Transformative Change through Clinical Supervision with Cultural Humility
Mental health needs in South Africa are significant. An estimated one out of every eight people currently have a diagnosable mental health condition (Sorsdahl et al., 2023); one in six adults met diagnostic criteria for depression, anxiety, or substance use in a 12-month period (Herman et al., 2009; Sorsdahl et al., 2023). In addition, there is a significant and severe shortage of providers: .97 public sector psychologists and .31 public sector psychiatrists per 100,000 uninsured in the population who include a historically marginalized, culturally, racially and linguistically diverse client population. As Pillay and Nyandini (2020) concluded in their follow-up to a study by Pillay and Siyothula (2008), no increase in admissions of black students had occurred even though the Health Professions Council of South Africa had set a target for increasing training numbers of black African students two decades prior.
In their study of South African clinical and counseling supervisors’ perceptions, Hendricks, Cartwright, and Cowden (2021) concluded that currently, individuals begin supervising prematurely, without formal training or readiness. This impacts quality of care, attitudes towards psychological intervention.
Addressing this crisis, clinical supervision through a frame of cultural humility has potential to be an agent of change. In South Africa, data on admissions and completion of graduate training indicate critical need for attention to multicultural diversity recruitment, familiarity and comfort with cultural diversity in mental health, and availability of services, distinct needs of the client population, and demographics generally. Introducing the study of psychology early in elementary school curriculum is a good entry point.
Mental health needs in South Africa are significant. An estimated one out of every eight people currently have a diagnosable mental health condition (Sorsdahl et al., 2023); one in six adults met diagnostic criteria for depression, anxiety, or substance use disorders in a 12-month period (Herman et al., 2009; Sorsdahl et al., 2023). However, there is a severe shortage of mental health providers: only 0.97 public sector psychologists and 0.31 public sector psychiatrists per 100,000 uninsured individuals in the population, which includes a historically marginalized, culturally, racially, and linguistically diverse client population (Pillay & Nyandini, 2020). Despite the Health Professions Council of South Africa setting a target to increase the training of Black African students two decades prior, Pillay and Siyothula (2008) found no increase in admissions of Black students.
Hendricks, Cartwright, and Cowden (2021) concluded that in South Africa, clinical and counseling supervisors often begin supervising prematurely, without formal training or readiness, impacting the quality of care and attitudes toward psychological intervention. Addressing this crisis, clinical supervision through a frame of cultural humility has the potential to be an agent of change. Data on admissions and completion of graduate training in South Africa indicate a critical need for attention to multicultural diversity recruitment, familiarity and comfort with mental health, availability of services distinct to the client population’s needs, and demographics generally, including introducing the study of psychology early in the elementary school curriculum.
Strategies to address interest in psychology training through use of a competency-based supervision model in the frame of cultural humility are presented to enhance accessibility, value attached, and perceived relevance of mental health treatment and career development.
Carol Falender, Ph.D. is co-author/editor of seven books on clinical supervision and consultation, has presented workshops on clinical supervision, the competency-based model, multicultural supervision, and ethics and regulatory issues in supervision in the U.S., Canada, and internationally. She received the Society for the Advancement of Psychotherapy Distinguished Award for International Advancement of Psychotherapy in 2023.