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Multicultural Affairs

Considerations for School Psychologists Working With Arab American Children and Families

By Anisa N. Goforth

Ali, who is 7 years old, recently emigrated from Iraq during the war and does not consider himself “American.” He does not speak English fluently and teachers referred him to the school psychologist because he is acting out in his classroom, frequently yelling in Arabic. They are concerned that his behavior is affecting his peers and his learning. Zaynab, who is 16 years old, was born in Detroit and can speak both Arabic and English fluently. She wears the hijab (head covering) and is proud to be a Muslim American. She has both Arab and non-Arab friends. She has recently lost interest in activities, lacks appetite, and sleeps poorly. The school psychologist suspects that Zaynab is experiencing symptoms of depression, but Zaynab’s mother does not want her to seek counseling because of “what it will look like.” Moreover, the school psychologist is a male, and Zaynab’s mother does not feel comfortable providing Zaynab with a male counselor.

Ali and Zaynab are like the many Arab American youth in schools across the United States. Although their national backgrounds may differ, their similar cultural and linguistic backgrounds as Arab Americans present a unique context in which to provide school psychological services. There are an estimated three million Arab Americans in the United States, with 25% of the population under the age of 18 (Frisby & Reynolds, 2005). Given this significant population, it is likely that some school psychologists come across children from Arab backgrounds during their career. Many school psychologists, however, may not be aware of the unique cultural characteristics and needs that they must consider when providing culturally appropriate services.

The purpose of this article is to provide information about Arab American culture and traditions that school psychologists may take into account when providing assessment, consultation, and intervention services to Arab American youth and families. Developing the skills and knowledge necessary for working with specific minority populations, such as Arab Americans, is challenging because of the lack of available research or resources. School psychologists who encounter Arab American children and families in their practice may understand that they need to further their knowledge and skills in working with this population, but may not have adequate resources or information to provide culturally relevant services. There is limited discussion of Arab Americans in school psychology texts or research. Texts available to school psychologists on diverse populations (e.g., Frisby & Reynolds, 2005) include descriptions of various minority groups such as Latino or African Americans, but many do not include descriptions of Arab American groups. This lack of information may be partly because Arab Americans are a relatively small minority group in the United States and partly because there is generally not a significant research base regarding the provision of psychological services to Arab Americans.

Despite the limited research and information, recent social and political context in the United States suggests a need for information and understanding about Arab American children and their families. The “War on Terror” and the events and aftermath of September 11 have led to increased negative perceptions and acts of discrimination toward the Arab American community (Haddad, 2004). In a report by the Council of American–Islamic Relations, 135 cases of hate crimes occurred in 2007. Additionally, approximately one in four Americans believe that Islam is associated with hatred and violence (Council on American-Islamic Relations, 2006). Although most Arab Americans are Christian (U.S. Census Bureau, 2004), the negative association of the Arab world and Islam has led to increased discrimination against Arab Americans and Muslims.

These negative perceptions and acts of violence toward the Arab American community may pose an additional stress to its members. Moreover, many Arab Americans are also recent immigrants who may be experiencing acculturative stress. Mental health problems frequently arise during acculturation. Research suggests Arab Americans have higher rates of posttraumatic stress disorder (PTSD) compared to the general U.S. population (Rippy & Newman, 2006). These high rates of mental health problems may suggest an increased need for school psychologists to provide support and services. Additionally, surveys of Arab American youth suggest a high prevalence of psychological problems. Sulaiman (2008) found that among Arab American youth, 30% were diagnosed with anxiety disorder, 28% with attention deficit hyperactivity disorder, 24% with depressive disorder, 13% with oppositional defiant and conduct disorders, and 6% with adjustment disorders.

Mental health concerns as well as the national attention on the Arab American community suggest a need for a better understanding of the experiences of Arab Americans and ways to provide culturally appropriate school psychological services. First, a brief overview will be provided of the demographics and history of Arabs in the United States. One facet of cultural competence is to increase one’s knowledge of specific ethnic minority communities. Therefore, this article will provide a discussion of the unique characteristics and experiences of Arab Americans. Then, specific suggestions will be discussed about ways that school psychologists can consider cultural issues when providing services. The purpose of this overview is not to generalize Arab Americans; rather, it is intended to provide a basis from which school psychologists can provide culturally competent services to Arab American children and families.

Who Are Arab Americans? Americans of Arab descent are an ethnically and religiously diverse group. The term “Arab American” encompasses Americans who trace their roots to numerous countries in the Middle East and North Africa, including Lebanon, Iraq, Morocco, Palestine, Egypt, Syria, Yemen, Algeria, Bahrain, Comoros Islands, Djibouti, Kuwait, Libya, Oman, Qatar, Saudi Arabia, Tunisia, and the United Arab Emirates (de la Cruz & Brittingham, 2005). Although these nationalities are included in the term “Arab American,” there are significant differences in traditions, practices, beliefs, and values within this group.

People of Arab descent have been in the United States for more than a century and have experienced challenges similar to other immigrant groups. The first wave of immigrants from Arab countries arrived in the United States in the late 1800s, when immigrants were encouraged to assimilate to the Protestant culture and lose their “foreign” traditions (Huseby-Darvas, 1994). After the end of World War II, a second wave of immigrants arrived. The U.S. government had been interested in the oil fields in the Arab world, and encouraged young Arabs to attend American universities in the hope that they would return to their home country and support American interests (Haddad, 2004). The Asia Exclusion Act of 1965 was revoked and this led to a dramatic increase in the number of highly educated, professional immigrants (Haddad, 2004). Indeed, currently 85% of Arab Americans have at least a high school diploma, and 40% have a bachelor’s degree or higher (Arab American Institute, 2002).

There is diversity of religious beliefs among Arab Americans. According to the Arab American Institute (2002), the majority of Arab Americans are Christian. Specifically, 35% are Roman/Eastern Catholic, followed by Muslim (24%), Eastern Orthodox (18%), Protestant (10%), or other religions or no affiliations (13%). The public perception that Arab Americans are mainly Muslim may suggest a misunderstanding of this population. Nonetheless, because of the large percentage of Muslims in the Arab world, the cultural traditions and practices associated with Islam are also held by Christian Arabs. Religion and culture are intertwined in the Arab world. For example, many Christian Arab women may wear the hijab, which is emphasized in Islamic traditions to maintain modesty.

In summary, Arab Americans are culturally, religiously, and racially diverse. Although there are differences among Arab American communities in terms of specific customs, traditions, and values, there is a great deal of commonality in that Arab Americans have distinct traditions and practices that differ from other ethnic communities in the United States.

Cultural Considerations in Service Delivery Cultural competence is an important component in the provision of school psychological services for Arab American youth and their families. Both NASP and APA emphasize cultural competence within professional standards of practice (e.g., APA Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists; American Psychological Association, 2003). In school psychology, cultural competence is not only an additional skill that psychologists must master, but it should be integrated within all aspects of practice (Ortiz, Flanagan, & Dynda, 2008). Indeed, cultural competence is considered one of the four domains of practice, as delineated in the School Psychology: Blueprint for Training and Practice III (Ysseldyke et al., 2006).

Culturally competent service delivery includes three major components: awareness, knowledge, and skills (Sue, 2001; Sue et al., 1982; Sue, 2006). First, psychologists should be aware of, and sensitive to, their own values and biases and how these biases may influence perceptions of the client, the client’s problem, and the working relationship (Sue, 2006). Second, psychologists should develop cultural knowledge, which includes an understanding of the sociopolitical context within which the client is nested, sensitivity to different styles of communication, and knowledge of minority family structures and indigenous practices (Sue, 2006). Finally, cultural competence includes the ability to provide psychological services (e.g., consultation, assessment, and intervention) in culturally sensitive and culturally relevant ways. Developing cultural competence may include providing a variety of verbal and nonverbal responses to the client or providing help that may not follow the Western style of help-giving, such as utilizing religious or community leaders for supporting the client (Sue, 2006).

Considerations for Arab Americans. In this section, specific strategies and recommendations are provided for school psychologists who may work with Arab American children and families. As noted earlier, there are many within-group differences among Arab Americans. While the following suggestions are meant to guide school psychologists in the provision of culturally appropriate services, it is important that school psychologists take time to learn about each child and his/her family, and the context of the surrounding community.

Arab culture can be described as collective, in which the individual is embedded within a patriarchal family context (Hammad, Kysia, Rabah, Hassoun, & Connelly, 1999). An individual’s economic and social status is highly connected with the family’s status, and decisions are made with all members in mind. Family honor and avoidance of shame are central in the Arab American culture. Family obligation, or filial piety, is the sense of duty, respect, and deference to the family (Fuligni, Tseng, & Lam, 1999). An individual’s actions or decisions not only affect the individual, but also affect the entire family (Hammad et al., 1999). For example, when a child is disruptive in school, his or her actions reflect upon and bring shame to the entire family.

As a result, family involvement is particularly important when working with Arab American families (Erickson & Al-Timimi, 2001). When an Arab American child is referred to a problem-solving team for difficulties in school, school psychologists should especially consider involving the family throughout the assessment and intervention process. Including the family in all decisions will be important not only to help family members feel that their honor is maintained, but also to promote acceptability of the assessment or interventions.

Furthermore, with an understanding of the importance of family honor, school psychologists may need to emphasize more than usual that all information regarding the child and family is confidential. Because of the sense of shame related to the child’s behavior, the family may not quickly or honestly share personal problems (Al- Krenawi & Graham, 2000). Moreover, there may be stigma associated with receiving mental health services (Soheilian & Inman, 2009). Arab Americans, as a result, may choose not to reveal personal problems or not engage in help-seeking.

Given the significance of maintaining family honor and the stigma surrounding mental health problems, school psychologists should take a great deal of time to meet with the family during initial stages of assessment. Involving the family early in the process and providing many opportunities to develop trust and rapport will be essential in facilitating the provision of services. During the assessment stage, school psychologists can discuss their concerns and reinforce that all school professionals will maintain confidentiality. Moreover, school psychologists should use a multisystem, collectivist approach when gathering information during the assessment process (Nassar-McMillan & Hakim-Larson, 2003). When conducting interviews, for example, both the immediate and extended family can be invited to the meeting. During the interviews, school psychologists could gather various kinds of information, including levels of acculturation, educational and child-care practices in their home country, and immigration history. The family’s immigration history may be important because some Arab American families are refugees from war, such as those from Kuwait, Iraq, or Iran. Questions during the interview can determine whether the child or other family members experienced physical or emotional stress (Nassar-McMillan & Hakim-Larson, 2003).

During the assessment process, it may also be important to gather information about the child’s English language proficiency. Understanding issues related to the process of second-language acquisition as well as the implications of being an English language learner (Rhodes, Ochoa, & Ortiz, 2005) may be applicable for understanding academic difficulties among Arab American youth. Some Arab American children may speak only Arabic in the home, whereas others speak both English and Arabic. During the initial interview with parents, it is important to ask questions about the degree to which the child speaks English at home. Additionally, depending on the child’s age and when the child arrived in the United States, it is important to understand the child’s ability to write in Arabic. There are variants of Arabic language—there is a standard Arabic that is typically used in writing and by the media, and a colloquial Arabic that is considered the everyday spoken language. If a child is having difficulties in school related to reading or writing, it may be useful to discuss with the parents the child’s current Arabic speaking and writing abilities to gather more data about the child’s learning difficulties in his or her native language.

In addition to the importance of family, another aspect of Arab culture that may have implications for service delivery is the importance of religion. Among Arab Americans, there is a strong association between religion and mental health (Amer & Hovey, 2005). Religious practices, values, and beliefs are part of every aspect of the Arab American community, including child rearing, education, and relationships with others (Ajrouch, 2000). For example, if an individual experiences mental illness, Arab Americans may perceive that individual as “touched by demons (jinn) or that God is punishing him” (Hammad et al., 1999, p. 18). Traditionally, religious leaders are sought to intervene for personal or mental health concerns. If a family is having difficulties with their children’s behavioral or emotional issues, the family may seek help from a religious leader, such as an imam (Abu-Ras, Gheith, & Cournos, 2008).

School psychologists should consider religion when providing services to Arab Americans. For example, school psychologists could include cultural consultants, such as religious leaders or other respected members of the Arab American community, when providing services (Nassar-McMillan & Hakim-Larson, 2003). Including cultural consultants may facilitate rapport and trust with the family, and may help encourage Arab American families to seek mental health support. Another way to consider religion is during the assessment stage, when school psychologists may consider conducting a religious history (Chaleby, 1992). Religion is often infused in Arab American ethnic and cultural identities, especially for Muslim Arab Americans. Identifying oneself as Muslim has strong implications for psychological adjustment. Research indicates, for example, that Muslims who endorse higher intrinsic religiosity have better overall mental health (Amer & Hovey, 2005). This information will be useful in understanding how the family practices its religion and whether religion plays a role in the child’s presenting problem.

Gender is also important to consider when providing services to Arab Americans. Traditionally, there are different expectations for females and males in Arab culture. Girls may be expected to stay at home whereas the boys are to seek secondary education and jobs (Gregg, 2005). Girls and boys are expected to be physically separate and only have interactions if they are members of the same family. Moreover, many Arab families are patriarchal, in which the father makes all major decisions for the family. When working with Arab American families, school psychologists should consider addressing the father during family meetings. School psychologists should not try to change the power hierarchy in the family, as this could damage rapport (Al-Krenawi & Graham, 2000). Additionally, school psychologists should be aware that being the opposite gender to the client may present some difficulties (Al-Krenawi & Graham). If the referred child is female and the school psychologist is male, for example, maintaining certain gender boundaries will be necessary. Al-Kranawi and Graham suggest using certain “culturally appropriate techniques as referring to the client as ‘my sister,’ maintaining minimal eye contact and appropriate physical distance between client and worker, and integrating the family in many, if not all, stages of treatment” (p. 13). This boundary may be especially important if the client is an adolescent or young adult. If possible, it may be more culturally appropriate to seek a colleague of the same gender to provide services.

Finally, school psychologists should consider the unique Arab American cultural values when providing counseling or therapy. Unfortunately, there is a lack of research examining whether Western-style counseling or therapy is effective with Arab Americans (Erickson & Al-Timimi, 2001). Nevertheless, research reviews have suggested that considering the culture of Arab American clients is important when providing counseling. For example, information gathered during assessment will help inform the extent to which religion or other cultural factors play a role in the presenting problem. Establishing rapport early with the child and his or her family will also be essential when providing counseling (Nassar-McMillan & Hakim-Larson, 2003). Rather than using the typical Western insight-oriented approach to therapy, counseling may be more effective in the context of developing a therapeutic relationship within a “benevolent authority role” (Nassar-McMillan & Hakim-Larson). In other words, rather than focusing on the client’s beliefs about the self, the school psychologist may be more effective if developing a caring yet hierarchical relationship with the client. Erikson and Timimi (2001) suggest that instead of focusing on the child’s individuation from the family as the goal for treatment, counselors should focus on understanding the child’s treatment needs in the context of interactions within the family.

Developing Arab American cultural competence is important given the current social and political context and the increasing need to meet the needs of this underrepresented group. Therefore, when providing school services to Arab American children and their families, school psychologists should consider the importance of family honor, the culture-based stigma related to mental health services, the role of religion, and gender expectations. Understanding Arab American culture and the unique factors that affect service delivery will help school psychologists provide more culturally appropriate services to children like Ali and Zaynab.

Resources

The Arab American Institute (http://www.aaiusa .org/pages/arab-americans)

Haboush, K. L. (2007). Working with Arab American families: Culturally competent practice for school psychologists. Psychology in the Schools, 44, 183–198.

Jones, J. M. (2009). The psychology of multiculturalism in the schools: A primer for practice, training, and research. Bethesda, MD: National Association of School Psychologists.

Nassar-McMillan, S., Choudhuri, D. D., & Santiago- Rivera, A. (2010). Counseling & diversity: Arab Americans. Belmont, CA: Wadsworth Publishing.

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