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Issue Being Considered Baobab Training Seeds Literature and Research
As human beings our mental health and our physical health are inter-related. Holistic approach, being attentive to psychological, emotional, physical and cognitive aspects in the content and delivery of training. Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M.R., and Rhaman, A. ( 2007). No health without mental health. The Lancet, September 8, Vol 370 , 859 -877.
Chronic  shortage of mental health professionals. Zambia has three psychiatrists for a population of 12 million people (p10). Recognising psychiatric provision is unlikely, the training seeks to provide training to other professionals in basic listening, counselling and group facilitation skills making some provision for better understanding and  basic emotional support within local communities. “Mental Health and Poverty Project, Mental Health Policy Development and Implementation in Zambia: A Situation Analysis”, 30 March 2008. 
There is growing recognition that mental health is a crucial public health and development issue in Zambia. By  addressing some of the lower level mental health issues, other societal issues are addressed. “Mental Health and Poverty Project, Mental Health Policy Development and Implementation in Zambia: A Situation Analysis”, 30 March 2008. 
There is a continuing exodus of health care specialists of all kinds from Zambia. Training is not to a level which would encourage professionals to leave the country. “Mental Health and Poverty Project, Mental Health Policy Development and Implementation in Zambia: A Situation Analysis”, 30 March 2008. 
Skills should be basic and therefore more likely to become more widespread. Training people living and working in the area encourages skills spread into the local community. Providers of care at a local level do not need specialised training, but should have basic knowledge and skills.
Mwape, L., Sikawese, A., Kapungwe, A., Mwanza, J., Flisher, A., Lund, C., and Cooper, S. (2010). Integrating mental health into primary health care in Zambia: a care provider's perspective. International Journal of Mental Health Systems , July 2010 4:21.
Good counselling and communication skills are recognised as an important building block for emotional support. Good listening skills, and some understanding of psychotherapeutic process empowers local people to provide their own emotional support systems. Dr. Munalula-Kunyanda, School of Medicine, University of Zambia highlights the role of good counselling and communication skills as part of the basic support for emotional issues.
Menon, A.,Munalula, B., Mambwe A., Glazebrook, C. (2005) Communication Skills- A Handbook for Health Practitioners.
Scarce resources Focusing on professionals already established and respected within a community enhances the access to support and reduces stigma. Integrating mental and physical care would encourage “improved access to care, reduction in stigma, improved social integration, and improved human resources for mental health” (p128) and suggest ongoing training in counselling and interpersonal skills.  Ssebunnya, J., Kigozi, F., Kizza, D., Ndyanabangi, S. (2010). Integration of Mental Health into Primary Health Care in a rural district in Uganda. African Journal of Psychiatry, 2010; 13 , 128-131.
Community based. Focusing on local people to provide local support. A project in Ghana, highlighting the need for an increased number of “psychosocial service providers in the communities” (p114) as a desirable way forward.
Akapalu, B., Lund, C., Doku, V., Ofori-Atta, A., Osel, A., Ae-Ngibise, K., Awenva, D., Cooper, S., Flisher, A.J. . (2010). Scaling up community-based services and improving quality of care in the state pscyhiatric hospitals: the way forward for Gahana. African Journal of Psychiatry, May 2010, 13 , 109-115.
The need for community cohesion. By training professionals widely regarded as community role models there is more likely to be acceptance of the support offered.  Patel, V., Araya, R.  & Bolton P. (2004) note “support and sharing between members of the same community was highly effective in Uganda and Chile” (p540) when interventions were offered by local people, in a bottom-up approach. 
Patel, V., Araya, R. and Bolton, P. (2004). Treating depression in the developing world. Tropical Medicine and International Health, May 2004, Volume 9 No. 5 , 539-541.
Counselling skills help to open up communication and are likely to facilitate the kind of sharing which would benefit common and community life. Training which encourages good communication and group facilitation skills makes community conversations about shared struggles more possible. The Salvation Army (1998), working in Zambia, concluded that “community counselling is a process of listening and reflection within a community to acknowledge issues, losses, ... Through this facilitated truth telling it is possible for the community to move beyond helplessness and into choices and agreements which result in change” (p9)
The HIV and AIDS Programme Facilitation. (1998). Finding Hope in the River of Life: Community Counselling. London: The Salvation Army.
Encouraging a focus on society as well as the individual. By providing skills for groups of professionals, rather than training individual counsellors to work with individuals the African focus on society and the notion of Ubuntu within that society are respected and built upon. Nwoye from University of Tanzania says there must be a focus “not only on the distressed in the society but also on the society itself, or on the psychosocial-cultural conditions” (p28)
Nwoye, A. (2010). A Psycho-Cultural History of Psychotherapy in Africa. Psychotherapy and Politics International 2010 8(1) , 26-43.
Supporting self sufficiency, self belief and belief in African cultural identity. All training is offered within a Humanistic framework, respecting the power of co-creating an approach which best fits the community. Facilitating assessing and choosing between modern Western cultural values and traditional African values “to help the upcoming generation to evolve and assimilate a sense of African cultural identity, the spirit of community and the power of psychological independence” (Nwoye, 2010, p36).
Training must be Africa-centric The training approach is based in Humanistic philosophy, the African philosophy of Ubuntu: acknowledging the importance of the environment or context; focusing on strengths; not seeing  variance as pathological, focusing on the individual's reality and working with polarity and the notion of everything being on a continuum. Psychotherapeutic work in Africa should facilitate “independent action and increased choices” (Mickel, 2005, p135)
Mickel, E. (2005). Africa Centered Reality Therapy and Choice Theory. Trenton, NJ: Africa World Press Inc.
Encouraging a trust in the resources of the community Providing understanding and skills within the local community encourages a sense of pride and of being able to support themselves, increasing resilience. All projects work towards self-sufficiency. UNESCO (1997) hold “a deeply embedded conviction that, under proper conditions, people can help others with their problems.” (p5), they suggest schools are an important social institution within a community, carrying respect, particularly with regard to the role of teachers in preparing students for life’s challenges. As such, they suggest counselling skills are an asset to teachers. 
UNESCO Training Package on Guidance and Counselling, Zambia Module 2 (1997) Gordon Programme Co-ordinator, Wilma Guez and John Allen (Eds.) France : Ag2i Communication.
Reducing reliance on resources outside the country, building local skills and resources. The final phase of each project is focused on using people who have just completed the training to co-train on a new project locally. Mickel, E. (2005). Africa Centered Reality Therapy and Choice Theory. Trenton, NJ: Africa World Press Inc.
“ A good technician works to educate the community to perform activities for themselves at the expense of the technician’s job security. Dependence may become a form of oppression.” (Mickel, 2005 P135 cites Harris 1977 p78).
Respecting local tradition The training is experiential, working directly from the experiences of the individuals in the group to create an approach which is appropriate. UNESCO (1997) notes the traditional African approach to supporting others which values advice giving and wisdom in preference to consultation and mutual exploration of a problem.
Provision of support should be as close to family level as possible Training teachers, health workers etc has the greatest chance of these skills and understandings being handed on to local people through their interaction with these services. Jenkins R, Strathdee G. (2000). The integration of mental health care with primary care. International Journal of Law and Psychiatry 23(3-4):277-91.
Cross cultural issues Experiential learning and self exploration as opposed to "chalk and talk" instruction is not common. All training provides time for exploration of cross-cultural issues including uses of language, and use of vernacular. Gilbert, J. (2001) Cross cultural issues in Counselling Skills Training: Lessons
from Lesotho. The Health Exchange, April, 18-19.
Gilbert, J. (2001) Cross cultural issues in Counselling Skills Training: Lessons
from Lesotho. (Part 2) The Health Exchange, June, 22-24.
Issues of power, particularly in a cross cultural
All training has space for addressing issues of power, making these immediate and experiential. Kearney, A. (1996). Counselling, Class and Politics. Ross-on-Wye: PCCS Books Ltd   “The counsellor brings to the relationship whatever “amount” of power they are endowed with by society and , inevitably the client does the same thing.” (Kearney, 1996, p 48)
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