Asian journal of psychiatry · 2026
Perspectives on psychotherapy in Southeast Asia: Insights from psychiatrists and trainees (Part II: Barriers to access and future directions).
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Aunjitsakul Warut, Anantapong Kanthee, Werachattawan Nisan, Jongbovonwiwat Kreuwan, Kalayasiri Rasmon, Aniwattanapong Daruj, Chompoosri Poom, Tay Andre Teck Sng, Cheng Samuel Eng Teck, Nair Sanjiv Sasidharan, Teo David Choon Liang, Lukman Petrin Redayani, Elvira Sylvia Detri, Almasyhur Alfi Fajar, Nik Jaafar Nik Ruzyanei, Abd Majid Farah Nabila Binti, Loo Jiann Lin, Mohd Shukor Nuur Asyikin Binti, Bui Eric, Vu Thi Tuong Vi, Tran Anh Ngoc, Nguyen Tan, Nguyen Tien, Sullivan Timothy B, Alfonso César A
Аннотация
BACKGROUND: Psychotherapy's integration into Southeast Asia (SEA) clinical practice is limited despite its recognized effectiveness. This study examined psychiatrists' and psychiatry trainees' perspectives on barriers to accessing psychotherapy, expectations for its future delivery, and attitudes toward digital mental health.
METHODS: A cross-national survey was conducted between March and August 2024 among 253 psychiatrists and psychiatry trainees from Indonesia (n = 121), Malaysia (n = 39), Singapore (n = 6), Thailand (n = 74), and Vietnam (n = 13). The questionnaire explored perspectives on delivering psychotherapy including barriers, provider roles, therapy formats, and digital delivery. Data were analyzed descriptively and comparatively.
RESULTS: Key barriers to delivering psychotherapy included time constraints, cost concerns, systemic limitations, and insufficient psychotherapy skills, respectively. Regarding preferences for psychotherapy providers, trainees rated psychiatrists as most suitable, while psychiatrists preferred psychologists. Crisis intervention and individual therapy were the top priorities for training. Although videoconferencing and mobile apps were favored for future delivery, concerns about clinical effectiveness and system-level limitations hindered wider acceptance of digital psychotherapy.
CONCLUSION: A major barrier was that psychotherapy is too time-consuming, and a lack of skills was a significant challenge for healthcare professionals. Both psychiatrists and trainees agreed that training should prioritize crisis intervention and individual therapy. For internet-based psychotherapy, the primary challenge was concern over its low clinical effectiveness, as many felt face-to-face interaction was necessary. The findings highlight the need for enhanced psychotherapy training, systemic support, and digital infrastructure to improve psychotherapy accessibility in SEA. These insights can inform the development of targeted interventions and policies to promote the effective integration of psychotherapy into mental health services in the region.
METHODS: A cross-national survey was conducted between March and August 2024 among 253 psychiatrists and psychiatry trainees from Indonesia (n = 121), Malaysia (n = 39), Singapore (n = 6), Thailand (n = 74), and Vietnam (n = 13). The questionnaire explored perspectives on delivering psychotherapy including barriers, provider roles, therapy formats, and digital delivery. Data were analyzed descriptively and comparatively.
RESULTS: Key barriers to delivering psychotherapy included time constraints, cost concerns, systemic limitations, and insufficient psychotherapy skills, respectively. Regarding preferences for psychotherapy providers, trainees rated psychiatrists as most suitable, while psychiatrists preferred psychologists. Crisis intervention and individual therapy were the top priorities for training. Although videoconferencing and mobile apps were favored for future delivery, concerns about clinical effectiveness and system-level limitations hindered wider acceptance of digital psychotherapy.
CONCLUSION: A major barrier was that psychotherapy is too time-consuming, and a lack of skills was a significant challenge for healthcare professionals. Both psychiatrists and trainees agreed that training should prioritize crisis intervention and individual therapy. For internet-based psychotherapy, the primary challenge was concern over its low clinical effectiveness, as many felt face-to-face interaction was necessary. The findings highlight the need for enhanced psychotherapy training, systemic support, and digital infrastructure to improve psychotherapy accessibility in SEA. These insights can inform the development of targeted interventions and policies to promote the effective integration of psychotherapy into mental health services in the region.