This paper explores the exceptional intercultural encounter between secular therapists and Ultra-Orthodox Jews in Israel, focusing on two key aspects. Firstly, it explores the distinctive attributes and conflicts inherent in treating Ultra-Orthodox individuals. On the one hand is the secular Israeli therapist, whose base is in Western philosophy that prioritizes individuality, cultural diversity, and tolerance of differences. On the other hand is the Haredi client, entrenched in values from Jewish tradition and religious principles that amplify solidarity and collectivism while rejecting prevalent secular culture. The existing socio-political climate in Israel often positions these two as potentially conflicting cultures. Secondly, the paper seeks to illuminate the uncommon dynamics of the minority-majority power balance within the therapeutic relationship. In contrast to prevalent literature in intercultural therapy, which typically frames the client as a representative of a disadvantaged minority and the therapist as a representative of a dominant majority, this article aims to unravel a nuanced power balance, where those in the minority perceive the dominant culture both as a threat to its way of life and as a despised entity, but paradoxically rely entirely on its financial support. This reveals a complex and intricate interplay of dominance and dependence, shaping a therapeutic relationship that defies conventional expectations.

Relationship between the therapeutic alliance, clients' reactions to artistic work and outcomes of arts therapies with ultra-orthodox 4–15 year olds

ABSTRACT Background: Compared to the general German population, refugees in Germany are a high-risk group for trauma spectrum disorders. Currently, many barriers exist for the implementation of a screen-and-treat approach for mental disorders as part of the routine health care provision during the early stage of the immigration process. Objective: The aim of the present study was to develop and test a systematic screening approach to identify individual refugees in need of mental health care during the initial immigration phase. Method: 167 newly arrived refugees underwent a screening interview with the Refugee Health Screener (RHS) carried out by Intercultural Therapy Assistants (ITAs). The ITAs were super­vised by psychologists at a reception centre in Bielefeld, Germany. A subsample of 48 persons partici­pated in clinical validation interviews. Results: Findings demonstrated the need for and feasibility of a systematic screening during the initial immigration phase. However, established cut-off values of the RHS had to be adapted and the screening procedure had to be adjusted due to the needs of a significant number of refugees in severe psychological crises. Conclusion: A systematic screening that is applied shortly after arrival facilitates the early identification of refugees at risk of developing mental disorders and may be helpful to prevent chronic symptom development and an aggravation of psychological crises.

In this reflection the author makes connections between the themes of the special issue and an early series of seminars held at the Freud Museum London, in 1992, ‘Psychotherapy Black and White’, organized in cooperation with the intercultural therapy centre Nafsiyat. These seminars were invested in the social mission of psychoanalysis, and were intended not only for psychotherapists but for social workers, counsellors, psychiatrists, probation officers, community health workers, teachers and others. The author reflects on psychotherapy as an ecosystem and on the issue of the ‘boundaries’ of psychoanalysis: when they are excessively policed, this limits the domain of psychoanalytic knowledge, including by undermining the legitimacy of social clinics.

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents’ sense of responsibility for their child’s religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents’ experiences in therapy; (2) The parents’ perceptions of the child’s experiences in therapy; (3) Implications of environmental-social factors on the parents’ perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents’ challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents’ preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children.

Globally, nearly 80 million people are forcibly displaced. Being a refugee can impact one’s mental health profoundly. Although specific approaches for psychotherapy with refugees have been developed, this study is the first to investigate psychotherapy with refugees in Brazil. Semi-structured interviews were conducted with 18 psychotherapists in Brazil and analysed using consensual qualitative research and thematic analysis. Supportive and hindering elements in psychotherapy with refugee patients in Brazil were identified at eight different levels: the patient, the therapist, their relationship, the setting, the psychotherapeutic approach, the context of the patient, the context of the therapist and the societal context in Brazil. Hindering elements in the therapy include missing preparation for the integration of refugees, lack of interpreters, patients’ mistrust and therapists feeling untrained, helpless and becoming overinvolved. Supportive elements include a trusting therapeutic relationship, therapists’ cultural humility and structural competence, patients’ societal inclusion as well as working with groups and networks. This study shows that in light of the enormous structural challenges for the mental wellbeing of refugee patients, therapists’ flexibility and the reliance on collective work and networks of support is crucial. Future research might investigate in more detail notions of collectivity-based mental healthcare in intercultural therapy settings.

Annex: CPD training in Intercultural Therapy, Mindfulness & Psychotherapy Workshops

An autoethnographic approach critically analyzes personal experiences to aid understanding of cultural experiences. This written account shares the experiences of a young white Afrikaner art therapist within South Africa, a country that is culturally diverse and has a history of racial oppression. In this article, the author explores how multiple identities intersect and interact in an intercultural art therapy encounter by engaging in critical self-reflection and reflexive practices demonstrated in writing a mixture of autobiography and ethnography. This article emphasizes the importance of South Africa's historical and social contexts as well as sociocultural theories to help deepen and widen art therapists' lenses with which they see their clients and themselves.

Working with a family from a cultural background other than one's own is considered to be challenging for the therapist. Influenced by social constructionism, the family therapy field highlights the importance of contingency and cultural differences and therapists are encouraged to develop their cultural competency in order to deal with these differences. In this article, starting from contemporary critiques of notions of Western societies' cultural diversity, we address the way in which the cultural competency framework, by highlighting the importance of cultural differences and the therapist's culture‐specific knowledge, may underestimate the importance of the social dimensions of the issues involved. Furthermore, highlighting cultural differences may obscure the shared humanity present in a transcultural encounter. In this article, as an alternative to the cultural competency framework, we propose a view of intercultural family therapy in which the unresolvable dialectical tension between differences and universalities is central.Practitioner points The article addresses the challenge of working with families from diverse cultural backgrounds. The traditional framework of cultural competence is critically reviewed. Family therapists should not only be open for cultural differences, but also for universalities and especially for the never‐ending tension between differences and universalities.

In this work the authors aim to present a case study of intercultural therapy undertaken during a hospitalisation. Starting from a view of comprehension and de-centralisation of one's own cultural points of reference, typical of the complementarist method theorised by Georges Devereux, it highlights the relevance of the patient's own theories concerning their suffering during the course of psychiatric treatment. The effort of the therapists in this context is to return to each migrant their own history and to reinstate their own specific life context, avoiding the attempt to fix the patient's definition within nosographic categories or rigid models based on a priori assumptions. In this sense, the methodology employed by the ethno-therapist is not only suitable for patients belonging to cultures distant from ours, but it also becomes applicable for those who are local whenever, during the course of a therapy, specific cultural elements might emerge.

The verbalization of feelings plays an important role as a component in music therapy. People show culture-specific ways of dealing with the expression of emotions. The theoretical section of this article focuses on the connection between culture and emotional expression. Based on the results of a survey of two hundred persons questioned on the qualities of emotions and descriptions when listening to music, the universality of these emotional qualities evoked by the music and culture-specific differences in emotional expression are shown in this work by means of test groups from Japan and Austria. In summary the potential of music therapy as an intercultural therapy method is examined.

The therapist's capacity to imagine is one specific part of the endeavour of empathy which lies at the heart of the processes of the therapeutic relationship. This article offers beginning ideas about the significance of therapist's imagination of self in relation to her/his clients in the task of trying to understand their experience. In seeking to ‘understand’ the experience of others, the therapist is able to move between an imagination of sameness/identification with the client/s, and an imagination of difference/‘foreignness’. The family therapy orientation of curiosity and ‘not‐knowing’ relies on the imagination of self as different to our clients; more traditional understandings of empathic connection rely more heavily on the imagination of sameness/identification with clients. This article argues that flexibility in the therapist's use of self in moving between these positions allows an expanded capacity for therapeutic connectedness. These ideas have special valence in the practice territories of impasse and intercultural therapy.

The assumption that such a delicate practice as therapy is universal is a fault belonging to the past. The universality of therapy has been questioned for a long time without any consistent or final answer. The biggest contribution of Anthropology to therapy has been to open up new approaches to and points of view about therapy. Therefore the problems linked to assumptions about therapy’s universality have been overcome partially through the analysis and the understanding of differences and peculiarities of cultures. Ethnopsychoanalysis and Intercultural Therapy are two approaches to therapy that have been developed in response to the Anthropological critique and its identification of cultural variance. They both give effect to Littlewood’s suggestion (1990), which was developed in his article that promoted the rise of a new cross-cultural psychiatry: According to Littlewood, ‘we need to take into account the whole context of a particular experience and its personal meaning even if it leads us to such areas as local politics or social structure’. Each of the new therapies referred to above give effect to Littlewood’s suggestion in different ways. On the one hand, Intercultural Therapy, starting from the Western traditional theories, has been modeled on other cultures; on the other hand, Ethnopsychiatry has been based on traditional therapy belonging to non-Western cultures, with some help from psychoanalytic theories. Both these therapies are an attempt to overcome the problems caused by the assumption of universality. A question still remains: is this effort just another way to make therapy fit into non-Western cultures? Is this effort simply another way to ‘possess’ cultures?

Effective intercultural psychotherapy generally has been conceptualized in terms of a specific knowledge and skills base, combined with relevant attention to the practitioner's cultural attitudes and beliefs. Although such an approach continues to be the gold standard in the field, it has yet to be demonstrated that these components are either necessary or sufficient for effective treatment. This paper presents an approach to intercultural therapy based on Gadamer's philosophical hermeneutics. Humans are always in the process of making sense of the world around them, a process which is predicated on culturally given preunderstandings. Cultural difference means that the preunderstandings are rarely mutual, and therefore, communication and psychotherapy are often problematic. These preunderstandings often show up in the form of racial and ethnic prejudice and the therapist is rarely aware of this. Therapist preunderstanding influences all aspects of the psychotherapy process, such as treatment planning, interventions chosen, and the therapeutic relationship. Recommendations are given for improving the intercultural therapy process, and draw strongly on the twin notions of the dialogical relationship and cultural imagination.

SUMMARY Interethnic and interracial marriages of Latinos and White Americans are on the rise and will continue to reshape the identities of individuals, couples, families, and communities. Clinicians working with these intercultural couples find no systematic training to address what is becoming a significant segment of our society. Couple therapists, however, cannot be culturally competent and effective based solely on knowledge of some dimensions of a couple's cultural backgrounds. Using clinical and theoretical ideas, the author defines clinical work with these couples as an explicit intercultural exchange. Our task as clinicians requires a rethinking of our conversations with these couples. It involves a caring therapeutic approach that is sustained on relational and systemic levels, and intercultural conversational skills inspired by clinical and other literatures that are explicitly dedicated to work with cultural difference and the “other.”

Abstract This article questions some of the assumptions which seem to be implicit in discussion about intercultural psychotherapy. It questions the kind of language used in such discussions, as well as the assumed centrality of racial or ethnic difference in the therapeutic encounter. It argues for a different approach to notions of ‘difference’ in psychotherapy and counselling.

Intercultural therapy: Themes, interpretations and practice

Intercultural Therapy: Themes, Interpretation and Practice. Edited by J. Kareem and R. Littlewood. (Pp. 257; £18.99.) Blackwell Scientific Publications: Oxford. 1992.

Book Reviews In this Article Intercultural Therapy: themes, interpretations and practice Mental Handicap and the Human Condition:new approaches from the TavistockThe Claustrum:an investigation of claustrophobic phenomenaLove of Beginnings by J B Pontalis. PublishedA Psychology for Living:personal construct theory for professionals and clientsMemorial Candles:children of the HolocaustShared Experience:the psychoanalyticThe Psychoanalytic Theory of Greek Tragedy

Abstract Adolescence is a difficult time for most children, but even more complex for the adolescents coming from immigrant families. Immigrant is a vague, broad concept and is difficult to define. Not all immigrants experience financial, psychological and social adjustment in the same way. In this paper it refers to the ones who experience ‘cultural misunderstanding’ characterized by social isolation, social confusion and deep general uncertainty. The paper focuses on some of the general aspects of the lack of appropriate support that the offspring of immigrant parents experience. A brief outline is given to show the attempt made by the Intercultural Therapy Centre (NAFSIYAT) to provide a transcultural therapeutic milieu for the adolescents from immigrant parents.