based, where the person who is
suffering the most is referred
for treatment that’s focused on
symptom reduction,” says Walsh.
She is a co-founder and co-director of the Chicago Center
for Family Health, which trains
mental health professionals in
its family-centered, resilience-oriented approach and provides
services to refugees and others.
That individual focus is not
enough, says Walsh. For one,
trauma and loss affect everyone
in a family. “The shock waves
reverberate throughout the
family,” she says.
But the family also holds
the key to healing, says Walsh.
“We focus on the strengths that
enable people to endure and
overcome trauma and tap into
the natural resource for resilience
in the family,” she says.
When Bosnian and Kosovar
■ Emphasize trust building. Seeking
help from a psychologist is not something many refugees and asylum-seekers
are comfortable with. “The notion of
coming to a stranger you’ve never met
and spilling out your most embarrassing, shameful secrets is very foreign,”
says Adeyinka Akinsulure-Smith, PhD,
a senior supervising psychologist at the
Bellevue/New York University Program
for Survivors of Torture. Chung agrees.
When she goes into a refugee community, she doesn’t want to be seen as an
expert. Many refugees come from countries where psychologists could be seen
as part of the government and intake
questions seen as disturbingly intrusive.
“They might perceive it as, ‘Oh, my
gosh, I might suddenly disappear the
next day,’” says Chung. Instead, she asks
community leaders how she can help,
then engages in active listening while
working with people on everyday tasks.
“I might be working with women in the
kitchen, with difficult topics coming
up,” she says.
■ Focus on symptoms. Some refugees
and asylum-seekers, especially Muslims,
come from countries where talking
about feelings isn’t as accepted as it
is here, says Abdulrehman. That’s
why he uses cognitive-behavioral
therapy with his Muslim clients. In
addition to focusing on symptoms,
cognitive-behavioral therapy also has a
practical, solutions-oriented approach
that helps restore clients’ sense of control over their lives, he says.
■ Build strong relationships with
professional interpreters. Bringing
another person into the therapy session
introduces potential new complications,
says Akinsulure-Smith. The patient
may worry about confidentiality; an
interpreter from the same country may
have their own issues when hearing
about the patient’s experiences. Spend
some time with the interpreter before
the session, be clear that you expect
word-for-word translation and debrief
afterward, she suggests. –Rebecca A. Clay