A TERM PAPER ON HISTORY OF CLINICAL

PSYCHOLOGY IN NEPAL

A term paper submitted for the partial fulfilment as the requirement of the first
semester M.A. in History and Systems of Psychology (PSY.551)

Submitted To:

Tribhuvan University

Faculty of Humanities and Social Sciences

Central Department of Psychology

T.U. Kritipur

Submitted By:

Saphal Sapkota

Roll:6

September, 2017

1
 Table of content

1. Introduction 3
1.1 Background 3
1. 2 Aim 4
1.3 Objectives 5
1.4 Method 5

2. Chapter-Academics and teaching in Clinical Psychology 5

3. Chapter-Clinical Psychology and practices in Nepal 8

4. Chapter-Training 10

5. Discussion/ Conclusion 11

6. Refrences 12

2
 1. Introduction

1. 1 Background

Psychology in Nepal is stack in infant state for long period. Since the introduction of
Psychology in Nepal, Clinical Psychology has been brought upon in Nepal. Clinical
Psychology is a broad branch of psychology that focuses on diagnosing and treating mental,
emotional and behavioural symptoms. Some of the common disorders that might be treated
include learning disabilities, substance abuse, depression, anxiety and eating disorders. In
Nepal, Clinical Psychology is running in terms of its teaching or academics, focusing on
clinical work and various training activities. From the end of the Nineteenth century, Clinical
Psychology has crossed different stage of development worldwide.

As a student or field related person of clinical psychology; it is essential to understand

past or history of clinical psychology in Nepal because it can help to solve out the barriers
and obstacles for progress of clinical psychology in Nepal. Equally, it will predict the
direction of future status of clinical Psychology and the direction it will take.

History of Clinical Psychology in Nepal

Tribhuvan University as a national institution for higher education was established in

1959. But long before that in 1947 Psychology as an academic subject was introduced at Tri-
Chandra college and taught under the department of Philosophy. In Nepal, it was indeed a
great step to introduce Psychology at a time when only a few educated people knew its
importance. Psychology was taught by Professor Godutta Man Shrestha, a Philosophy teacher
at Tri-Chandra College. However, specialization wasn’t there in clinical psychology.

In the year 1982 important development weas noticed in the field of clinical
psychology that opened new opportunities for the discipline. Nevertheless in terms of
popularity, utility and its role in the main steam of national development remained passive.

The slow but steady activities, teaching and researches and professional activities since
1985 and the activities of NPA especially during 1990 to 1993 gave new ways for the
development of clinical Psychology.

3
 Dr. Minakshi Nepal was first lady and Professor Dr. Pannalal Pradhan was first man
who did PHD from outside of Nepal. Sociology, Anthropology and Psychology were
introduced in same period. But Sociology and Anthropology more focus on national
development level but Psychology only stack on clinical setting and mental health.

Many of us, Nepalese are aware about clinical psychology itself let alone its history.
Likewise, since we have very limited knowledge on clinical psychology, its obvious that we
also don’t know very much on what would be the role of clinical psychologists or what do
they do. Clinical psychologists work in many areas, depending on the population they choose
to treat. A psychologist can specialize in chronic illness like diabetes or obesity, mental
problems like depression and anxiety, and psychological problems like bipolar or
schizophrenia. They work with children and adults with ADD or Asperger's Syndrome.

In a school setting, they can help children with learning disabilities. At a university, they can
help students make career decisions, stay emotionally healthy and achieve success
academically. In community-based facilities, they can help culturally diverse and
economically disadvantaged populations. As the country ages, many are working with
seniors. Others do research into mental health issues, policies and training. With this, its
important to know, how clinical psychologists worked in the past and how clinical
psychology progressed over the years. As a product of our own country it is important to
know about clinical psychology. The Psychologists should not forget history because it lets
the latter psychologists to understand the context, therapeutic techniques used and what
approach would be more efficient in the context of Nepal combating mental health problems.
So, for better improvement of future of clinical psychology in Nepal; it is essential to dig out
history of clinical psychology in Nepal. Without knowing the past or history it will be hard to
contribute on the future. So, this paper is plot out to understand, the requirement knowledge
about past status of clinical psychology in Nepal which shall contribute in challenging and
hopeful scope about future.

1. 2 Aim

The aim of this paper is to discuss and elaborate how clinical psychology developed in Nepal.
How can the history of clinical psychology in Nepal shall help understand the context, relate
with present status so that it can contribute for the future?

4
 1. 3 Objectives
 To understand the history of clinical psychology and academics in Nepal.
 To have a close view about how clinical psychology’s practices have been done in
Nepal.
 To analyze clinical psychology’s contribution in trainings

1. 4 Need/ Importance
While assessing the need for clinical psychology in Nepal, its important to look at the
field of health sector in mental health. Also, its importance can be seen in the
psychosocial counselling and other psychological therapies. The need for clinical
psychology has been felt even more lately, particularly after the disastrous earthquake
hit Nepal in 25th April, 2015.

1. 5 Method

Documentary method (secondary data) is the employed methodology. For this paper
presented in national seminar-1995 by Professor Shishir Subba was collected. It was about,
Psychology In Nepal: Its status and prospect of development: As an academic discipline and
profession. Also, the blog namely shishirs.wordpress.com and sujenmanwordpress.com was
consulted, in order to get the information on the history of clinical psychology in Nepal.

5
 2. Chapter- Academics and teaching in Clinical Psychology

Since the year 1982, clinical psychology has been brought to Nepal as a specialization
course. The Central Department of Psychology has well equipped laboratory and good
seminar hall and class rooms for study. Nepalese Psychological Association (NPA) has on the
way of professionalization. In recent years, clinical psychology has greater potentialities to
grow among other disciplines and institutions in teaching and academics.

Clinical Psychology is taught at the Master’s Level in the Tribhuvan University as a

specialization course. In the years between past five years or so, clinical psychology has been
taught in Tri-chandra multiple campus as well as Padma Kanya Campus of Kathmandu.
Psychology students study in their MA level and start working as a psychologist, others go on
to do M.Phil (additional 2 years course) at Tribhuvan University Teaching Hospital to
become the licensed clinical psychologists.

Specialization course starts in clinical psychology only after third semester while doing M. A
in psychology. Then to pursue further in psychology and in order to become”clinical
psychologist”, two years course is essential for M. Phil at Teaching Hospital, Maharajgunj,
Kathmandu. There are only three seats each year for M. Phil, so the competition is tough and
Nepal hasn’t been able to produce as many clinical psychologists since its inception.

The M.Phil. program in clinical psychology started in 1998 AD at Institute of Medicine,

Tribhuvan University Teaching Hospital (TUTH). The installation of this academic program
was greatly supported by United Mission to Nepal (UMN) with the purpose of capacity
building and human resource development in the mental health sector. UMN is one of the
first INGOs to run community mental health projects in Nepal around 1980s.

The M.Phil. Clinical psychology is a two years course with eligibility for MA students in
general psychology with clinical psychology as specialization course from Tribhuvan
University or any other recognized university. The applicants have to appear on entrance
exams and interview for admission. Only three students are admitted in a year. The student
goes through two years full time residential training in TUTH with a designated guide for
clinical supervision. The cost of the course is around Rs. Three hundred thousands with 10%
increment every year. One of the problems with this program is that the students are not
provided any sort of financial incentives for the whole period during the course. Student has
to learn and work at the same time voluntarily. However, there are good chances of

6
employment after that. Upon completion of course, the student will be able to provide
services to deal with mental health and psychological problems. S/he will be able to work in a
team with other mental health professionals. It is important to note that s/he is not authorized
to prescribe medications for clients. S/he helps the clients with psychotherapy,
psycho-education and counseling.

The first batch of students from M.Phil program was Pashupati Mahat and Jamuna Sangraula.
Dr. Mahat is now working as a clinical psychologist in CMC Nepal. The second batch
included Mita Rana and Subash Sharma. Ms. Rana is the co-ordinator of the M.Phil. program
in TUTH and she did her PhD on “A Comparative study of cognitive therapy and
pharmacotherapy in depressive disorder in hospital setting in Nepal.” The MPhil program
offers a good opportunity for students who are interested to specialize in clinical psychology
with hospital based residential training. The psychology students in Tribhuvan University are
getting little exposure and very less clinical supervision required to work as a professional in
this area. Students are theoretically trained but the practical experiences are lacking. They
have the required knowledge but they are missing opportunity to apply it and increase their
competencies. With none of the psychology students able to make it to Mental Hospital, the
one and only mental health institution for the whole population of the country, this program
kindles the hope that they will be able to make it there one day. The psychology students
deserve a chance to work and contribute at Mental hospital and other hospitals in Nepal. They
can help to fulfill the demand for adequate human resource required to serve the people. At
the same time, this could also help to fill the gap between the need and delivery of the mental
health services in the nation.

7
 3. Chapter-Practice

There are very few clinical psychologists in Nepal and almost all of them are working in the
urban centers. There is no proper mental health care system for people living in the rural
areas. People mostly visit faith healers to seek help for their problems. People with severe
mental disorders and their family members are targets of stigma and discrimination in the
society. Due to the stigma attached with their problem, they hesitate to come forward for
appropriate treatment even when services are accessible. According to various reports, 25-30
% of the general population has one or more mental disorders. Very few epidemiological
studies have been done so far to find out the incidence and prevalence of mental disorders in
Nepal. It is estimated that the total prevalence rate of all psychiatric disorders put together
exceeds more than 20 % of the total population.

Majority of the people in Nepal take mental disorders not as disorders or problems which
could be solved or treated but as a moral weakness caused by supernatural forces like Bhoot
[ghost], Boksi [witches], Mohini [black magic], Paap[sins of previous lives ]or as a result of
celibacy. There is an utter lack of awareness that mental disorders are treatable. There is a
concept that once, a person becomes mad, her/his condition will remain the same for the rest
of the life. The patients, who have recovered fully from mental disorders, also continue to be
stigmatized and discrimanted in their society and work places on the basis of their history.
Unfortunately, there is no law in Nepal to protect someone with mental illness. In the civil
code [muliki ain], the legal definition of mental illness is not clarified, but the language of the
legislation refers to someone with broken mind [magaz bigreko] or madness [Baulayeko].
The Local Administration Act of 1972 gives the power to the Chief District Officer to detain
mentally ill people in jail either for their own safety or for the safety of the community.
Today there are more innocent mentally ill people in the jails of Nepal, than there are in the
psychiatric wards. The National Mental Health Policy formulated in 1997 has not yet been
passed in legislation. As an element in primary health care, mental health continues to have a
low priority on the national health agenda. Only 0.14% of the national health budget is spent
on mental health and the government keeps no official record of the mental illness prevalence
rates of the country.

The leading mental health service providers in the country includes “Mental Hospital

Lagankhel”, “Teaching Hospital”, “Nepal Medical College, Jorpati” etc. Mental health
services in Nepal were started as a department of Psychiatry in Bir Hospital in 1961 AD. Dr.

8
Bishnu Prasad Sharma after completion of his Diploma in Psychiatry from London was the
founder figure to start psychiatric service. It had started out-patient services initially then 5
bedded inpatient services in 1965 AD and further extended to 12 beds in 1971. Afterwards it
was shifted in Naxal, Kathmandu in a rented home around a year and planned to shift to a
building of mission hospital situated at Suryabinayak, Bhaktapur but it was shifted to
Lagankhel as a Mental Hospital in 1984. It started its services with 25 beds. Currently it is
operating 50 beds with other services. The services provided in Mental Hospital Lagankhel
under clinical psychology department includes ;

 Psycho diagnostic tests

 Counselling and Psychotherapy
 Recreation and Meditation

Apart from that, some efforts were made to open counselling center to deliver psychological
services by other psychologists and Self- Reliance is one of them. An integrated approach
was made where medical, psychiatric and psychological services was provided however
these clinics couldn’t survive for long. Psychotherapeutic intervention was started in the
eighties on individual level when late Prof. Dr. Sarvagya Narayan Shrestha opened a clinic.
His psychological therapy was the combination of both eastern and western techniques.
During these years there were also some experts in drug rehabilitation centres, namely late
Father Gaffney, who advocated that social psychological conditions as one of the major
causes of drug addiction in Nepal. Cognitive Behavioral Therapy is mostly used to treat the
psychological problems by the clinical psychologists and client-centered counseling is
practiced by the counselors.

9
 4. Chapter- Training

Training to teachers in Psychotherapy, counselling and Mental testings are provided

by foreign Psychologists, Such trainings are indeed very rewarding. Likewise, various
training focused on psychometric tests in diagnosis of an individual is also taking
pace such as CBT, REBT training etc.

Psychoeducation can be an effective method for awareness raising related to mental

health. Psychosocial counseling services need to be regulated through proper system
in order to ensure the quality and effective service to the clients and consumers. There
is an urgent need for the licensure system for the practising counselors. The term
“Counselor” has been often misused and expolited in context of Nepal which could
mislead people and ultimately, give the negative and wrong understanding of the
counseling.

10
 5. Discussion/ Conclusion

From 1980 to 2015, focus topic of Psychology is only about clinical and mental health.
Psychology put effort on the area of counselling and clinical setting only. But, despite all
these, the area of clinical psychology is still constrained in Nepal. People having mental
health problems don’t often feel the need to consult clinical psychologists and clinical
psychologists also can’t easily reach out to them as they feel their area of work is too
constrained.

Previous clinical psychologists didn’t have much of an options in terms of their area
of profession, so government should put an effort to expand the scope area of clinical
psychology. Individuals pursuing clinical psychology careers will often find that they will be
able to secure employment in a number of different healthcare facilities, such as hospitals and
mental health facilities. Depending on their specialties, clinical psychologists might also be
able to find employment with a number of other private and government run organizations.
Universities often employ clinical psychologists, for example, to perform research and help
steer eager young minds toward clinical psychology careers. Schools, police departments, and
military branches are also usually in need of professional psychologists as well. Many clinical
psychologists also choose to open their own private practices and work for no other boss but
themselves. Opening a private psychology practice can often be expensive and difficult but
can also be very rewarding and lucrative as well.

Clinical Psychology in Nepal stack in infant state for many years due to the lack of
manpower, and practicing area. But recently it has begun to move forward in terms of
teaching, research, applied field and professional activities. In its nearly thirty five years of
history, clinical psychology has crossed different stage of development. So, Nepal will be no
more virgin land for clinical psychological studies in future. That’s why its direction in
Nepal after 10 to 20 years will cover vast area of concern in the sector of mental health and
clinical setting and move beyond the realms of history

11
 References

Regmi, M.P.(1990); A History of Psychological Researches in Nepal, Psychologia,32, 24-27.

Subba, S. (1995); Psychology in Nepal: Its Status And Prospects of Development: As an

Academic Discipline And Profession.

https://shishirs.wordpress.com/2010/07/15/57/

Maharjan, S (2010); Clinical Psychology and Mental Health in Nepal

https://sujenman.wordpress.com/2010/04/25/clinical-psychology-mental-health-in-nepal/

https://sujenman.wordpress.com/2011/04/22/m-phil-in-clinical-psychology/

12