Developing sustainable efforts to address the psychosocial consequences of complex emergencies is often a challenge. There is a limit to what humanitarian efforts can achieve, even with the best of intentions. Locally based tertiary education programmes are needed to provide conceptual frameworks and to develop and sustain professional psychosocial support programmes both during and after the emergency.

Afghanistan has one of the highest rates of substance use in the world, yet existing treatment focuses on detoxification, residential rehabilitation and with very low intensity aftercare. Current available treatment should be changed to more evidence-based modalities, such as structured psychosocial interventions. In addition, the main role of affect in development, maintenance and abstinence of substance use disorders should be also taken into account.

This paper reports on the results of a research study that was conducted by the members of the Departments of Counselling at Kabul University and Herat University in collaboration with their international advisors. The purpose of the study was to determine how Afghans practicing counselling psychology or wishing to employ professional psychological counsellors understand and operationalize the knowledge, skills and values required to be a professional counsellor in Afghanistan.

Little is known about who and what Afghans turn to cope with mental distress precipitated by ongoing socio-political and economic problems. In a cross-sectional survey, the authors examined help-seeking behaviour for mental distress in 306 Afghans residing in Kabul, Afghanistan, and how their choice of what to access for help is influenced by various social and mental healthrelated factors. Factors predicting the use of six distinct resources for support were examined, including biomedical and behavioural health and community-based resources.