Working with Jewish ultra-orthodox patients: Guidelines for a culturally sensitive therapy

Abstract

The epistemological gap between the medical reality of mental health practitioners and the sacred reality of their Jewish ultra-orthodox patients poses a major challenge for therapy. Based on our work with psychiatric patients from the ultra-orthodox community of northern Jerusalem, we propose a set of guidelines to cope with this challenge. Basically, we seek to incorporate religiously congruent elements, composed of metaphoric images, narratives and actions, into the wide range of our "secular" treatment modalities in order to respond to the patient's suffering, often expressed through distinctively religious idioms of distress. This endeavor calls for "a temporary suspension of disbelief" on both sides. The guidelines presented include three sets of factors which appear pertinent to working with ultra-orthodox patients. The first set is contextual in nature, dealing with the image of the clinic and its physical setting; the second discusses the necessary role requisites of the therapists; and the third one, accorded a central importance, deals on various levels with the therapeutic interventions administered in terms of form and content. Several case vignettes are presented to illustrate three classes of religiously informed interventions: healing rituals, dream interpretation, and the use of culturally congruent metaphors and stories. In the concluding part we discuss ethical and instrumental issues that the proposed therapeutic guidelines may raise.

Religious Explanatory Models in Patients with Psychosis: A Three-Year Follow-Up Study

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Ultra-orthodox women in Israel: A pilot project in social work education

“…Films introduce secular values that could influence those who come in contact with them. As Bilu and Witztum (1993) 'From the ultra-orthodox perspective, the fact that the secular unabashedly breach the religious commandments viewed by the observant as the sine qua non of Jewish life makes contacts with them in many spheres of life (let alone marriage) entirely impossible. Moreover it situates them in a morally inferior and condemnable position, part of the impure world of sin'.…”

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

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