Beyond cultural competence: a qualitative analysis of psychologists’ experiences with Muslim clients in South Africa

Introduction Muslim mental health is an emerging field of inquiry in the global South. Understanding how mental health conditions are interpreted within diverse Muslim communities is important for culturally responsive psychological care. Methods This qualitative study explored psychologists’ experiences of providing services to Muslim clients in the Western Cape, South Africa, and explored psychologists’ accounts of explanatory models of mental health conditions encountered in therapeutic practice. Semi-structured interviews were conducted with 15 clinical and counseling psychologists practicing in the Western Cape. Data were analyzed using Reflexive Thematic Analysis. Results Three themes were constructed. First, psychologists emphasized the importance of understanding Muslim clients within their broader sociocultural and historical context, particularly the enduring influence of Apartheid, migration histories, intergenerational trauma, and institutional mistrust. Second, psychologists reported encountering diverse explanatory models among Muslim clients, including interpretations of distress in relation to religiosity, supernatural influences, stigma, personal weakness, and biomedical understandings. These explanatory models were described as shaping emotions such as fear, guilt, and shame, as well as pathways to help-seeking and engagement with treatment. Third, psychologists highlighted the importance of culturally responsive practice, including reflexive engagement with clients’ religious worldviews, ongoing self-education, culturally informed supervision, and ethical collaboration with Muslim religious leaders. Discussion The findings suggest that explanatory models are not solely individual beliefs about MHC but are embedded within broader religious, familial, historical, and sociopolitical contexts. By exploring psychologists’ accounts of therapeutic encounters with Muslim clients in the Western Cape, this study extends explanatory-model scholarship by highlighting how collective histories and relationships with systems of care shape understandings of mental health and help-seeking.