1

Understanding gender, culture and ethnicity in the

helping process: Practioners' experiences from
around the world

Table of Contents, Chapter abstracts and author information

Claire Rabin, Editor

Professor Claire Rabin teaches and supervises in social work and family
therapy at Tel Aviv University. The author of books (Living in partnership;
Equal partners:Good friends; Being different in Israel; Treating multiproblem
poor families) and over 40 articles,. She was the head of the master's
program in social work at Tel Aviv University for 7 years and currently is the
head of the continuing education program in family therapy. Born in the US
and having immigrated to Israel in 1974, Professor Rabin has traveled
extensively and lectured worldwide. Her most recent work has related to
interviews around the world with women in developing countries. She has a
regular column in the most circulated Israeli women's magazine and a private
practice with couples and families.

Forward by Phyllis Chessler, author of Women and madness

Introduction

Chapter 1: The significance of gender, culture and ethnicity in the

helping process: Theory and practice issues

Claire Rabin
Tel Aviv University
Israel

This introduction to the book will cover the major theoretical unpinnings of
gender, culture and ethnicity in the therapeutic endeavor. It will present a
theoretical model that integrates gender, culture and ethnic issues as they
apply to helping people. Specific topics to be covered in this chapter:

I) Some emerging views on diversity and the location of men and women
in different power heirarches. How people's lives are lived within the context of
different social categories. How these categories can be viewed as threads in
the therapeutic endeavor.

II) Current research on gender, culture and ethnicity in the helping

process
 2

III) Implications on the self of the therapist of focusing on gender

and ethnicity--issues related to power, marginality, differences and
sensitivity to ones own prejudices and position in the different heirarchies of
power.

Several case studies will be presented of how the integration of gender,

culture and ethnicity of both client and therapist are interwoven within the
encounter of helping others. These case studies will be presented to introduce
a model of how to integrate and consider the gender, culture and ethnicity of
client and therapist.

Chapter 2: Exporting High Cultural Artifacts: The Selling of the Therapy

Industry as a Form of Neo- Colonialism.

Elaine Leeder
Ithaca College
United States

This chapter will focus on ethnic cultural issues and how they need to be
taken into account when one does psychotherapy. This chapter will review the
literature on the need for ethnic-cultural sensitive, with specific emphasis on
cultures that have not been given much coverage heretofore in the literature.
A few books have been written but most of them focus on cultures in the
United States and are anglocentric in nature. I would like to help the
practitioner understand the need for cultural relativity and an attempt to
overcome ethnocentrism. I will define those terms and give examples from my
own experience in travelling to places outside of western societies.
Further, in this chapter I will explore the nature of colonialism and post-
colonialism as its relates to the therapeutic industry. Western practitioners
have attempted to export their brand of therapy to peripheral counties, along
with other high cultural artifacts. I will take a critical perspective on this
exportation and what I see as the resultant neo-colonialism. I will particularly
focus on gender and how western forms of thyera0y are being adapted for
export. I will make the case that the Stone Center for the Study of Women at
Wellesley College is one of those organizations. I hope to offer a challenge to
psychotherapists to understand the nature of the economic and political world
system and their role in the globalization process, through psychological neo-
colonialism.

References

Lechner, F. & Boli, J. (2000) The globalization reader. Malden, MA: Blackwell.

McGolderick, M. & Giordano, J., & Pearce, J. (1998) Ethnicity and family
therapy. Second edition. NY: Guilford Press.
 3

Mies, M. (1986) Patriarchy and accumulation on a world scale: Women in the

international division of labor. London: Zed Books

Moane, G. (1999) Gender and colonialization: A psychological analysis of

oppression and liberation. NY: St. Martins Press

Ritzer, G. (2000) The McDonaldization of society. Thousand Oaks, CA: Pine

Forge Press.

Schwartz, L. (1998) Culture and mental health: A South African view.

Capetown: Oxford U. Press.

About the Author

Elaine Leader, Ph.D., is a Professor of Sociology and Social Work at Ithaca

College. She is chair-elect of that department and is the author of three
books, the most recent entitled : We are family: A global journey into the
family. McGraw-Hill, 2001. Her articles have appeared in Women and
Therapy, International Journal of Women and Violence, Social Anarchism and
Off Our Backs. She has traveled expensively and writes on global social
issues, particularly domestic violence.

Part 1: Gender, culture and ethnicity as it impacts on the

treatment of trauma

Chapter 3: Political Transformation Processes and Effects on the Theory

and Practice of Psychoanalysis

Doris Goedi
Institute for Social Research
Salzburg, Austria

1. Preliminary Remarks

This century has often been described as an Age of Extremes in which

political and social instability have characterized conflicts all over the globe. It
has especially been the events that have taken place since 1989 in Europe
and Russia that have ‘redrawn’ the political map. The political transformation
process has proceeded peacefully in some countries (such as the former
Czechoslovakia), but this was not possible in others (for example, the former
Yugoslavia). In the successor states of Yugoslavia, the political upheaval was
initiated and advanced by means of ‘ethnicized’ violence that ultimately led to
war. In this work, I examine on a psychoanalytic level the question of gender-
specific ways of coming to terms with these violent processes of radical
political change in the former Yugoslavia. Above all, my therapeutic and
 4

analytical experience both in Zagreb, Croatia as well as in Salzburg, Austria

constitute the practical basis of my reflections and considerations.
By way of introduction, it can be stated (and I am fully cognizant of the
necessarily abbreviated nature of this discussion) that the wars in former
Yugoslavia led to ethnicized and ‘genderized violence’ within society, which
are elaborated on a social psychological level as the ‘psychopathology of
misery.’ Feelings of despair and powerlessness, imposition of prohibition on
mourning and increasing feelings of guilt as individual and collective
emotional states lead to growing isolation and mounting frustration among a
significant portion of the population. Within the framework of this investigation,
the attempt will indeed be made to describe this phenomenon that has been
characterized as a ‘depressive syndrome,’ as well as to integrate it into its
social, ethnic and gender-specific contexts and, in light of this background, to
attribute a significance to it.

2. On Theory Formation in Psychoanalysis

In the first part of this work, the attempt will be made to test the possibilities
of theory formation within psychoanalysis—first and foremost with respect to
ethnicity and gender—for their emancipative content. This means that
contributions of psychoanalysis to the understanding of politically induced
situations of violence—for example, trauma theories, ‘narcissism and the least
difference,’ tension between internal and external reality, transference and
reverse transference—will be described and investigated or elaborated further
with respect to gender and ethnicity. In this theoretical encounter, the
conceptual pair ‘conscious’ and ‘unconscious’ described in psychoanalysis
assumes, in my opinion, central significance. In going about this work, the
effort will be made to extract this conceptual pair from its narrow
psychoanalytic context, and to describe its elements as relatively open
(analytical) categories on the following levels:
1) conscious/unconscious as an internal psychic category that relates to the
processual way women and men deal with themselves and their respective
surroundings;
2) conscious/unconscious as a social-political category that attempts to
describe the interaction between the individual and society and thus tries to
link the individual and the collective;
3) conscious/unconscious as an intersubjective category that endeavors to
encompass the confrontations of women and men in the microsocial sphere
(such as the family).
This categorization of ‘conscious’ and ‘unconscious’ and the analysis of them
on the levels described above constitute in my opinion a theoretical challenge
to psychoanalysis, in that it offers the opportunity to adopt and integrate into
psychoanalytic theory formation both ‘gender’ and ‘ethnicity’ as complex and
interconnected categories. The second part of this work elaborates on
considerations about what therapeutic consequences such a theoretical
approach to gender and ethnicity might have in the framework of
psychoanalysis.
 5

3. On the Practice of Psychoanalysis

In the encounter with practical considerations, I rely heavily on the (social)

political experiences and therapeutic work of Chilean therapists who, with
their therapeutic concept of ‘Vincolo comprometido,’ have, in my opinion,
developed an important foundation for working with people who have been or
are being subjected to politically induced conditions of violence. The
consequence of this is that central importance is attributed to the question of
therapeutic setting (questions of psychoanalytic neutrality and therapeutic
abstinence). Moreover, I would like to focus on the following issues on the
basis of my own experience:
1. What significance is assumed by the fact that a therapist who has come to
do therapeutic work in a country currently at war happens to be a foreigner
from a neutral country? Which conscious and unconscious expectations,
fantasies and feelings are projected onto the therapist?
2. How is it possible to establish a ‘vincolo comprometido’ in a situation of
insecurity, violence and fear? What significance is assumed by the gender
aspect and ethnicity here?
3. What significance does the encounter or clash of foreign languages have in
this connection? What does it mean to have no common language, and thus
to have to involve an interpreter in the therapeutic work? What does it mean
when one establishes a common ‘third’ language? On the basis of case
studies, I will attempt to delve into these questions on a concrete level and try
to work out their relevance for therapeutic work.

4. Conclusion

Finally, these theoretical considerations will be tied together with

consequences for therapeutic practice, and tested for their emancipative
relevance, which, in my opinion, can be formulated as follows: the integration
of the traumatic story and perhaps the possibility of giving the story a new
meaning; private shame should be transformed into political dignity.

References

Bloom, Ida et.al.: Gendered Nations. Nationalism and Gender Order in the
Long Nineteenth Century. Oxford, New York 1999.
Bronfen, Elisabeth et.al.: Trauma. Zwischen Psychoanalyse und kulturellem
Deutungsmuster. Köln, Weimar, Wien 1999.
Cooke, Miriam et.al.: Women and the War Story. Berkeley and London 1996.
de Zuleta, Felicity: From Pain to Violence. The traumatic roots of
destructiveness. London 1993.
Gödl, Doris: Wir wollten Demokratie. Interview mit Vesna Kesic. Zagreb/Wien
1998.
Gödl, Doris: Mit der Psychoanalyse im Reisekoffer. Ein Reisebericht aus dem
ehemaligen Jugoslawien. Salzburg 1996.
Hermann, Judith: Trauma and Recovery. The aftermath of violence – from
domestic abuse to political terror. New York 1997.
 6

Kappeler, Susanne et.al.: Vergewaltigung, Krieg, Nationalismus. München

1994.
Oper-Cohn, Liliane et.al.: Das Ende der Sprachlosigkeit? Auswirkungen
traumatischer Holocaust-Erfahrungen über mehrere Generationen. Gießen
2000.
Rüsen, Jörn et.al.: Die dunkle Spur der Vergangenheit. Psychoanalytische
Zugänge zum Geschichtsbewußtsein. Frankfurt 1998.
Uremovic, Olga et.al.: Frauen zwischen Grenzen. Rassismus und
Nationalismus in der feministischen Diskussion. Frankfurt und New York
1994.
Waller, Marguerite et.al.: Frontline Feminisms. Women, War and Resistance.
New York and London 2000.

About the Author

Doris Gödl, Ph.D.

Ziegelstadlstr. 14
5026 Salzburg/Austria
Tel.: 0043-662-647141
Fax: 0043-662-886623-9
e-mail: Doris.Goedl@salzburg.co.at
•1 Graduated on the University of Salzburg (Ph.D.) in 1986
•2 Training in Psychoanalysis – Graduated in 1991
•1 Lecturer on the University of Salzburg and Innsbruck
•2 Scholar on the research staff on the ‘Institue for Social Research and
Develpement” in Salzburg
•3 Therapeutic and educational work with war traumatized women in
Zagreb/Croatia (1994-1997)
•4 Lecturer in an educational program for psychologists focused on Trauma
•5 Lecturer in groups of different experts in different countries (f.e. in
Germany for a group of attorneys who got involved in the establishing of the
International Criminal Court ICC; in the USA contacts to the ICC Women-
group / Women’s caucus for gender justice) about the psychological aspects
of Traumatization
•1 Contacts to the Bellevue/NYU Hospital specially to the Program for
Survivors of Torture
•2 Contact / Member of the International Society for Traumatic Stress
Studies, New York
•1 Member of the ‘European Network of Feminist Psychoanalysis’

Areas of Research Concentration

Social Research, Women and gender-studies (f.e. National Socialism:
Women’s Contributions to the Political Policies of National Socialism; Getting
those who remain silent), psychoanalytical approach in trauma and gender-
research.
 7

Chapter 4: Gender Issues in the Therapy of Adult Survivors of

Childhood Sexual Abuse in Israel

Sheri Oz, M.Sc.

Israel

Childhood sexual abuse usually has devastating effects on the victim.

In Israel, there is growing awareness of the problem among professionals
(teachers and staff at the education ministry, social workers, psychologists,
psychiatrists) and the general population. Not one day goes by without a
notification in the media reporting on a new case of abuse. Autobiographies
written by Israeli abuse survivors are now being published at a rate of two or
so a year. In addition, the country is currently reeling in the wake of the arrest
and trial of a respected army general and government minister for sexual
harassment. His arrest over a year ago brought the subject of sexual coercion
to the attention of every citizen. The subject just won't go away. Many men
talk in public about being scared to say the "wrong thing" or to pat a woman
on the shoulder, and some women joke when a man touches her innocently
by saying, "Watch it, or I'll charge you with harassment". Nobody knows,
however, whether the same awareness is striking at the hearts of perpetrators
of sexual abuse against minors. Are they also afraid of "saying the wrong
thing" or "touching in the wrong way", for example?
What is evident is that more adults are coming to therapy with the
identified problem of having been a victim of childhood sexual abuse. In
addition, more cases of suspected abuse are coming to the attention of the
schools and the public social service agencies. There is a sense of
emergency and these professionals on the front line, so to speak, are
overwhelmed by the magnitude of the problem. As a result, there are many
more requests for training in the treatment of sexual abuse now than there
were even two years ago.
Boys and girls, alike, suffer from the assault upon their immature minds
and bodies in both the short-term (e.g., school performance, social skills
acquisition, self image development) and the long-term (e.g., decision-making
skills, career choice, mate selection). According to published research
reports, boys and girls are affected differently from the victimization and
experience different patterns of symptomology. For example, it has been
suggested that boys are abused more often by strangers or extrafamilial
perpetrators, whereas girls are more often abused by members of her family
(Finkelhor, 1986; Gold, Elhai, Lucenko, Swingle and Hughes, 1998,
Levesque, 1994). This would imply a greater sense of betrayal for abused
girls. Researchers agree that sexually abused boys "act out", becoming
aggressive and criminal, while girls "act in", becoming anxious and depressed
(e.g., Dhaliwal, Gauzas, and Ross, 1996; Feiring, Taska and Lewis, 1999;
Garnefsky and Diekstra, 1997).
The literature is inconsistent, however, with respect to who suffers
"most" from abuse, boys or girls. Some claim that girls are more seriously
damaged by the abuse (e.g., Browne and Finkelhor, 1986; Stein, Golding,
Siegal, Burnam and Sorenson, 1988); others that boys are more disturbed
(e.g., Gold, Lucenko, Elhai, Swingle and Sellers, 1999). Some writers
suggest that boys abused by older women are not negatively affected by the
 8

experience at all, viewing it as an early initiation into the secrets of sex (e.g.,
Baker and Duncan, 1985; Fromuth and Burkhart, 1986). However, Gartner
(1999) argues that it is part of Western cultural myth that women cannot
abuse men/boys and that even when there is a large age difference between
the woman and the boy, he is still in control of the situation. Those who find
that childhood sexual abuse results in serious psychological damage to the
adult male survivor usually refer to the socialization of men to believe that
men are not victims as the explanatory factor (e.g., Lisak, 1994; Lisak, 1995;
Schwartz, 1994; Struve, 1990). However, this is far too simplistic and gender
socialization is much more multi-dimensional than this.
Perhaps complicating the matter further is the fact that the Israeli
Jewish population is multicultural. There are Ashkenazim (North European),
Sapharadim (Mediterranean) and Jews from Arab countries. There are those
whose families have been established in the area for 5 or more generations,
those who immigrated or whose parents immigrated, and there are converts
to Judaism. Some of the population lives in the cities or villages whereas a
large minority live on kibbutzim which can be characterized as large extended
families. The effects of these differences upon sexual victimization and the
ability of the survivor to disclose the secret and heal from the wounds have
only recently begun to be discussed in the country, and only with respect to
sexual abuse victims in the kibbutzim.
The proposed chapter will look at the effects of gender on the
childhood sex abuse victim within the framework of the nature of Israeli
society. It will investigate findings reported in the research literature, offering
a critical survey of published studies concerning gender differences in the
aftermath of childhood sexual abuse. It will explore the possibility that gender
effects are not so dichotomous as current evidence suggests, but rather
multiaxial. In other words, gender differences are not either/or but, rather, lie
along a gradient from male to female, with no clear distinguishing point
between them and impacted by a variety of different influences. In order to
understand the effects of sexual abuse on male and female victims, one must
take into account: differences in normal gender development, the effect of
age-at-abuse with regard to the stage of gender development at which the
abuse occurs, age of disclosure of the abuse, socialization regarding gender
identity, and the "era" during which the abuse occurred, was recalled, or was
disclosed (for example, abuse disclosed during the 1950s would draw far
different societal responses than does abuse revealed today).

References:

Baker, A.W. and S.P. Duncan, (1985). Child sexual abuse: a study of
prevalence in Great Britain. Child Abuse and Neglect, 9, 457-467.

Dhaliwal, G.K., L. Gauzas, D.H. Antonowicz, & R.R. Ross. (1996). Adult
male survivors of childhood sexual abuse: prevalence, sexual abuse
characteristics, and long-term effects. Clinical Psychology Review, 16, 619-
639.
 9

Garnefsky, N. and R.F.W. Diekstra. (1997). Child sexual abuse and

emotional and behavioral problems in adolescence: gender differences.
Journal of the American Academy of Child Adolescent Psychiatry, 36, 323-
329.

Layton, L. (1995). Trauma, gender identity and sexuality: discourses of

fragmentation. American Imago, 52, 107-125.

Levesque, R.J.R. (1994). Sex differences in the experience of child sexual

victimization. Journal of Family Violence, 9, 357-369.

Lisak, D. (1994). The psychological impact of sexual abuse: content analysis

of interviews with male survivors. Journal of Traumatic Stress, 7, 525-548.

Lisak, D. (1995). Integrating a critique of gender in the treatment of male

survivors of childhood abuse. Psychotherapy, 32, 258-269.

Little, L. and S.L. Hamby. (1996). Impact of a clinician’s sexual abuse

history, gender, and theoretical orientation on treatment issues related to
childhood sexual abuse. Professional Psychology, Research and Practice,
27, 617- 625.

Kluft, R.P. (1990). Incest and subsequent revictimization: the case of

therapist-patient sexual exploitation, with a description of the sitting duck
syndrome. In: R.P. Kluft (Ed.). Incest-Related Syndromes of Adult
Psychopathology. Washington, DC: American Psychiatric Press,

Meiselman, K. (1978). Incest – A Psychological Study of Causes and

Effects with Treatment Recommendations. San Francisco, CA: Jossey-Bass.

Morris, L. (1995). The need for a multidimensional approach to the

Treatment of male sexual abuse survivors. In: M. Hunter (Ed.). Adult
Survivors of Sexual Abuse. Treatment Innovations. Thousand Oaks, CA:
SAGE.

Nuttall, R. and H. Jackson. (1994). Personal history of childhood sexual

abuse among clinician. Child Abuse and Neglect, 18, 455-472.

Putnam, F.W., K. Helmers, L.A. Horowitz, and P.K. Trickett. (1995).

Hypnotizability And dissociativity in sexually abused girls. Child Abuse
& Neglect, 19, 645-655.

Schwartz, M. (1994). Negative impact of sexual abuse on adult male gender:

issues and strategies of intervention. Child and Adolescent Social Work
Journal, 11, 179-194.

Stoller, R.J. (1964). A contribution to the study of gender identity.

International Journal of Psycho-Analysis, 45, 220-226.
 10

Struve, J. (1990). Dancing with the patriarchy: the politics of sexual abuse.
In: M. Hunter (Ed.). The Sexually Abused Male: Vol. I. Prevalence, Impact,
and Treatment. Lexington, MA: Lexington Books.

About the Author

Sheri Oz received her M.Sc. in Marital and Family Therapy in 1986

from the University of Guelph, Canada. Since then, she has run a private
clinical practice in Israel. Specializing in the treatment of adolescent and adult
survivors of childhood sexual abuse and their families, Ms Oz developed a
model for therapy which she has been teaching to therapists for the past 6
years. Several of her articles have been published in reviewed professional
journals and she has presented her work in conferences in Israel, Canada,
and Morocco. In 1999, she opened The Eitan Institute, a clinic for the
treatmet of trauma survivors and their families. At the Institute, courses and
workshops are offered to therapists on various approaches to the treatment of
trauma.

Chapter 5: Interrogating Fear, Yearning for Safety:

Femicide Victims Speak Out

Nadera Shalhoub-Kevorkian,Ph.D
Hebrew University, Jerusalem
Israel

The extent to which gender discrimination has modified the response of

Arab women to cultural industry and production has never been examined.
We are aware politically of the dangers emanating from the reproduction of
cultural products that encourage and romanticize gender relations rooted in
domination and female subordination. This masculine domination serves in
undermining efforts to create critical consciousness of the need to eradicate
gender racism. Although Arab societies have been liberated from political
colonialism, they continue to be burdened by the colonization of their minds.
The proposed chapter will focus on how this colonization reinforces gender
violence and discrimination on the one hand, and the manner in which it is
collectively, covertly, and critically resisted by victims of femicide on the other
hand. Furthermore, the chapter will introduce intervention strategies that are
not only culturally sensitive, but also serve to decolonize and liberate the
victim’s mind.
The proposed chapter will attempt to demonstrate that femicide victims
tend to perceive and analyze their social realities in a dualistic (good – bad;
include – exclude), bipolar fashion. Challenging this dualism through cultural
criticism, I propose to show, could lead to the liberation of dormant energy
needed to fuel the process of coping with trauma and abuse. My proposition
will rely on the thesis that cultural criticism has functioned historically in the
lives of women to promote critical resistance. It has enabled Arab feminists to
pose critiques and analyses that served to disrupt and even deconstruct
 11

cultural productions designed to promote and reinforce domination. Non-

conformance to social norms (especially those set by male supremacy),
however, could lead to deleterious consequences, even death. I propose to
demonstrate in this chapter how women victims of abuse, especially those
who are under the threat of being killed on the basis of what is termed “crimes
of honor, are dominated by socio-cultural images of good and bad. Hence,
the prospect of entering the valley of death leads victims of femicide to
perceive and critique their self image and reputation in bipolar (good – bad)
terms. The degree to which a victim develops a positive (i.e., good) self
image, will determine to a large extent her chances of being included within
the social stream.
Consequently, the proposed chapter will be based on case studies of
Palestinian females who entered the valley of death ( were threatened to be
killed by family members). It will focus mainly on strategies that target the de-
colonization of the victim’s mind in order to liberate her from her oppression.
The proposed liberation interventions are designed to connect the victim’s
perception and attitudes to contextualized political strategies on the one hand,
and to deal with her yearning for safety on the other hand. I propose to show
that unless the victim is provided with this needed space for thought, the
liberation strategies used could lead to her further oppression. The strong
yearning for safety could be realized only when experiencing the victim’s
discourse of pain and deprivation of the sense of safety and longing liberating
vitality. The proposed mode of intervention will allow what bell hooks defined
as speaking up yearning, and what I consider as building “liberation
intervention”. The chapter will conclude with the reasons why such an
approach could be effective in dealing with the abuse of women.

References

Shalhoub-Kevorkian, N. (2001). Using the Dialogue Tent to Break Mental

Chains:
Listening and Being Heard. . Social Service Review, 75 (1), p.135-
150

Shalhoub-Kevorkian, N. ( 2000). Blocking her exclusion: a contextually

sensitive model of intervention for handling female abuse. Social Service
Review, .620-634.

Shalhoub-Kevorkian, N. ( 2000). The efficacy of Israeli law in preventing

violence within Palestinian families living in Israel. International
Review of Victimology. Vol.7, no.1/2/3. 47-66.

Shalhoub-Kevorkian, N. ( 1999). Towards a Cultural Definition of Rape:

Dilemmas in Dealing with Rape Victims in Palestinian Society.
Women Studies International Forum. 22/2, pp.157-173.

Shalhoub-Kevorkian, N. ( 1999). Law, politics, and violence against women:

The case-study of Palestinian-Isrealis. Law and Policy. 21/2. 189-211.
 12

Elbedour, S., Baker, A.M., Shalhoub-Kevorkian, N., Irwin, M. & Belmaker, R.

(1999).
Psychological responses in family members after the Hebron
massacre. Depression and Anxiety. 9: 27-31.

Shalhoub-Kevorkian, N. (1999). The politics of disclosing female sexual

abuse: A case study of Palestinian society. Child Abuse & Neglect.
23/12.

Baker, A.M. & Shalhoub-Kevorkian, N. (1999). The effects of political and

military trauma on children: The Palestinian case. Clinical
Psychology Review.
19/89:35-950

Shalhoub-Kevorkian, N. ( 1998). Reactions to a case of female child sexual

abuse in the Palestinian society: Protection, silencing, deterrence, or
punishment. Plilim. (In Hebrew). 7:161-195

About the Author

Dr. Nadera Shalhoub-Kevorkian is a lecturer at the both the school of Social

Work and the Institute of Criminology- Faculty of Law, Hebrew University,
Jerusalem. Her theoretical and research interest has focused on the study of
victimization of vulnerable groups in society, especially females. The thrust of
her study revolved on demonstrating the victimization of women, and the
social reaction to it while emphasizing that such victimization is better
understood if analyzed within culturally and politically sensitive contexts
(Doctoral Dissertation, 1994; International Review of Victimology., 1999; Child
abuse and Neglect, 1999). Pursuant to this line of research, she also studied
the efficacy of the existing Israeli Law Against Family Violence, and social
reaction (formal and informal social control agents) to victimization of women
in Israel and the areas under the control of the Palestinian Authority (Women
Studies International Forum, 1999; Law and Policy, 1999; Plilim, 1998; Arab
Studies Quarterly, 1997). In her latest research she challenged common
assumptions underlying criminological and victimological theories related to
the abuse of women, asserting that feminist theories should be built on the
voices of women whose voices have been muted for years. Consequently,
her most recent research not only studied the crime of femicide, but also
challenged the existing definition of femicide, and elaborated on the atrocities
embedded within such a definition (UNIFEM, 2000). Dr. Shalhoub-Kevorrkian
have published extensively both in books as well as in international journals
such as Child Abuse and Neglect, Social Service Review, Law and Policy,
WSIF, International Review of Victimology.
 13

Chapter 6: Violence Against Women in the Family: Immigrant Women

and the US Health Care System

Susan Ivey, MD, MHSA*

University of California, Berkeley

Shobha Srinivasan, PhD *

Asian and Pacific Islander American Health Forum

*Authors names appear in alphabetical order

Our chapter will focus on cultural issues related to the identification,

assessment, and referral of domestic violence cases among immigrant
women in the US health system. The US is experiencing the highest level of
immigration since the beginning of the 20th century. This calls on clinicians to
familiarize themselves with the cultural nuances of health and safety issues
for their female patients. We review the literature available on domestic
violence across various cultures. We describe a system for sensitive but
universal screening and an insight into how these cases are handled within
the framework of current US policy related to domestic violence and
protections for immigrant women who may require assistance with
immigration processes.

Because 25% - 50 % of all women experience domestic violence in their

lifetimes, the authors recommend universal screening protocols for all types of
practitioners. We believe that incorporating discussion of these issues into
practice will enhance therapy and improve diagnostic categorization due to
the high overlap among diagnoses such as depression and post-traumatic
stress disorder. Differentiation will be helpful in planning type and length of
psychotherapeutic intervention. This chapter calls for sensitivity to the differing
definitions of violence in different cultures and family structures while avoiding
a strictly culturally relativistic approach. While we have couched our
description of domestic violence within the US health system, the
phenomenon of domestic violence is worldwide and affects women’s lives,
productivity, and well being. We believe all practitioners will benefit from a
better understanding of violence in the family setting.

For most persons, the family is the main source of sustenance and shelter in
times of crisis enabling them to develop coping mechanisms for later in life
(Doherty & Campbell, 1988; Gurin, 1985). However, for a growing number of
persons, the family is a major source of stress, violence and abuse (Straus
and Gelles, 1988). Individuals are more likely to be abused physically and
verbally within the confines of the family than anywhere else in society (Gelles
& Cornell, 1990). Until recently domestic violence was considered a private
matter (Bair & Cayleff, 1993), an issue to be resolved within the realm of the
family. However, efforts by the United Nations, women’s organizations and
health care professionals throughout the world have shifted the focus of the
debate to a public arena. They argue that violence in the family has
psychological, physical health and social consequences not only for the
woman but also for other members of the family.
 14

It has been argued that asking a women about the abuse is in itself an
intervention (Heise, 1994). However, given the barriers that confront
immigrant women, even the chance of sharing their experiences is often
denied. Battering may be identified first within the context of the emergency
department or within primary care due to frequent under-utilization of mental
health services by immigrant women in the US.. While care should be taken to
approach the issue in a culturally sensitive manner, it is important that every
woman be given the opportunity to have private time with an appropriately
trained translator, away from family members, This will help to fully assess her
risks and inform her of her options for receiving care, support services, and
asylum. The “choice” to report the violence to the police or governmental
authorities has to be made by the woman unless serious injury or injury to
children is present. It is important that she is not pressured to prematurely
sign a consent decree to disclose the violence. She has to be given sufficient
time, resources, support and information before she can arrive at such a
decision. That information must include information on any protections she is
due under the law of the country in which she currently resides.

The authors will also briefly describe the involvement of women’s

organizations in domestic violence intervention and safety provision. In the
US, many culturally and ethnic-specific organizations continue to form and
seek to provide counseling and protection within a woman’s own cultural
framework. Approaches vary between individual, family, and community level
approaches including education campaigns that target men for domestic
violence prevention education.

References

Bair, B., & Cayleff, C.E. (1993). Introduction. In B.B. Bair & S. E. Cayleff
(eds.), Wings of Gauze: Women of color and the experience of health and
illness. (pp. 19-22) Detroit, MI: Wayne State University Press.

Barnett, O, and Fagan, R. Alcohol Use in male spouse abusers and their
female partners. Journal of Family Violence. 8(1): 1-25. 1993.

Campbell, Jacquelyn C. and Campbell, Doris W. (1996). Cultural competence

in the care of abused women. Journal of Nurse-Midwifery, v.41 (n.6): 457-
462.

Chin, K. (1994). Out of town brides: International marriage and wife abuse
among Chinese immigrants. Journal of Comparative Family Studies, v.25:
53-69.

Chung, Rita C. and Kagawa-Singer, Marjorie (1993). Predictors of

psychological distress among Southeast Asian refugees. Social Science &
Medicine, v.36 (n.5): 631-639.

Crites, Laura (1991). Cross-cultural counseling in wife battering cases.

Response to the Victimization of Women and Children. v.13 (n.4): 8-12.
 15

Dasgupta, Shamita D. And Warrier, Sujata (1996). In the footsteps of

Arundhati. Violence Against Women, v.2 (n.3): 238-259.

Frye, Barbara A. and D’Avanzo, Carolyn D. (1994). Cultural themes in family

stress and violence among Cambodian refugee women in the inner city.
Advances in Nursing Science, v.16 (n.3): 64-77.

Gurin, Patricia (1985). Women’s gender consciousness. Public Opinion

Quarterly, v.49 (n.2): 143-163.

Kanuha, Valli (1994). Women of color in battering relationships. In Lillian

Comas-Diaz and Beverly Greene (Eds.). Women of color: Integrating ethnic
and gender identities in psychotherapy. New York, NY: Guilford Press.

Kanuha, Valli. (1990). Compounding the triple jeopardy: Battering in lesbian of

color relationships. Women & Therapy. Special Issue: Diversity and
complexity in feminist therapy, v.9 (n.1-2): 169-184.

Luluquisen, Esminia M., Groessl, Kristin M., & Puttkammer, Nancy H. (1995).
The health and well-being of Asian and Pacific Islander American Women.
Oakland, CA: Asians and Pacific Islanders for Reproductive Health American
Women.

Mayeno, L., & Hirota, S.M. (1994). Access to health care. In N.W.S. Zane,
D.T. Takeuchi, & K.N.J. Young (Eds.), Confronting critical health issues of
Asian and Pacific Islander Americans. Thousand Oaks, CA: Sage
Publications.

McAfee, R. Physician’s role in the fight against domestic violence. North

Carolina Medical Journal. 1994. 55: 398-399.

McLeer, SV, and Anwar, R. The role of the emergency physician in the
prevention of domestic violence. Annals of Emergency Medicine. 16(10):
October, 1987.

Narayan, Uma. (1997). "Male-Order" brides: Immigrant women, domestic

violence and immigration law. Hypatia, v.10 (n.1): 104-119.

Nilchaikovit, Tana, Hill, James M., and Holland, Jimmie C. (1993). The effects
of culture on illness behavior and medical care. General Hospital Psychiatry,
v.15: 41-50.

Olson, L., Anctil, C., Fullerton, L., Brillman, J., Arbuckle, J., and Sklar, D.
(1996). Increasing emergency physician recognition of domestic violence.
Annals of Emergency Medicine, v.27 (n.6): 741-746.

Orloff, Leslye E. and Kelly, Nancy (1995). A look at the Violence Against
Women Act and gender-related political asylum. Violence Against Women,
v.1 (n.4): 380-400.
 16

Poirier, Linda (1997). The importance of screening for domestic violence in all
women. The Nurse Practitioner, v.22 (n.5): 105-108.

Song-Kim, Young I. (1992). Battered Korean women in urban United States.

In Sharlene Maeda Furuto, Renuka Biswas, Douglas K. Chung, Kenji Murase,
Fariyal Ross-Sheriff (eds.). Social work proctice with Asian Americans.
Newbury Park, CA: Sage Publications, Inc.

Takagi, T. (1991). Women of color and violence against women. In C. Moliner

(Ed.), Violence against women supplement. St. Paul, MN: National Network
of Women?s Funds and Foundations/Corporate Philanthropy

True, R.H., & Guillermo, T. (1996). Asian/Pacific Islander American women.

In M. Bayne-Smith (ed.), Race, gender, and health. (pp. 94-120). Thousand
Oaks, CA: Sage Publications.

About the authors

Dr. Susan Ivey, MD, MHSA, is a board-certified emergency and family

physician who currently works in prevention research at the Center for Family
and Community Health, University of California, Berkeley, School of Public
Health. She was a co-author and co-editor for the book Immigrant Women’s
Health: Problems and Solutions (Kramer, Ivey, and Ying, 1999) and wrote
chapters on health services utilization, health policy, cardiovascular diseases,
and assessment, screening, and immunization. Dr. Ivey has also written about
the impact of policy change on immigrant women in the emergency
department. She currently conducts research on the health status of Asian
Indians in Northern California.

Dr. Shobha Srinivasan, PhD, is a sociologist and is the research director for
the Asian and Pacific Islander American Health Forum, San Francisco, CA.
She has also worked at the National Center for Research on Asian American
Mental Health, University of California, Davis. Dr. Srinivasan has done
research in the areas of domestic violence, acculturation, and the impact of
stress on chronic disease risks. She currently participates in a study on the
health status of Asian Indians in Northern California along with a number of
other studies conducted through APIAHF. Dr. Srinivasan co-authored the
chapter on domestic violence for the book Immigrant Women’s Health:
Problems and Solutions (Kramer, Ivey, and Ying, 1999) and has several other
peer-reviewed articles.

Chapter 7: Therapeutic Interventions for Albanian Women in Post-War

Kosovo

Melissa Stone
Kosovo
 17

During the decade of ethnic apartheid, which began in 1990, the dominant
Yugoslav state engaged in policies of segregation by ethnicity and civil law
became self-legitimized regime’s tool for colonial rule, used against its
citizens. (Malcolm, p. 349) In the absence of functional rule of law, those
who were not part of the regime resorted to centuries old culturally
appropriate cultural 'law,' some of which are based on the Kanun of Lek
Dukagjini, a hold over from when the entire region was controlled by the
Ottoman empire. Under these conditions, women in Kosovo, particularly
those of Albanian cultural identity from rural areas had fewer options than
anyone else for working outside the home, attending school and generally
participating in public life. These factors, compounded with trauma of long-
term apartheid and war have left rural Albanian women more than men, or
urban women at higher risk for post-traumatic stress syndrome.
Essentially, the Kanun, which is more prevalently honored in rural areas,
empowers males as the heads of households, provides for exclusively male
inheritance of family assets and for distinct separation of women from their
families of origin beginning at the time of her marriage into her husband's
family. The children resulting from a marital relationship are the property of
the husband's family. In the post-war period there have been numerous
reports of incidences, where after the death of a husband, his wife was forced
to leave his family, without claim to his property, and to leave her children
behind, with the husband's family. (Gjelov, pp. 28-44) In Albanian, the word
orphan implies fatherless rather than parentless and again de-legitimizes the
parental power of mothers with regard to their children. In post-war Kosovo,
these traditions continue to contribute to the disempowerment and poverty of
rural, undereducated women disproportionately, by leaving widowed women
homeless, unemployed, with few opportunities for earning income, and also
encourage the maternal abandonment of children. (IHF, 2000)
Another way in which the traditional cultural paradigm defined by the Kanun
disenfranchises women is through the association of virginity with marriage-
ability. A man has the right to kill his wife if she commits adultery. In the post-
war period, as evidence of rape as a war crime propagated by the Yugoslav
state is gathered for use at the International War Crimes Tribunal, it has
become clear that women who have endured this inhumane experience are
being subjected to double jeopardy. In addition to the horror of rape, and the
accompanying trauma, these women experiencing rejection and shaming by
their communities, who consider them to have been ruined for life, and
therefore unmarriageable or worthless. Self-perceptions of potential
worthlessness can serve to further silence women, because if they provide
public testimony against rape as a war crime, they bring shame to their
families.
However, there is an observable dichotomy in the willingness of rural and
urban women to subscribe to these traditional cultural values, which
corresponds closely to the levels of participation in public life, defined as a
woman's willingness and courage to vocally express her ideas publicly.
Women from rural areas have often lived isolated in their communities, where
access to formal education and diverse European and International cultural
inputs are absent. Women from urban areas are more likely to have had
more access to formal education structures as well as the opportunity to gain
 18

exposure to a wider array of cultural influences.

The behavioral differences between urban and rural Kosovar women show
direct correlation with their levels of conscious awareness, and their personal
concepts of the permeability of cultural influence. Women's perceptions of
state authority appear vary according to the particular woman's exposure to
influences beyond her immediate community. Rural women often see the
state as unchangeable or ‘intransitive’ authority. Urban women are more
likely to see the state as a ‘transitive’ representative body charged with
Kosovar self-governance. They view it as a structure that according to
principles of democracy that provides for the needs of all Kosovars equally,
regardless of gender or ethnicity -a structure that can be influenced, revised
and evolved according to the constituents it represents. (Freire, 1970)
The impact of epistemic differences in perceptions of authority, shown by
Paolo Freire’s four-stage model of culturally-conditioned consciousness that
range from:
1) intransitive - absence of awareness beyond biological survival, 2)
semi-intransitive – perceptive association of living environment with fate or
destiny, 3) semi-transitive – naive understanding of human influence on socio-
cultural factors, and 4) transitive – capacity for critically thinking about and
intentionally influencing social change: suggest that increased 'transitivity' in
perceptions of culture and authority among urban women in Post-war Kosovo
is likely to boost their participation in public life. This same concept of
‘transitivity’ or ability to take action in the face of crisis, is a critical factor which
determines whether a person can survive and overcome hardship free of
post-traumatic stress symptoms. (Levine, 1997)
Currently, the results of numerous new projects promoting women as
active social change makers confirm the therapeutic affects of developing
personal perceptive awareness of transitivity as strategy for healing those
most likely to suffer psycho-socially from the traumatic consequences of long-
term apartheid and war. The chapter will elaborate on how these projects
have opened a new window of opportunity for enabling women to shed some
of the out-dated cultural traditions that even now keep them in positions of
economic disadvantage; and are encouraging women to be more vocal,
active, political and social participants in public life.

The chapter I propose would:

1) Describe how the social regulatory structure of the Kanun silences

women in the family and society, and the ways the Yugoslav state policies
rendered intransitive the majority Albanian population in Kosovo. In
combination, both systems have mutually-reinforced the social intransitivity
and non-participation of Albanian women disproportionately compared to
men.
2) Explore the connections between increasing transitivity in awareness
and modalities for addressing mass post-traumatic stress symptoms that
hinder women’s participation in public life.

3) Show how the new opportunities for participating in democratic self-

governance systems currently being established in Kosovo, are therapeutic in
a post-apartheid environment for the ethnically Albanian population,
 19

particularly women who are new participants in numerous community

development projects. Examples will include perception and related
behavioral distinctions between those in urban and rural areas, and those who
have access to international experiences compared to those who have not;
with a particular focus on women's responses to various internationally
facilitated participatory group interactions in Peja, Klina, Istog and other
municipalities.

References

Brown, Daniel, "Stress, Trauma and the Body," in Healing Emotions:

Conversations with the Dalai Lama on Mindfulness, Emotions and Health,
edited by Daniel Goleman (Boston: Shambhala Publicatios, 1997).

Freire, Paolo. Pedagogy of the Oppressed. (New York: Herder and Herder,
1970)

Gjelov, Shtjefln, ed. The Code of Leke Dukagjini. (New York: Gjonlekaj
Publishing, 1989)

Goleman, Daniel, Emotional Intelligence: Why It Can Matter More than IQ,
(New York: Bantam Books, 1995).

International Helsinki Federation, ed. Women 2000: An Investigation into the

Status of Women’s Rights in Central and South-Eastern Europe and the
Newly Independent States. (Vienna: International Helsinki Federation, 2000)

Levine, Peter A. with Ann Frederick, Waking the Tiger: Healing Trauma,
(Berkeley: North Atlantic Books, 1997).

Malcolm, Noel. Kosovo: A Short History. (New York: New York University
Press, 1999)

About the Author

Melissa Stone is a social psychologist and Ph.D. candidate at California

Institute of Integral Studies, who began living and working in Kosovo after the
entry of NATO peacekeeping troops in mid-1999, at the invitation of Kosovar
women members of the Network of East-West Women. During the post-war
emergency phase, she co-directed a community development project (U.S.
Agency for International Development, Office of Transition Initiatives) in
Peja/Pec, the region of Kosovo that experienced the most physical damage.
In Peja/Pec, she and her colleagues met regularly with groups of community
members to develop participatory decision-making processes to address the
most pressing community needs, including those specifically identified by
women, and ethnic and religious minorities. In collaboration with the Kosovar
NGO women's community, she worked with the Media Project for young
women journalists, and NGO affiliate of RadioTelevision 21 in Prishtina that
 20

includes conflict resolution techniques in its practices, to develop a curriculum

and training space, where the creativity and enthusiasm of young women can
be realized through print, photo, Internet, radio and television journalism. She
is currently an Equal Opportunity Advisor in the Department of Democratic
Governance and Civil Society (under the supervision of the Organization for
Security and Cooperation in Europe) of the joint United Nations and Kosovar
interim administrative government, where she concentrates on programs that
increase the participation and influence of women, minorities and disabled
persons in the joint government structures.

Chapter 8: Refugee Women: Post Traumatic Experiences and

Interventions

Hurriyet Babacan and Narayan Gopalkrishnan

University of the Sunshine Coast,

Maroochydore, Queensland,
Australia

Migration and movement of people are complex processes that uproot people
and transplant them in a new environment. People create meaning out of the
context in which event occur. Consequently an experience of migration
always involves a strong subjective component of people’s lived experiences
and their reaction to the new environment. Rapid social change results in both
physical and psychological effects, which in turn determine the patterns of
immigrant adjustment to their new country.

Refugees are people who move involuntarily from their countries of residence.
Reasons for the move often relate to fear of persecution based on
race/ethnicity, religion or political opinion; wars or disasters. They often face
physical hardships, emotional trauma, torture and physical deprivation. In
each of these situations refugees experience situations which provoke strong
reactions and emotions. Therefore, migration patterns and settlement
processes for refugees are very different from those of other migrants.
Refugees carry with them the history of their traumatic experience that
determines how they adjust and settle to a new life in the host country.

Australia has been a country of major waves of immigrants since World War
2. Refugees comprise a significant component of the immigration intake.
Refugee programs are permanent in Australia, which requires people to
adjust and cope in their new environment. Refugee women and children
constitute a significant proportion of the world’s refugees and are considered
“at risk” by the United Nations. Australia has a special program for refugee
women called “Women At Risk”. This chapter will examine the settlement
experiences of refugee women in Australia through an exploration of the links
between trauma and adaptation. As traumatic experiences shake the
foundations of our beliefs about safety, society and human nature and shatter
 21

assumptions about trust, refugee women face major obstacles to successful

settlement to a new environment, which requires trust and risk taking
behavior.

The authors will outline the impact of the refugee experience on women in the
“settlement process” in the Australian context. The linkages between
‘successful settlement’ and post-traumatic stress will be explored. As the
settlement process involves coping strategies, the relationship between post
-traumatic factors and adjustment gain primacy. Some of the post trauma
symptoms include depression, low self esteem, fear, insecurity, anxiety,
panic, disassociation, avoidance, nightmares, flashbacks, paranoia and re-
living of events.
The new environment also poses new challenges and threats. For women
issues can emerge in relation to gender roles in the family, adjustment to work
environment, issues around sexuality, caring responsibilities and numerous
other issues. In addition, there may be complications in relation to social
values. For example, the dominant societal values of the host society in
relation to women may clash with the values of that individual’s culture.
These challenges leave refugee women in a position of vulnerability and
alienation in the settlement to a new life and limit their coping strategies.

The authors, drawing from their own work experience with refugees and their
research, will explore the correlation between traumatic refugee experiences
and settlement for women in the context of Australia. The chapter will
conclude with a critique of dominant approaches in therapy in relation to
refugee women. The authors will explore culturally sensitive intervention
strategies as a way forward to enhance the successful settlement of refugee
women.

References:

Adelman H., Borowski A., Burstein M., Foster L., (1994) Immigration and
Refugee Policy: Australia and Canada Compared, Melbourne University
Press, Melbourne.

Babacan H (1998) I Still Call Australia Home… An Exploration of Issues

Relating to Settlement and Racism, Centre for Multicultural Pastoral Care,
Brisbane.

Babacan H., (1999) Death, Dying and Religion: An examination of non-

Christian beliefs and Practices, a Guide for Human Services Workers, 2nd
edition, Queensland Health, Brisbane.

Basoglu M. (1992) Torture and Its Consequences, Cambridge University

Press, Cambridge.

Bottomley G., De Lepervanche D., Martin J., (1991) Intersexions: Gender,

Class, Culture, Ethnicity, Allen and Unwin, Sydney.
 22

Ewalt P.L., Freeman E.M., Kirk S.A. Poole D.L. (1996) Multicultural Issues in
Social Work, NASW Press, Washington DC.

Gardiner H.W., Mutter J.D. & Kosmitzki C., (1998) Lives Across Cultures,
Cross Cultural Human Development, Allyn and Bacon, Boston.

Gopalkrishnan N., & Padhee RP (1997) Whose Interest? Ensuring

Community Ownership and Participation, in Rural Australia, Charles
University Press, Wagga Wagga.

Ivey A.E., Ivey M.B., Simek-Morgan L., (1997) Counselling and

Psychotherapy: A Multicultural Perspective, Alyn and Bacon, Boston.

Lago C & Thompson J., (1996) Race, Culture and Counselling, Open
University Press, Buckingham.

Lopez J.C. P., & Marcelino E.P., (1995) Torture Survivors and Caregivers,
Proceedings of the International Workshop on Therapy and Research Issues,
University of the Philippines, Quezon City.

Masi R., Mensah L., McLeod K., (1993) Health and Culture: Exploring the
Relationships, Mosaic Press, Ontario.

Pettman J., (1992) Living in the Margins: Racism, Sexism and Feminism in
Australia, Allen and Unwin, Sydney.

Pittaway E., (1991) Refugee Women: Still at Risk in Australia, Australian

Government Publishing Service, Canberra.

Sharf R.S. (1996) Theories of Pscyhotheraphy and Counselling, Brookes/Cole

Publishing Company, Pacific Grove.

About the Authors

Narayan Gopalkrishnan: is currently a lecturer in Social and Community

Studies at the University of the Sunshine Coast. Narayan has a background
in community development and counselling. He has worked in India with
indigenous and rural communities for over 6 years. Since his migration to
Australia, Narayan has worked with immigrants and refugees at the Logan
Migrant Resource Centre and the Australian Red Cross. Narayan is involved
in numerous advisory, policy and training bodies in relation to multicultural
and indigenous issues. Narayan’s research interests relate to cross cultural
and indigenous issues, globalisation, and ethnicity and crime. Narayan is
currently working on his PhD on globalisation and its impact on the quality of
life.
 23

Hurriyet Babacan: Hurriyet is a Senior Lecturer in Social and Community

Studies at the University of the Sunshine Coast. Hurriyet has a background in
social work and has over 15 years work experience in ethnic and multicultural
affairs in the positions of social worker, senior policy officer, manager,
researcher, trainer and academic. Hurriyet is founder and currently the Vice
President of Multicultural Development Association Inc. , a peak non-
government organization. Hurriyet is currently completing her Ph.D. on ethnic
identity. Hurriyet’s research interests include multiculturalism, immigration,
women’s issues, aging and racism.

Part 2: Gender, culture and ethnicity in helping immigrant

populations

Chapter 9: Immigrant Women, Abortion and Preventive Intervention

Mauro Gonzo, psychologist, psychotherapist,

West Vicenza, Italy

Since ‘Family Therapy’ (later frequently called ‘Systemic Therapy’) was

born and expanded its influence, it has often specified public health and social
services as particularly suitable to its social and egalitarian values. Particularly
in Italy, the systemic approach – with its strongly characterized attention to the
social context and to relationships – found a fertile soil in the laws of the late
seventies, which established a new welfare system based on unified health
and social services, located throughout the country. The public health and
social services became a context sensitive to the issues of the people and to
the social changes which took place during that period and later.
A new social phenomenon occurred in Italy, as in the rest of Europe and
other developed countries in the 1990's. A wave of immigrants from poor
southern and eastern countries of the world has transformed the last culturally
homogeneous western countries - like Italy - into multiethnic and, in
perspective, multicultural societies.
This social-demographic shift has also lead to new issues for the public
health and social service system. The West-Vicenza district, where I work for
a public Family Advisory Centre, attracts a large number of immigrants thanks
to the job opportunities offered by its tanning industry. Statistical data for the
Veneto region - which comprises the West - Vicenza district - indicate that
whereas abortion is decreasing among Italian women, thanks to the process
of awareness and the extensive use of contraception, there is a simultaneous
increase among immigrant women, and, in particular, among the Ghanaians
and Serbians.
This high incidence of abortion has been attributed to the immigrant
women’s lack of information and their disadvantaged socio-economic
situation. As a result, the health and social services have launched an
awareness campaign with the aim of providing these women with the
necessary information on contraception and on their psychological and
 24

physical well-being. There are socio-economic factors, such as the difficulty

of bringing up a large number of children in a typically Western industrial and
urban environment where the traditional support network present in the
country of origin is lacking. In addition, there are also cultural factors,which
can explain the statistical high rate of abortions amid these ethnic groups.
Such an explanation can be found in the concepts of femininity,
motherhood, and fertility, all three interwoven in the cultural context of Serb
and Ghanaian society. In fact fertility is the foundation of the Ghanaian and –
in a different way – of the Serbian female identity through which a certain
balance of power is established within the couple, the family and society.
The hypothesis is that the Ghanaian or the Serbian women who migrate to a
foreign country abandon all their past referential points, as well as their
affective and practical support network (i.e. the extended family, the
neighborhood, etc.). As a result, they feel that, on the one hand, the continuity
of their identity is threatened, and, on the other, that the latter is all the more
necessary for them. Therefore, the ‘partial pregnancy’ that abortion -unlike the
pill or IUD or other modern contraceptives- allows, can be seen as a possible
substitute for pregnancy at the symbolic level.
In the chapter I’m going to present, I’m also going to discuss how the
Family Advisory Centre has answered to this situation, with instruments as a
specific systemic questionnaire that we use in the interviews with women and
their partners. When couples present their application for abortion at the
service a questionnaire is used which aims to assess the ethnic, social and
family situation, collecting useful data that can be put together with the
information taken from other women. This increases the quantity of
information which is circulating within the communicative system of the
Service - between operators, clients and managers of the Local Social and
Health Unit.
This increase of information within the system has a neghenthropic
effect: it opens different perspectives and facilitates the communication
between clients and operators which often are closed in their own
prejudices that make the communicative system obstruct. In this way, the
practitioners (nurses, gynecologists, social workers and psychologists) of
the Service will be able to know better this new kind of clients and, hence,
provide them with the care that they need.
The questions of the second part of the questionnaire examine the
following information: the family relations; the role of the woman and of the
man in the couple; the reciprocal expectations; the relationship with sons;
the ideas about fertility, family planning (and so on) from a cultural and gender
sensitive point of view. These are used in order to know the family and
individual context and to prevent abortion as a way to control the family size
within the new industrial and urban environment where these immigrants have
come to work and live.

The questionnaire, at the same time as it increases the knowledge and the
information, creates more compliance, allows women, their partners and the
operators to discuss and negotiate between themselves their ideas about
health, family, couple, parenting and ‘well-being’.
The questions also allows women to talk about their own individual way
of thinking, feeling, their expectations, fears, stories, myths and specific
 25

problems, in a free and empowering dialogue where both – therapist and

client - explore new ideas. The context of the conversation isn’t therapeutic
because the clients just haven’t asked for therapy but only for specific
practical help for the undesired pregnancy. This often changes so that the
patients can be somehow helped in a therapeutic manner about thinking over
their life choices and constructing different ways of looking at themselves in
which the sorrow of abortion is not necessary. That is, "something like"
therapy in a non-therapeutic context.

This chapter will include a case study that consists in an interview with a Serb
couple asking for abortion. It will be shown how the therapist and the clients
discuss the choice of abortion, the background of the couple and try to think to
prevention.

References

Anderson, H., Goolishan, H. (1988) Human systems as linguistic systems,

preliminary and evolving ideas about the implications for clinical theory.
Family Process, 27, 4, pp. 371, 393.

Boscolo, L., Cecchin,G. Hoffmann, L., Penn, P. (1987)Milan Systemic Family

Therapy, Basic Books, New York.

Mosconi, A. Gonzo, M. Sorgato, R. Tirelli, M., Tomas, M. (1999) “From

Counterparadox and the Milan Model to Therapeutic Conversation and the
Milan Systemic Approach: Origin and Development of the Milan Centre for
Family Therapy”, in: Gielen, U., Comunian, A.L., (eds) "International
Approaches to Family and Family Therapy", Unipress, Padova, 1999, pp. 7-44

Morokvasic, M.(1981) Sexuality and control of procreation. In: Young, K.,

Wolkowitz,C.,Mc Cullagh, R., (eds) Of Marriage and the Market: Women’s
Subordination Internationally and its Lessons. Cse Books, London, pp. 193-
209

About the Author

I was born in 1954; I’m doctor in psychology (Padova, 1978) and specialized
in psychotherapy of the family (Padova, 1988). I’ve worked within the National
Social and Health Service, before as a psychologist at the SERT (Service for
Addictions) and after at the Family Advisory Centre, of the ULSS (Local Social
and Health Unit ) no.5, West Vicenza, Italy. I’m responsible for the Family
Advisory Centre and also responsible for some projects for the immigrants of
my organization and in collaboration with other institutions as schools,
hospitals, city halls (‘Project Welfare for Stranger Women 1995/96’; ‘The child
and the family in the Multiethnic Society 1998-2000’ and the new one
‘Learning and communicating across cultures2001-2003’). I’m teacher in a
course for social workers at the ‘Centro Milanese di Terapia della Famiglia’
 26

office in Padova and member of the SIRTS (Società Italiana di Ricerca e

Terapia Sistemica).
I’m the editor of the web page ‘Sistemi e culture/Systems and cultures’ and
I’ve published some essays about family therapy and intercultural
communication in Italian and international reviews and books.

Chapter 10: Helping Immigrants from the Former Soviet Union

Roni Berger Ph.D. CSW

Adelphi University
United States

Goals and objectives

The goal of the proposed chapter is to familiarize the reader with

characteristics and issues of immigrants from the former Soviet Union, and
principles for servicing them, on the basis of empirical knowledge and clinical
experience.
Recent years have seen increasing recognition of the importance of
understanding people within their cultural context and developing strategies
for culture-competent practice. This is especially essential when the culture of
origin and the host culture differ significantly, as is the case for emigrants from
former Soviet Union to the Western World.
Specifically, the objectives of the chapter will be:
1. To review characteristics of immigrants from the former Soviet Union:
a. Characteristics related to the experience of relocation: losses,
phases in the process of immigration, typical stresses and coping
patterns.
b. Characteristics related to Soviet culture- issues of authority,
attitudes toward groups, typical family configurations.
2. To discuss the complexities of the processes of emigration, acculturation
and adjustment of these immigrants.
3 . To address unique issues of these immigrants that result from the
aforementioned complexities and may effect their functioning and well
being.
4. To address specific sub-groups such as immigrant adolescents,
immigrant stepfamilies and the elderly, and their special needs.
5 . To suggest guidelines for effective service development and delivery for
immigrants from the former Soviet Union.

Rationale

Immigration is a multi-faceted process that creates stresses with potential

short and long- term social, psychological, economic and legal implications on
individuals and families. With the growing waves of immigration, the
 27

professional and paraprofessional community has been called in recent years

to develop services for newcomers. While programs to assist people in the
process of resettlement are not novel, the paucity of knowledge about
particular demands and nuances related to specific immigrations fails to
provide service providers with tools for specificity. Immigrants from the former
Soviet Union, who come from a- totalitarian, anti-religious society that
controlled many aspects of their life, meet the American liberal, individualistic
and capitalistic norms. Understanding the effects of this experience and
developing ways to help the immigrants cope with the complicated transition
are of utmost importance. This chapter will offer the reader the necessary
knowledge for such understanding.

References

Berger, R. (in press). Immigration & mental health: Principles for successful
social work practice. In R. P. Perez-Koenig & B.D. Rock, eds., Social
and economic justice: Devolution and social work practice. NY: Fordham
University Press.
Berger, R., (1996). Characteristics of adolescent immigrants from the former
Soviet Union. The Jewish Social Work Forum, 32, 42-50.
Christensen, C.P. (1992). Training for cross-cultural social work with
immigrants, refugees, and minorities: A course model. Journal of Multi-
Cultural Social Work, 2(1),79-97.
Harper, K.V. & Lantz, J. (1996). Cross-cultural practice : Social work with
diverse populations. Chicago, ILL: Lyceum
Hulewat, P., (1996). Resettlement: A cultural and psychological crisis. Social
Work, 41(2), 129-135.
Nah, K.H., (in press). Adjustment experience of new Americans: Soviet-
Jewish refugees and Korean immigrants. The Journal of Multi-Cultural
Social Work.
Zapf, K. M., (1991). Cross cultural transitions and wellness: dealing with
culture shock. International Journal for the Advancement of
Counselling, 14: 105- 119.

About the Author:

Roni Berger
Adelphi University School of Social Work, Garden City NY
Tel. 516 877 4365 e-mail bergerroni@yahoo.com

Dr. Berger holds a BSW, MSW and Ph.D. from the Hebrew University of
Jerusalem, Israel and a Diploma in Psychotherapy from Tel Aviv University/
School of medicine. She has been practicing, supervising, teaching and
researching in the field of immigrants from the former Soviet Union for a
decade and published numerous articles. Currently she serves as an
Associate Professor at Adelphi University School of Social Work in NY, USA
and a consultant to the Jewish Board for Families and Children Services in N)
(, USA. In her capacity as a consultant she trained workers who treat
 28

adolescent immigrants from the former Soviet Union. Currently she is working
on an international research to study cross-cultural aspects of coping with
identity issues of immigrant adolescents.

Chapter 11: Converging Forces: Mexican Culture and Clinical Issues of

Mexican Women Living in the United States

Jeanne M. Hinkelman
United States

The purpose of this chapter is to describe Mexican culture and the

clinical issues of Mexican Women living in the United States. Mexico is a
large country having a diverse range of cultural and ethnic backgrounds
represented. As such, it is impossible to account for the many individual
differences found between Mexican women. In general, Mexican women
experience and face a wide range of clinical issues which are heavily
influenced by the values and beliefs of their culture, which may vary
somewhat depending upon what region of Mexico they grew up in.

The effects of socioeconomic status and sociopolitical issues have an

enormous impact on the clinical issues which Mexican women face. Part of
the social context which Mexican women encounter is the manner in which
they were received into the United States. Mexican women have fewer
economic resources and employment opportunities than Mexican men do in
Mexico, and this trend often continues after Mexican women come to the
United States because they may arrive without money or marketable skills.
Strongly-defined sex roles also play a part in the clinical repercussions of life
for Mexican women in the U.S. Additional cultural influences will be
described.

Many of the problems of Mexican women result from external sources

including poverty, poor nutrition, and exposure to pathogenic agents (Phinney
& Rotheram, 1987). Mexican women often suffer stresses involved with
situations such as inadequate food and shelter, unemployment, and stressful
interactions within the sociopolitical system. Symptoms of these stresses are
often similar to those displayed during personal conflicts. In addition, the
Catholic Church continues to play an important role in the family life of
Mexican women, and some life events may be attributed to luck, supernatural
forces, or acts of God. This fatalism has been linked to a high prevalence of
depression in Mexicans in general. Other clinical issues are intrapsychic, and
may include common psychiatric conditions such as psychological conflict,
depression, anxiety, and psychosomatic symptoms.

Mexican women, particularly those of lower socioeconomic status,

living in the United States tend to have limited access to medical and mental
health care resources, including information about clinical issues and their
treatment. Treatment approaches that may be appropriate with this
 29

population vary depending upon the nature (e.g., intrapsychic versus external)
of the problem. Approaches to treatment will be summarized and a clinical
case study (or studies) may be presented in the chapter.

References

Baca Zinn, M. (1999). Women's untold stories: Breaking silence, talking

back, voicing complexity. New York: Routledge.

Baca Zinn, M. (1997). Women and work: Exploring race, ethnicity, and
class. Newbury Park, CA: Sage.

Blea, I. (1997). U.S. Chicanas and Latinas within a global context.

Westport, CT: Greenwood.

Lopez, A. S. (1999). Latina issues: Fragments of historia. New York:

Garland.

Phinney, J. S. & Rotheram, M. J. (1987). Children’s ethnic

socialization: Pluralism and development. London: Sage.

Romero, M. (1992). Maid in the U.S.A. New York: Routledge.

Romero, M. (1997). Challenging fronteras: Structuring Latina and

Latino lives in the U.S. New York: Routledge.

Segura, D. (1994). Mothering, ideology, experience, and agency. New

York: Routledge.

Zavella, P. (1997). Situated lives: Gender and culture in everyday life.

New York: Routledge.

Zavella, P. (1993). Sunbelt working mothers. Ithaca, NY: Cornell

University Press.

About the Author

Dr. Jeanne M. Hinkelman is a Licensed Health Service Psychologist in

Oklahoma and is on the staff at Counseling & Psychological Services,
University of Tulsa where she provides individual/group counseling, outreach,
consultation, and assessment services to students, faculty, staff. She
supervises and trains psychology students in an American Psychological
Association-accredited degree and predoctoral internship programs. Dr.
Hinkelman is also a Research Professor in the Department of Psychology at
The University of Tulsa, where she teaches and maintains a program of
research involving studies in the areas of Hispanic and international issues,
musical aptitude and experience, performance enhancement, career
development, and stress and coping. She supervises an ongoing research
team of both masters and doctoral-level graduate research assistants who are
students in the APA-approved Clinical and Industrial/Organizational graduate
 30

programs. She is also on the Board of Trustees of the Hispanic American

Foundation and the New Music Committee, Living Arts.

Part 3: Gender, culture and ethnicity and the minority

experience

Chapter 12: Understanding and Helping Women of Color: Effects of

Marginalization on Therapy in the Israeli Experience

Claire Rabin
Tali Lahav
Tel Aviv University
Israel

In recent years, we have heard the voice of Israelis of Asian and

North African origin, called "oriental" or "mizrachi (eastern) heard in the public
sphere. Public figures, politicians and artists openly discuss pains of self-
identity, that is often tense, confused and conflicted internally. There are many
reasons for this interest in race, ethnicity and identity in Israel. These include
the affair of the missing Yemenite children and the emergence of movements
of intellectuals who focus on identification with their Oriental origin. These
have resulted in apologies made by political leaders and the rise of political
parties of Mizrachi origins all reflect the forces at work in the Israeli society.
People have become suddenly conscious of the fact that a large group of
Israelis live on the margins. Mizrachi Israelis no longer accepts its blurred
image, the result of its own and others’ doing. Renewed interest has lead to a
proliferation of the symbols of ethnic identity in the media, including foods,
holiday customs, clothing, slang and other signs of cultural identity.
The very fact that there is a need for a separate discussion of Oriental
Women in 50-years-old Israel, decades after these groups immigrated,
indicates that there is a problem and much pain that seeks an honorable
expression in Israel of the third millenium. Even if Oriental women in Israel
view themselves as Israelis for all intent and purpose, we cannot be sure that
this is how their environment sees them – including the people who treat
them.
The voices heard must guide their therapists to try and understand the
majority of those seeking help from the social and welfare services. This
paper will specifically observe the Israeli women of Oriental origin whose dark
cheek has been slapped twice – once for being a woman and another for
being of Oriental origin.
A discussion of ethnic origin in clients might be perceived as a symptom of
alienation, but we intend to address the issue as part of an affirmative action
trend in the local evolution. This is an attempt at self-reflection and an effort to
step out of the self-evident therapeutic discourse. This is an attempt to
criticize the institutionalized system which, through insensitivity at best, sought
 31

to establish a unified identity while humiliating the other, describing him as

negative and unworthy.
This chapter seeks to expand awareness of the identity of the Oriental
woman in Israel, describe factors of her identity and display the central
conflicts she experiences, as they may be expressed in therapeutic sessions
with families and couples. It aims to forge a set of guidelines for treatment that
would be culturally appropriate in addressing her identity. Western society
developed the concept of family therapy, often replacing the clergy, the clan
elders and anyone representing moral codes, examples of behavior, the old
lore and the traditional healers of the Jewish Oriental culture. Western-based
family therapy is established on universal and humanistic values and seeks
openness, new processes and forsaking past traditions and dictates. As such,
it poses a threat to the traditional family structure.
The male often perceives the need for therapy as weakness on his part
because it threatens his standing as a source of authority. In that sense, it
could become the women’s resort. Furthermore, seeking therapy might be
interpreted as an attempt to “go over the head” of the traditional family
authority which, according to tradition, should have fulfilled this “need.” The
fact that people charge money for having a conversation is often seen as
wasteful. In addition, meetings with professionals who represent the
Ashkenazi therapeutic establishment – in an environment where the needy
are of one origin and the powerful establishment belongs to another – created
an ambivalent approach to therapy. This ethnic-based distribution of roles is
clearly visible in the Israeli public service. Seeking treatment, Oriental women
might find themselves in a bind here too: they are supposed to be treated by
the very establishment that started the problem in the first place. This might
be interpreted as a way of eternalizing her inferiority in her and the society’s
eyes. Hence, the Oriental woman can draw power from the fact that she uses
therapy to support her family and relationship with her husband, but might
acquire an ambivalent stand regarding its usefulness and adaptability to her
ethnic roots.
The conscious and skilled family therapist is there to help her. Aware of
the potential impact of her ethnic origin, as reviewed above, family therapists
should offer a thorough and direct probe of the dilemmas women face due to
their Oriental origin. The therapist can offer accompaniment during crises
such an inquiry might spark, guiding their client to making authentic and

References

* Carter, B. & McGoldrick, M. The changing family life cycle. A

framework of family therapy. Boston: Allyn & Bacon, 1989.

* Field B.M & al., Women’s ways of knowing:The development of self,

Voice and mind, N.Y: Basic Books, 1986.

* Gale N. Love and Marriage, Past and present: The case of the oriental
Jews in Sidney. Int. Journal of sociology of the family, 24 (1), 1994.
 32

* Goldschneider, C., Friedlander, D., Reproductive Norms in Israel, in

Schmelz, 4.0: Nathan, G., Studies in the population of Israel.
Jerusalem: The Hebrew University, Magness Press, 1986.

* Haberfeld, R., Cohen Schooling and income gaps between western

and eastern Jews in Israel, 1975-1992. Tel-Aviv University, Golda Meir
Institute for Social & Labor Research, 1995.

* McGoldrick, M., Women through the family life cycle, in McGoldric M.

et al, Women in families, N.Y.: W.W. Norton, 1989.

* Okun, B. Sex preferences, Family, Planning and Fertility: An Israeli

Sub-population in Transition Journal of Marriage & The family 58<2>,
1996.

* Sue S. & Zane M., The Role of culture and culture technique in
psychotherapy. Am. Psychologist, 42, 1987.

Chapter 13: Emotional Isolation, Depression and Suicide Among African

American Men: Reasons for Concern

Deryl F. Bailey- The University of Georgia - Athens, Georgia USA

James Moore- The University of South Carolina - Columbia, South Carolina
USA

The lack of access to mental health services for African Americans and other
people of color have been well documented. In his latest report, David
Satcher, United States Surgeon General, brings to the forefront the disparities
in mental health services for minorities in the US. Among those with limited
access to mental health services, are African American men.

This chapter will address the how the socialization process for men in the US
results in their emotional isolation. This isolation coupled with other factors,
such as, racism, historical hostility, unemployment, and pressures of
fatherhood lead to depression and suicide among African American men. In
addition, the chapter will cover the following:

Overviews of how African-American males generally define masculinity and

how it negatively impacts their perceptions of counseling.

Highlight and explain their general cultural attitudes and perceptions of

counseling and seeking help in general.

Describe methods, techniques, and interventions for effectively working with

African-American males.

Identify the common physical symptoms associated with depression as it

relates to African-American males
 33

Explain why African-American males suppress their feelings and emotions

and the effects of doing both.
Explain why counselors have traditionally failed to meet the needs of African-
American males.

References:

Poussaint, A.F. & Alexander, A. (2000). Lay My Burden Down: Unraveling

Suicide and the Mental Health Crisis among African-Americans. Boston,
Massachusetts: Beacon Press.

U.S. Public Health Service, The Surgeon General’s Call to Action to Prevent
Suicide (Washington, D.C., 1999).

Karp, D. (1996). Speaking of Sadness: Depression, Disconnection, and the

Meanings of Illness. Oxford University Press

About the Authors

Deryl F. Bailey is an Assistant professor of counseling and human

development at the University of Georgia. He earned his master’s degree in
guidance and counseling from Campbell University, and his EdS and PhD
degrees in counselor education from the University of Virginia. His primary
research areas are, adolescent development, psychosocial development
among adolescent African American males, school counseling, and issues
related to multiculturalism and diversity. He is the developer of the Project:
Gentlemen on the Move empowerment and transformation model for
adolescent African American male.

James Moore is an assistant professor at the University of South Carolina.

He earned his B.A. in English education from Delaware State University, his
M.A.ED. and Ph.D. in Counselor Education at Virginia Tech. His research
areas of interest include but not limited to Multicultural Issues, Counseling
Student-Athletes, Counseling Adolescents, Black male issues, Mentoring, and
Community approaches to psychosocial issues.
 34

Chapter 14: Minority Parents and Children Who Cope with Cultural
Transition

Dorit Roer-Strier
Paul Baerwald School of Social Work
The Hebrew University of Jerusalem

The chapter addresses the multivariate nature of research on minority

children and families in Israel, and offers an alternative framework for
investigation of these families. The ecological approach toward the study of
child development is applied in an attempt to identify variables that influence
the child and family at various levels of the ecological context. In addition to
identifying variables directly related to the child and family, the main
contribution of this framework is its focus on wider social and cultural contexts
and on interactions at all levels. These dimensions are ignored in many
quantitative studies of minority children and their families in Israel. The paper
further discusses research methods and data analysis techniques that
conform to the proposed ecological approach. Most of the cases presented in
the paper are drawn from examination of families in cultural transition and
perceived risk factors threatening the children’s well being. These examples
illustrate the importance of addressing social and cultural contexts and their
interactions at different levels. These data show how the significance and
interpretations of data change when viewed through this wider lens.

References

1. Frankel, D. G., & Roer-Bornstein, D. (1982). Traditional and modern

contributions to changing infant-rearing ideologies of two ethnic
communities. Monograph of the Society for Research in Child
Development, 47(4).
2. Roer-Strier, D. (1996). Coping strategies of immigrant parents:
Directions for family therapy. Family Process, 35, 363-376.
3. Roer-Strier, D. (1996). Ecological study of child-care quality: A call for
attention to the cultural context. European Early Childhood Education
Research Journal , 4(2), 77-88
4. Roer-Strier, D. (1996). In the mind of the beholder - Evaluation of
coping styles of immigrant parents. International Migration, 35 (2), 271-
286.
5. Roer-Strier, D. (1996). Coping of immigrant parents: Implications for
prevention and intervention. Society and Welfare, 16 (4), 467-481.
(Hebrew)
6. Roer-Strier, D., & Rivlis, M. (1998). Timetable of psychological and
behavioral autonomy: Expectations among parents from Israel and
 35

Former Soviet Union. International Journal of Psychology, 33(2), 123-

135.
7. Roer-Strier, D., & Haj-Yahia, M. (1998). Arab students of social work in
Israel: Adjustment difficulties and coping strategies. Social Work
Education, 7(4), 449-467.
8. Roer-Strier, D. (1998). Coping with cultural transitions: Minority parents
and children in Israel. European- Early Childhood Education Research
Journal, 6 (2), 71-87.
9. Roer-Strier, D. (1999). Child care quality in cultural context. Society
and Welfare, 19 (1) 53-65. .(Hebrew)
10. Haj-Yahia, M., & Roer-Strier, D. (1999). Dilemmas of supervising Arab
social work students. Clinical Supervisor, 18 (2) 17-37.
11. Roer-Strier, D., & Rosenthal, M. K. (in press). Socialization in changing
cultural contexts: A search for images of an “adaptive adult”. Social
Work. (25 ms pages)
12. Sands, R., & Roer-Strier, D. (in press). Ba’alot teshuvah daughters and
their mothers: A view from South Africa. Contemporary Jewry. (28 ms
pages)
13. Rosenthal, M. K., & Roer-Strier, D. (in press), Cultural differences in
mothers’ developmental goals and ethnotheories.
International Journal of Psychology. (23 ms pages)
14. Roer-Strier, D. & Sands, R. (in press), The impact of religious change
on intergenerational family relations: A South African example. Journal
of Marriage and the Family. (30 ms pages)
15. Roer-Strier, D. (in press), Reducing risk for children in changing cultural
contexts: Recommendations for training and intervention. Child Abuse
and Neglect. (24 ms pages)

About the Author

1992 Ph.D., Department of Clinical Psychology, University of North
Carolina, Chapel Hill, North Carolina, USA.
1996-present Lecturer at the School of Social Work and in the Graduate
Program of Early Childhood Studies, Hebrew University of
Jerusalem, Israel.
1984.1996Teacher at the School of Social Work and in the Program of Early
Childhood Studies at the School of Social Work, Hebrew
University of Jerusalem, Israel.
1993- present Research projects at the Hebrew University, Jerusalem
• Coping styles of immigrant parents.
• Evaluation of coping styles among immigrant parents by
professionals from various disciplines.
 36

• Cultural sensitivity in the training of Arab students in social work

(in collaboration with Dr. Haj-Yahia, Hebrew University ).
• Family relations and coping strategies among Israeli, American
and South African families whose daughters have become Ultra
Orthodox (in collaboration with Dr. Sands, University of
Pennsylvania, USA ).
• Continuity and change in modes of socialization among
immigrant parents.
• Education and welfare of the children of illegal guest workers
from South America in Israel.
• Israeli and Russian immigrant parents: Timetable of
psychological and behavioral autonomy( in collaboration with Mrs.
Rivlis, Hebrew University)
• Parental goals and Ethno-theories of development among
different cultural groups in Israel (in collaboration with Professor
Rosenthal, Hebrew University).
• Cultural effects on early childhood educational programs:
Parental perceptions of quality of care in early childhood.
• Perceptions of religious and secular encounters in the school
setting among young children and their parents( in collaboration with
Dr. Weil, Ben Gurion University).
• Study of immigrant and refugee fathers in Canada and Israel ( in
collaboration with Dr. Este and team, University of Calgary,Canada).

Part 4: Gender, culture and ethnicity in different therapeutic

contexts

Chapter 15: Cross-Cultural Perspectives on Psychological Assessment

and Intervention

GRAHAM DAVIDSON*
Central Queensland University
Australia
PRASUNA REDDY*
Swinburne University of Technology

*The authors are listed alphabetically.

The practice of psychology in a pluralistic society is surrounded by

controversy. By a pluralistic society we mean one in which there are
individuals or groups differing in ethnicity (E), language (L) behavior, and
 37

cultural practices and customs (C). These ethnic, linguistic and cultural
indicators of difference, or pluralism, (ELCD) are often found to be associated
with social, educational, vocational and economic differences between
individuals in western societies like our own. In the case of some ethnic
groups the association between group membership and success in
educational and economic terms is generally considered to be positive -- the
educational success of Chinese American and Chinese Australian children
are cases in point. In other instances that association is said to be negative,
i.e. it is disadvantageous educationally, economically and vocationally to
belong to a particular ethnic or cultural grouping. In Australia Aboriginal and
Torres Strait Islander people and those originally of South Sea Islander
descent have been described as disadvantaged on the basis of their access
to further education and employment, their standards of living and health, and
their over-representation in correctional and community justice populations.
Many recently arrived migrants to Australia from Asian countries such as
Vietnam have been similarly described as disadvantaged. Having access to
psychological services is one indication of whether ELCD groups are said to
be treated fairly by service providers. However, fairness in terms of access
should not be confused with psychological judgments about the
appropriateness of services for ELCD clients, and with other scientific
principles on which professional services are founded. The terms, scientific
bias, cultural bias and fairness, are used in the psychological assessment and
counseling literature, and a distinction between them will be maintained in the
following sections.
We start by suggesting that controversy surround the provision of
psychological services in pluralistic societies. What is the controversy or,
more correctly, what are the controversies? The first, though not necessarily
the prime, controversy is about how psychology prioritizes the desirability of
having standard, scientific techniques and approaches against the needs for
fair and culturally appropriate treatment of individuals and groups. Put in
another way, this controversy is about whether it is more important to aim for
measurement equivalence and technical standardization of assessment and
treatment irrespective of who the clients are. Or to have services to which all
clients believe they have equal access and that produce a just and moral
distribution of resources and service benefits. In the testing and assessment
literature, as will be shown, this controversy takes the form of deciding
whether it is more important to demonstrate that tests used for diagnostic and
selection purposes have similar psychometric properties for members of
ELCD groups on whom they are used. Or to demonstrate that members of
ELCD groups have an equal chance of obtaining an educational or work
placement, or other benefit. In the clinical and counseling literature, the
controversy is about whether it is more important that the services offered
appear to be equal for each individual in terms of what the clinician. Or that
the potential for ELCD clients to benefit from using the service be maximized.
The consequences of these contrasting viewpoints are most obviously seen in
approaches and services that either mainstream ELCD clients or are
designed for clients from a specific ELC background and usually located
within their own community.
The origin of these contrasting views can be found within the debate
between the universalistic and culturalist schools of psychology (Shweder,
 38

1990). That debate is about whether psychological phenomena are universal

in the sense that they are independent of one's cultural circumstances but are
manifested through culturally learned behavior, or whether they are culture-
specific, and require interpretation specifically with the cultural context in
which they are observed. In our view there is really no definitive answer to
this debate. It is, in one sense, an ideological debate that has to do with
psychologists' views of what the psychological sciences purport to derscores
contentious questions such as whether psychology has a societal role and
mission, whether psychology is used internationally for political purposes, and
whether one should prioritize the goal of establishing psychological
equivalence, i.e. unbiased tests, ahead of the need to ensure fair and
equitable access to resources and services. While there seems to be no
resolution to the debate, it is increasingly the case that psychologists from
both sides - the universalistic side and the culturalist side - are being asked to
consider the ethical implications of their positions. As we will discuss in some
detail, such a self-examination requires consideration of three general ethical
principles. The first of these is the requirement that psychologists be
competent to offer specific services to ELCD clients. Dana (1994) and
Davidson (1999) have argued that professional competence includes having
knowledge about, and an appreciation of, individual clients' cultural and
language backgrounds, and then making appropriate use of that knowledge
when offering psychological services. The second general principle that
psychologists need to consider is the commitment to clients' welfare. Clients
should be better off - at least they should not be worse off - as a result
psychological services provided for them. While being better off can be
judged by a number of criteria, clients who come from disadvantaged groups
and communities will not be better off from professional services that exclude
fairness of outcome as one of those criteria. Finally, individuals from
disadvantaged groups are often vulnerable to a variety of abuses and
discriminatory practices. Psychologists have a special duty of care to
vulnerable clients.
Although the rhetoric of adopting the culturalist position sounds appealing,
there are some important questions to consider in relation to that approach.
How might a psychologist become competent to assess and treat clients from
ELCD backgrounds? This in turn raises the question about whether
psychologists have to be conversant with many cultures in addition to their
own in order to be competent, or whether the competent psychologist is one
who can read for cultural factors and sensitivities as the ELC backgrounds of
clients change. We will also explore the notion of cultural competence in
psychological practice in more detail. When faced with those questions, the
universalistic approach may seem appealing. However, the sections that
follow will also address the need for psychologists to apply cultural knowledge
in their practice after carefully comprehending how the limitations of their
assessment and treatment techniques developed within and for the
mainstream of society are exacerbated by ELC variables. How could
psychologists not have and use that knowledge and still be judged to be
competent? Thus the easy road does not exist.
This chapter which is essentially about practicing psychology in a pluralistic
society sets out, therefore, to look specifically at the following professional
competencies: psychological testing and assessment across cultures; clinical
 39

and counseling issues across cultures; and cultural competence. It then

summarizes the various sets of guidelines for working with ELCD clients,
paying specific attention to the recently released Guidelines for the Conduct of
Psychological Research with and Provision of Psychological Services for
Aboriginal and Torres Strait Islander People (Australian Psychological
Society, 1996) and the APA (1993) Guidelines for working with ELCD groups.
Finally, some general recommendations for practicing psychology in pluralistic
communities are set down.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual

of mental disorders (4th ed.) Washington, D.C.: Author.

Axelson, J. A. (1985). Counseling and development in a multicultural society.

Monterey, CA: Brooks/Cole.

Bond, M. H., & Forgas, J.P. (1994). Linking person perception to behaviour
intention across cultures: The role of cultural collectivism. Journal of Cross-
Cultural Psychology, 15, 337 - 352.

Church, A. T. (1987). Personality research on a non-Western culture : The

Philippines. Psychological Bulletin, 91, 540 - 572.

Davidson, G. R. (1982). Educational assessment of socially and culturally

different children. International Journal of Educational Development, 2, 153 -
162.

Davidson, G. R. (Ed.). (1988). Ethnicity and cognitive assessment :

Australian perspectives. Darwin: Darwin Institute of Technology Press.

Davidson, G. R. (1992). Toward an applied Aboriginal psychology. South

Pacific Journal of Psychology, 5, 1 - 20.

Davidson, G. R. (1995a). Cognitive assessment of indigenous Australians :

Toward a multiaxial model. Australian Psychologist, 30, 30 - 34.

Davidson, G. R. (1995b). The ethics of confidentiality : Introduction.

Australian Psychologist, 30, 153 - 157.

Davidson G. R. (1996a). Fairness in a multicultural society! Reply to Dyck

(1996). Australian Psychologist, 31, 70 - 72.

Davidson G. R. (1996b). Short-comings in cross-cultural research ethics :

The Tapp et al (1974) report revisited. In J. Lasry, J. Adair & K. Dion (Eds.),
Latest contributions to cross-cultural psychology. (pp. 355-365). Lisse, Neth:
Swets & Zeitlinger.
 40

Davidson, G. R. (1999). Cultural competence as an ethical precept in

psychology. In P. Martin & W. Noble (Eds.) Psychology and society. (pp. 162-
174). Brisbane, Qld: Australian Academic Press.

Davidson, G. R., & Sanson, A. (1995). Should the APS have an ethical code
of social action? Bulletin of the Australian Psychological Society, 17 (5), 2 - 4.

Dudgeon, P., & Oxenham, D. (1990). The complexity of Aboriginal diversity:

Identity and kindredness. Ngulaig (Monographs of the Aboriginal and Torres
Strait Islander Studies Unit, University of Queensland, No. 1 (whole issue).

Dyck, M. J. (1996). Cognitive assessment in a multicultural society: Comment

on Davidson (1995). Australian Psychologist, 31, 66 - 69.

Helms, J. E. (1984). Toward a theoretical explanation of the effects of race on

counselling: A Black and White model. The Counseling Psychologist, 12,
153-165.

Labov, W. (1975). Academic ignorance and Black intelligence. In M. L.

Maehr and W. M. Stallings (Eds.), Culture, child and school. Monterey:
Brooks Cole.

LaFromboise, T. D., & Foster, S. L. (1989). Ethics and multicultural

counseling. In P. D. Pedersen, J. G. Draguns, W. J. Lonner and E. J. Trimble
(Eds.), Counseling across cultures (3rd ed.) (pp. 115-136). Honolulu:
University of Hawaii Press.

Marsella, A. J. (1980). Depressive experience and disorder across cultures.

In H. C. Triandis and J. Draguns (Eds.), Handbook of cross-cultural
psychology. Volume 6 (pp. 237 - 289). Boston: Allyn and Bacon.

Marsella, A. J. (1982). Culture and mental health: An overview. In A. J.

Marsella and G. M. White (Eds.), Cultural conceptions of mental health and
therapy. (pp. 359-388). Dordrecht, Holland: D. Reidel.

Matarazzo, J. D. ( 1983). The reliability of psychiatric and psychological

diagnosis. Clinical Psychology Review, 3, 103 - 145.

Matarazzo, J. D. (1990). Psychological assessment versus psychological

testing. American Psychologist, 45, 999-1017.

Matsumoto, D. (1994). People: Psychology from a cultural perspective.

Pacific Grove Cal.: Brooks/Cole.

Mercer, J. R. (1984). What is a racially and culturally nondiscriminatory test?

A sociological and pluralistic perspective. In C. R. Reynolds and R. T. Brown
(Eds.), Perspectives on bias in mental testing. (pp. 293 - 356). New York:
Plenum Press.

Prilleltensky, I. (1994). Psychology and social ethics. American

 41

Psychologist, 49, 966.

Reddy, P., Knowles, A., & Reddy S. (1995). Language issues in cross-
cultural testing. Australian Psychologist, 30, 27 -29.
Shweder, R. A. (1991). Thinking through cultures: Expeditions in cultural
psychology. Cambridge, MA: Cambridge University Press.

Smith, K. K. (1966). A validation of the Queensland Test. Bachelor of Arts

Honours Thesis. Brisbane: University of Queensland Library.

Smith, P. B., & Bond, M. H. (1993). Social psychology across cultures:

Analysis and perspectives. Hertfordshire: Harvester Wheatsheat.

Sue, D. W. (1990). Culture-specific strategies in counseling: A conceptual

framework. Professional Psychology: Research and Practice, 21, 424-433.

Sue, D. W., Bernier, J. E., Durran, A., Feinberg, L., Pedersen, P. B., Smith, E.
J., & Vasquez-Nuttail, E. (1982). Position paper: Cross-cultural counseling
competencies. The Counseling Psychologist, 10, 45-52.

Sue, D. W., & Sue, D. (1990). Counseling the culturally different. (2nd ed.)
New York: Wiley.

Tapp, J. L., Kelman, J. C. , Triandis, H. C., Wrightsman, L. S., & Coelho, G.V.
(1974). Continuing concerns in cross-cultural ethics: A report. International
Journal of Psychology, 9, 231-249.

About the Authors

Graham Davidson BA (Hons) PhD FAPS is Foundation Professor of

Psychology and Head of the School of Psychology and Sociology Department
at Central Queensland University, Australia. Some of his recent academic and
professional contributions are as follows:
1989 - 1996 Editor, Australian Psychologist
1993 - 1997 Chair, Central Queensland University Human Ethics Research
Review Panel
1995 - 1997 Director of Communications, Australian Psychological Society
1997 - 2000 Chair, Ethics Committee, Australian Psychological Society
Professor Davidson's primary teaching and research interests are in the
areas of Cross-Cultural Psychology, Developmental Psychology, Ethics and
Issues in Psychological Research and Practice. He has published more than
70 books, chapters or refereed articles, in addition to 25 reviews,
abstracts and bulletin pieces and 60 conference presentations. His
published work includes articles relating to assessment of Aboriginal and
Torres Strait Islander people, and reseach and professional ethics in
pluralistic settings.

Prasuna Reddy MA PhD holds the substantive position of Senior Lecturer in

 42

the School of Psychology at Swinburne University of Technology in Victoria,

Australia. For 5 years she was the coordinator of the Masters and Doctoral
degrees in Counselling Psychology in that School, and has been the Director
of the University's Psychology Clinic. She is registered as a specialist
supervisor in the area of counselling psychology and is currently Treasurer
of the APS College of Clinical Psychologists. She has conducted extensive
cross-cultural research into the nature of self and emotion. Dr Reddy is
currently on secondment to the National Centre for Gender and Cultural
Diversity at Swinburne University, but will soon take up a position as
Senior Lecturer in Psychology at the University of Melbourne, Australia.

Chapter 16: Group Dynamics and Diversity: The Interface of Gender,

Culture, and Ethnicity

Tamah Nakamura/ Japan

Cathy Collins/ United States

The interface of the multiple factors of gender, culture, and ethnicity has
received scant attention in group dynamics research literature. Issues of
race and ethnicity, and gender have been examined separately in the studies
of group work practices, but rarely from a multiple characteristic
perspective. Nonetheless, the interplay of these salient attributes
influences the dynamics of the group. The proposed chapter will chart new
territory through focus on the dynamics of group interaction at the
intersection of gender, culture, and ethnicity as they are played out among
group members with particular focus on the role of the leadership in those
dynamics. In addition, the chapter will suggest guidelines for intervention
and coping strategies as well as ideas for transforming group dynamics.
a group perception in an affective domain
The proposed chapter looks at racial/cultural/gender through social
dynamics in group processes from a theoretical base of social
constructionism. Constructionism views human interaction as a social process
of co-creating the world, therefore, the examination of gender, culture, and
ethnicity factors in the process of group interaction can reveal human relation
dynamics created in group collaboration. Both the group dynamics and role of
the leader in relation to and interaction with the group will be examined from
the perspective of a multifaceted theoretical framework. Pedersen's cross-
cultural counseling view of the positionality of the therapist, and Mindell's
group process work with power and individuality around processing core
issues will be interwoven with feminist theory (Tisdell, hooks). This also
foregrounds positionality and privilege of group leaders and members with the
specific aim of empowering the voice of the marginalized person by valuing
diversity.
Group processes and experiential learning through personal case studies
of the authors in two specific settings will inform the framework in a unique
comparative perspective. One setting is in Japanese academic
 43

administration. The demographic diversity factors examined will be Japanese

female leadership, Japanese male majority membership, and White American
female faculty member. The other setting is within the context of city
government in Little Rock, Arkansas. Specifically the case study will
examine the interaction between the White female Executive Director of the
Racial & Cultural Diversity Commission, the Black and White male leadership
within the city government and members of the Black and White community.
The juxtaposition of these diversity factors provides insight into the
complexity of relationships that emerge within a group. Outcomes include
exposition of power dynamics, positionality, prejudice, conflict, problem
solving and group work.

References

Aronson, Ellliot. (1999). The social animal (eighth edition). New York: Worth
Publishers.
Berger, P. & Luckmann, T. (1972). The social construction of reality. New
York: Doubleday.
Davis, L. & Proctor, E. (1989). Race, gender & class. New Jersey: Prentice
Hall.
Douvan, L. (1997). Sex and gender in social psychology. In Michael Gold and
Libby
Douvan (Eds.), A New Outline of Social Psychology (pp. 221-233).
Washington,
D.C.: American Psychological Association.
Gergen, K. (1999). An invitation to social constructionism. Thousand Oaks:
Sage.
Helms, J. (1993). Black and white racial identity: Theory, research and
practice.
Greenwood Publishing Co.
Gilligan, C. (1982). In a different voice: Psychological theory and women’s
development. Cambridge, MA.: Harvard University Press.
Goldberger, N., Tarule, J., Clinchy, B. & Belenky, M. (1996). Knowledge,
difference
and power. New York: Basic Books.
hooks, bell. (2000). Where we stand: Class matters. New York: Routledge.
hooks, bell. (2000). Feminist theory: From margin to center. South End Press.
Johnson, D. & Johnson, F. (2000). Joining together: Group theory and group
skills.
Boston: Allyn and Bacon.
Jones, J. M. (1997). Prejudice and racism, 2nd ed. New York: McGraw-Hill
Companies,
Inc.
Kondo, D. (1990). Crafting selves: Power, gender and discourses of identity in
a
Japanese workplace. Chicago: University of Chicago Press.
Lips, H. (1981). Women, men and the psychology of power. New Jersey:
Prentice Hall.
 44

Mindell, Arnold. (1995). Sitting in the fire: Large group transformation using
conflict and
diversity. Portland, Oregon: Lao Tse Press.
Ogasawara, Yuko. (1998). Office ladies and salaried men: Power, gender,
and work in
Japanese companies. University of California Press.
Pedersen, P. (1990). Handbook of cross-cultural counseling. Greenwood
Publishing Co.
Pearce, W.B. (1994). Interpersonal communication: Making social worlds.
New York:
HarperCollins College Publishers.
Ridley, C. (1995). Overcoming unintentional racism in counseling and therapy.
London:
Sage.
Steier, F. & Ostrenko, W. (2000). Taking cybernetics seriously at a science
center:
Reflection-in-interaction and second order organizational learning.
Cybernetics &
Human Knowing, 7, 47-69.
Sue, D. W., & Sue, D. (1998). Counseling the cross-culturally different. Wiley,
John &
Sons.
Taylor, J., Gilligan, C. & Sullivan, A. (1997). Between voice and silence:
Women and
girls, race and relationship. Cambridge, MA: Harvard University Press.
Tisdell, E. J. (1998). Poststructural feminist pedagogies: The possibilies and
limitations
of feminist emacipatory adult learning theory and practice. Adult Education
Quarterly,
48, 139-156.
Tisdell, E. J. & Perry, C. A collaborative inter-racial ‘border’ pedagogy in adult
multicultural education classes. In P. Armstrong, N. Miller, and M. Zukas
(Eds.) Crossing Borders, Proceedings of the 27th Annual SCUREA
Conference. London:
Birbeck College, University of London, July, 1997.
.

About the Authors

Tamah Nakamura is an Associate Professor in the Faculty of Human

Relations at Fukuoka Jo Gakuin University, Fukuoka, Japan. She teaches
intercultural communication, gender issues, and communication skills, and
facilitates two discussion groups in the community: gender issues for
Japanese women,and cross-cultural communication for non-Japanese
women. Her experience as an intercultural educator includes Korea,
Singapore, and the United States.She is currently working toward a doctoral
degree in human development.
Address: 750-91 Oaza Haru, Chikushino-shi, Fukuoka, 818-0005, Japan
E-mail: tamah@gol.com Tel: 81-(0)92-921-2572 Fax: 81-(0)92-921-5976
 45

Cathy Collins is the Executive Director of P.A.R.K. (Positive Atmosphere

Reaches Kids), providing at-risk youth with tutoring, recreation, and
community service. Previously, she was the first Executive Director of the
Racial & Cultural Diversity Commission for the City of Little Rock, Arkansas,
USA. Her commitment to racial equity and valuing of diversity was deepened
through her intercultural studies in Mali, India; Mexico, Guatemala, and Japan
as well as her living experience in Dakar, Senegal. Currently she is pursuing
her doctorate in Human and Organizational Systems with an emphasis on
diversity and anti-racism/sexism
Address: 321 South Martin, Little Rock, AR 72205/USA
Email: cathymartin@aristotle.net Tel: 501-661-023 Fax: 501-562-5877

Chapter 17: The road to multicultural sensitive student supervision

Nava Arkin Haifa University

Israel

Despite years of experience with mass immigration and cultural variability,

many social workers in Israel, remain “culturally encapsulated,” following
prescriptions for treatment from the dominant “Israeli” culture and,
downplaying, denying or rejecting the need for sensitivity. Nowhere is this
more salient than in the field of social work education and supervision. The
present paper focuses on the supervision of students from other cultures,
specifically from Ethiopia, and supervisors from the majority culture in Israel,
and explores the difficulties in the supervisory process from two approaches:
one that minimizes and the other that magnifies cultural differences. Clinical
examples and dilemmas are presented, and culturally sensitive ways of
working through these issues are suggested. Implications for training and
supervision are also discussed.

References

Batten, C. (1990). Dilemmas of cross-culture psychotherapy supervision.

British Journal of Psychotherapy, 7(2), 129-140.

Ben-David, A. (1996). Therapists' perception of multicultural assessment and

therapy with immigrant families. Journal of Family Therapy, 18(1), 23-41.

Ben-David, A. (1998). Teaching awareness of cultural pluralism: The Israeli

experience. Social Work Education, 17(1), 101-109.

Bernal , M.E., Barron, B.M., & Leary, C. (1983). Use of application material for
recruitment of ethnic minority student in psychology. Professional
Psychology: Research & Practice, 14, 817-829.
 46

Bernard, J.M. (1994). Multicultural supervision: A reaction to Leong and

Wagner, Cook, Priest and Fukuyama. Counselor Education and
Supervision, 34(2), 159-171.

Bernard, J.M., & Goodyear, R. (1992). Fundamental of clinical supervision.

Boston: Allyn & Bacon.

Black, J.E., Maki, M.T.,& Nunn, J.A. (1997). Does race affect social work
student – field instructors relationship. The clinical supervisor, 16(1), 39-
54.

Carney, C.G., & Kahn, K.B (1984). Building competencies for effective cross-
cultural counseling: A developmental view. The Counseling
Psychologist, 12(1), 111-119.

Christensen, C.P. (1989). Cross-cultural awareness development: A

conceptual model. Counselor Education and Supervision, 28, 270-287.

Cnaan, R.A., Goodfriend, T., & Neuman, E. (1996). Jewish ethnic needs in
multicultural social work education. Journal of Teaching in Social Work,
13(1/2), 157-174.

Cook, D.A. (1994). Racial identity in supervision. Counselor Education and

Supervision, 34(2), 132-141.

Davidson, L. (1987). Supervision of psychotherapy, East and West. American

Journal of Psychoanalysis, 47, 230-236.

Devore, W., & Schlesinger, E. (1987). Ethnic sensitive social work practice,
2nd ed. Colombus, OH: Merril.

Falicov, C.J. (1988). Learning to think culturally. In H.A. Liddle, D.C. Breunlin,
& R.C. Schuartz (Eds.), Handbook of family therapy training and
supervision (pp. .(335-357 New York: The Guilford Press.

Ford, K., & Jones, A. (1987). Student supervision – Basic practical social
work. London: MacMillan Education.

Fukuyama, M.A. (1990(. Taking a universal approach to multicultural

counseling. Counselor Education and Supervision, 30, 6-17.

Fukuyama, M.A. (1994). Critical incidents in multicultural counseling

supervision: A phenomenological approach to supervision research.
Counselor Education and Supervision, 34(2), 142-151.

Hardy, K. (1989). The theoretical myth of sameness. In G. Saba, K. Hardy, &

B. Karrer (Eds.), Treating minority families. New York: Haworth.

Harper, K.V., & Lantz, J. (1996). Cross-cultural practice: Social work with
diverse populations. Chicago, Ill.: Lyceum Books.
 47

Heppner, M.J., & O'Brien, K.M. (1994). Multicultural counselor training:

Students' perceptions of helpful and hindering event. Counselor
Education and Supervision, 34(2), 4-18.

Hilton, D.B., Russell, R.K., & Salmi, S.W. (1995). The effect of supervisors'
race and level of support on perception of supervision. Journal of
Counseling and Development, 73(5), 554-563.

Hoag, K.M.H., & Beckler, P.S. (1996). Educating for cultural competence in
generalist curriculum. Journal of Multicultural Social Work, 1(3), 37-56.

Holloway, E. L. (1997). Structures for analysis and teaching of supervision. In

C. E, Jr. Watkins (Ed..), Handbook of psychotherapy supervision (pp.
249 -276). New York: John Wiley & sons.

Ibrahim, F.A. (1991). Contribution of cultural worldview to generic counseling

and development. Journal of Counseling and Development, 70, 13-19.

Jaffe, E.D. (1995). Ethnic and minority groups in Israel: Challenges for social
work theory, value, and practice. Journal of Sociology and Social
Welfare, 22(1), 149-171.

Lago, C., & Thompson, J. (1997). The triangle with curved sides: Sensitivity to
issues of race and culture in supervision: In G. Shipton (Ed.),
Supervision of psychotherapy and counseling, making a place to think
(pp. 119-130). Philadelphia: Open University Press.

Leong, F.T.L. (1994). Emergence of the cultural dimension: The roles and
impact of culture on counseling supervision. Counselor Education and
Supervision, 34(2), 114-116.

Leong, F.T.L., & Kim, H.H.W. (1991). Going beyond cultural sensitivity on the
road to multiculturalism: Using the intercultural sensitizer as counselor
training tool. Journal of Counseling and Development, 70, 112-118.

Leong, F.T.L., & Wagner, N.S. (1994). Cross-cultural counseling supervision:

What do we know? What do we need to know? Counselor Education
and Supervi*sion, 34(2), 117-131.

Lopez, S. R. (1997). Cultural competence in psychotherapy: A guide for

clinicians and their supervisors. In C. E, Jr. Watkins, (Ed.),Handbook of
psychotherapy supervision (pp. 570-588). New York: John Wiley and
Sons.

McRae, M.B., & Johnson, Jr., S.D. (1991). Toward training for competence in
multicultural counselor education. Journal of Counseling and
Development, 70, 131-135.

Midgette, T.S., & Meggert, S.S. (1991). Multicultural counseling instruction:

A challenge for faculties in the 21st century. Journal of Counseling
.and development, 70, 136-141
 48

Newfeldt, S.A., Iversen, J.N ., & Juntumen, C.L. (1995).Supervision strategies

for the first practicum. Alexandria, VA: American Counseling Association.

Pedersen, P. (1991). Multiculturalism as a fourth force in counseling. Journal

of Counseling and Development, 70, 6-12.

Petterson, F.K. (1991). Issues of race and ethnicity in supervision:

Emphasizing on who you are and not what you know. The Clinical
Supervisor, 9(1), 15-31.

Priest, R. (1994). Minority supervisor and majority supervisee: Another

perspective of clinical reality. Counselor Education and Supervision,
34(2), 152-158.

Ryan, A.S., & Hendricks, C.O. (1989). Culture and communication:

Supervising the Asian and Hispanic social worker. The Clinical
Supervisor, 7(1), 27-40.

Solicido, R.M., Garcia, J.H., Cota, V., & Thomson, C. (1996). A cross-cultural
training model for field education. Arete, 20(1), 26-36.

Sue, D.W. (1991). A model for cultural diversity training. Journal of

Counseling and Development, 70, 99-105

Watson, M.F. (1993). Supervising the person of the therapist: Issues,

challenges and dilemmas. Contemporary Family Therapy, 15(1), 21-31.

About the Author

Nava Arkin, field coordinator and teacher, in school of Social Work at Haifa
University in Israel. The areas of teaching are, methods of psychosocial
intervention, and group psychotherapy. In addition, teacher of the Diploma in
Supervision course, and doctoral student. Involvement in training and
supervision of social workers and in developing programs of social work
education.

Mailing address: School of Social Work, Faculty of Social Welfare and Health
Studies. University of Haifa, Mount Carmel, Haifa, 31905, Israel.Email:
arkin@research.haifa.ac.ilPhone: 972-4-824-0368

Chapter 18: Culture, Authority, Gender in Sex Therapy: The Treatment

of Sexual Problems in Ireland

Yvonne Jacobson
Ireland
 49

Up until recently it has been a well-known and documented truth that the
Catholic Church owned and controlled people's sexuality in Ireland. This
power over adult and children's lives included seeing sex as dirty, sinful and
totally unacceptable outside of marriage and was dealt with as a subject by
being banned from spoken and written word as much as possible. The fact
that any contraception other than "natural" methods was also unacceptable
and unavailable further influenced the lack of control individuals and married
couples alike had over their sexual needs.
There are several unwanted consequences of the Church's domination over
people's sexual lives, not least the frequency of sexual problems between
couples. The Church's attitudes and beliefs unquestioningly imposed on its
members have contributed hugely to the guilt and shame that blocks ordinary,
desirable sexual behavior.
The demise of the Church's power over the last few decades, supported by
the secularization, increased affluence and modernization of Irish Society has
enabled those troubled by sexual problems to seek help, through the medical
profession and other, non-medical, health careers. Such help has been aided
by the valued findings of Masters and Johnson in the 1960's, and by the
inclusion in the 1980's of definitions of sexual disorders in the internationally
approved DSM-IV. More recently, the significant pharmacological
breakthrough of the anti-impotence drug Viagra, has enabled many to receive
help. It is perhaps no small irony that this magic pill is actually manufactured
in Ireland! At the same time, the Irish media have contributed to making sex
and sexual matters a common, every day subject.
And yet, it is possible that the opening up of sexuality just reveals the
enormity of the problem. Judging from the extent of on-going sexual
problems presenting to doctors and therapists today, the forces of tradition
are a worthy opponent to the normalization of sex, which is progressing slowly
in Irish society.
This chapter proposes to look at how the power and control of sexuality
has been passed from the Church into the hands of other experts - doctors,
scientists, pharmacologists and psychotherapists. It will be argued that these
specialists, while well meaning, have unfortunately and unwittingly taken over
this expert role. Encouraged and supported by the media, the dominant
discourse on sexuality in Ireland would erroneously suggest that people have
at last become empowered to trust their own sexual feelings and behavior.
This chapter proposes that empowerment is not occurring as long as sexuality
is now in the hands of a new brand of authority.
In this chapter, a brief historical description of the Irish construction of
sexuality will be presented. A substantial part of the chapter will discuss the
role of the medical and psychological health care profession in the "take-over"
of sexuality, and ways in which disempowerment of both genders occur. An
alternative to the expert stance is proposed flowing from a post-modern
analysis of power and authority. Narrative methods based on post-modern
thinking are described as an alternative to the medical model, one that returns
sexuality (perhaps for the first time) to those seeking help. This chapter will
describe how Narrative Therapy, by deconstructing the social and familial
origins of attitudes and beliefs, can empower people to find solutions and be
experts of their own lives. Case examples will be presented to demonstrate
 50

how a personal issue such as sexuality can be treated within a context of

sense of cultural consciousness.

References

Dallos S & Dallos R (1997) Couples, Sex and Power - The Politics of Desire,
Oxford University Press.
DSM-IV [Diagnostic & Statistical Manual of Mental Disorders - Fourth Edition]
(1995) American Psychiatric Association.
Freedman J & Combs, G (1996) NarrativeTherapy The Social Construction of
Preferred Realities, Norton, New York.
Inglis T (1998) Lessons in Irish Sexuality, University College Dublin Press.

About the Author

BA Hebrew University of Jerusalem.(1969 - 1972)

Higher Diploma in Education, Trinity College, Dublin. (1976-1977)
Diploma in Psychology, University College, Dublin. (1982 - 1984)
Certificate in Couple Counseling: Theory & Practice, Relate UK. (1984 - 1987)
Diploma in Psychosexual Therapy, Relate UK (1989 - 1991)
Full time Supervisor and Head of Research and Development
with Marriage & Relationship Counseling Services, 24 Grafton Street, Dublin
Position in this part Government-funded Voluntary Organization includes
supervision of trained and trainee counselors; provision of supervision for
external contracts, internal and external training; maintaining a client practice;
involvement in policy-making and management of the organization; co-
ordination of 3 year Research project (1999 - 2002) evaluating the
effectiveness of counseling; provision of annual statistics for Marriage &
Relationship Counseling Services' Annual Report.
I have trained in and worked for this organization since 1984, with a part-time
salaried post from 1993 - 1999 and a full-time post since October 1999.

Conclusion

Chapter 19: A Practitioner's Reflections on the Lives of Women in

Developing Countries: Some applications of conversations in Barbados,
Cuba, Brazil, South Africa, India, Kenya, and Malysia.

Claire Rabin
Tel Aviv University

This chapter presents interviews with men and women from developing
countries to investigate the way these women view their lives and themselves,
and the ways the ways they have found to create a sense of identity. Women
from South Africa, Kenya, Brazil, Cuba, Vietnam, India, and Barbados were
 51

interviews about issues that concern them. Most of them are mothers, many
are divorced, some are married. Almost all live in poverty, and only a few
have had a high school education. While most live in traditional and
patriarchal societies, many of these women have distanced themselves from
these patriarchal values and have curved out their own unique and
individualistic path within cultures moving between tradition and modernity.
These women tell stories of hopes, disappointments, and regrets as well as
challenges, struggles and hardships. These women tell of their attempts to
create personal identity within a social context that does not support women's
development. As such, these are stores of agency and identity in situations
and contexts of sexism, poverty and oppression.
This chapter will present the background context of third world women as an
introduction to their lives. It will then focus on the common themes found in
the interviews of the women and will discuss the ways these women from
different developing countries differ from each other. The chapter will look at
some of the implications of these life stories for the directions and
development of feminism worldwide and for those practitioners working with
women from developing countries. In addition, this chapter will demonstrate
the commonalities and differences of work with women from different
economic, social and ethnic backgrounds. The chapter will point to key
themes and issues that need to be dealt with in practice with women, such as
issues around financial independence, relationship with men, attitude toward
their children and families, relationship to their culture and ethnic group,
issues relating to dependency and conflict and their hopes for the future.

References

Bazilli, S. (Ed.), (1991). Putting women on the agenda. Ravan, Braamfontein.

Bennholdt-Thomsen, V. (1988). Why do housewives continue to be created in
the Third world too? In: V. Bennholdt-Thomsen, & G, Von Werlhof (Eds.),
Women: The last colony, (159-169). London: Zed.

Bisilliant, J., & Fieloux, M. (1987). Women of the Third World: Work and daily
life. Associated Univ. Press. Granbury, NJ.

Blumberg, R.L. (1991). Income under female Vs. male control: Hypotheses
from a theory of gender stratification and data from the third World. In: R.L.

Blumberg (Ed.), Gender, family and economy: The triple overlap. Newburry
Park, CA: Sage.

Bush, B. (1990). Slave women in Caribbean society. Kingston, Jamaica:

Heinemann: Indiana Univ. press.

Chant, S. (1997). Women-headed households. NY: St. Martin’s Press Inc.

Dallos, R., & Sapsford, R. (1995). Patterns of diversity and lived reality. In:
J.Munice, M. Wetherell, R. Dallos, & A Cochrane (Eds.), Understanding the
family. (pp. 70-125). London: sage.
 52

Edin, K. (2000). What do low-income single mothers say about marriage?

Social Problems, 47(1), 112-133.

Halebsky, S., & Kirk, J.M. (1990). Transformations and struggle: Cuba faces
the 1990’s. London: Praeger.

Hardey, M., & Crow, G. (1991). Introduction. In: M. Hardey, & G. Crow, (Eds.),
Lone Parenthood: Coping with constraints and making opportunities. (pp. 1-
18). Hemel Hempstead: Harvester Wheatsheaf.

Hill-Collin, P. (1997). The meaning of motherhood in black culture and black

mother-daughter relationships. In: M.B. Zinn, P. Honegneu-Sotelo & M.A.

Messner (Eds.), Through the prism of difference : Readings on sex and

gender. Boston: Allyn & Bacon.

Hoodfar, H. (1988). Household budgeting and financial management in a

lower-income Cairo neighborhood. In: D.Dwyer & J. bruce (Eds.), A home
divided: Women and income in the Third World. Stanford, CA: Stanford Univ.
press.

Hoschild, L. (1989). The second shift.

Kaplan, B. (1994). (Ed.), Changing by degrees? Equity issues in South

African tertiary education. Cape town: UCT Press.

Kibria, N. (1997). Culture, social class and income control in the lives of
women garment workers in Bangladesh. In: M.B. Zinn, P. Honegneu-Sotelo &
M.A. Messner (Eds.), Through the prism of difference : Readings on sex and
gender. Boston: Allyn & Bacon.

Luker, K. (1996). Dubious conceptions: The politics of teenage pregnancy.

Cambridge, MA: Harvard Univ. Press.

May, J., & Norton, A. (1997). “A difficult life” – The perception and experience
of poverty in South Africa. Social Indicators Research, 41, 95-118.

McCray, A.C. (1980). The black woman and family roles. In: L.Rogers-Rose
(Ed.), The black women. Beverly Hills, CA: Sage (67-78).

Momsen, J.H., (1996). Women and development in the Third World. NY:
Routledge.

Morrissey, M. (1989). Slave women in the Neo World: Gender stratification in

the Caribbean. Lawrence : Univ. of Kansas Press.

Seager, J., 7 Olson, A. (1986). Women in the world: An international reader.

NY:Simon & Schuster.
 53

Shapira-Berman, O. (2000). The Relations Between Assertiveness, Attitudes

Towards Equality and Equity and Marital Egalitarianism and Its Influence on
Marital Quality. Ph.D. Dissertation, Tel-Aviv University (Hebrew).

Sizoo, E. (Ed.), (1997). Women’s lifeworlds: Women’s narratives on shaping

their realities. NY:Routledge.

Slayter-Thomas, B., & Rocheleau, D. (1995). Gender, environment and

development in Kenya: A grassroots perspective. Boulder, CO: Lynne Renner
Pub.

Willson, W.J. (1996). When work disappears. NY: Alfred A Knopf.

Zinn, M.B., & Dill, B.T. 91997). Theorizing difference from multiracial
feminism. In: M.B. Zinn, P. Honegneu-Sotelo & M.A. Messner (Eds.), Through
the prism of difference : Readings on sex and gender. Boston: Allyn & Bacon.