Objectives
1. Understand the challenges and process that Muslim immigrants face
2. How religion plays a major role in the mental health treatment that Muslims receive
3. Understand the dynamic of family roles and cultural beliefs
4. Learn the effect that discrimination has had on Muslims especially post 9/11
5. Be knowledgeable in the role that mental health counseling has in Muslim cultures
1. Understand the challenges and process that Muslim immigrants face
2. How religion plays a major role in the mental health treatment that Muslims receive
3. Understand the dynamic of family roles and cultural beliefs
4. Learn the effect that discrimination has had on Muslims especially post 9/11
5. Be knowledgeable in the role that mental health counseling has in Muslim cultures
OOoobffbfbf mv nv dOMuslim Immigrants
There are approximately 7 million Muslims in the United States. The majority of Muslim immigrants in the United States come from the Middle East and North Africa. The second largest group consists of South Asians from Afghanistan, Pakistan, India, Bangladesh, and Iran. Other Muslims have immigrated from East and South East Asia, Africa, South and Central America, and Europe. Many Muslim immigrants came here for reasons ranging from education to escaping political prosecution. They face many challenges such as marginalization (to put someone in a powerless or unimportant position within a society or group), discrimination, racism, and acculturation (when members of one cultural group adopt the beliefs and behaviors of another group) (Amri & Bemak, 2013).
Immigrant families have to deal with economic transitions such as different types of employment than they are accustomed to because their previous educational and work experiences may not meet standards or requirements that are accepted by state licensure boards. Immigrant parents must be able to quickly learn and adapt to their new cultures, become fluent in the language, and enroll their children in unfamiliar educational systems with unaccustomed educational philosophies, expectations, norms, and styles of testing (Ahmed & Reddy, 2007).
Religion
Islam is the fastest growing religion and second most popular religion in the United States. Islam is known to be the last of the Abrahamic faiths, revealed through the Prophet Muhammad in the form of a holy book called the Qur'an. The Qur'an was originally written in Arabic but has since been translated into almost every major language in the world. The Qur'an is divided into 114 chapters that are in order from the longest to the shortest. Some of the verses are considered to be answers to specific questions or crises (Ali, Liu, & Humedian, 2004).
Muslims are required to perform four acts: pray five times a day, fast in the Islamic month of Ramadan (the ninth month of the Islamic calendar), give charity, and perform the pilgrimage to Makkah at least once in their lifetime (Ahmed & Reddy, 2007). Makkah is also known as Mecca, which is a city in Saudi Arabia that is the birthplace of Muhammad and the site of Muhammad's first revelation of the Qur'an.
The basic teaching of Islam is to remember God (Allah in Arabic) and do good things for everyone at all times. Life in this world is rewarded in the afterlife, which is eternal. These are the governing principles for all practicing Muslims as taught from birth (Podikunju-Hussain, 2004).
Families and Relationships
Many Muslim societies are collectivistic, and individualism and individuation from families is deterred. Muslims are also deterred from sharing personal or family difficulties outside of their immediate family. Family structures are typically hierarchical and interdependent, therefore, family members need to consider benefits to the family and larger community before making most decisions (Ali, Liu, & Humedian, 2004).
Interaction between men and women is limited to immediate family and relatives. Virginity is valued and dating or interaction between males and females is extremely discouraged. Arranged marriage is a tradition and marrying within your own ethnic group is part of your obligation to your family (Podikunju-Hussain, 2004).
There is usually a change in family roles for most individuals that immigrate to the United States. Children are often "parentified" because they are usually able to learn English a lot quicker than their parents. They are required to speak on their parent's behalf in most situations and also are responsible for making critical decisions that impact the family. Women are often forced to work along with the men and at times are the sole financial provider, which then leads to the male who is the head of the household feeling a loss of control and incompetence.
Family violence and domestic violence are issues that are becoming more common. These issues seldom get addressed due to cultural stigmas and beliefs that domestic violence is a proper form of discipline. Muslim women feel that they need to stay in abusive relationships to keep their family together, because it is their responsibility, or because they feel there are not many options outside of marriage to be able to financially support themselves and being isolated from their community (Amri & Bemak, 2013).
There are approximately 7 million Muslims in the United States. The majority of Muslim immigrants in the United States come from the Middle East and North Africa. The second largest group consists of South Asians from Afghanistan, Pakistan, India, Bangladesh, and Iran. Other Muslims have immigrated from East and South East Asia, Africa, South and Central America, and Europe. Many Muslim immigrants came here for reasons ranging from education to escaping political prosecution. They face many challenges such as marginalization (to put someone in a powerless or unimportant position within a society or group), discrimination, racism, and acculturation (when members of one cultural group adopt the beliefs and behaviors of another group) (Amri & Bemak, 2013).
Immigrant families have to deal with economic transitions such as different types of employment than they are accustomed to because their previous educational and work experiences may not meet standards or requirements that are accepted by state licensure boards. Immigrant parents must be able to quickly learn and adapt to their new cultures, become fluent in the language, and enroll their children in unfamiliar educational systems with unaccustomed educational philosophies, expectations, norms, and styles of testing (Ahmed & Reddy, 2007).
Religion
Islam is the fastest growing religion and second most popular religion in the United States. Islam is known to be the last of the Abrahamic faiths, revealed through the Prophet Muhammad in the form of a holy book called the Qur'an. The Qur'an was originally written in Arabic but has since been translated into almost every major language in the world. The Qur'an is divided into 114 chapters that are in order from the longest to the shortest. Some of the verses are considered to be answers to specific questions or crises (Ali, Liu, & Humedian, 2004).
Muslims are required to perform four acts: pray five times a day, fast in the Islamic month of Ramadan (the ninth month of the Islamic calendar), give charity, and perform the pilgrimage to Makkah at least once in their lifetime (Ahmed & Reddy, 2007). Makkah is also known as Mecca, which is a city in Saudi Arabia that is the birthplace of Muhammad and the site of Muhammad's first revelation of the Qur'an.
The basic teaching of Islam is to remember God (Allah in Arabic) and do good things for everyone at all times. Life in this world is rewarded in the afterlife, which is eternal. These are the governing principles for all practicing Muslims as taught from birth (Podikunju-Hussain, 2004).
Families and Relationships
Many Muslim societies are collectivistic, and individualism and individuation from families is deterred. Muslims are also deterred from sharing personal or family difficulties outside of their immediate family. Family structures are typically hierarchical and interdependent, therefore, family members need to consider benefits to the family and larger community before making most decisions (Ali, Liu, & Humedian, 2004).
Interaction between men and women is limited to immediate family and relatives. Virginity is valued and dating or interaction between males and females is extremely discouraged. Arranged marriage is a tradition and marrying within your own ethnic group is part of your obligation to your family (Podikunju-Hussain, 2004).
There is usually a change in family roles for most individuals that immigrate to the United States. Children are often "parentified" because they are usually able to learn English a lot quicker than their parents. They are required to speak on their parent's behalf in most situations and also are responsible for making critical decisions that impact the family. Women are often forced to work along with the men and at times are the sole financial provider, which then leads to the male who is the head of the household feeling a loss of control and incompetence.
Family violence and domestic violence are issues that are becoming more common. These issues seldom get addressed due to cultural stigmas and beliefs that domestic violence is a proper form of discipline. Muslim women feel that they need to stay in abusive relationships to keep their family together, because it is their responsibility, or because they feel there are not many options outside of marriage to be able to financially support themselves and being isolated from their community (Amri & Bemak, 2013).
Discrimination
Peer pressure, racism, discrimination, and social pressures to conform to mainstream values can put Muslims in a vulnerable position where they are likely to experience psychological issues such as anxiety and depression.
Since the 9/11 terrorist attacks, the United States has focused more attention on Muslims in America and abroad. Media coverage has produced both fear and curiosity for several people in regards to the social and cultural behaviors of the Muslim culture. "Right-wing media figures have smeared the image of Muslims and Islam and make no apologies for their Islamophobic views and beliefs" (Amri & Bemak, 2013:46). Even though there has been more focus on Muslims they still remain to be misunderstood and misrepresented. Just like Americans, American Muslims also had to deal with the trauma and aftermath of 9/11 and the resulting war on terror, both domestically and internationally. Following the events of 9/11, American Muslims have experienced religious harassment and racial profiling. According to The Federal Bureau of Investigation, they reported a 1,600% volume increase since 2000 in the number of hate crimes committed against Muslims (Ahmed & Reddy, 2007). "Since the terrorist attacks, the Council of American-Islamic Relations has logged over 700 discriminatory acts against Muslims. Many of these have been violent attacks or threats against Muslims or those perceived to be Muslim" (Ali, Liu, & Humedian, 2004:635).
Apart from having to deal with acts of violence, threats, hate messages and harassment following the 9/11 terrorist attacks, Muslim Americans had to deal with feelings of anxiety and concerns for their own safety. Some began to question their devotion to the Islamic faith because they felt lost and confused about their faith. They felt like they needed to be viewed differently from the criminals that committed the terrorist attacks because they felt that committing terrorist acts such as 9/11, did not follow the righteous path of Islamic religion.
As a result of the 9/11 terrorist attacks, on October 26, 2001 George W. Bush signed into law the USA Patriot Act. Since then Muslims have been the target of travel restrictions, home raids, unjustified arrests and detentions, and interrogation. Muslim immigrants have also dealt with discrimination in the workplace through denial of employment or wrongful termination, in school systems through denial of religious accommodations, and in public places.
Discrimination
Peer pressure, racism, discrimination, and social pressures to conform to mainstream values can put Muslims in a vulnerable position where they are likely to experience psychological issues such as anxiety and depression.
Since the 9/11 terrorist attacks, the United States has focused more attention on Muslims in America and abroad. Media coverage has produced both fear and curiosity for several people in regards to the social and cultural behaviors of the Muslim culture. "Right-wing media figures have smeared the image of Muslims and Islam and make no apologies for their Islamophobic views and beliefs" (Amri & Bemak, 2013:46). Even though there has been more focus on Muslims they still remain to be misunderstood and misrepresented. Just like Americans, American Muslims also had to deal with the trauma and aftermath of 9/11 and the resulting war on terror, both domestically and internationally. Following the events of 9/11, American Muslims have experienced religious harassment and racial profiling. According to The Federal Bureau of Investigation, they reported a 1,600% volume increase since 2000 in the number of hate crimes committed against Muslims (Ahmed & Reddy, 2007). "Since the terrorist attacks, the Council of American-Islamic Relations has logged over 700 discriminatory acts against Muslims. Many of these have been violent attacks or threats against Muslims or those perceived to be Muslim" (Ali, Liu, & Humedian, 2004:635).
Apart from having to deal with acts of violence, threats, hate messages and harassment following the 9/11 terrorist attacks, Muslim Americans had to deal with feelings of anxiety and concerns for their own safety. Some began to question their devotion to the Islamic faith because they felt lost and confused about their faith. They felt like they needed to be viewed differently from the criminals that committed the terrorist attacks because they felt that committing terrorist acts such as 9/11, did not follow the righteous path of Islamic religion.
As a result of the 9/11 terrorist attacks, on October 26, 2001 George W. Bush signed into law the USA Patriot Act. Since then Muslims have been the target of travel restrictions, home raids, unjustified arrests and detentions, and interrogation. Muslim immigrants have also dealt with discrimination in the workplace through denial of employment or wrongful termination, in school systems through denial of religious accommodations, and in public places.
Mental Health Counseling
Some of the mental health disorders that are common among Muslims are depression, anxiety, and posttraumatic stress disorder (PTSD). There are higher rates of depression among Muslim women than there are men. There has been more cases of PTSD since the 9/11 attacks have occurred due to the trauma they have endured. American Muslims have higher rates of PTSD symptoms than does the general population in the United States (Ahmed & Reddy, 2007). Other challenges such as discrimination, acculturation and identity, and family and marital problems are also issues that Muslims have but do not have the resources they need in order to get through them.
Most Muslims believe that the symptoms related to mental health disorders are not biological but rather due to demonic possession. Other reasons for these symptoms are due to consequences of past sins, being cursed, or losing faith in God. Therefore, most Muslims seek traditional treatment such as Islamic faith healing. Due to the social stigma that surrounds seeking mental health services, Muslims tend to turn to the spiritual healer (shaykh) within their community to act as their counselor. The spiritual healer uses faith to treat and heal members of the community. Spiritual healers have been the primary source for treating mental illness for several generations in the Muslim community. During this process Muslims put their life and problems into the hands of the spiritual healer in hopes of helping them perfect their faith and spirituality.
The six common barriers of mental health counseling among Muslims are mistrust of service providers, fear of treatment, fear of racism and discrimination, language barriers, differences in communication, and issues of culture and religion. It is the belief that the Qur'an is the cure to spiritual, psychological, and physical illness. It is common for Muslims to recite the Qur'an and pray more than usual during times of physical and mental difficulty. Therefore, it is extremely important that mental health providers incorporate religion and spirituality into their treatment plan for Muslim clients (Keshavarzi & Haque, 2013).
Islam strictly forbids suicide and Muslims consider it to be a criminal act. Therefore, mental health providers that need to assess for suicidal ideation should ask about passive expression of suicidal ideation. Most Muslims consider suicide a criminal act but there are many political groups that approve of and support suicide bombings as a way to make political statements. There are Muslims that approve suicide bombings and the killing of innocent people in the name of Islam, no matter what the cause may be.
It is important for counselors to avoid using professional jargon and labeling because translated words can hold different meanings for American Muslims. It is essential that prior to providing treatment to the Muslim population that counselors gain a strong understanding of the Muslim culture. It is necessary that the counselor is aware of their biases and reaction to Muslim clients seeing that they may present differently than clients that they are accustomed to treating. The counselor needs to recognize the limitations of their ability to help Muslim clients and be aware of negative reactions they may have that may compromise treatment. If this occurs, it is recommended that the counselor makes an appropriate referral for the client while identifying their personal boundaries serving the best interests of the client (Keshavarzi & Haque, 2007). "A professional counselor can understand the client as an individual and not as a stereotype of the Muslim community, or a specific culture, based on nationality. Such an understanding is the foundational building block of a meaningful working alliance between the counselor and the client and sets the stage for effective therapeutic progress" (Ibrahim & Dykeman, 2010:393). In order to provide a proper assessment the counselor needs to know background information such as demographics of the cultural group, and have an understanding and appreciation for the teachings of the Qur'an. This information helps provide a better understanding of what life is like for the client, their culture and beliefs and how their religion impacts them. If the client does not feel that the counselor understands his or her spiritual or religious concerns and needs, the necessary therapeutic relationship will not be created. Counselors need to assure clients that their concerns and resolutions to their problems will be addressed from a religious perspective. It is extremely important for the counselor to show sensitivity at all times in order to help build a trusting relationship with the client. Asking too many questions can become an issue because the client may feel like they are being interrogated causing them to shut down leading to a break in the therapeutic relationship.
One of the common methods to treating Muslim immigrants is the Multi-Phase Model of Psychotherapy (MPM). This model consists of five phases and requires the psychologist or counselor to have in depth knowledge of the immigrants past and present traumas, history of discrimination and racism, religious and spiritual beliefs, as well as the cultural beliefs surrounding mental health. Phase 1: Mental Health Education involves the counselor educating the client on what actually happens in counseling and the benefits of counseling therefore, eliminating any social and cultural myths of mental health. Phase 2: Individual, Group, and Family Intervention requires the psychologist or counselor to be aware of issues such as language needs, gender roles, family hierarchy, family history, and spiritual practices. Phase 3: Cultural Empowerment consists of the counselor providing the client with tools and resources to navigate through barriers such as using public transportation, applying for employment opportunities, and where to obtain language training. Phase 4: Integration of Traditional and Western Healing Practices requires the psychologist or counselor to give the client the option of incorporating religious and traditional healing practices into the therapeutic process. Phase 5: Addressing Social Justice and Human Rights Issues is when the psychologist or counselor encourages the client to join community groups to advocate for social justice issues in the Muslim immigrant community (Amri & Bemak, 2013).
Resources
Ahmed, S., & Reddy, L. (2007). Understanding the Mental Health Needs of American Muslims: Recommendations and Considerations for Practice. Journal of Multicultural Counseling and Development, 35(4), 207-218. Retrieved June 3, 2015, from http://web.a.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=9ecdb531-3d18-4bf4-ac68-49a128bfd6f8@sessionmgr4003&vid=6&hid=4107
Ibrahim, F., & Dykeman, C. (2010). Counseling Muslim Americans: Cultural and Spiritual Assessments. Journal of Counseling & Development, 89(4), 387-396. Retrieved June 3, 2015, from http://web.b.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=d5acfb9d-1dfc-45e0-9e38-63439f42cc23@sessionmgr112&vid=5&hid=116
Keshavarzi, H., & Haque, A. (2013). Outlining a Psychotherapy Model for Enchancing Muslim Mental Health Within an Islamic Context. The International Journal for the Psychology of Religion, 23(3), 230-249. Retrieved June 3, 2015, from http://web.b.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=c6ab67a5-3693-47b2-873d-8263f4261127@sessionmgr198&vid=4&hid=110
Amri, S., & Bemak, F. (2013). Mental Health Help-Seeking Behaviors of Muslim Immigrants in the United States: Overcoming Social Stigma and Cultural Mistrust. Journal of Muslim Mental Health, 7(1), 43-59. Retrieved June 3, 2015, from http://quod.lib.umich.edu/cgi/p/pod/dod-idx/mental-health-help-seeking-behaviors-of-muslim-immigrants.pdf?c=jmmh;idno=10381607.0007.104
Ali, S., Liu, W., & Humedian, M. (2004). Islam 101: Understanding The Religion And Therapy Implications. Professional Psychology: Research and Practice, 35(6), 635-642. Retrieved June 8, 2015, from http://isites.harvard.edu/fs/docs/icb.topic551849.files/Ali Liu and Humedian.pdf
Podikunju-Hussain, S. (2004). Working with Muslims: Perspectives and Suggestions for Counseling. Retrieved June 8, 2015, from http://www.counseling.org/knowledge-center/vistas/by-subject2/vistas-multicultural-issues/docs/default-source/vistas/working-with-muslims-perspectives-and-suggestions-for-counseling
Amri, S., & Bemak, F. (2013). Mental Health Help-Seeking Behaviors of Muslim Immigrants in the United States: Overcoming Social Stigma and Cultural Mistrust. Journal of Muslim Mental Health, 7(1), 43-59. Retrieved June 3, 2015, from http://quod.lib.umich.edu/cgi/p/pod/dod-idx/mental-health-help-seeking-behaviors-of-muslim-immigrants.pdf?c=jmmh;idno=10381607.0007.104
Ahmed, S., & Reddy, L. (2007). Understanding the Mental Health Needs of American Muslims: Recommendations and Considerations for Practice. Journal of Multicultural Counseling and Development, 35(4), 207-218. Retrieved June 3, 2015, from http://web.a.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=9ecdb531-3d18-4bf4-ac68-49a128bfd6f8@sessionmgr4003&vid=6&hid=4107
Ibrahim, F., & Dykeman, C. (2010). Counseling Muslim Americans: Cultural and Spiritual Assessments. Journal of Counseling & Development, 89(4), 387-396. Retrieved June 3, 2015, from http://web.b.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=d5acfb9d-1dfc-45e0-9e38-63439f42cc23@sessionmgr112&vid=5&hid=116
Keshavarzi, H., & Haque, A. (2013). Outlining a Psychotherapy Model for Enchancing Muslim Mental Health Within an Islamic Context. The International Journal for the Psychology of Religion, 23(3), 230-249. Retrieved June 3, 2015, from http://web.b.ebscohost.com.libserv-prd.bridgew.edu/ehost/pdfviewer/pdfviewer?sid=c6ab67a5-3693-47b2-873d-8263f4261127@sessionmgr198&vid=4&hid=110
Amri, S., & Bemak, F. (2013). Mental Health Help-Seeking Behaviors of Muslim Immigrants in the United States: Overcoming Social Stigma and Cultural Mistrust. Journal of Muslim Mental Health, 7(1), 43-59. Retrieved June 3, 2015, from http://quod.lib.umich.edu/cgi/p/pod/dod-idx/mental-health-help-seeking-behaviors-of-muslim-immigrants.pdf?c=jmmh;idno=10381607.0007.104
Ali, S., Liu, W., & Humedian, M. (2004). Islam 101: Understanding The Religion And Therapy Implications. Professional Psychology: Research and Practice, 35(6), 635-642. Retrieved June 8, 2015, from http://isites.harvard.edu/fs/docs/icb.topic551849.files/Ali Liu and Humedian.pdf
Podikunju-Hussain, S. (2004). Working with Muslims: Perspectives and Suggestions for Counseling. Retrieved June 8, 2015, from http://www.counseling.org/knowledge-center/vistas/by-subject2/vistas-multicultural-issues/docs/default-source/vistas/working-with-muslims-perspectives-and-suggestions-for-counseling
Amri, S., & Bemak, F. (2013). Mental Health Help-Seeking Behaviors of Muslim Immigrants in the United States: Overcoming Social Stigma and Cultural Mistrust. Journal of Muslim Mental Health, 7(1), 43-59. Retrieved June 3, 2015, from http://quod.lib.umich.edu/cgi/p/pod/dod-idx/mental-health-help-seeking-behaviors-of-muslim-immigrants.pdf?c=jmmh;idno=10381607.0007.104