Perspectives on psychotherapy in Southeast Asia: Insights from psychiatrists and trainees (Part I: Attitudes, current practices and training preferences)

Abstract

Introduction

Psychotherapy is an evidence-based treatment for mental disorders. Despite its global development, neuroscientific advances, and measurable efficacy, attitudes toward psychotherapy in Southeast Asia (SEA) remain underexplored, particularly among psychiatrists and psychiatric trainees.

Objectives

This study aimed to assess attitudes toward psychotherapy, its current use in clinical practice, and stated preferences for future training among psychiatrists and trainees in SEA.

Methods

A cross-sectional online survey was conducted across Indonesia, Malaysia, Singapore, Thailand, and Vietnam. The questionnaire explored perspectives on psychotherapy and its integration into practice. Data were analyzed descriptively and comparatively.

Results

Of 253 respondents, 149 (58.9 %) were psychiatrists and 104 (41.1 %) were psychiatric trainees. Both groups exhibited positive attitudes toward psychotherapy, recognizing its professional value, clinical efficacy, and integration with pharmacotherapy. Combination therapy was frequently used; pharmacotherapy dominated for severe disorders, psychotherapy for adjustment and personality disorders, and ECT primarily for schizophrenia, depression, and bipolar disorder. Commonly used therapies include cognitive behavioral therapy, supportive psychotherapy, and mindfulness-based approaches. Psychiatrists favored expanding the number of psychotherapists, while trainees expressed stronger interest in advanced psychodynamic techniques and psychoanalysis. Both groups advocated for additional training in evidence-based psychotherapies and foundational clinical skills.

Conclusion

Psychiatrists and trainees in SEA value psychotherapy and its relevance to both clinical practice and everyday life. There is a general preference for integrating psychotherapy with psychopharmacological treatment. Future efforts should focus on enhancing psychotherapy training, addressing cultural adaptations, and overcoming systemic challenges to improve access and efficacy of interventions in SEA.