Engaging in Psychotherapy with the Orthodox Jew: A Critical Review

Abstract

A critical overview of the current knowledge of engaging in psychotherapy with a cultural minority, Orthodox Jews, is provided. The various forms of psychotherapy that have been utilized to engage Orthodox Jews in meaningful psychotherapeutic encounters are discussed. Psychodynamic, cognitive, behavioral, couple, family, and group therapies have all been employed with success. The first key in working with cultural minorities, including Orthodox Jews, is patience. Patience is required to allow a therapeutic alliance to develop in which the therapist, the outsider, can be trusted. When patients are reluctant to accept the treatment proposed, patience is necessary to give them the time required to verify the treatment with someone they trust, often their rabbi in the case of the Orthodox Jew. Patience is also valuable when patients request a change in the frame of therapy, such as the use of a chaperon or leaving the door slightly ajar if being treated by a member of the opposite sex. The second key in working with this or any other cultural minority is flexibility. Flexibility is required, to chose treatment modalities that best fit with the patient's beliefs, to respect the patient's beliefs no matter the extent they deviate from the therapist's own, and finally, to be critical of oneself when examining transference and countertransference reactions.

Rabbis and Health: A Half-Century Review of the Mental and Physical Health Care Literature:1950–1999

“…A survey of 212 Jewish and Christian congregations in the northeastern United States found that 84% had visitation programs for the homebound, 80% had visitation programs to nursing homes, 70% offered regular hospital visits for seniors, 44% provided transportation, 37% gave telephone reassurance calls, and 16% delivered meals to homes (Sheehan, Wilson, & Marella, 1988) The strong tie to the Jewish community can have a negative effect on psychiatric care in some instances. It has been observed, for example, that Orthodox Jews are reluctant to seek mental health treatment because mental illness is seen as a stigma in their community (Margolese, 1998;Wikler, 1986). Alcoholism is also stigmatized by the Jewish community, but as Zimberg notes "the socio-cultural attitudes toward drunkenness that have developed over thousands of years have a protective value against the tendency toward alcoholism .…”

“…Of the remaining two articles, one focused on the role of the synagogue and rabbis in programs for the elderly (Biller, 1952). The other, which mainly described the role of a psychologist in a synagogue school, mentioned referrals from rabbis (Imber, 1960) Most of the expositional articles in secular journals also provided a Jewish perspective on health and mental health issues and problems (Margolese, 1998;Rosner, 1969;Schecter, 1987;Shrut, 1960). Among these were articles about abortion (Nussbaum, 1971), alcoholism (Zimberg, 1977), and screening for genetic disorders (Brown, 1990;Rosner, 1998).…”

A review and critical appraisal of measures of therapist-patient interactions in mental health settings

“…39,56,93,95,104,106,115,116 This suggests that there are engagement and relationship issues in working with patients from minority ethnic groups. 117,118 Again, there is little research on whether patients should be matched with therapists from the same ethnic background, social class, religion, and so on.…”

An idiographic analysis of women’s accounts of living with mental health conditions in Haredi Jewish communities

“…This law and its interpretations cover a range of aspects of life including family life, diet, dress code, social behaviour, sexual behaviour, study, and engagement with or separation from the secular world (Margolese, 1998). For example, the Hasidic stream within Haredism tends to separate itself from secular society but even here there is a notable exception as the Chabad-Lubavitch Hasidic grouping engages in outreach to unaffiliated Jews (Heilman, 2000).…”

“…The efforts made by many Haredi communities to ensure separation from secular society serve to protect these commitments and structures (Greenberg & Witztum, 2001). This evokes a strong "in-group"/"out-group" distinction (Margolese, 1998;Ysseldyk, Matheson, & Anisman, 2010).…”