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The Obstacles to Involving the Parent or Parents in Therapy

             The obstacles can come from many corners to test the enthusiasm and commitment of the clinician, or other professionals attempting to help the immigrant family. Mostly they come from the difficult everyday life of the undocumented immigrant who, perhaps is a mother, struggling by herself to keep the children’s needs taken care and her energy and resources are so scarce. Or even if she has a husband, or a compañero, to help her out, how is she going to ask for time at work to go to an appointment again, when she knows she is lucky to have a job in her undocumented situation and the supervisor is not sympathetic at all to people having family problems. After all, there are so many others that can replace her. Or, the father or stepfather who works long hours, perhaps doing two jobs and has to carve time from needed restorative sleep to come talk to the counselor. And there is always a car breaking down and no ride available, or a small one getting sick, etc. This sort of life clashes so much with the time conscious, punctuality aware large systems in the USA, like for example the school system, where the professionals are frustrated constantly by “these parents always being late or not showing up at all for the meetings set up for them!” And they don’t even call! Giving up on them and judging them as not caring, when perhaps this was an overwhelmed and embarrassed person, facing jet another crises, or even a fight with their equally overwhelmed mate who cannot come either.

Because I was lucky enough to set up my own appointments, I started resorting to marathon sessions of two or even two and a half hours, so I could work with the adults in the family while I had them and this is what I shamelessly recommend. However, I know that this is not always possible for time pressed professionals working in mental health systems or other systems, although perhaps there are some creative solutions to be found. In the 90’s I was so happy to hear the concept of the single session by Dr. J. Szapocznik, Ph. D., a famous Cuban family therapist working with the Cuban refugee immigrants in Miami. I felt some validation. Ultimately, the idea is to know that you have to make the best use of the time you have and then be flexible and non-judgmental with the families in their struggles to comply with treatment demands.

The other major roadblock has to do with the internal emotional resources of the adults, who are many times themselves the victims of either traumatic events in their communities, such as war or violence, or in their own families, growing-up. These experiences can make it very threatening and intolerable for them to engage in counseling, as this requires a certain degree of trust that they will not be hurt in placing themselves vulnerable to another person that may let them down once more; or perhaps make them face painful feelings and realities in their current life that they are trying to manage in the only way they know: through avoidance and not talking about it, a very common reaction of the trauma victim, coming from the numbing automatic response to threat and trauma . Or perhaps they will be criticized as parents and be made to feel even more inadequate than they already feel. So they may not come.  This is then a time to work with the children in group counseling or therapy.