Culturally Sensitive Social Work Practice with Arab Clients in Mental Health Settings
Al-Krenawi, Alean, Graham, John R., Health and Social Work
Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.
Ethnic Arab peoples have one of the world's highest rates of population increase. There are 255 million people in 21 Arab countries in North Africa and the Middle East, and they constitute a significant and growing population in such Western countries as Australia (210,000), Canada (80,000), France (2 million), Britain (210,000), and the United States (700,000), as well as Israel (1 million). (Al-Boustani & Farques, 1991; Al-Krenawi & Graham, 1998; UNESCO, 1996). A notable proportion of Arab peoples are Muslim, and Islam is the world's second most practiced religion, with one of the highest increases in the number of practitioners. Today there are an estimated 6 million Muslims in the United States, and nearly 15 percent are people of Arab ethnic origin (Newsweek, 1998). Despite Arab peoples' presence in the West and East, there has been little published social work practice research to date related to this population.
Researchers in social work (Al-Krenawi & Graham, 1996a, 1996b, 1997a, 1997b; Al-Krenawi, Graham, & Al-Krenawi, 1997; Lum, 1992; Mass & Al-Krenawi, 1994) and allied disciplines (Al-Issa, 1995; Bilu & Witztum, 1995; Budman, Lipson, & Meleis, 1992) have differentiated among the knowledge and skills necessary to respond to the ethnic and racial diversity of people who may need mental health and social services. The literature provides insight into mental health practice with families of various ethnic origins, among them African (Franklin, Sarr, Gueye, & Sylla, 1996), African American (Ahia, 1997; Baker, 1994; Kendall, 1996; Logan, 1996), Asian American (Lorenzo, 1988), Chinese (Bentelspacher, DeSilva, Goh, & LaRowe, 1996; Lai, 1995; Pearson, 1996; Pearson & Phillips, 1994; Shek, 1996; Wang, 1994; Xiong et al., 1994), Greek (Madianos, GefouMadianou, & Costas, 1993), Italian (Fandetti & Gelfand, 1978), Japanese American (Hsu, Tseng, Ashton, & McDermott, 1983), Korean (Hurh & Kim, 1994), ), Latino (De Snyder, Diaz -Perez, Maldonado, & Bautista, 1998), Maori (Chaplow, Chaplow, & Maniapoto, 1993), Native American (Angell, 1997; Trimble, 1990), and Vietnamese (Phan, 1997). However, a great deal remains unknown, because multicultural social work is a heterogeneous and multifaceted phenomenon. Also, many ethnic groups, such as Arab peoples, have not received comparable scrutiny by academic researchers.
Because the topic of social work practice with Arab peoples is complex and because the literature disparate, the present article concentrates on one field of intervention, mental health practice. Future research should analyze other fields such as addictions, child welfare, or gerontology. Presented here is an overview of major practice intervention guidelines resulting from the integration of recent interdisciplinary research (Abudabbeh & Nydell, 1993; Al-Krenawi, 1996; Al-Krenawi & Graham, 1997b, 1997c; Al-Krenawi et al., 1997; Jackson, 1997; Katchadourian, 1974; Qouta, Punamaki, & El-Sarraj, 1995; Savaya & Malkinson, 1997; Timmi, 1995). Although we recognize the diverse aspects of ethnic Arab life, as well as its presence in virtually all countries, the article emphasizes principles of mental health practice that have common and transnational applications. …