Clinical Social Work Journal

, Volume 40, Issue 4, pp 438–449 | Cite as

Ethical Standards for Transnational Mental Health and Psychosocial Support (MHPSS): Do No Harm, Preventing Cross-Cultural Errors and Inviting Pushback

  • Siddharth Ashvin ShahEmail author
Original Paper


Important components of bioethics are routinely underappreciated in cross-cultural and transnational mental health and psychosocial support (MHPSS) efforts. This article provides case examples of cultural errors and/or harm by outsiders delivering MHPSS on different continents. The errors illustrate violations of informed consent (principle of autonomy) and avoiding harm (nonmaleficence). Ethical cultural adaptation standards are presented in order to avert such errors. Given the real risk of outsiders applying culturally erroneous and/or harmful practices in the process of delivering aid, the ability to discern pushback (resistance and redirection by intended beneficiaries) can yield ethically significant data. Actively inviting pushback is proposed as an additional methodology for ethical cultural adaptation with the purpose of at least gaining informed consent and, at best, shaping the most beneficent MHPSS.


Global health Complex emergencies Disaster mental health Cultural competence Cross-cultural trauma Cultural adaptation Bioethics Medical errors International social work Transcultural psychology Humanitarian aid First responders 



The best practices of cultural adaptation and recommendations for further research in this paper are predicated on work done by the author while commissioned by Psychology Beyond Borders to establish organizational guidelines for cultural adaptation.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Greenleaf Integrative Strategies, LLC

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