Working internationally as an early career professional: My journey

Dr. Hu is an early career clinical psychologist in the San Francisco Bay area who has worked in Cambodia, China and Uzbekistan. In this article, he discusses his journey in developing an international career and highlights ways that other early career psychologists can become involved internationally.

By George Hu, PsyD

The Chinese philosopher Lao Zi, in the sixth century B.C., said that a journey of ten thousand "li" begins with a single step. When I began graduate school, I thought I would take the Jim Collins approach and begin with the end in mind. I envisioned my career in professional psychology to look a certain way, with a certain type of practice and treating a certain type of client. But though the ink on my diploma is barely dry, the career I currently have already looks very different from my initial vision. My full-time job is as a program coordinator for outpatient services at a community mental health clinic in the San Francisco Bay Area. In addition to that, I lead a weekly consultation group in China via Skype; travel yearly to consult with a non-governmental organization in Uzbekistan; completed a six month clinical practicum in western China; and conducted my dissertation research with victims of sex trafficking in Cambodia. It can often be challenging for an early career professional to develop an international aspect to a career, but some things can facilitate the process.

Dr. Hu teaching a seminar to psychologists and mental health workers in Tashkent, Uzbekistan.The first step in my ten thousand "li" journey was to make contacts. Contacts are to an early career international psychologist as location is to a homebuyer. When I was a practicum student at the San Francisco VA Medical Center, I met a colleague who was a psychiatrist in China before earning her PhD in clinical psychology in the United States. When she heard about my interest in Chinese psychology, she put me in touch with someone she knew in China. That contact, who had become the chief psychiatrist in a provincial medical center, led to my and my wife’s move to Xi’An so I could complete a clinical rotation, utilizing my skills in Mandarin to treat patients and teach seminars to clinicians there. This became one of the richest experiences for me, as I had the opportunity to immerse myself in the culture, mindset, history and traditions of a culture that to me seemed simultaneously familiar, yet so foreign. While working here, I began to question so much of what we have come to accept as universal in western psychology (e.g., theories of attachment, developmental stages, how to build a therapeutic alliance and provide a sense of safety and what we consider “state” versus “trait”). I began to wonder if much of what we consider immutable in psychology today has in fact been borne out of western culture and worldview, and needs to be reinterpreted and/or rebuilt for individuals from a completely different tradition.

Today, I continue my work in China by leading a weekly consultation group with five mental health clinicians in the city of Hangzhou. Our Skype sessions this past year have covered topics of personality assessment, cross-cultural therapy, attachment, developmental disorders and trauma. Additionally, we discuss topics of cross-cultural psychology and treatment, such as how functional impairment may be expressed differently in members of the Chinese culture, or how concepts of privacy or confidentiality need to be redefined for that society. Currently, we are working through a curriculum I developed using Judith Beck’s Cognitive Therapy: Basics and Beyond as a text, and supplementing with discussions around case studies and examples from their own clinical work. Every time we meet, it is a mutual exchange as I bring knowledge and training I’ve gained in the United States while at the same time receiving and experiencing the views and perspectives from my colleagues in China.

Many years ago, I had the opportunity to travel to Uzbekistan. At that time, the nation had just concluded Soviet control and was attempting to rediscover its identity and to build a social, economic and political infrastructure that would be viable in the long term. While in the capital city of Tashkent, I met an American couple who were volunteering at a government orphanage for children with disabilities. As the nation attempted to find its way, so many of its children were forgotten and abandoned in orphanages throughout the country, especially those with any sort of disabling condition. The orphanage supported by this couple stood in contrast to the others; it offered education, recreation and therapeutic services that were uncommon in Uzbekistan at that time.

Years later, that same couple formed an LLC named Opportunities Unlimited, based in Tashkent, in order to continue the work they started at the orphanage. They asked me to become a consultant in their project to build a center that helped adults with disabilities gain skills and receive services that would aid their transition to society. This “transition center” is the first of its kind in the region, as broader society still believes that those with disabilities have little hope of living independently as a functional part of the community.

The Transition Center boasts a therapy pool, a physical therapy room and several large areas for vocational training (including a computer lab, a fully functional area for cosmetology and hairdressing, a jewelry studio, a sewing room and outdoor fields for agricultural training and beekeeping). Additionally, the center houses a large sensory room with areas designed to stimulate sensory modalities and facilitate engagement and communication. It also intends to provide support groups where residents can share and process their experiences, challenges and victories with one another, facilitated by trained staff members. Initially, I became involved with the construction of the sensory room and utilized my experience with similar environments during past training experiences with the developmentally disabled. However, my role has expanded to include training the staff in handling crisis situations, utilizing behavioral therapy techniques with the developmentally disabled, group therapy and advising on schedule, layout and organization of the center itself.

The Transition Center in Tashkent is to be a residential facility, with living spaces intended for several residents to live together with a mentor family or couple. It is designed to mirror the family and community structure of the Uzbek culture, in order to facilitate cultural understanding and foster relationships. Though it has been fully completed and operational for a few years, the center has not yet opened and is pending final approval from relevant government authorities. Because of this, I find that my role has changed from consultant and trainer to advocate, seeking to educate and bring awareness to the fact that those with physical or mental disabilities can indeed become contributing members of society.

Early career psychologists need not discount an international career, but can utilize perseverance to build contacts and relationships abroad.

For more information on any of the projects mentioned above, please contact George Hu.