Cultural Factors in Family Therapy
Alena and Jaber are Palestinians who first met in the United States in 1998. Alena immigrated to the US in 1992 and Jaber in 1996. The two got married in 1998 and had a son, Jordan, in the following. Alena is now 31 years old and Jaber is 35 years old. They were a picture of a happy married couple, but over the last two years, the relationship between them has worsened when Jaber started to go to the casino habitually. He would come home late and would not pay the expenses of the family. Every time Alena complained about her husband’s behavior he would beat her.
In the beginning Alena tried to confront the marital problem alone. However, when she could not solve the problem herself, she turned for help to her closest friends. Their situation worsened when their child, Jordan, witnessed one of their violent fights. The boy locked himself up in his room. When Alena realized that she could have no effect on her husband’s behavior, she turned to her parents and asked them to take the appropriate steps in dealing with Jaber.
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Obviously, many Arab families do not go to strangers to solve a marital, family or psychological problem. There are a number of reasons for this. One major reason is that specialists in such professions are rare in relation to the needs of the population (Abu Baker, 2001). Another explanation is that, since the first psychiatric services to be offered to the Arab population resulted in the hospitalization of psychotic patients, the stereotype emerged that psychological services are rendered to “crazy” people. This caused those in need of these services to delay seeking them, until the psychological problem worsened to the degree that it became complex, and needed longer therapy (Dwairy, 1998).
Furthermore, there are those in the Arab society who offer therapy such as fortunetellers, palm readers, and Moslem sheikhs. A sector of the population believes these people have the capacity to solve crises of a psychological nature and turn to them when the need arises (Al-Krenawi, 2000). Finally, an important factor is the role the extended family plays in the support and treatment of psychological, marital and family problems of its members. However this issue is not as simple as it might seem. The extended family, in itself, is also a source of all these problems.
Thus, it is proposed that Alena and Jaber undergo a family therapy to sort things out, to solve their marriage, and to improve their relationship with Jordan. Family therapy allows clients a unique chance to express their complaints, especially when their voices are silenced by society. Many Arab couples go to a therapist as a result of losing confidence in the extended family after it has repeatedly failed to solve the marital conflict. Others go because they have detached themselves from the extended family of the spouse and refuse to accept its involvement in their lives or its decisions. Many Arab clients believe that the mental health clinic is a modern version of social interference in marital problems. Thus they have specific expectations of the therapist and they soon feel disappointed when these expectations are not fulfilled. For instance, when a couple comes to therapy, they would like to present their complaints as soon as possible in order to hear the therapist’s judgment: who is to blame and who should surrender to the other
In a society in which there are all kinds of traditional and modern characteristics, reasons for seeking family therapy reflect the many different faces of the society. Among all the categories, the family and marital therapy clinic in Arab society is related to at the one polar extreme as an office for social complaints, and at the other as a place where people discover the deep roots of their problems. Misunderstanding of the nature of psychological and family therapy services developed in recent years has led to many expectations which are not in accordance with the nature of the profession. Traditions in society both cause and affect these expectations. In order for therapists to succeed in their work, they must understand the nature of the collective identity of the Arab society. Therapists would benefit from putting some emphasis on mass mental health education. They could then spread knowledge of the essence of their work. The similarities and differences between the therapists' type of intervention and the family and social one should be pointed out.
Sometimes therapy relationship is put at stake because of the clients' lack of previous experience in the culture of therapy. They expect the therapist to function as an extension of the traditional problem solving. As an alternative of blaming the client for her belief system, therapists may discuss with the client what had been beneficial for her from the cultural intervention. This helps to learn more about her expectations from family therapy. Family therapists will serve clients better had the therapists accepted themselves as extensions of their client’s cultural environment.
Alena and Jaber would benefit from co-planning an intervention in which the therapist invites significant figures from each other’s extended families. Those figures should be able to collaborate between the accustomed cultural intervention and the family therapy intervention. In the fast therapy meeting the he couple and those who tried to intervene in according to cultural norms may be praised and empowered for their attempts to help the family. Family therapy plans may be shared with them out of respect to their contributions. Alena and Jaber would feel secure and encouraged in this procedure. They would be less tense since they would have the notion that they are using all strategies to solve their marital problems.
It is very important that the fast session should not end without some type of intervention, future plan, or significant advice, which will be implemented soon in the lives of Alena and Jaber. As mentioned earlier, Arab clients expect that a family therapist should be more efficacious than the cultural support system. Therefore the clients need to feel immediate results of family therapy or counseling.
In cases where the therapist comes to the conclusion that it is better for the family that the Alena and Jaber separate, having a therapy relationship with representatives of the two extended families helps to reduce the damage of divorce on all parties. Because marriage is a familial and social bond between two extended families, divorce is conceived as a declaration of war and enmity between these two sides. Here the aim of the family therapist is to achieve a peaceful divorce.
The family therapist must make the effort to explain the importance of the psychological health of all family members, particularly Jordan. The therapist may ask family members to collaborate in taking responsibility for the psychological health of all family members, which includes Alena, Jaber, and Jordan, as well as their extended families. Inviting extended family members in therapy may help in reducing the rejection of the husband to collaborate with the therapist. Importantly, the therapist should approach the therapy as an attempt to help all extended family members rather than a cooptation between the therapist and the clients.
The family therapist should listen for verbal statements and observe non-verbal signals that represent clues about the emotions pf the clients. He or she should also listen to the tone of their voices when they make their statements. The therapist should feel comfortable during the experience. It can be a very emotional event for everyone and the therapist needs to be prepared to experience strong emotions. Timing is extremely important and the therapist must be guided by intuition. Sometimes it will feel right in the first interview or it may be appropriate to wait until a later session.
Moreover, it should be noted that a ritual will not be appropriate in all cases. If a ceremony does not achieve a clear definition, it nevertheless reveals a great deal to both the worker and the couple. For instance it may show distinctly which parent is having most difficulty in emotionally relinquishing the marital relationship. The episode itself may have the effect of sowing seeds for future work with the couple. Finally, the family therapist should be alert to the possibility of a couple wishing to reconcile their marriage after the ceremony. In this event the therapist should adopt a cautionary stance and the couple should be seriously warned that it really may be premature.
Arab people are characterized by a mixture of traditional and modern societies. The Arab family lives between its nuclear state, consisting of the married couple and their children, and its need for the support of the family of origin, the extended family. In most Arab societies one may find values that attempt to include modernism and follow modern life style. At the same time, the influence of social values that safeguard the traditional family and social structure has a precious weight.
Psychological and family problems are seen as being personal, and to be solved secretly and in silence. Those in need initially try traditional remedies such as religious ceremonies, witch doctors, or ask the extended family for advice. In general, the Arab population does not view some behaviors such as addiction, violence, depression, and sexual frigidity as psychological problems. Therefore, most of them do not reach individual, couple, or marital therapy in the first stages of the onset of the problem.
On the other hand, the expectations of Arab clients from family therapy may be overstated. Couples may expect to see changes occurring in their lives immediately during the first session. For the benefit of Alena and Jaber, it is sensible to include in family therapy sessions some representatives of the cultural support network. The expansion of the intervention introduces the therapist as part of the ecology of the extended family instead of introducing him or her as an outsider who is in competition with the extended family and its culture.
Abu Baker, K. (2001). The social and educational welfare politics towards the Arab citizens of Israel. Jerusalem: The Institute for Israeli Arab Studies.
Al-Krenawi, A. (200). Ethno-psychiatry among the Bedouin-Arab of the Negev. Tel Aviv: Hakibbutz Hameuchad.
Dwairy, M. (1998). Cross cultural counseling: The Arab Palestinian case. New York: Haworth Press.
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