CARED Perspectives: The Political Climate, Government Shutdown, and Unavoidable Dialogue in the Therapy Room

This blog post is a part of the series, “CARED Perspectives,” developed by the APAGS Committee for the Advancement of Racial and Ethnic Diversity (CARED). This series will discuss current events and how these events relate to graduate students in psychology. If you are interested in contributing to the CARED Perspectives series, please contact Aleesha Young, Chair of APAGS-CARED.

By: Aleesha Young

shutdownDecember 21, 2018 marked the longest federal government shutdown in United States (U.S.) history and was prompted by a political divide around the President’s demand to fund and build a wall along the U.S – Mexico Border. Notably, the border wall has been at the center of the President’s immigration policies and was imposed to prevent illegal entry into the U.S.  Thus, immigrants who were once protected from deportation, even DACA recipients, are faced with pervasive fear and uncertainty about their future and livelihoods. Consequently, these xenophobic government policies have a remarkable impact on individuals from marginalized groups.

Because immigration and other hot-button issues affect what our clients bring into therapy, multicultural competence requires practitioners to establish a level of political awareness in order to adequately assess client needs, risks, and contextual factors that influence their presenting problems. Immigrant populations are subject to unique vulnerability to deportation. Deportation not only involves the micro and macro systems that the client belongs to, but also has psychological impacts on the individual. These looming consequences of immigration serve as therapy-interfering barriers that cannot be adequately addressed by focusing solely on the client’s intrapsychic issues (emotional, cognitive, and behavioral processes). In fact, proceeding in this way reinforces that the client is exclusively responsible for change. Therefore, it is important for practitioners to use their institutional power to advocate for their undocumented clients since they risk exposure to federal law enforcement agencies the more they make themselves known. This advocacy takes many forms that may include providing a list of pro bono immigration attorneys, contacting these lawyers to facilitate initial meetings with the client, and identifying sanctuary locations and safe havens for these consumers.

As a practitioner, it is also important to consider one’s citizenship status and how that privilege may shape one’s worldview leading to blind spots in larger systemic issues. For example, I worked with a client whose immigration status was unknown and was dealing with a long-term thought disorder. He was doing well and preparing to obtain his driver’s license. However, this objective was interrupted by U.S. Immigrations and Customs Enforcement (ICE) officials who learned of his status throughout this process. Consequently, ICE officials warned he could be deported back to his country of origin, even though he had lived in the U.S for 30 years and was in middle of applying for citizenship.

Unfortunately, the client showed an immediate emotional decline and appeared to cope by engaging in aggressive behavior. Initially, I was inclined to focus on increasing his coping skills in the wake of these events; however, I realized that a larger systemic issue was to blame for his behavioral changes. Therefore, focusing on the client’s internal processes alone would not be a culturally appropriate conceptualization.  I had an ethical responsibility to learn of the immigration process of the United States and use my institutional power to seek out resources on his behalf.

My clinical work has involved broadening my political awareness, especially when working with diverse populations. Perhaps the most important lesson is that multicultural competence is a process and not an end-point; and social justice is embedded in everything we do.

References

Hays, P. A. (2009). Integrating evidence-based practice, cognitive-behavioral therapy, and multicultural therapy: Ten steps for culturally competent practice. Professional Psychology: Research and Practice, 40, 354-360. doi: 10.1037/a0016250.

Sullivan-Bolyai, S., Bova, C., & Harper, D. (2005). Developing and refining interventions in persons with health disparities: The use of qualitative description. Nursing Outlook, 53,127-133.

Check out other posts in the CARED Perspectives series: