Therapy Without Borders

The graduate school adds a new international track to its Marriage, Couple, and Family Therapy program.

By Genevieve Long

When students and faculty from Lewis & Clark’s Marriage, Couple, and Family Therapy (MCFT) program visited Colombia this spring, they collaborated with Afro-Colombian women from Se Quien Soy, a local community group, to teach each other about identity, mourning rituals, gender, and community building.

They also learned about healing methods from Santos Jamioy, a psychologist and indigenous healer. Such experiences are part of a new specialization in international family therapy added to the MCFT program last fall. Through coursework and overseas collaborations, counseling students and faculty are stepping outside their own cultures to learn new ways of supporting mental health and well-being in relationships.

The international track is rooted in Lewis & Clark’s strong tradition of cross-cultural education. Teresa McDowell, professor and chair of counseling psychology, has taken students to several countries, including Egypt, India, and Uganda, since arriving at Lewis & Clark in 2008. Beginning with preparation months in advance, these visits have involved collaborating with students and faculty at overseas institutions, followed by additional study, reflection, and often publication. Creating the new track formalized these activities and added coursework to help students prepare for overseas study and enrich the experience. Faculty members’ relationships with colleagues overseas, plus strong support from President Barry Glassner and Graduate School Dean Scott Fletcher, made 2012 the year when “everything came together,” McDowell says.

The international track brings Lewis & Clark many new opportunities, including expanding the school’s multicultural focus, promoting social justice, increasing global awareness, helping recruit international students, and increasing student diversity. Working with international partners also increases research opportunities and gives graduates new skills and work opportunities.

“I see myself more as more than just a citizen of the U.S.—I am a citizen of the world,” says Therese Long GRAD ’14, who visited Colombia in June. “If I want to work successfully with others, I need to have experiences with other cultures and be able to operate outside my comfort zone.”

The International Classroom

The international track includes eight semester hours of coursework on global awareness and international family therapy. In addition, students and faculty take a two-week international trip each spring to collaborate with one of the program’s overseas partners in the global south: the Bishop Magambo Counsellor Training Institute (BMCTI) in FortPortal, Uganda, or the Pontificia Universidad Javeriana in Cali, Colombia. Because the trip is part of the department’s Culture and Community course, students from other counseling psychology programs may participate.

Each trip includes approximately 10 students—11 went to Colombia in June 2013—and two faculty members. Participants typically stay in hostels or dormitories and spend their time in workshops, presentations, and research. “The goal is to get to know our colleagues and learn together,” says McDowell.

The international track’s partners were chosen for their strong ties with Lewis & Clark’s faculty. McDowell has worked with BMCTI’s director, Paschal Kabura, for nearly a decade; Pilar Hernandez-Wolfe, MCFT program director and associate professor of counseling, is a visiting faculty member at Pontificia Universidad Javeriana. At least half the students on the Colombia trip were fully bilingual in English and Spanish (the rest spoke Spanish from beginner to advanced levels), facilitating a meaningful academic collaboration.

“Because professional mental health counseling is new to Uganda, we don’t encounter many training programs here,” says Kabura, BMCTI’s director. “The Lewis & Clark visits have provided a grand opportunity for our students, and even other counselors in the area, to check out a number of professional issues.”

In addition to the two-week cultural immersion each spring, two MCFT students per year are eligible for a final-semester internship in Uganda or Colombia. They spend the summer assisting with research, teaching a family therapy course, and doing therapy alongside overseas colleagues, with opportunities to work with individuals, couples, families, and communities.

Exchanging Colonialism for Collaboration

McDowell and Hernandez-Wolfe stress that Lewis & Clark students do not visit partner sites to impart knowledge to colleagues or communities viewed as less fortunate. Rather, coursework and travel are designed to help students examine and transform their own cultural paradigms. “The cross-cultural experience is important because it challenges our assumptions about people and their behavior—and about ourselves,” says Marisol Garcia, assistant professor of counseling psychology. “Understanding that there are many ways to live a healthy life gives therapists more tools for helping clients.” 

This philosophy dovetails with the transformative family therapy model taught in Lewis & Clark’s MCFT program, which reflects the institution’s commitment to global citizenship and social justice. Transformative family therapy helps clients explore how power, privilege, and oppression shape their lives, and then helps them work in their communities to create healthier life patterns. What makes our program unique is the extent to which we examine the effects of global economic, political, and social systems on local mental and relational health,” says McDowell. “For example, if one person in a family is an undocumented immigrant, how does that affect family power dynamics? What if a family is transnational, with members in more than one country? Therapists today must consider not just cultural differences but global dynamics of power and privilege.”

Understanding factors such as ethnic background, social class, gender, and sexual orientation helps students care for clients more effectively, says Hernandez-Wolfe. “We want graduates to be able to hold multiple perspectives, challenge their own privileged positions in society, and recognize other family configurations than they’ve been used to.” For example, a therapist who participated in the international track may have witnessed members of a Colombian community grieving together for the loss of a beloved elder instead of following the North American norm of keeping loss private. Or the therapist might have studied the effect of clan and tribe membership on Ugandan families, expanding his or her perspective on extended families.

A Rich Learning Experience

Cultural immersion brings coursework alive for students on the international track. “The trip presented our group with a whole new lens through which to examine the [therapeutic] healing process,” says Toren Volkmann GRAD ’14, who traveled to Colombia in 2013. “We saw firsthand the complexity of cross-cultural interactions, issues of power and privilege, and new ways to consider social justice in our practice. These opportunities are not found in books.”

Students begin preparing for the overseas experience long before they leave Portland. They discuss the history of colonization, relations between the global north and south, and mental health models in the host country. In keeping with the transformative family therapy approach, they interrogate their own cultural power and privilege, which may change or emerge as they travel. “Visiting an international location may be the first time students experience being ‘outsiders’ based on phenotype and country of origin or see the deep inequalities of global resource distribution firsthand,” says McDowell.

Creating Scholars and Opportunities

Developing an international track keeps Lewis & Clark in the vanguard of family therapy research and teaching. “All fields are looking toward what it means to practice in a world that is getting smaller,” McDowell says. “With travel and technology, we can now reach across what once were pretty significant borders. Leaders in our field are working on international issues, and we want to help lead the way.” Students and faculty are already publishing findings from their international collaborations in peer-reviewed journals, such as the Journal of Marital and Family Therapy. Their research helps broaden perspectives on family therapy and cross-cultural education.

Although the international track has been an official part of the MCFT curriculum for only a year, students who have enrolled or participated in earlier cultural exchanges are enthusiastic. “Traveling to Uganda expanded my understanding of family systems,” says Catherine Jones GRAD ’14. “For example, I realized that in the U.S., families are quite isolated from their larger communities, while in Uganda, the community is important in family life. Seeing how community members support individual families who face challenges gave me hope that we can build supportive communities here.”

Therese Long GRAD ’14 says, “So far, my international MCFT studies have forced me to look beyond my own scope of experience and think about issues from numerous perspectives. It’s also helped me take my time when approaching a situation and remember to consider all possible contributing factors.”

The international track makes the MCFT program more attractive to prospective students. In admissions interviews, the most frequently asked question is about the international track, especially the possibility of doing a last-semester internship. “The international focus and social justice missions of our program are very important to applicants,” says Garcia.

Over time, program faculty expect to expand the international specialization to include new partners and conduct more research. A trip to the Dominican Republic, Garcia’s home country, is tentatively planned for 2015, and the MCFT program will host its first international research forum on campus this fall (see related article at right). In a shrinking world, broadening our understanding of healthy families and communities is an important task, and Lewis & Clark and its partners are rising to the challenge.

Genevieve Long is a freelance writer in Portland.