A grounded theory study of the treatment of mental illness and life problems within a Cambodian cultural context was conducted. A review of the literature examined the increasing importance of cultural competence in psychology and the difficulties faced when accommodating cultural values while maintaining a Western worldview. Although some researchers have developed modified treatment approaches incorporating Khmer cultural values, these models continue to approach working with Cambodians from a Western prospective. This study sought to alleviate this concern and to improve the Western clinician's ability to help Cambodian clients in a culturally relevant manner by examining the actions of culturally designated helpers within Khmer culture. Cambodians who are struggling with life problems or mental illness frequently seek assistance from Buddhist monks. This study examined the manner in which Buddhist monks help Cambodians with life problems. In an effort to reduce Western cultural bias, this study employed a grounded theory methodology, a qualitative methodology permitting theory development solely on data. This approach was chosen over quantitative methods in order to avoid testing pre-conceived hypotheses that are likely to reflect merely the researcher's frame of reference.
Buddhist monks residing in Cambodia and the United States were interviewed regarding their experiences helping others with life problems. Data analysis revealed that Cambodian Buddhist monks primarily perform four interventions: (1) preaching on the laws and principles of Buddhism, (2) giving blessings with water, (3) prescribing meditation and (4) teaching about the cycle of life according to Buddhism. The ultimate result of all these actions was the relieving of the emotional distress of those experiencing life problems, according to the participants' perceptions. A follow-up interview strengthened the importance of the relationship with the monk in order to help those with life problems. Relationship with the monk appeared to play a moderating role between the interventions employed by the monk and relieving distress. This models is congruent with much of the research on psychotherapeutic process, particularly therapeutic alliance. Applications of these findings include the inclusion of mindfulness meditation, Buddhist beliefs regarding the cycle of life and collaboration with Buddhist monks when working with Cambodian clients.
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