In 1989 the United Nations held the “Convention on the Rights of the Child,” and called for the promotion of child well-being worldwide, including the physical, psychological, and spiritual. The Convention members said that protection of children was the responsibility of governments and of all adults, and they called on the scientific and professional community to promote learning, development, and the general protection of children across the globe.
Tulane’s Dr. Bonnie Nastasi, Professor in the Department of Psychology, has been at the forefront of this movement for decades. She and her international colleagues have taken up the goal of helping children around the world, much of what began with the “Promoting Psychological Well-Being Globally Project,” a brainchild of school and educational psychologists meeting at a conference of the International School Psychology Association.
From that beginning, a multi-year research project involving 12 countries emerged, in Brazil, Estonia, Greece, India, Italy, Mexico, Romani, Russia, Slovak Republic, Sri Lanka, Tanzania, USA (Boston, Puerto Rico, New Orleans). The work has taken Nastasi from the streets of New Orleans, to the shores of rural Sri Lanka, to the slums of Mumbai, India.
Her work to protect and promote the well-being of children worldwide has spanned the globe and over twenty years. She told the Times, “Doing work in another country, and especially cultures so different from my own has been an amazing experience,” she said, “and has changed the way I think about cultural competence in the US as well.” For example, she explained, the work has helped her “think more deeply about what constitutes culture and how we can best assess and honor the culture of others.”
“Sri Lanka especially feels like my second home,” she said. “I could imagine living there. It is a place I found peace.”
Nastasi and her colleagues have worked to create and develop interventions that address the complex goals of children’s well-being, while at the same time dealing with the issues involved in exporting psychological science developed in the US, to other countries. And, she has authored numerous articles, books, and book chapters on the topic.
In one of her most recent books, Nastasi and colleague Amanda Borja, describe many of the findings and experiences of their global efforts: International Handbook of Psychological Well-Being in Children and Adolescent; Bridging the Gaps Between Theory, Research, and Practice (Springer, 2016).
Also recently published is her co-authored text, Mixed methods research and culture-specific interventions: Program design and evaluation (Sage, 2016). She is working on two edited texts, International handbook on child rights and school psychology, and Handbook of School Psychology in a Global Context, both to be published by Springer.
In a keynote presentation to the Louisiana School Psychological Association this past November, Nastasi explained that the World Health Organization has found that 20 percent of children worldwide suffer from mental health problems and at least 5 percent of these are severe. Access to services ranges from 20 to 80 percent but access is not sufficient in any country, she explained. The risks to children are many––war, ethnic conflicts, poverty, illnesses, lack of education, disasters, Dr. Nastasi told the school psychologists.
At the same time, Nastasi cautioned that research psychologists and psychological practitioners must be careful in “… exporting theories and practices developed in the United States to other cultures and contexts.”
The development of interventions for people across the globe is hampered, Nastasi says, by the tendency for those with the best knowledge to apply existing theories and techniques without fully considering differences in cultures and contexts.
Exporting our knowledge is more challenging than it might seem, she notes. Evidence-based practice is often confused with the search for the ‘one-size-fits-all,’ Nastasi says, and confusion comes with the Western method of randomized controlled trials as the benchmark, which places “emphasis on internal validity at the expense of external validity.”
She and her colleagues set out to resolve some of these issues when they developed the “Participatory Culture Specific Consultation Model” and methods, supporting the development of culture-specific programs for use in the global community.
Nastasi and colleague Asoka Jayasena applied their culture-specific methods in a program to support psychological well-being in youngsters in Sri Lankan school systems, a project spanning almost two decades and which included interventions before and after the 2004 tsunami.
Nastasi and Jayasena illustrated the steps in “An International Partnership Promoting Psychological Well-Being in Sri Lankan Schools,” published in the Journal of Educational and Psychological Consultation in 2014.
Sri Lanka is a small island south of India in the Indian Ocean, with a population of about 20 million. The household income is $231 a month in the provinces where Nastasi and Jayasena worked, with 70 percent rural and high levels of poverty and unemployment.
While government-funded health care was free for the general population, access was severely limited by a shortage of mental health professionals, Nastasi explained. There were only 20 psychiatrists for the 18 million people in 1995 when Nastasi and her group began their work.
With the goal of promoting psychological well-being of the school-age population, the co-consultants engaged in a research–intervention process using participatory culture-specific system consultation.
Each step required careful efforts where the consultants learned the culture, conducted formative research, and formed partnerships with people in the social systems. The researchers developed culture– and context–specific conceptual models, interventions, and assessments for promoting the psychological well-being of the Sri Lankan youngsters.
The collaborative approach included four main phases, Nastasi has explained in various articles. These are a participatory process of consultation, a focus on cultural and contextual specificity, and the use of research to inform and evaluate interventions, “and efforts to promote sustainability and capacity building,” she explained.
In Mumbai, Nastasi and her colleagues developed a culturally constructed model for clinical practice to prevent HIV and sexual disease transmission.
Nastasi and her colleagues attributed much of the program’s success to the capacity for a partnership-based approach.
While extremely rewarding, the work was also at times challenging, she said.
“Especially initially adjusting to the different environment and culture-e.g., the food, the climate,” she said.
“In Mumbai especially, we were conducting work in slum communities—I was overwhelmed initially by the level of poverty, the sanitary conditions, the number of people living on the streets (including children),” she explained, “and by the sheer number of people in the metro area of Mumbai.”
“That took some adjustment,” she said.
“The experience made me wonder,” she said, “if we can ever solve the world’s poverty…” She explained that the scope of need for children, women and families seemed at times, overwhelming.
“The other challenge in Mumbai was the relative status of men and women, even at a professional level. I had not encountered gender discrimination of that magnitude since my early career in academia in the US. That was a huge adjustment, but a female colleague (and later friend) from Mumbai was an enormous help in figuring out how to manage gender relationships professionally.”
The projects in Sri Lanka and Mumbai have concluded, and Dr. Nastasi has moved to new projects, while staying connected.
“I spent 2.5 months of my sabbatical in the Fall 2015 in Sri Lanka—exploring possibilities for the future,” she said. While working with international colleagues on book projects, she also initiated work on another text, this one on supporting the “… psychological well-being of adolescents in the context of ‘Child–Friendly Schools,’ a concept taken on in multiple countries by UNICEF.” This work is to be published in English by Springer first, and then translated to local language for Sri Lanka, she said.
Dr. Nastasi is also working with two charter elementary schools in New Orleans, and directing the work of her doctoral students.
“The most rewarding experiences,” she said, “have been working with colleagues and local participants in research and intervention projects. I have made life-long friends in both places and continue to communicate with them. In both places, I found a place to call home,” she said, and she resides there when she traveled for her work.
“I learned from my interactions with others¬–both colleagues and local participants–and discovered just how similar we all are in terms of our human qualities and struggles, despite cultural differences.”
“The interpersonal aspects plus my own personal growth were the primary rewards,” she said.
Dr. Nastasi is a past-president of APA Division for School Psychology, past-president of the Louisiana School Psychological Association, President-elect of the International School Psychology Association, past co-chair of APA’s Committee on International Relations in Psychology. She is also the current representative to APA Council for Division 16 (School Psychology), among her other achievements.