Describes some of the more demanding stresses and adjustment problems experienced by refugees living in the United States and provides suggestions for working with refugees in counseling situations. Before escape, major stressors include experiences of imprisonment, death of family members, loss of home and repeated relocation, loss of livelihood, and inadequate nutrition. During escape and processing, stress is occasioned by robbery, physical assault, rape, and long waits in refugee camps. Upon arrival in the U.S., stress can be caused by disappointment in the face of the demands of day-to-day life in American society, low social and economic status, language barriers, role reversals within families, intergenerational conflict, bad news from home, transportation limitations, discrimination, and overcrowded housing in high-crime areas. Counselors assisting refugees with the mental health problems that often are triggered by the stress of escape and relocation, can follow a number of guiding principles, including: providing a clear explanation of the counselor’s role and what the refugee client should expect from counseling; using elements of an individual’s culture in developing a treatment plan; avoiding assessments based on cultural stereotypes; and taking time to help clients make sense of past traumatic events.
