Multicultural Counseling and the Orthodox Jew

Research suggests that minority groups tend to underutilize mental health services provided by the majority culture, and even those who do enter psychotherapy often terminate prematurely (Margolese, 1998). Orthodox Jews are no exception. When surveyed, 90% of Orthodox mental health professionals reported that the mental health needs of their community are poorly met (Feinberg & Feinberg, 1985). Wikler (1989) pointed out that the cultural diversity literature has usually ignored the effects of religion, and certainly Judaism, on psychotherapy (see also Wieselberg, 1992). Even the field of counseling, although styling itself as especially sensitive to issues of diversity (American Counseling Association [ACA] Mission Statement, 2005, Bylaws, Article 1, Sec. 2) has disappointingly chosen to mostly ignore the needs of Jews. According to Arredondo and D'Andrea (1999), "Jews have been largely attributed an invisible status in the fields of counseling and psychology in general and within the multicultural counseling movement in particular" (p. 14). A thorough review by Langman (1999) found that "multiculturalism has typically not included Jews" and "books, journals, classes, and conferences [in counseling and psychology] make little mention of Jews, Jewish issues, or anti-Semitism" (p. 2). In a review, published in ACA's flagship publication, the Journal of Counseling & Development, Weinrach (2002) observed that the counseling diversity literature fails even to recognize "the notion of Jews as a culturally distinct group" (p. 300). He further presented substantial and compelling evidence to support his assertion that "the treatment of Jews and Jewish issues within the counseling profession suggests a disturbing pattern of anti-Semitism" (p. 303). This tradition of neglect especially compromises the efficacy of those mental health professionals who treat Orthodox Jews but who lack the research studies that would guide them. Indeed, "there are no scientifically rigorous studies that examine psychotherapy with Orthodox Jews" (Margolese, 1998, p. 38). Ironically, Bilu and Witztum (1993) suggested that transcultural therapy involving this group is more complex than with any other diverse group. Moreover, there is evidence that Orthodox Jews, and particularly the newly religious, suffer increased rates of severe psychiatric disorders (Bilu & Witztum, 1993) and are increasing as a proportion of Jews entering psychotherapy (Wikler, 1986). Their numbers in therapy are almost certain to continue rising, because their community is presently awakening to the reality of their mental health needs (Lightman & Shor, 2002; Shaviv, 2002; B. Twerski, 2002) and experiencing a "dramatic" (Sorotzkin, 1998, p. 94) increase in readiness to accept help from the mental health profession in meeting those needs. As with any minority group, there are circumstances when it may be beneficial or time-saving for the Orthodox Jew simply to engage a counselor or therapist who shares similar religious beliefs and cultural values (Simmons, 2001), yet there are few available (Bilu & Witztum, 1993). Furthermore, even when they are available, they may represent a poor choice for the patient. For example, even a slight variation in religious commitments may trigger suspicion on the part of one or the other. In addition, countertransference arising from the Orthodox professional's own unresolved religious conflicts may complicate matters (Rabinowitz, 2000). Moreover, university-educated Orthodox Jews are sometimes outright hostile to their more traditional coreligionists--or may be suspected by the client of being such a "traitor" (Bilu & Witztum, 1993; Greenberg, 1991). Given the frequent complexity of using an Orthodox Jewish counselor or therapist, and their relative scarcity, the option of a non-Orthodox or non-Jewish one must be considered. …