It is a common belief that clients seek counseling to begin or continue change. In the case of recent immigrants, change is a significant, ongoing process. Deciding to leave one’s home country to make a new life somewhere else requires considerable bravery and faith that the future will be as good, if not better, in another place. But the enormous demands of such a transition often exceed even the most realistic expectations. I have friends who, upon visiting the United States for the first time, were awed by the openness and freedom of American culture but simultaneously startled by the traffic, grit and destitution they observed.

This is supposed to be the land of opportunity, but for many who live here, life is still very, very hard. The new immigrant will not only witness such disheartening scenes, but may, in fact, be living them out on a daily basis — a circumstance that can produce considerable disillusionment and regret. It is important for culturally sensitive counselors to recognize and validate the immigrant client’s culture shock and efforts to persevere in the face of these challenges and disappointments.

New arrivals to the United States often endure a considerable amount of psychosocial upheaval as they struggle to adapt to a new culture, language (possibly), social structure and financial reality. Their economic circumstances substantially impact such transitions. Individuals or families with adequate, stable incomes are likely to find such adjustments less difficult than those with minimal funds. Having the time and resources to maintain connections with significant others, either in the new community or back home, and the ability to access needed or desired products, such as traditional food items, can also affect the ease with which they adjust to their new environment.

Being unable to communicate in English is socially isolating and limits employment opportunities. Even immigrants who are verbally fluent and functionally literate may be puzzled by regional language patterns and colloquialisms, contributing to their sense of being out of sync with others. Dining and sleeping, activities that, depending on the immigrant’s culture, might previously have taken place on the floor, now involve tables and beds. Holiday customs, such as the exchanging of Christmas gifts, may be unfamiliar. Moreover, any obvious differences in speech or appearance can make these individuals vulnerable to unusual scrutiny or prejudicial treatment. For instance, during the sniper attacks that took place in the Washington, D.C., metro area in 2002, police stopped one of my students who was traveling in a vehicle similar to the one reportedly driven by the suspects and subjected him to particularly close examination because he was Turkish.

Political refugees and asylum seekers confront challenges of an entirely different order of magnitude. At best, they face the prospect of indefinite separation from family members who were unable to accompany them. At worst, they have witnessed the killings of loved ones or been tortured or maimed themselves. Survivors endure tremendous emotional losses, in addition to post-traumatic stress, and may require treatment for physical as well as psychic wounds. (The Center for Victims of Torture provides resources for survivors and clinicians through its websites: and

Although recent immigrants are subject to a myriad of stressors, counseling is unlikely to be the first resource to which these individuals ordinarily turn. Generally, family members form their most important support system. The immigration process itself has likely strained these relationships, however, either due to increased physical distance from loved ones or because relatives who immigrate together frequently adapt to the new culture at different rates and to varying degrees. When separated from one’s biological family, the larger circle of those with shared heritage and experiences may become an important substitute. Comfort might be derived from common religious observances or mere proximity to others who speak the same dialect.

Once an immigrant client does present for counseling, it is important to explore the circumstances leading up to this event. Although some of these clients come voluntarily, others may be mandated by the court to attend counseling. In the latter case, domestic relations or child-rearing practices are sometimes significantly different in the client’s country of origin, and the individual might not have a clear understanding of why his or her accustomed behaviors are not accepted in the new locale. Counselors may need to spend a substantial amount of time familiarizing these clients with American culture, including key aspects of the legal system, and helping them to identify healthy ways of accommodating new demands without abandoning traditional and personal values.

In certain instances, clients’ children or other relatives encourage them to seek professional guidance in coping with some life problem. One of my friends who is a therapist was recently approached by a former client, a college student who is a first-generation immigrant from Afghanistan. Her family still struggles with issues related to their relocation some years earlier and is attempting to cope with long-ago losses that continue to haunt them. My friend and I talked at length about the availability of low-cost or free services from a competent provider who would be willing to visit the family in their residence. We concluded it was also important to find someone who would recognize and honor the family’s cultural and religious principles.

Whatever the client’s presenting issue, it can be helpful to devote some time to exploring any ongoing cultural conflicts. One of my clients noted the substantial differences in etiquette between her Caribbean culture and that of Americans living in a semirural region of the Midwest. She was accustomed to greeting everyone with a pleasant “Good day” or “Good night” but found that this struck others as odd, particularly because “Good night” is generally used as a farewell rather than a welcome in the United States.

It is essential to view the immigrant client as an individual rather than as a stereotyped representative of a particular group, even if he or she identifies strongly with a certain faction or places high value on membership in a given community. For example, the term “South American” encompasses a wide variety of cultures and ethnicities, but it provides an insufficient description of a specific young mother whose ancestors were part of the indigenous population of Bolivia. Furthermore, people of common nationality may be members of tribes that have long been at odds with each other. Clients who were in the majority group in their home countries may suddenly find the tables turned, increasing their sense of displacement. In other cases, civil conflicts have resulted in the creation or dissolution of state boundaries, often without consideration for the ethnic identities of the affected people, many of whom were forced to flee their homes to escape the fighting. Among the places where this has occurred are the Balkan states, the Kashmir region of India, the former Soviet Union, Korea and various parts of Africa.

A key element of establishing rapport with immigrant clients is getting a sense of their internal rhythms and learning to work at a pace that is optimal for them. While at some point it may be appropriate to challenge these clients to stretch beyond their comfort zones, this cannot be broached effectively until trust is established and they feel respected and understood. Especially in the case of a cross-cultural counseling relationship, it is incumbent upon the therapist to become familiar with the client’s social traditions and principles. Prescriptively imposing one’s own standards implies a value judgment, which is likely to leave the client feeling further alienated.

As a counselor begins to understand the client in context, he or she might discover a wealth of sociocultural resources available to support the activities taking place in session. Members of the client’s family, religious organization or other community groups may be quite willing to encourage the client’s personal growth if the counselor explains the importance of their support and invites them to contribute their unique wisdom and understanding to the process. Working in concert with the client’s value system and traditions instead of against them is much more likely to result in a successful outcome.