Adult clinical psychologist profession in Indonesia

Information regarding the adult clinical psychologist profession in Indonesia is rare. So I want to share some information regarding the topic, as well as my personal view.

Unlike in the United States and Germany, psychotherapy is not covered by insurance in Indonesia. This is an arguable statement as the current BPJS insurance system does cover psychotherapy in its document, but I have yet to witness it in practice. Anyway, this is not very surprising since perhaps the majority of Indonesians are not covered by a medical insurance. Most middle class families use private health care and self-pay. Although to be fair to the Indonesian government, there are many medical expenses under general subsidy, such as vaccines and many types of medicines. This lack of insurance coverage in psychotherapy, to my opinion, has greatly hindered the growth of clinical psychology as a profession in Indonesia.

In Indonesia a typical counseling session begins by making an appointment. The client visits an office that provides various psychology services, describes his/her problems briefly, and then sets up an appointment. At the counseling session, the client consults his or her problem to the clinical psychologist. The typical client usually only come for 1 or 2 counseling sessions from what I have heard and experienced. Most of the time, the client is not given a psychiatric diagnosis (Axis 1 in the DSM diagnostic guideline) and instead, an Axis 3 diagnosis (social situation problem). Besides counseling for personal problems, the two most typical services asked by clients are IQ test and career counseling.

The small number of therapy sessions makes it difficult to deliver evidence based psychotherapy. Most evidence based psychotherapies depend on the existence of a psychiatric diagnosis and require at least 8 sessions. At the current practice, in which psychiatric diagnosis is seldom given and clients usually only come for 1 or 2 sessions, providing evidence based mental health care is close to impossible.

This situation is not without reason and one important contributing factor is that psychotherapy is expensive. For each counseling session (50 minutes), the client typically has to pay around 300,000 rupiah (equivalent to around 30 USD) and around 80% of that will go to the psychologist. This will, of course, depend on the office and the credential of the psychologist. I have heard of a psychologist with a rate of 700,000 rupiah (equivalent to around 70 USD) per session in her private practice. This estimation is based on what I have heard in Jakarta (capital city of Indonesia), it can be very different in other cities. All in all, this rate is not affordable for most people, to put it into context: the minimum monthly wage in Jakarta is at around 2.4 million rupiah (equivalent to 240 USD).

Therefore, I do not have any colleagues who only work as a clinical psychologist and earn enough for a living. Colleagues who practice psychotherapy often earn most of their living from other part time jobs, such as teaching classes at universities and work in projects. Many of my friends from my master degree class work as a staff in a human resource management department. Many also become part-time workers who work in different projects, in which a large part of it will be from businesses. They provide services such as assessment, training, interviews, and others. A smaller proportion of them works in universities and become an academic.