Working with Immigrants and Refugees

Abstract

This chapter deals mostly with the challenges and opportunities in mental health clinical work with people from a different cultural background. The question of unconscious biases and prejudice in the therapist is explored, as well as the presumptions and fears of families seen in a mental health setting. There are different cultural norms or codes to express distress, and the communicational style and what topics can be addressed are dictated by the family’s background. Clinicians may experience frustration if they misinterpret a person or family’s reaction to questions, reticence, “inefficient” use of time during sessions, and how problems may be not addressed directly. In some cultural groups, expression of emotion is discouraged as it may bring shame and goes against the expectation of enduring emotional pain by oneself. The clinician should try to understand the client’s perception of therapeutic goals, etiological theories for their problems, and the need to incorporate traditional remedies and healing strategies, which may be effective. Also, the participation of interpreters is described. Often, therapists are “stereotyped” as Latino, or African American, and it is assumed that they should treat all patients of that same background. Families also may hide their unique problems as dictated by “their culture.”