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Try out PMC Labs and tell us what you think. Learn More. Alcohol use and misuse for 3. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society. This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact.


Lorinda Kiyama, EdD, was already living abroad when she decided to pursue a psychology career. Dimas advised social workers on how to consider the psychological needs of clients, many of whom reported experiencing depression, trauma and domestic violence. George Hu, PsyD, and his wife are second-generation Chinese-Americans, but they always felt disconnected from their Chinese heritage.

There are no social workers, no foster-care system and only limited availability of inpatient care, so Scull often felt helpless to aid his patients.


An American psychology degree is highly regarded around the world—and some adventure-seeking U. Operating in a variety of settings, including research, practice, government and applied, psychologists find overseas work both rewarding and challenging. For those moving overseas with children, Kiyama recommends searching online for parent support groups.

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Then, sparked by an interest in adoption mediation, she decided to pursue a degree in counseling psychology online through Argosy University. Before Allyn Enderlyn, PhD, MBA, ever practiced psychology, she had already moved from Bethesda, Maryland, to Switzerland to serve as the head of resource mobilization for a sister agency of the United Nations, where she managed infrastructure projects for developing nations. To ease the transition, he completed his internship year in London.

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Asshe had spent six years in Venezuela and Brazil and wanted to provide a similar international experience for her daughter. For several years, Bade-White worked at U. Now, she works at the American School of Bombay, a private, international elementary, middle and high school. Such areas preserve some Western customs. She grew up in Darien, Connecticut, and in moved to Japan to her husband, a Japanese native she met while studying abroad.

Most U. Dimas also treats other expatriates, who can face challenges around identity and belonging, drawing on her own experiences of such stressors. Enderlyn loves the diversity of her clinical practice. Her expat support systems helped her family transition to new countries by providing insight about language, housing and safety. Raising children abroad has also made it easier to connect with other expatriate families, she says.

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Priscilla Bade-White, PhD, a school psychologist based in Mumbai, India, was inspired to move abroad when she started a family. So, when Hu had the opportunity to travel to China for a training rotation during graduate school, he seized it. In addition, she works online with patients from countries all over the world, such as Australia, Colombia and Spain, that recognize her California to practice. It was an adventurous decision for Kiyama since in Japan, many people are ashamed to seek psychological help—especially to address relationship problems—although that stigma is starting to lessen, she says.

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While his resettlement package made his transition smooth—many international universities cover the costs of moving, housing and even school tuition for children—in Saudi Arabia, Msall has encountered some obstacles in obtaining visas and residency permits for his wife and even his dog.

Kiyama suggests that psychologists who are interested in working abroad reach out to international counseling agencies and English-speaking universities to find out about possible job opportunities. Msall got the position and spent two years there, then secured a job as assistant professor of international psychology at King Fahd Security College in Riyadh, Saudi Arabia. That was a really challenging adjustment for me," he says.

Bade-White says living abroad has benefited her children, now ages 9 and They have made friends quickly, have a great appreciation for cultural differences and have developed a sense of social justice. Ever dream of taking your career abroad? For clinical psychologists interested in practicing in Europe, she recommends carefully tracking licensure requirements.

In some countries, getting d can feel almost as challenging as completing a doctoral degree, she says. After he finished studying counseling psychology at the University of Wisconsin—Madison, that dream became a reality: He moved to Salmiya, Kuwait, and secured a job through familial contacts as the first psychologist at Fawzia Sultan Healthcare Network, a nonprofit clinic that serves children, adolescents and adults.

Living far from extended family can be tough, yet many have found new and refreshing perspectives culture culture, identity and even their own psychological training. He had already taught an English-language course to Middle Eastern students at Missouri State University in Springfield and chose to focus his doctoral dissertation on humanitarian organizations in Iraq. At first, she taught Japanese literature at Tokyo Institute of Technology.

The journey reminded me that I have always been a psychologist at dating she says. Her work with international families, she says, has shown her that children may struggle to acclimate to a foreign school and that some may even experience bullying. He says the different regulations, therapies and priorities in England have exposed him to many new areas of psychology, including neuropsychology, older adult therapies and treatments for people with rican disabilities.

After five years in Costa Rica, Dimas recently accepted a new job in Northern California to be closer to her extended Fremont. Kiyama earned that degree in and now uses her psychological knowledge in a variety of professional roles: She teaches conflict resolution at the Academy for Leadership at Tokyo Tech, researches adoption mediation and sees patients at the student counseling center.

Despite these benefits, some Japanese employers require long hours that can be challenging for those with young children or other family-care responsibilities, but Kiyama says her colleagues have been supportive. Then, he saw a recruitment ad in the international section of HigherEdJobs. The growth opportunities here are endless," Hu says.

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After obtaining her doctorate in clinical psychology with an emphasis in depth psychology from the Pacifica Graduate Institute in Santa Barbara, California, Enderlyn returned to Switzerland, where she started a clinical practice in Geneva focused on analytical psychology, narrative therapy and cognitive-behavioral therapy.

Back in the United States, Hu, who earned his degree from Alliant International University in San Francisco, did clinical and administrative work as the program coordinator for outpatient services at a clinic in Fremont, California. He says that while many Chinese consider mental illness shameful, the demand for psychological services is growing because the country is still reeling from globalization and the radical legal and cultural shifts that followed the Communist revolution, reshaping Chinese society.

Later this year, Burgess will transition to a new job at the Salomons Institute for Applied Psychology, a specialized center for postgraduate psychology training within Canterbury Christ Church University. She later launched an online practice, which now serves about half of her clients, obtaining training online and separately researching technological, legal and ethical considerations.

His success there led the clinic to launch a department of mental health and wellness, which he now directs, overseeing a clinical staff of Though mental health care carries a strong stigma in Kuwait, Scull has seen an uptick in patients seeking help for depression, anxiety and relationship concerns since he arrived in the country.

But she craved an international experience. In fact, working in a country where the discipline of psychology is at a younger developmental stage has been incredibly rewarding for him.

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When he arrived inScull was one of four U. Adding to the challenge is that Kuwait does not have a formal licensure process or ethics code for mental health professionals. Five years into the job, he decided to look for work in China and used LinkedIn and his professional network to find a full-time job in Beijing as director of the Center for Cognitive Behavioral Therapy at a large hospital system. Meet 10 American psychologists from a variety of subfields who revitalized their careers and their lives by moving to another country. Here are their stories.

Thanks to his familiarity with international travel, Scull quickly acclimated to daily life in Kuwait.

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In the clinic, Hu mostly delivers cognitive-behavioral therapy and treats problems such as anxiety and family difficulties. In a typical workweek, Burgess teaches neuropsychology and psychometrics to doctoral students and undergraduates, supervises research for multiple doctoral dissertations and performs administrative duties such as creating admission criteria for the psychology department.

At the same time, get to know the local psychologists," she says. Gerald Burgess, PsyD, had planned to move to England, where his wife was born and raised, even before he started his doctoral studies at James Madison University in Harrisonburg, Virginia. Though Enderlyn still maintains an office, home and in Maryland and travels there often, she feels that Switzerland is where she truly belongs.

Adapting professionally, however, was not as easy. Ten years later, she was ready for a career change. This is a fascinating place to be as these questions are being asked and answered. But over the years, as support for psychological services grew at the clinic, Scull has found his work incredibly rewarding, especially his efforts to adapt Western dating to a culture that is highly collectivistic.

He also sits on the board of the Shanghai International Mental Health Association and several other community organizations that work to increase access to mental health care and provide ongoing support to adults with developmental disabilities in Uzbekistan. For 20 years, Juanita Dimas, PhD, had a thriving career in academia, clinical practice and public health management while living in California.

Her clients include multinational families Fremont need help with cultural acclimation, expatriate professionals and diplomats from around the world. He is also culture adjunct professor at Lehigh University, based in Bethlehem, Pennsylvania, which hosts part of its international school counseling program in Kuwait. Psychologists who are looking for such communities should seek out connections through work, neighbors or even realtors who focus their business on expats, she suggests.

She sees the move as just another stop on her journey. While apartment living is standard throughout much of the Middle East, many Westerners in Saudi Arabia live in expatriate "compounds," gated residential communities with schools, restaurants and convenience stores. He also found himself questioning some of his basic psychological training when he began to apply certain concepts to the population. Msall recommends pursuing any international experience with an open mind and a willingness to be surprised.

In addition, Kiyama counsels international families with children in Japanese public schools and international couples seeking to adopt Japanese children. Practicing in both English and Spanish, Dimas treats Costa Ricans, who are generally open to psychological rican but often struggle to find high-quality, culturally relevant care, she says. She also teaches psychopathological assessment in the graduate program at the Geneva campus of Webster University.

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Costa Rican Americans estadounidenses de origen costarricense are Americans of at least partial Costa Rican descent.