Shannon Brown looks at a centre offering psychological and behavioural services in Ho Chi Minh City. Photos by Romain Garrigue.

Azrael Jeffrey moved to Vietnam from the United States in 2009  to work for an international school in Hanoi. After several years, he became concerned about the high unmet need for psychological services he observed, and left Vietnam to pursue a PhD in counselling psychology.

Five years later, Azrael returned with the intention of improving mental health in local and expat communities.

Simone Maffescioni moved to Vietnam from Australia in 2013 to coordinate speech therapy training at a Vietnamese university. After two years, she began to search for other ways to work in the country as a speech pathologist.

In 2014, Jeffrey and Maffescioni met in a networking group for specialists working with children. They realised they had a shared vision: both wanted to create an organisation where specialists could work in a stable, collaborative, and professional environment. Thus, the idea for the International Center for Cognitive Dissonance (ICCD) was born.

It took six months for the business to get off the ground and a year to become fully operational. I visited their offices in December of 2017 to discuss forming a mental health support group, and found the staff to be welcoming and knowledgeable. The center itself is on the top floor of a nondescript building in District 2 – it is set up to be as family-friendly and as private as possible. ICCD offers a range of services: psychological and educational assessments, psychotherapy and counselling, career coaching, speech and language pathology, occupational and music therapy, behavioral analysis for children, educational support services, and university coaching. They have a large client-base, great relationships with the international school system, and an ever-expanding team of professionals.

This month, I spoke with the team and asked them about the highs and lows of working in the mental health and special needs field in Saigon. Each employee of ICCD said that the support they receive from their colleagues makes all the difference.

“The invaluable aspect of working at ICCD is having a team of professionals to collaborate with,” Maffescioni said. “Particularly for children with complex needs, it is most effective to work together to best support the child and family holistically. For example, a child with significant special needs may require support from an occupational therapist to be able to regulate their body effectively, a behavioural therapist to learn necessary skills and target behaviours, and a speech pathologist to develop communication skills. We also provide psychology or counselling support for the family.”

Jessica McEachern echoed the importance of her team. “The ability to cooperate with other professionals at the center and to share our knowledge about how to best support our clients is extremely useful. It also feels amazing when clients report their successes and how we helped to make a difference in their lives.” Anne Peters said that for her, watching a smile come back to her clients is the best thing. “Not a polite smile, a genuine smile,” she elaborated.

There are challenges as well. Everyone in the centre lamented the lack of general information about mental health disorders in Vietnam and said that social stigma is still a very real barrier to accessing help.

In the smaller niches, it can become even more frustrating. Victoria Smith Lyons says many people don’t understand what she does for a living.

“I trained to be a music therapist in Cambridge in 2008 but ever since I left the UK, where music therapy is a well-recognised health profession, I feel like I have had to explain what music therapy is and who it can help. I think when you get to the specifics of how particular therapies work it can be overwhelming and confusing for people.”

Maffescioni said that speech pathology is such a new field in Vietnam that there have been many impediments to care along the way. Many of the issues arise because her clients are bilingual or multilingual.

“There are so few local and international speech pathologists in Ho Chi Minh City and so many people that are in need of services. The speech pathology caseload in Ho Chi Minh City is more complex than what I experienced in Australia. Almost all of my clients are at least bilingual and the typical speech pathology treatment resources are often inappropriate linguistically and culturally. I usually need to create specific resources for each separate case, which is particularly time-consuming. Also, standard tests for speech and language are normed on monolingual English speakers, so assessing a client’s communication skills requires extra tasks and analyses.”

One unique aspect of ICCD is that they host weekend groups to help children develop their social skills. Lyons noted that this area is neglected in most educational settings and that she finds it highly rewarding.

“The social skills groups at ICCD are a really important part of the work I do. The groups provide an opportunity for many kids from different backgrounds with various developmental, social and behavioural needs to come together every week and receive instruction in areas which are critical for their social development,  including: conversation skills and body language, cooperative play and sharing, empathy and kindness, emotional awareness, self-regulation, teamwork, and expected and unexpected behaviour in various contexts.”

ICCD does no marketing or advertising. Clients find them through word-of-mouth and former client referrals. Jeffrey said, “We believe our reputation and quality services speak for themselves.” He also talked a bit about the coming year and the goals that the team has set.

“We want to continue to provide professional services to the local and international community. We plan to link stronger with the Vietnamese community and we wish to develop and bring in more Vietnamese staff with international training. Currently, we are supporting our Vietnamese staff to gain training and international certification. We would like to expand locations within Ho Chi Minh City and other cities in Vietnam. And we want to continue to provide training and support to educational institutions to develop resources for children with special needs in the community.”

Currently, ICCD is nearing capacity. Jeffrey explained, “As our reputation developed, so did our team and caseload. We need qualified and experienced professionals to provide services for our growing caseload of children with special needs. This includes speech pathology, occupational therapy and behavioural therapy. We also need counsellors, psychologists and psychotherapists for our growing local and international client caseload. Interested professionals can contact us through the website and set up a time to come and meet us to discuss potential opportunities.”

ICCD is located at 191 Nguyen Van Huong, Thao Dien, District 2, on the fourth floor. They have several counselling rooms and you can make an appointment over the phone, over email, or in-person

International Center for Cognitive Development (ICCD)
191 Nguyen Van Huong, Thao Dien D.2 HCM City, Vietnam (4th floor)