Working predominantly with Uzbek-, Russian-, and Tajik-speaking men from the hinterlands of Central Asia over more than a decade has allowed me to refine some ideas on the concept of motivational interviewing via a "culturally competent" lens. I wish to make clear that I take the notion of cultural competence in utmost seriousness. However, the same idea begins to reek of predominant cultural imperialism (of the "modern world") when bandied about by most Western-oriented practitioners who often refer to these same cast of men as backwards, aggressive, controlling, and a litany of other clinically-couched pejoratives.

Let's get back to the topic at hand. Group counseling can work wonders. Providing individual Central Asian clients with rather foreign ideas to entertain about relationships, gender roles, gender expectations, family systems, and other ideas of adequate behavioral adaptation will move the needle to a degree. At worst, it can result in a complete therapeutic impasse, most typically seen when such clients begin to work with clinicians that do not have an understanding of (or worse: antipathy toward) Central Asian culture and mentality. However, something truly magical (ajoyib) begins to occur when one Uzbek-speaking client sees another Uzbek-speaking client in the same therapy group on a weekly basis. In a controlled setting, with firm yet receptive boundaries. That is a must.

My weekly Uzbek-speaking group therapy sessions often feel as if I am sitting in a room (in-person or virtual) of Genghiz Khan descendants, and I love every second of it. The more individuals in the room, the better...the more that I can see the magic of person-to-person benevolent influence begin to take shape. I do also take pride in the fact that I am planting "seeds of change" into the framework of my group therapy sessions with such men. It has become more noticeable of late that there is a dwindling of "mens' spaces" in our society. This contemporary cultural critique is not lost on the vast majority of my Uzbek-speaking and other Central Asian clients. In fact - when we begin to talk - this idea is expressed unilaterally by such clients in their own words. Those are the same moments where I can meet them (the group as-a-whole) in their yearning, their desire, their forgotten memories of what it was once like to gather in the "maydon" and speak openly about THEIR problems and concerns.

It is also the same place from which I can authentically, and respectfully (although directly, if needed), introduce concepts and ideas that those same clients have never heard of before, yet can begin to appreciate and think about. That is a major therapeutic and psycho-developmental milestone that can only be witnessed and experienced to truly understand.

More than ten centuries ago, one of the most prominent and prolific Persian/Central Asian academics, Abu Ali Ibn Sino introduced the world to a common CBT (Cognitive Behavioral Therapy) principle - way before the world would ever hear of such therapies or Ibn Sino would even dream of their popularity. "It is when the particular portion of the Breath of Life reaches the appropriate parts of the brain that it becomes impressed with the temperament of the brain and thereby becomes adapted for the operation of the soul's powers..." Bakhtiar, Laleh. (2013). Avicenna's Psychology: A Textbook on Perennial Psychology. Chicago IL: KAZI Publications, Inc.

When my Uzbek-speaking clients come back to me and begin to speak with their own mind and heart about the need to adapt their thinking and behaviors (not only in line with American standards of acceptability, but also out of an authentic desire to have healthier familial relations), I listen to them with deep respect and curiosity about how they have come to such a place. Inevitably, they also reference their group therapy experiences (with comparisons and contrasts to the next "d'ost", friend) - and perhaps how they unconsciously see aspects of themselves in the others in the group, and consciously wish to work on those very aspects of themselves they know can make their lives happier, healthier, and safer.

That is where I meet many of my Uzbek-speaking clients, and we begin to explore worlds never quite known or talked about in the public squares, but certainly in my private rooms. And then, hopefully, in their own homes, tea-houses, places of worship, buzkashi matches, and hearts.