Culturally Oriented Psychotherapy with Refugees
Fred Bemak and Rita Chi-Ying Chung
George Mason University
The United Nations (1995) has estimated that 70 to 100 million persons in the world today are displaced as a result of widespread political instability, regional and national conflicts, war, genocide, social and economic upheaval, poverty, natural disasters, deportation, and population increases. It should be noted that there is a distinction between displaced persons with regards to "forced" or "free" migration (Murphy, 1977) whereby refugees are involuntarily forced to relocate, while immigrants voluntarily choose to leave their communities or countries. Refugees consist of more than 26 million people worldwide (Balian, 1997). Despite growing numbers of refugees, many countries are increasingly reluctant to resettle them, resulting in governments more rigidly interpreting the 1951 United Nations Convention governing the determination of refugee status (Jupp,1994).
The international dilemma is exemplified in Great Britain, where recently there has been a controversy over what constitutes refugee status. The British government has defined refugees as victims of war, excluding those suffering from economic hardship due to war, national and state conflict, and natural disasters, which is the present plight of many of the refugees. The result of this has been national debate about who is a refugee and therefore admissible to Great Britain under these terms. One serious aspect of this debate is the neglect of victims of other war atrocities, such as the widespread repeated rape of women and girls who currently do not, but could, fall into this category. The repercussion of the narrow and rigid definition of refugee status is that refugees, who are already in a vulnerable position, may experience retraumatization due to the difficulties and stringent regulations that many are subjected to in entering developed or Western countries (Baker, 1992; Cox & Amelsvoort, 1994).
Similar to the British controversy over refugee status, the ongoing international debates regarding refugees are timely given the 35 current ongoing international conflicts and 118 countries currently involved in the resettlement of refugees. With the current status of geopolitical conflict and ongoing natural disasters, it is anticipated that there will be a continuation of the displacement of refugees emigrating to other countries. Western countries like the United States, which already have almost 10 percent of the population from refugee backgrounds (Balian, 1997), may again reexamine policy and practice. Given these realities and the growing number of refugees in the United States and other resettlement countries, this chapter focuses on specific issues encountered by refugees once in the resettlement countries, an examination of refugee mental health, and a discussion on culturally responsive psychotherapy.