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“Make addiction counselling culturally relevant”

Two of Samoa’s new addiction professionals Moana Solomona and Tuifagatoa Dr George Leao Tuitama believe training for drug and alcohol addiction counselling must be relevant to Samoa’s cultural context.

Last week, 17 Samoan professionals were awarded certificates in basic counselling skills for addiction professionals, thanks to a week of training in the Universal Treatment Curriculum. 

Ms Solomona is a drug and alcohol clinician in the Ministry of Justice and Courts Administration. She believes the training the group received was worthwhile but still needs to be more rooted in the Samoan context.

“We were taught you must not accept gifts from clients, but in Samoa that would be more offensive,” she said.

“Gift giving is a cultural norm here, while we are looking at it as an ethical dilemma.”

Of the eight or so counselling theories the group were taught, several are not relevant to Samoa, Ms Solomona believes.

She said she wouldn’t necessarily have her clients talk to imaginary friends or family in an empty chair, or discuss taboo topics like sex with them.

“People here have never heard of [Sigmund] Freud, yet there we were talking about the psychosexual, the ego and ID and they don’t need to know that.

“Couch therapy works for my American colleagues because American’s can talk and talk and the therapist doesn’t need to ask them anything, but here we need to probe and probe.”

Each morning, Ms Solomona and Tuifagatoa Dr George Leao Tuitama would review the previous day’s training with the participants in Samoan, and answer their questions on the material before a new day of training.

They were able to bring the training to a more locally relevant context and share which ideas would, and would not do well here.

“But the exam is still on the content we learned,” Ms Solomona said. She and nine other participants sat the International Certified addiction professional examination last week, and in three weeks will learn if they are certified alcohol and drug addiction counsellors. 

“That’s not what we will be practicing in the field; we can’t practice an American model of counselling here.”

Having the certificate is still largely a benefit, Ms Solomona said, and having herself and Tuifagatoa there to translate some counselling theories into Samoan, and into the Samoan context helped.

The in-depth look into addiction as a disease and the impacts drug and alcohol addiction have on the people and their families was a valuable part of the training.

“[The participants] were shocked at what drugs do to the brain and realised that when they are getting up on Sunday they are still drunk in church because of how long alcohol stays in your system,” she said.

“They got great learning out of it for themselves, like for police; now they can recognise symptoms of someone coming down from meth or what someone looks like high on marijuana or drunk.”

Tuifagatoa Dr George Leao Tuitama is the psychiatric registrar and head of the Mental Health Unit at Tupua Tamasese Meaole Hospital. He said he also helped the training facilitators to make the training more relevant.

One element of the code of ethics the group was taught is not to counsel any family members, relatives or people you have ties with.

“So, that is going to be very difficult here in Samoa, everyone is related and everyone has some sort of connection to another person. 

“What you can do about it is try and train yourself to sort of detach from whatever is conflicting, which is your way of helping the client, which is not easy.”

Having a variety of government agencies in the training will make a difference to Samoa’s response to drug addictions and mental health as a whole.

“We need a multi-disciplinary approach. Having this training, it’s helping to build awareness.

“It is quite obvious that there is an increased use in crystal meth (methamphetamine) and patients are now suffering from acute psychosis from that,” Tuifagatoa said.

The training was facilitated by addiction counselling professionals from the Colombo Plan in Sri Lanka, an intergovernmental program focusing on development of its member states across the Asia-Pacific region.

It was funded by the United States State Department Bureau of International Narcotics and Law Enforcement Affairs. US Embassy public affairs assistant Perelaaroi Siaosi said the costs were roughly T$26,000 per training. 

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