculiarly western. Thus, when it comes to the black patient we cannot assume an automatic right to intervene with our psychotherapy. He advocates an intercultural thera