Latinx Mental Health - S3E12

Announcer:

Welcome to the Voice of Counseling from the American Counseling Association. Today, we're going to listen in on a conversation with Dr. Edil Torres Rivera and Dr. Patricia Arredondo. They're joining us today to talk about Latinx mental health and counseling with immigrants and refugees. Dr. Edil Torres Rivera is the 72nd president of the American Counseling Association. He's a counseling professor and the Latinx Cluster coordinator at Wichita State University, Kansas. He specializes in multicultural counseling, liberation psychology, multicultural counseling, Puerto Rican studies, and much more. His primary research focuses on the complexity and how Indigenous healing techniques are necessary when working with ethnic minority populations in the United States.

Dr. Patricia Arredondo is the co-author of the upcoming ACA book, Counseling With Immigrants and Refugees and Their Families from the Social Justice Perspective, which will be available for purchase in early 2024. She holds fellow status with both the American Psychological Association and the American Counseling Association. She was the first Latina president of the American Counseling Association from 2005 to 2006. Welcome to the podcast, Dr. Torres and Dr. Arredondo.

Dr. Edil Rivera Torres:

Hello, Dr. Arredondo, it's been a while since I... I haven't seen you. But it's a great honor for me to being able to chat with you a little bit about an important subject that both you and I are being very passionate about, it's our own people, Latino counseling. And particularly, your new book is coming out. For those who don't know, Patricia Arredondo was the first president Latina of ACA, 25 plus years ago. She's been considered a Living Legend of counseling on psychotherapy, so I'm very honored to have her here. And I go on to ask her a few questions about her books, about what she's been doing since that. I'm going to pause here and let you the opportunity to say some things, Dr. Arredondo.

Dr. Patricia Arrendondo:

Okay. Gracias, Edil. Gracias, Dr. Torres Rivera. Again, it's an honor to be on this podcast and to be invited to meet with you. Dr. Torres Rivera is the second Latinx president of ACA, the first male, of course. Yeah, it's kind of cool to be able to engage in this way, and talk about what I know we're both, as he said, passionate about. And it's not only the Latinx population, but I think the future of counseling as it relates to working with Latinx populations at large. So there's quite a bit to cover, and I know that we can also, I guess, take pride in the work that's ongoing within ACA to advance Latinx mental health. I just want to also shout that out. Thanks, Edil.

Dr. Edil Rivera Torres:

Thank you, Dr. Arredondo. So in that line, can you tell us a little bit about what's so special about Latino clients, Latinx clients?

Dr. Patricia Arrendondo:

There's so many things to say, what makes Latinx clients special? And I think I'd start with the diversity of the population, is that there's a cultural richness, because we seem to... we can lump people together and think they're all Latinx, but we know that we have different cultural heritages that comes with different priorities, different ways of living and communicating, and so I think that's part of the richness. I think the second is the youth. The Latinx population is a very young population, kind of the average age is 29 years old, compared to the white population, which is about 37 years old on average.

So what we know is that there are ways that we will have to begin to frame our thinking about how we engage with Latinx, whether it's in schools, clinics, university counseling centers, in classrooms at the university, and in the workplace. And so I think that's a lot of why I think about the richness. Of course, there are the cultural values that I would say persists across generations, that emanate in the fact that Latinos are very family-centered, and we've talked about this over the years, and that hasn't gone away. I see that with young people. I mean, young people compared to my age, right? People who are in their 20s and 30s who are Latinx heritage, they could be Guatemalan or Puerto Rican, but they're very family-centered.

And I think that's another aspect of the strength of the Latinx population at large. If you look at the data, they are the population that has fewer divorces. So there's a way that there's certain guidelines in the family, or about persistence to support one another. There's a greater interdependence, and as we talk about in the literature, a sense of collectivism, that people depend on one another. And that goes back historically, but it continues.

It doesn't mean people don't have a sense of independence. Obviously, you and I are two examples of people who are very family oriented, but we've led our own lives, our own careers, and our children have done the same thing. So you can't categorize people as just collectivistic. We step out, and do our own careers and our lives, and that's what is complex, I think, about people in general. But in so much that there's not enough familiarity with counseling, with Latinx clients, we have to kind of push out the whole idea that people are complex, intersecting identities are part of who we are. Not only because you're Puerto Rican, I'm Mexican American, woman, man, heterosexual, gay or lesbian. So I think all of the immigrant, non-immigrant, all of those are what make us very complex. So that's just a little bit to comment.

Dr. Edil Rivera Torres:

Excellent. I know that I've been calling our group the Cosmic Race, because we have different races, ethnicity, it's a complexity of who we are as a population. With that, Dr. Arredondo, I want to kind of jump in into the whole, some pieces that you've been putting together for over the past years is the whole social justice pieces in terms of how we serve our population. Can you comment a little bit about the social justice principles when working with Latino populations?

Dr. Patricia Arrendondo:

Absolutely. It's such an important framework for working with the Latinx population. I mean, if we look at the context, which is really what social justice principles bring to counseling, the context of inclusion, of exclusion, the context of privileged, not privileged. The context of oppression and freedom. I mean, those to me, are a lot of the social justice principles that have influenced multicultural counseling, if we go back to that. So when we think about the Latinx population, we have to really think very holistically about the context in which they... What they bring to the story, the story. So I'll focus on immigrants in this example.

For many years, immigrants have come to the United States to seek a better life, to move away from oppression, religious oppression, economic oppression, and other hardships. So they came through Ellis Island, they came through other parts of the world. And so we have the Latinx population that historically has been... the boundaries have been blurred, whether it's with Puerto Rico, or Cuba, or Mexico. So those were all areas that were historically Latinx or Latino. And so what we have to keep in mind is that, from a social justice perspective, immigrants are also fleeing situations of oppression, and they're fleeing situations perhaps of trauma. I mean, not perhaps, but oftentimes trauma. So from a social justice perspective, a counselor has to be mindful of these experiences that still weigh on the mental wellbeing of clients, and not enter into a counseling relationship with some very simplistic questions about, "Where are you from? Or what do you want to get out of counseling?"

I think the counselor has to understand the dynamics of her privilege in relationship to the client. And for many Latinos, authority figures are people that have been oppressive to them. So, again, if we understand the social justice mindset of equity, of respect for the client, respect for difference, respect for cultural difference, and that there are these dynamics of marginalization and privilege. There's a very interesting article many years ago written by Derald Wing Sue that talked about locus of control and locus of responsibility. Yeah, you remember that, right?

And what I've always said about that concept is that in the United States, we have this idea of locus of control as being primary, I have to control everything, my destiny, what's in front of me. And Derald added the piece of responsibility. And I think this is what describes the Latinx immigrants and many Latinos who are not immigrants, is this sense of responsibility. So the immigrants want to control what they can do for themselves, what they can do for their families. They want to take responsibility. Sometimes they can't control everything because of their status, their immigration status. But it doesn't mean that they're being passive or helpless. And this is from a social justice perspective, counselors need to recognize all of these dynamics, and not start to label people because they're responding differently.

I'll just go one more thought on social justice, and that's the whole thing on colonialism and decolonization. And we still have a lot of work to do in the counseling profession to help our colleagues, all of us, all of us. I mean, we're always in the learning process, of what the effects of colonization have been on Latinx people. And I think of colonization from the very beginning, arriving to the Dominican Republic or the island that is the Dominican Republic where Columbus landed inadvertently, and then to the islands, the Caribbean island, Puerto Rico, and all the colonization that's occurred to Indigenous peoples. And how that has continued to, I think, needing to be unpacked.

And there's a concept in this new book that we just finished counseling with immigrants and refugees, the concept of settler colonialism, which you probably are aware of. And settler colonialism refers to what happened in the United States, as people who came in to settle in the US, primarily from Europe, much primarily from Europe, colonized wherever they settled. And it was with Indigenous people. It was in the South with the slaves that were brought from Africa, and then of course in the Southwest with, again, more Indigenous people and Latinos. So that whole thing of settler colonialism, I think is very alive still. And I'll just move to one more concept. How I think that concept relates is to when we look at gerrymandering in the United States, and how there was a state that was told that they needed to have their district be inclusive of the Black representation. Even though the court said, "You have to do that," they went against that. So I think it's that whole thing of domination, and realizing that social justice is about inclusion and not domination.

Dr. Edil Rivera Torres:

Yeah, I mean, I was going to touch a little bit on asking you of this colonization, but you just jumped in right in on it. When we talk about social justice, we need to start to talking about this colonization process, which was a violent act and the continued act of violence. So that means trauma. So our populations work with trauma. Doing that, Dr. Arredondo, talk to me about your book.

Dr. Patricia Arrendondo:

I think, Edil, you know that I've been passionate about working with immigrants and refuges for many, many years. That was my early, early research as a doctoral student. Well, in the past few years, I've worked with colleagues in... where are they? In Minnesota. And we engaged in a research project to understand the immigrants and refugees that had settled in this area of Minnesota. And we came up with such rich data. And then I thought about the work I had done in Arizona with families, primarily from Mexico, immigrant families living in a Habitat for Humanity community, and the research we conducted there.

And then there was another piece coming from my work in Milwaukee in Chicago. So I said, "There's so much we should be talking about and sharing with the world, and ACA does not have a book on working with immigrants, on counseling with immigrants and refugees." So a lot of the motivation was we need to tell the story of the commitment refugees and immigrants have to the United States, their commitment to contribute. As well on the mental health side, the understanding of how much people have sacrificed to get here, the sacrifices have been enormous. So we discussed the stages of migration, which is something that, again, I conceptualized many years ago working with immigrants, that there's a pre-migration stage, there's a migration specific, and then the post-migration, which is where acculturation processes take place.

And we, in particular, wanted to make sure that people understood that in writing our book is what we're trying to capture is that, there are so many obstacles immigrants face from leaving their country, and their decision to leave. But their decision to leave is very goal-oriented. And that's the other piece we emphasize. It's not like, "I'm going to go tomorrow." I mean, it's very thought provoked. It's thoughtful, it's thoughtful, it's a plan. And then we talk about the journey and the sacrifices people make, who to bring, who not to bring. The unaccompanied minors, and why parents let them go, so that they don't have to get involved in gangs and people that want to kill them.

And then the most important place where counselors will engage is in the post-migration or acculturation phase. And so we talk there about how to engage with clients, and the different reasons that an immigrant or a refugee will come to counseling. And it's usually to solve a problem, it's to get guidance. It's generally not to reflect on their issues. I mean, that's just not often what happens. People just have a lot going on inside of them, but they don't... I guess what I have learned over the years, they don't have the time when they're getting settled here, to mourn. They have to keep going. They have to remember why they came. So, they're purposeful. And what we remind counselors in the book is to support parents who want to know how to solve issues with their children.

We guide the conversations on working in schools. We talk about working in schools with adolescents, and what they need in terms of support from a counselor. Which is not to be judgmental, the counselor not to be judgmental. But the whole thing too about telling one's story is to be very careful to not re-traumatize people. You don't want to really get into, "Tell me about your past," if somebody says, "I need some help with my child who's bedwetting, or I need some help with my child who's getting bullied at school." So you don't have to go back and visit what happened to motivate them to be there in the United States.

I think there's a second thing I want to say, particularly about immigrants. And Edil, you might know a book that I edited in 2018, Counseling With Latinx or Working With Latinx Immigrants Transcending Xenophobia. And there, we talked about Latinx immigrants from different countries. And while more often, we think about those who come as being from agricultural areas, impoverished, there are some who come with some privilege, with university backgrounds. So we have to once again, be able to recognize that there is a lot of heterogeneity as well, within the immigrant population.

I'm excited about the book because I think we touch on areas that generally are not talked about in multicultural counseling because it's usually one chapter if it's at all talked about. But we talk about legislation that affects immigrants. And I think counselors need to know about that legislation, in order to see if they can be an advocate for that person, guiding them with where they need to go for paperwork and so forth. So that's a little bit about the story on the book.

Dr. Edil Rivera Torres:

Cool. Thank you. And just kind of thinking as I listened to you talk is that, this idea that how counseling as a profession is very, very complex, and allow us to do a lot of different things. That there used to be that the only thing we did was to stay in our offices. That's no longer true. We need to be in the community, we need to look at advocacy, and we need to start to look at legislation, which I think that that's a piece that people sometimes forget. With that in mind, Dr. Arredondo, I wonder... You touched on this, but what's, in your research to do this work, where were the unique needs of mental health in terms of immigrants? And you touched a little bit on it, but what do you think that there's unique needs in particular that you think that we need to pay attention to?

Dr. Patricia Arrendondo:

Yeah, very true. And again, one of the cross-cutting mental health needs... there are a couple. One is anxiety that people feel, whether they're children, adolescents or adults, there's a certain anxiety because of the change that they have experienced or are experiencing. And even if you're born in the United States as a Latina, you're still in a lot of contexts where you are underrepresented. And so how it feels to be, let's just say in a college classroom, when you are one of the only Latinas in there, that kind of anxiety, you could call it performance anxiety. But it's all mental, it's part of our mental health if we were experiencing performance anxiety.

I think of the other issues for immigrants and refugees, and that is of loss and grief, and how that cuts across children, adolescents and so forth, adults, and how that manifests differently. And how I think we have to understand what we might be hearing or seeing, or not hearing about. So when I was working as a school counselor a number of years ago, we had immigrant families that were from Korea, from Jamaica and so forth. So I was working at the high school with the students, and then there were people at the elementary school who also had students.

And I remember I was asked about a couple of children who were just kind of pulling... didn't get into the group, and it wasn't just language. But they couldn't get involved. And there was sort of, in some ways, I think they were experiencing some trauma. But I think they were experiencing that sense of confusion as well. There's a lot of confusion mentally, "Where am I? Lost." There's a sense of loss. This is all unfamiliar. And then I think for adolescents and adults who are recognizing the big changes, there's that loss and grief of what they've left behind.

And I think that is very cross-cutting. I remember a number of years ago when I was in Boston, working with a Cuban woman who was... she had just retired, she was in her mid-60s. And she came into counseling to begin to deal with issues she hadn't been able to deal with when she first arrived in the late 1960s. But she was full of grief. She was just in mourning about how she had to leave. She never got to be there with her parents dying and all of that. So I think we have to be sensitive to that loss and grief that many immigrants carry. Two diagnoses that often come up with Latinos are anxiety and depression. And I think we have to understand why the anxiety is there, and I've discussed that a little bit, but also the depression. And I look at depression and sadness as tied to loss, and a lot of confusion mentally, spiritually, and so forth.

Dr. Edil Rivera Torres:

Again, as you talk, one of the things that come to my mind is that Virgilio Enriquez came out with stages of colonization, and later on, a Hawaiian lawyer actually came with the stages of decolonization. And one of the first stages of decolonization that the Hawaiian lawyer talked about is the idea of grieving, of saying goodbye to the past life because they lost something. So when immigrants come here, they lost something. And they don't have time to grieve because they have a goal of mind. So I think that it creates some kind of complexity that sometimes we don't have in everyday counseling business. So that's an excellent point, Dr. Arredondo. Now, let me think... We have about five minutes left, so I would like to ask you what kind of resources do you recommend for counselors, in terms of advocacy or to work with this particular population?

Dr. Patricia Arrendondo:

More and more, there are more resources available to intervene with immigrants and refugees or Latinos. And I think once again, if you look at let's say, high school students and you're a counselor at a high school, so you're wanting to not simply address, you want to look more holistically. So we want to make sure students are getting into college and so forth and so on. And if students do not come from families where their parents went to school, so they need the guidance from the school, I mean, that's what happened to many of us. The counselor was important conduit.

So what I think about is counselors need to know about Hispanic serving institutions. Counselors need to know, and there are a lot of resources with especially Excelencia in Education that talks about the success rates of Latinos going to college, and why community college is often the best starting point. That's where you will see more success for Latino students is in community colleges. I think the second for counselors, and I always say this is, "Know what's in your community. Look around your community. More and more are Latino serving agencies in the community." And those are agencies one should become knowledgeable about, go and visit and find out what kind of advocacy those agencies are doing, and see how that informs the work they want to do. Or they can refer someone to that agency.

I think about some of the other... I mean, there are national organizations, Unidos. Unidos, which used to be the National Council of La Raza, if you recall it. So Unidos, which is also very much an advocacy group for Latinos. And then there are... Gosh, there's the groups that are doing their work on the... the lawyers who are doing their work to help immigrants and refugees at the border to... there's a whole list of them who are doing this kind of advocacy. And it doesn't mean that you have to go down there and do that in person, but you can get some of the tools for advocacy from the lawyers groups that are representing those immigrants.

At the University of Chicago, there's a immigrant serving unit, and they work with a lot of immigrants in transition. There's also a group in Chicago that works with survivors of torture. That's another example of an agency that does advocacy, I guess, advocacy and support. And those would be resources for counselors as well. I think the final thing I would say is, counselors really do have to keep up-to-date with legislation and with the events. You have to know what happened in the summer when they flew immigrants to Miami, and then to Martha's Vineyard and all of that, as a way of making a political statement. Immigration is not apolitical, it is political. And I think as counselors, we have to recognize that we are part of a political system as well.

Dr. Edil Rivera Torres:

Well, I want to thank you for sharing this time with me, this space. Excellent resources that you provide for us, and that good book. And I'm glad that it's published by ACA.

Dr. Patricia Arrendondo:

Yes. Yes.

Dr. Edil Rivera Torres:

So with that, thank you very much. Appreciate it.

Dr. Patricia Arrendondo:

Muchas gracias, Edil. Gracias, everyone.

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Speaker 4:

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