by Karen Cassiday, PhD, ACT

ADAA Past President Karen Cassiday, PhD, ACT has been volunteering in Bhutan with Health Volunteers Overseas (HVO). HVO is a Washington, DC-based nonprofit that improves the availability and quality of health care through the education, training and professional development of the health workforce in resource-scarce countries. HVO collaborates with more than 80 universities and health institutions around the world to provide continuing education, training, professional support, and consultation on academic programs and curricula development.

This is Karen's story.

"I am working and living in the middle of some powerful contrasts. Extreme natural beauty and a poorly developed waste management system.  I was really happy to see a truck that seemed to be picking up the biohazard waste that is on my walk to work. They did pick up some, about half and then ran over the rest, which exploded open many bags of biomedical waste that the feral dogs and birds pick through. 

There are lots of buildings in Bhutan but no power tools are evident and scaffolding is assembled from freshly cut bamboo and everything is done by hand. Dogs, donkeys and cows wander through the town and everyone steers around them. They sleep with impunity on the streets and in the middle of the road because they are sentient beings who are the reincarnations of other sentient beings. 

The ER also fields 6-8 severe dog bites every day and the dogs sleep all day like teenagers and then bark and howl all night. Smoking is against the law in this country and people burn incense everywhere to ward off evil spirits. The aisle for incense is always bigger than most other aisles in any store.

I love the challenge of trying to sort through how to translate evidence based treatment into a Bhutanese style treatment and empowering and training the local staff. My biggest challenge is trying to keep the focus on teaching and mentoring rather than just doing treatment. Once the MDs in the hospital discover that you can do something, then they flood you with referrals. Students in training are not allowed to see patients alone for treatment until they graduate, so that poses some challenges for training, unlike other countries.

I have gotten the hospital to start a new Facebook page, Mental Wellness for Bhutan, which I hope to have the locals self-maintain by the time I leave with twice weekly posts about mental illness, substance abuse and mental wellness. I have also started posting home-made posters about the new national suicide prevention hotline that has been in existence for a year, but no one knew about it because the Health Ministry had not yet thought to make posters or signs. Yesterday I got the first coffee shop in Bhutan to put up a poster! Yeah!"

More photos from Bhutan:

Dr. Karen Cassiday and the entire Psychology Department at dinner at the Bhutan Prime Minister's house. 

About Karen

Karen Cassiday, PhD, is ADAA's past board president. Dr. Cassiday’s areas of interest are anxiety disorders in children and teens, social anxiety disorder, treatment-refractory OCD, and working with children and teens who suffer from both developmental concerns and anxiety disorders. Her research has focused on information processing in posttraumatic stress disorder and cognitive-behavioral treatment of anxiety disorders in children, teens, and adults.

All I can say is, “Yikes!” What a life they live. Thanks for your service, Karen.

Wow. Those three videos were terrific. It sounds as if you've learned so much and have accomplished so much. I was thrilled with your success in the exposure therapy. Keep it up. I love you.

Jane Bodine, L…

August 13, 2019

Inspiring Karen-I wouldn’t mind doing some volunteer work there-need to talk-
Thanks for your sharing in video and text!

I am so proud of you! Your compassion and respect for others shines like a beacon. You not only talk the talk but you walk the walk.
As a Christian you make us so humble. Blessings to you.

You did it! Congratulations, Karen. No one talks about this kind of service to the world. You are a pioneer who's opening doors. Thank you.