Forging an international mentorship: CBT consultation

Eva Feindler, PhD, Long Island University clinical psychology program

As a member of the APA Tanzania International Learning Partner Program, I had the pleasure of meeting with some very dedicated and passionate counseling psychologists in Dar es Salaam and Zanzibar. We visited universities and schools of health and heard about new programs in counseling psychology even at the undergraduate level. We also visited government agencies, orphanages, trauma centers, sober houses, community centers for youth, inpatient and outpatient hospitals and a peaceful home for the aging.

It was a whirlwind of 10 days, filled with delicious food, sunset Dhow cruises, beaches, spices, music and gorgeous fabrics! What struck me was the generosity of our host country delegates and the incredible need for resources and clinical training. As a life-long educator in doctoral training of clinical psychologists, I know how our comprehensive approaches to training and supervision are very far from their current desire for the development of psychological practice in Tanzania.

During our first couple of days in Dar es Salaam, we were accompanied by several masters level psychologists including Saldin Kimangale. In fact, we toured the school where he worked: Al Muntazir Islamic Seminary. Across these days, we spoke about many things and he impressed me as a smart and dedicated young man who had received his degree in clinical psychology at Muhimbili University of Health and Allied Sciences and developed his own practice. Fluent in English, he helped us to translate the many conversations we had with others who only spoke Kiswahili. Further, he was a colleague of our in-country coordinator Hafsa Mzee Mwita, PhD, and was dedicated to continuing his own training.

Upon our return to the U.S., our group began discussions about how we might be of some help in providing resources and training to those we met while in Tanzania and Zanzibar. We were able to collect and share many electronic resources available to us in the U.S. but not to them. We pulled together treatment manuals, trauma materials including psychological first aid, and other readings and assessments. Saldin and I exchanged emails about the areas I have some competencies in and in mid-March I asked him what made sense to him in terms of consultation. We agreed to a clinical mentorship arrangement in which we would schedule a Skype video chat each week about clinical issues and his clients. He helped me frame the content for our sessions by completing a cognitive behavioral therapy (CBT) competency checklist and we focused in on the areas he wanted to develop.

Each week I send him readings for a chosen topic, we discuss those and work through some ideas like the following: collaborative empiricism, using self-monitoring data to develop case conceptualizations and treatment plans, developing and using thought records, use of Socratic questioning, how to develop homework assignments in CBT and get compliance, maintaining the therapeutic alliance and functional analyses. We also have settled on two clients that we review and I have even gotten to listen to audiotapes of his sessions, which is my preferred way to do clinical supervision. We have had some really rich clinical discussions about OCD behaviors and religious rituals as part of the Muslim faith for one of his clients and Saldin has taught me a great deal about his faith and the intersection of culture and CBT practice.

To date, we have had 12 Skype sessions and we plan to continue. This coming fall, I have two advanced doctoral students that have agreed to follow this weekly consultation model with two of Saldin’s colleagues. It is my hope that we can grow this network and give others in the states the opportunity to mentor those from across the world.

Saldin Kimangale, MSc, school counselor and clinical psychology private practice

“Abstaining from alcohol may lead to symptoms of grief and loss... like [the] death of beloved one, so they basically need grief and loss intervention.” This was the first insight I got from Virginia Waters, PhD, on Jan. 7, 2019 during the meeting with a few members of Alcoholics Anonymous while discussing challenges they’re facing after abstaining from alcohol consumption. This was the beginning of my eagerness to learn from this APA team.

It is hard to believe that now I have access to a highly respectable institution — APA, but that's how it is! With the clinical psychology training I received from my home college, which I believe has a high standard of training, my desire to learn more from advanced trainers and practitioners was so intense. I don’t know how it happened but currently I am exchanging emails and doing skype guidance and supervision from one of APA’s members and CBT trainer from a notable university in U.S. — Eva Feindler, PhD. This is an incredible opportunity, and I believe is one of the best fruits of the APA International Learning Partner Program in Tanzania

With Feindler, I am now much more confident doing CBT than before and hope to do the same in other areas, including psychological first aid. It has been very interesting to see how my client is responding and getting better every day with the implementation of properly used evidence-based interventions. I am realizing that with proper training and supervision we can help our clients more confidently. I believe we own only the skeleton of these interventions and lack technical know-how, hence the need for proper supervision from highly qualified practitioners. Am I alone in this program? No! Sheena Walker, PhD, and Virginia Waters, PhD, also from the APA delegation, are doing the same with my colleagues. I can see the future of counseling and clinical psychologists’ practices in our country with the help of this team from APA.