The goal of this study was to further local knowledge production and the ground-up cultural and contextual competencies needed for family therapy training and practice in Cambodia. First, expert interviews were conducted with Cambodian and international mental health professionals with several years of professional experience in Cambodia (N = 25
72% Cambodian, 52% female). Current characteristics of Cambodian family life and related problems were identified, as well as aspects of the current reality of mental health services in this Southeast Asian nation, which continue to be counted among the low- and middle-income countries (LAMICs). Second, in a group discussion with four Cambodian trainer experts in family therapy, the cultural and contextual competencies to be developed in the training of Cambodian family therapists were identified. The competencies for incorporating religious beliefs, respecting hierarchical family structures/expressing respect, and competencies for dealing with the cultural imperative of silence/face-saving appear to be significant. For the trainees, it is precisely here that areas of tension were described-triggered by collusion of their own value systems with those implicit in Western concepts. These moments of alienation should be carefully registered for reflection. The experience of dissonance in relation to certain content and procedures points precisely to the need for adaptation by local experts for the development of culturally appropriate curricula.