Immigration & Trauma Part 4: For Therapists Working with Immigrants

What Therapists Need to Keep in Mind When Working with Immigrants

Working with immigrant clients can be rewarding and powerful, but it also requires a level of understanding, cultural sensitivity, and flexibility that is essential for effective therapeutic work. Immigrants face unique challenges, and therapists must be equipped with the right tools to help them navigate such challenges.

From understanding cultural differences to addressing the trauma that often accompanies the immigration process, therapists need to approach their work with a trauma-informed, multicultural mindset.

Trauma-Informed Therapy and Multicultural Competency

When working with immigrants, a trauma-informed approach is vital. This means recognizing that many immigrants have experienced trauma - whether through displacement, the process itself, discrimination, or persecution - and understanding how these experiences can affect their social, physical, and mental well-being. Keep in mind that clients’ emotional responses and behaviors may have developed naturally to protect themselves, so keep an open mind and empathy, even if you may not understand some things at first.   

Multicultural competency is equally important as a trauma-informed lens, but what does that mean? It’s not about knowing everything about a client’s culture – that would be impossible. Rather, it’s about being curious and open-minded. It's about accepting that your own cultural norms may not always align with your client’s experiences. If you come from an individualistic culture and your client comes from a collectivistic background, for example, you might find that they view family dynamics and boundaries differently.

For instance, a client might express frustration with their parents, and you might think, “Why don’t they just move out or set boundaries?” However, this may not be a solution that fits within their cultural framework. Instead of imposing your worldview on them, get curious about their perspective. Try to understand where they are coming from and validate their experiences. Together, explore how they can express their needs in ways that honor their culture and values.

Dismantling Bias and Assumptions

Working with immigrants also requires us to examine our own biases and assumptions. As therapists - and as humans - we all have biases, whether conscious or unconscious. It’s crucial that we actively work to identify and dismantle these biases so that we don’t unknowingly perpetuate harmful stereotypes or oppressive practices. That is, we must learn and unlearn to decolonize therapy from a White, Eurocentric and colonizing perspective that is still so dominant in the field of psychotherapy.

We need to educate ourselves so we do not put the burden of education on our clients. Call out not only yourself but also your communities, colleagues, and places of work when you notice oppression and harmful messages. 

Everyone who immigrated has their own unique immigration story. Avoid making assumptions about a client’s story and identity without understanding the full picture. Their distress or grief may not be a “problem” to fix; it could be a natural, valid response to their lived experience. Take the time to get to know your client’s specific story and how their immigration experience has shaped their mental health.

Collaborating with Clients and Supporting Their Needs

Effective therapy involves collaboration. Learn about the resources your clients need and help guide them to access those resources. As therapists, we don’t have to know everything, but we should be proactive in finding resources that can help our clients. For example, if a client’s primary language isn’t English, offer support in navigating language barriers in therapy, and perhaps outside of it.

In addition to language barriers, there can also be a cultural barrier that could make accessing services difficult, and I encourage you to actively seek out culturally appropriate resources as well.

Additionally, creativity can be a powerful tool when working with immigrants. Different cultures may not have direct translations for concepts that are central to Western therapeutic practices. For example, in working with Korean clients, I noticed that there is no direct translation to the concept of self-compassion. Rather, I found that using words such as “mercy,” “foster,” or “care” resonated more with many clients.

By thinking creatively and adapting your approach, you can meet clients where they are and communicate in ways that are meaningful to them.

Adjusting Assessments and Techniques

It’s essential to adapt your assessment tools and methods to fit your client’s cultural context. Immigrants might downplay or normalize their struggles because these difficulties are often seen as a natural part of their cultural experience. As a therapist, be mindful of this when assessing their mental health. Instead of expecting them to talk openly about distress in the same way someone from the dominant culture might, ask questions that take into account their cultural background and experiences.

Self-Disclosure: Connecting as Humans

A helpful strategy when working with immigrant clients can be self-disclosure. Sharing your own background and personal experiences, especially if you come from an immigrant or marginalized community, can help build trust and foster a sense of connection. Of course, self-disclosure should always be appropriate to the situation, and your comfort level should guide how much you share. However, by being authentic and transparent, you can make your clients feel seen and understood, which can be an important part of the therapeutic relationship. Go to them as a human. The moment we walk into the room, we are disclosing ourselves already.

Key Resources for Understanding Immigration-Related Trauma

It’s hard to talk and learn about immigration-related trauma and mental health without learning about decolonizing therapy, anti-oppressive and racism, and trauma healing, as understanding this topic requires more than just clinical knowledge. Therapists should also engage with resources that address the broader social, cultural, and historical contexts of immigration. Further, reading memoirs or novels by immigrants can be valuable even though they are not clinical or academic literature, as they can offer firsthand perspectives on their experiences and struggles to enhance our understanding. 

Here are some valuable resources to deepen your understanding:

Books on Decolonizing Therapy and Anti-Oppressive Practices:

• Decolonizing Trauma Work: Indigenous Stories and Strategies by Renee Linklater

• Decolonizing Therapy by Jennifer Mullan

• My Grandmother’s Hands by Resmaa Menakem

Sometimes the best resources are not on paper, but out in the open world. Consider becoming involved with immigrant-focused organizations, cultural associations, or newcomer societies. Volunteering, consulting, or simply interacting with immigrants can provide valuable insight into their lived experiences.

Additionally, seeking advice from BIPOC therapists or immigrant therapists is an invaluable resource for developing a deeper understanding of cultural dynamics in therapy.

Conclusion

Working with immigrant clients is an opportunity to expand our understanding and practice as therapists. It requires us to approach our work with openness, curiosity, and a deep respect for cultural differences. By examining our own biases, understanding the unique challenges of immigration, and adapting our therapeutic techniques to meet our clients’ needs, we can create a space where healing can occur in a culturally sensitive and empowering way.

As therapists, we are all on a journey of learning. The more we educate ourselves, the better we can support our clients. With an open heart and mind, we can be the kind of ally and guide that immigrants need in their healing process.

Jiwon You is a psychologist specializing in working with adults in trauma therapy and self-esteem therapy. She is passionate about helping people heal from racial trauma and self-criticism so they can feel better and live more fulfilling lives. Jiwon provides affirming online therapy in Calgary and across Alberta for all folks 18+ and can provide services in Korean and English.