This document provides an overview of treating Orthodox Jewish patients and discusses some cultural and clinical considerations. It notes that the Orthodox Jewish population in the New York/New Jersey area is nearly 2 million people. It identifies several local Orthodox communities and emphasizes that Orthodox Jews are culturally unique with their own clinical considerations. Therapists treating Orthodox Jews must have some religious and cultural sensitivity to effectively work with this population.

1. Treating Orthodox Jews Cultural Overview & Clinical Implications By: Rabbi Binyamin L. Goldman, PsyD

2. Demographics 1,970,000 Jews in NY/NJ metro area (DellaPergola, 2002) 30% of U.S. Jewry 15% of world Jewry 2nd in rank only to Tel Aviv

3. Demographics

4. Demographics

5. Demographics Local Orthodox Communities Teaneck/Bergenfield/New Milford Paramus Fair Lawn Passaic/Clifton Fort Lee Monsey/Spring Valley/Airmont/Suffern (Rockland County, NY)

6. Multiculturalism

7. Multiculturalism & Jews Culturally unique Own specific clinical considerations Largely underserved Therapists lack resources to develop cultural competency

8. Multiculturalism & Jews Therapist must have: Some background Genuine curiosity Religious sensitivity

9. Initial Barriers Therapist Patient

10. Therapist Barriers Intricate religious-cultural framework Can mystify outsiders Large number of Orthodox subgroups: Ashkenizim Sepharadim Hassidim “ Ultra-Orthodox” “ Modern Orthodox” Lubavitch (Chabad)

11. Patient Help-Seeking Barriers Confidentiality concerns Close-knit, concentrated communities Fear of supposed stigma Shidduchim (marital elligibility) Siblings Practice location “ Paranoia”

12. Religious Issues Presenting Problems Sexuality

13. Religious Issues Presenting Problems Religious guilt/inadequacy Realistic and nonrealistic standards Obsession vs. piety

14. Religious Issues Presenting Problems Intergenerational commitment differences Children > Parents “ Flipped Out” post-seminary students Ba’alei Teshuvah (newly religious) Parents > Children Rebellious teens “ Off the Path”

15. Religious Issues Sexuality Gender Separation Sheltering Parents may resist interventions that involve exposure to: TV, movies (any) Beaches, gyms Co-ed activities Masturbation prohibition Family purity laws

16. Religious Issues Sexuality Office visit conduct Limit eye contact Closed door issue No handshake

17. References Bilu, Y. & Witztum, E. (1994). Culturally sensitive therapy with ultra-orthodox patients: the strategic employment of religious idioms of distress. 31(3). DellaPergola, S. (2002). World Jewish Population 2002. American Jewish Year Book, 102. Heilman, S. C. & Witztum, E. (1997). Value-sensitive therapy: learning from ultra-orthodox patients. Am J Psychother, 51(4), 522-541. 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. Schnall, E. (2006). Multicultural counseling and the Orthodox Jew. Journal of Counseling & Development, 84, 276-282. 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. 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. Wikler, M. (1986). Pathways to treatment: How Orthodox Jews enter therapy. Social Casework, 67, 113-118.