Treating Orthodox Jews Cultural Overview & Clinical Implications By: Rabbi Binyamin L. Goldman, PsyD
Demographics <ul><li>1,970,000 Jews in NY/NJ metro area (DellaPergola, 2002) </li></ul><ul><ul><li>30% of U.S. Jewry </li>...
Demographics
Demographics
Demographics <ul><li>Local Orthodox Communities </li></ul><ul><ul><li>Teaneck/Bergenfield/New Milford </li></ul></ul><ul><...
Multiculturalism
Multiculturalism & Jews <ul><li>Culturally unique </li></ul><ul><li>Own specific clinical considerations </li></ul><ul><li...
Multiculturalism & Jews <ul><li>Therapist must have: </li></ul><ul><ul><li>Some  background </li></ul></ul><ul><ul><li>Gen...
Initial Barriers   <ul><li>Therapist  </li></ul><ul><li>Patient  </li></ul>
Therapist Barriers <ul><li>Intricate religious-cultural framework  </li></ul><ul><ul><li>Can mystify outsiders  </li></ul>...
Patient Help-Seeking Barriers <ul><li>Confidentiality concerns </li></ul><ul><ul><li>Close-knit, concentrated communities ...
Religious Issues <ul><li>Presenting Problems </li></ul><ul><li>Sexuality </li></ul>
Religious Issues <ul><li>Presenting Problems </li></ul><ul><ul><li>Religious guilt/inadequacy  </li></ul></ul><ul><ul><ul>...
Religious Issues <ul><li>Presenting Problems </li></ul><ul><ul><li>Intergenerational commitment differences </li></ul></ul...
Religious Issues <ul><li>Sexuality </li></ul><ul><ul><li>Gender Separation </li></ul></ul><ul><ul><li>Sheltering  </li></u...
Religious Issues <ul><li>Sexuality </li></ul><ul><ul><li>Office visit conduct </li></ul></ul><ul><ul><ul><li>Limit eye con...
References <ul><li>Bilu, Y. & Witztum, E. (1994). Culturally sensitive therapy with ultra-orthodox patients: the strategic...
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Treating Orthodox Jewish Patients

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A guide for mental health professionals on treating Orthodox Jewish clients

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Treating Orthodox Jewish Patients

  1. 1. Treating Orthodox Jews Cultural Overview & Clinical Implications By: Rabbi Binyamin L. Goldman, PsyD
  2. 2. Demographics <ul><li>1,970,000 Jews in NY/NJ metro area (DellaPergola, 2002) </li></ul><ul><ul><li>30% of U.S. Jewry </li></ul></ul><ul><ul><li>15% of world Jewry </li></ul></ul><ul><ul><li>2nd in rank only to Tel Aviv </li></ul></ul>
  3. 3. Demographics
  4. 4. Demographics
  5. 5. Demographics <ul><li>Local Orthodox Communities </li></ul><ul><ul><li>Teaneck/Bergenfield/New Milford </li></ul></ul><ul><ul><li>Paramus </li></ul></ul><ul><ul><li>Fair Lawn </li></ul></ul><ul><ul><li>Passaic/Clifton </li></ul></ul><ul><ul><li>Fort Lee </li></ul></ul><ul><ul><li>Monsey/Spring Valley/Airmont/Suffern (Rockland County, NY) </li></ul></ul>
  6. 6. Multiculturalism
  7. 7. Multiculturalism & Jews <ul><li>Culturally unique </li></ul><ul><li>Own specific clinical considerations </li></ul><ul><li>Largely underserved </li></ul><ul><li>Therapists lack resources to develop cultural competency </li></ul>
  8. 8. Multiculturalism & Jews <ul><li>Therapist must have: </li></ul><ul><ul><li>Some background </li></ul></ul><ul><ul><li>Genuine curiosity </li></ul></ul><ul><ul><li>Religious sensitivity </li></ul></ul>
  9. 9. Initial Barriers <ul><li>Therapist </li></ul><ul><li>Patient </li></ul>
  10. 10. Therapist Barriers <ul><li>Intricate religious-cultural framework </li></ul><ul><ul><li>Can mystify outsiders </li></ul></ul><ul><ul><li>Large number of Orthodox subgroups: </li></ul></ul><ul><ul><ul><li>Ashkenizim </li></ul></ul></ul><ul><ul><ul><li>Sepharadim </li></ul></ul></ul><ul><ul><ul><li>Hassidim </li></ul></ul></ul><ul><ul><ul><li>“ Ultra-Orthodox” </li></ul></ul></ul><ul><ul><ul><li>“ Modern Orthodox” </li></ul></ul></ul><ul><ul><ul><li>Lubavitch (Chabad) </li></ul></ul></ul>
  11. 11. Patient Help-Seeking Barriers <ul><li>Confidentiality concerns </li></ul><ul><ul><li>Close-knit, concentrated communities </li></ul></ul><ul><ul><li>Fear of supposed stigma </li></ul></ul><ul><ul><li>Shidduchim (marital elligibility) </li></ul></ul><ul><ul><li>Siblings </li></ul></ul><ul><li>Practice location </li></ul><ul><li>“ Paranoia” </li></ul>
  12. 12. Religious Issues <ul><li>Presenting Problems </li></ul><ul><li>Sexuality </li></ul>
  13. 13. Religious Issues <ul><li>Presenting Problems </li></ul><ul><ul><li>Religious guilt/inadequacy </li></ul></ul><ul><ul><ul><li>Realistic and nonrealistic standards </li></ul></ul></ul><ul><ul><ul><li>Obsession vs. piety </li></ul></ul></ul>
  14. 14. Religious Issues <ul><li>Presenting Problems </li></ul><ul><ul><li>Intergenerational commitment differences </li></ul></ul><ul><ul><ul><li>Children > Parents </li></ul></ul></ul><ul><ul><ul><ul><li>“ Flipped Out” post-seminary students </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Ba’alei Teshuvah (newly religious) </li></ul></ul></ul></ul><ul><ul><ul><li>Parents > Children </li></ul></ul></ul><ul><ul><ul><ul><li>Rebellious teens </li></ul></ul></ul></ul><ul><ul><ul><ul><li>“ Off the Path” </li></ul></ul></ul></ul>
  15. 15. Religious Issues <ul><li>Sexuality </li></ul><ul><ul><li>Gender Separation </li></ul></ul><ul><ul><li>Sheltering </li></ul></ul><ul><ul><li>Parents may resist interventions that involve exposure to: </li></ul></ul><ul><ul><ul><li>TV, movies (any) </li></ul></ul></ul><ul><ul><ul><li>Beaches, gyms </li></ul></ul></ul><ul><ul><ul><li>Co-ed activities </li></ul></ul></ul><ul><ul><li>Masturbation prohibition </li></ul></ul><ul><ul><li>Family purity laws </li></ul></ul>
  16. 16. Religious Issues <ul><li>Sexuality </li></ul><ul><ul><li>Office visit conduct </li></ul></ul><ul><ul><ul><li>Limit eye contact </li></ul></ul></ul><ul><ul><ul><li>Closed door issue </li></ul></ul></ul><ul><ul><ul><li>No handshake </li></ul></ul></ul>
  17. 17. References <ul><li>Bilu, Y. & Witztum, E. (1994). Culturally sensitive therapy with ultra-orthodox patients: the strategic employment of religious idioms of distress. 31(3). </li></ul><ul><li>DellaPergola, S. (2002). World Jewish Population 2002. American Jewish Year Book, 102. </li></ul><ul><li>Heilman, S. C. & Witztum, E. (1997). Value-sensitive therapy: learning from ultra-orthodox patients. Am J Psychother, 51(4), 522-541. </li></ul><ul><li>Rabinowitz, A. (1999). Psychotherapy with Orthodox Jews. In P. S. B. Richards, A. E. (Ed.), Handbook of Psychotherapy and Religious Diversity. (pp. 237-259). Washington, D.C.: American Psychological Association. </li></ul><ul><li>Schnall, E. (2006). Multicultural counseling and the Orthodox Jew. Journal of Counseling & Development, 84, 276-282. </li></ul><ul><li>Sublette, E. & Trappler, B. (2000). Cultural sensitivity training in mental health: treatment of Orthodox Jewish psychiatric inpatients. Int J Soc Psychiatry, 46(2), 122-134. </li></ul><ul><li>Weinrach, S. G. (2002). The counseling profession's relationship to Jews and the issues that concern them: More than a casse of selective awareness. Journal of Counseling & Development, 80, 300-314. </li></ul><ul><li>Wikler, M. (1986). Pathways to treatment: How Orthodox Jews enter therapy. Social Casework, 67, 113-118. </li></ul>

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