Seeking mental health support in a foreign country can be more difficult than it would be in your home country. Where do you go for counseling when living in a foreign country? How do you know the credentials of the counselor? How do you know this person is who they say they are?

Shanghai International Mental Health Association (SIMHA) does some of the detective work for you. Our members are counselors and therapists from many different countries. The background, nationalities, experience, education, and gender of the therapist can be found on our website directory. All applicants to SIMHA are screened, and their home country credentials are verified to the extent possible. All members pledge to adhere to the SIMHA ethics code, which is available on our website.

For expatriates coming to China, the cultural differences quickly become apparent. Family or relationship issues that were dormant in your home country may be pushed to the forefront by the stress of living overseas. New issues may also appear that result from living as a foreigner in China; your children may have adjustment issues, your marriage may be feeling the strain, or the gray, wet winters may bring on extended feelings of sadness and isolation.

Expatriates report a myriad of symptoms. You are not alone. Behind closed doors, others are struggling with the same issues of isolation, lack of family support, increased alcohol use, anger issues, infidelity, culture shock, depression, and anxiety.

Accompanying spouses (trailing partners) often struggle, especially if they have left rewarding or challenging jobs in their home country. The romantic notion of having free time can quickly wear thin. Many partners have defined themselves through their own careers and face a loss of identity when they arrive in China without employment.

There are many solutions to these issues. Being an expatriate in Shanghai can be the amazing experience that you want it to be. A mental health counselor who understands your needs and makes you feel comfortable can quickly help you to find your path to a successful experience.

Benefits of Counseling

Counseling is an interaction between a professionally trained individual and a client intended to help the latter solve difficulties in psychosocial adjustment; counselors may also advise and instruct to direct another’s judgment or conduct.

Whether you seek a marriage and family counselor, a social worker, psychologist, psychiatrist, or a psychotherapist, you should expect a confidential listener that can give you some new tools while building on your strengths. These tools are what you need to help you experience success and to help you manage your environment and your personal life.

A SIMHA counselor can help you problem-solve, refer you to resources that will help you manage your life here in Shanghai, and discover what you need for personal growth and happiness.

Benefits include:

• More satisfaction in life
• A safe place to “vent”
• Increased self-esteem
• Improved physical health
• Improved scholastic performance for children
• Greater control over emotions
• Improved relationships with others
• Identification of abilities, qualities, hopes, and expectations and how to act on these
• Understanding of unhelpful patterns and cycles that negatively affect your life
• New ways to deal with your concerns

Choosing a Counselor

Research has shown that the most important factor in a successful counseling experience is the relationship between the client and the counselor. There are many great counselors who have unique skill sets that benefit different populations. Each client and each counselor have a different personality and style of communication. It is important that you find a counselor with whom you feel comfortable. Working together in the best interest of our clients, SIMHA’s counselors often refer to each other if they do not feel they are the best fit for you.

SIMHA has two membership categories: Clinical membership and Associate. All SIMHA Clinical members are trained mental health professionals who must provide proof of their education and home country (or state) credentials and sign a pledge to abide by a comprehensive code of ethics. If someone is still a student or has not met their home country’s qualifications for full licensure, they can join and be listed as an Associate member. While our verification process is not a guarantee, it does provide some critically important safeguards for clients choosing a therapist.

SIMHA members pledge to provide all therapy safely and ethically. All Clinical and Associate Members must sign and adhere to the SIMHA Code of Ethics, which is an essential part of our profession. Our code of ethics combines the best parts of codes from several mental health provider associations around the world. In addition to detailing the rules of ethical behaviour, the SIMHA Code of Ethics also provides a method for clients to voice complaints against members for suspected unethical treatment.

The first step to selecting a counselor is to look at the counsellor’s background.

Experience. What experience does this counselor have? Do they have experience treating the problem and the type of client for which you seek help? Some practitioners work exclusively with children or adults. Some have specialized training or skills for certain problems. What is the nationality of the counselor? Does the practitioner’s home country match your needs if there are cultural issues? If you have childrearing issues, does this practitioner have children or experience with children? Several of our counselors can speak multiple languages.

University Degrees. What degree does your practitioner have? What country is the degree from? What are the requirements for this degree in that country? The requirements vary from country to country.

A Clinical License. In many countries, mental health practitioners practice under the guidelines of licensing boards such as the California Board of Psychology in the United States. To maintain a license, there are continuing education requirements. A licensed practitioner must hold specific degrees and have completed thousands of hours of supervision. In addition, the practitioner must have passed a written exam. You should check the requirements in your home country or state.

Other factors to consider include the office’s location, the confidentiality of the setting, the therapist’s age and gender, the counselor’s schedule, and the hourly rate.

The next step is contacting the counselor by phone or e-mail.

Some Definitions

The terms “counselor” and “psychotherapist” are often used interchangeably. Since SIMHA members have been trained in different places all over the world, the distinction we care most about is whether a person has appropriate clinical training and experience in mental health. That usually means someone with a master’s degree, a Ph.D. (or other doctorate), or an MD. The important factor is that it is not just an academic degree. It must be a degree with good supervised clinical or practical therapy training.

Briefly: in the US, a master’s degree (MA, MS, or MSW, Masters in Social Work) leading to a clinical credential usually takes two to three years to complete. In Australia and the UK, a Clinical Psychologist must have a Clinical Master followed by two years of supervised clinical experience for a total of 4 years post-undergraduate degree training. A doctorate (Ph.D., Psy.D. or Ed.D.) in a clinical field generally requires 4 to 5 years. A Psy.D. is a doctoral degree that requires a case study rather than a research dissertation. An Ed.D in counseling is a doctorate in education, including mental health service training.

A psychiatrist is a medical doctor (M.D.) specializing in psychiatry. If your SIMHA therapist is not a doctor themselves, they can refer you to a medical practitioner for further assessment for the appropriate use of medication as part of your treatment. All SIMHA therapists are also well-versed in the availability of other community resources and can assist with other referrals/recommendations as part of your treatment.