Why Therapy Is Crucial For Refugee Children

Refugees bear an unbelievable weight of emotional, mental, and physical trauma. The children suffer the most because they’re unable to defend themselves or make sense of their situation. They experience the loss of everything they’ve known. Even worse, they lose those important to them, such as their family members, friends, homes, traditions, identity, and peace.

Child refugees have to leave their childhood behind. That is the cruel reality of victims of 

    • wars, 
    • human rights violations,
    • economic and environmental hardships, 
    • persecution, and 
    • displacement. 

The effects of these difficulties far outlast their duration, leaving refugees with profound psychological and physical wounds.

Source: pexels.com

A person can only bear so much pain and trauma. Without a doubt, their situation will negatively impact the quality of their lives for a long time. After escaping torment from their country of origin, they still face numerous difficulties in their host country. Because of this, it’s crucial for refugees, especially children, to receive the help of a therapist. 

Treating Their Trauma

Refugee children get exposed to so much trauma at an early age. So, they would benefit from professional help. Whether their resettlement stems from fleeing from war-torn countries, environmental disasters, or discrimination and persecution, it negatively affects them. They may have also witnessed others around them suffer from death, destruction, or abuse. 

The actual process of them seeking safety is another traumatic process entirely. Refugees don’t immediately get the green light to move to a different place. Often, they’re left months or even years struggling to survive in their situation. Rarely do they arrive at their host country without casualties and losses.

Young refugees bear witness to these hardships. And it’s damaging to see their family resort to desperate measures to survive. In addition, these children’s parents and guardians have their hands full, striving to keep their family fed and safe. This experience can lead refugee kids to develop a sense of isolation and loneliness even before fleeing their country of origin.

Source: pexels.com

Those things are bound to impact a child’s psyche. Therapy becomes even more crucial when the child refugee was a direct victim of such atrocities. It’s not uncommon for these children to experience or be exposed to

    • physical violence, 
    • diseases and infections, 
    • injuries, 
    • forced labor, and 
    • sexual assault.

Because of these, they’re at a higher risk of developing post-traumatic stress disorder or PTSD. 

What they experienced and witnessed severely inhibits their holistic growth and degrades their quality of life. To give refugee children a chance at a healthy life, they need the help of a therapist.

Supporting Them In Facing Their Losses

One of the biggest heartbreaks refugee children go through is losing those they hold dear. They experience profound losses, regardless of their reason for fleeing from their country of origin. They lose the familiarity they’ve grown accustomed to growing up. That includes their

    • home, 
    • community,
    • customs and traditions, and 
    • lifestyle and routines.

They may feel like they lost their identity and what they’ve built over the years. When refugee children reach their host countries, they don’t get to enjoy lavish lifestyles. Most of the time, they deal with poverty and cultural shock. So, they can’t go back to the comfort of their familial and cultural traditions and celebrations.

But perhaps the most traumatic loss refugee children experience is the death of loved ones. Extreme conditions, like wars and disasters, force families to flee their homes. Their displacement comes with the loss of numerous lives. Deaths take a toll on the well-being of refugee children. So, therapy is integral in helping them heal from that experience.

Source: pexels.com

Helping Them Adjust To A New Life

Refugees face a new set of problems after reaching their host country. Their struggles are worsened by

    • language barriers, 
    • culture shock, 
    • poverty, 
    • mental and physical health problems, 
    • lack of employment, 
    • isolation from the community, and more. 

So, it will be tremendously challenging for refugees, more so for children, to adapt to that new environment.

A therapist can help refugee children begin to adapt to their current situation. That entails supporting them mentally and emotionally as they learn about what happened to them and what will happen after. It’s almost guaranteed for them to be confused and in shock. But a therapist can help refugee guardians and parents in supporting their children’s adjustment.

With the help of a therapist, these kids could start learning how to adapt to their new lives. Their circumstances aren’t ideal, but refugees must learn how to cope with their situation. This adjustment stage also includes processing and accepting previous problems. Through this, they can start their journey toward healing.

Source: pexels.com

Empowering Them In Their Journey Forward

Being a refugee entails entire sets of pains, heartbreaks, and challenges. Unfortunately, children aren’t exempted from those difficulties. At such a young age, they experience things that not even adults can survive through unscathed.

A therapist may recommend them to attend support groups, especially with those who speak the same language. A support system like that may instill a sense of community in them. It may also help them connect with those who’ve had similar experiences. Moreover, letting children mingle with those who speak their mother tongue will encourage them to communicate more.

Additionally, therapists may suggest art activities to help refugee kids express themselves. Once they do, professionals will be able to help them more. To many refugee children, the future doesn’t seem so bright. That is the sad reality for many, so it’s crucial to help empower them. Through the help of therapy, they can begin to take steps forward.

To Wrap Up

Life isn’t easy for refugee children. Their experiences leave trauma which will likely stay with them even as they grow older. Their mental, emotional, and physical wounds run deep and affect how they live and view life.

Every day is a struggle for these young kids. After all, the challenges don’t stop once they’re able to flee to safety from their country of origin. Instead, they have to deal with a new set of hurdles. However, with the help of therapy, they may begin taking small steps toward healing. 

These children deserve a chance at life. That must start with the opportunity to heal from past wounds. Therapy can help them process everything they’re going through so that they can lead brighter lives in the future.

Why Pregnant Refugee Women Should Receive Therapy

Refugees are at greater risk for infectious diseases, trauma, violence, and insufficient access to healthcare. For pregnant female refugees, these dangers are heightened due to the possibility of prenatal complications.

While migrant and refugee women are entitled to healthcare services in the host country, they still experience challenges that impede their access to proper healthcare. These can include cultural differences, racial prejudice, language barriers, and limited financial resources. Therefore, female refugees are in an extremely vulnerable position. 

Source: pexels.com

As such, we should prioritize pregnant refugee women’s mental health. Alongside proper physical care, we need to set systems to give them accessible therapy and counseling services. In doing so, we provide them with a better chance of integrating and thriving in our communities. 

Read on to find out how therapy is beneficial for pregnant refugee women.

For Pregnancy Complications

Up to 15% of pregnant refugee and immigrant women experience life-threatening obstetric complications. Pregnant refugees and immigrants have an increased risk of adverse perinatal outcomes. As much as 47.7% of pregnant Syrian refugees suffer miscarriages, while other infants die during or shortly after childbirth.

Because of these prenatal complications, the risk of mental health issues among pregnant refugees is higher. In addition, other factors related to pregnancy and childbirth may pose negative effects on their mental health. These factors include:

    • congenital anomalies, 
    • stillbirths, and 
    • cesarean sections.

In such events, a woman may feel depressed and isolated. Feelings of guilt, anger, anxiety and overwhelming grief may arise. To address these experiences, therapy can help them in

    • easing the pain of their loss,
    • regaining control over their emotions, 
    • working through their worries, 
    • eliminating fears of pregnancy, and
    • healing faster.
Source: pexels.com

For Traumatic Experiences

Many events and factors can cause trauma, such as war, abuse, and poverty. Often, refugees have experienced all three. After fleeing their homes, they are usually forced to live under dire circumstances. Lack of access to water and electricity and food scarcity are just some of the problems they face. These poor conditions lead to more issues, such as malnutrition.

The difficulties of poverty are even more prominent among refugees, especially pregnant women. They may be so busy surviving, scavenging for food and shelter that they disregard their prenatal needs. Their feelings of stress and powerlessness may also increase because of:

    • financial issues
    • employment insecurities
    • infectious diseases
    • poor housing conditions

 All these factors can contribute to the trauma they experience.

So, therapy should be accessible to help pregnant refugee women as they work through their trauma. Through therapy, they can learn skills on how to manage symptoms and develop healthy coping strategies. Ongoing nutritional support, counseling, and early intervention are also critical for having a healthy and safe pregnancy. 

For Sexual Violence

Sexual and domestic abuse can traumatize an individual. All genders suffer from this type of trauma. But women have the highest rate of suffering from sexual and domestic abuse. An estimated 90% of sexual assault victims are female.

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It is common for pregnant women with a history of sexual abuse to have traumatic flashbacks, even before or during childbirth. Refugee women have been found to suffer most from intimate partner violence, domestic violence, or other forms of gender-based violence. Due to cultural differences, refugee women might hesitate to speak up about the abuse. They fear that perceptions toward this type of violence would only lead to more emotional hurt. 

Exposure to violence can affect maternal and newborn health outcomes. A study in Switzerland found that immigrant women were more likely to be exposed to violence during pregnancy. Trafficked or infibulated women may find it difficult to access maternity care due to the fear of disclosing details of their situation.

Sexual violence might make it harder for refugee women to avail themselves of prenatal care. Reluctance to seek healthcare leads to several pregnancy complications and, in severe cases, death. Therefore, victims of abuse, especially pregnant refugee victims, should receive therapy. Counseling and therapy will help them:

    • move past the trauma
    • reclaim their sexual health
    • improve their physical health
    • feel empowered again

For Depression

There is an increased risk of mental illnesses and depression in refugee women during the pregnancy and perinatal phases. Though there may be other causes of depression, the factors indicated above may only worsen their diagnosis. To a grave extent, mental illness might even push them to suicide. Other factors affecting their mental health include social isolation, language barriers, and belonging to an ethnic minority.

Having a solid support group is crucial for pregnant women. However, many refugees and immigrant childbearing women lack social networks. This negligence leaves them feeling:

    • lonely
    • isolated
    • hopeless
    • deeply distressed

Without support, women become worried about having no one to turn to for advice, making child-rearing more difficult and causing tension between spouses.

Pregnant refugee and immigrant women are in dire need of access to psychological help and appropriate support programs. More than making them feel supported, therapy helps them to:

    • address the root of their problems
    • manage stress and emotions better
    • foster good relationships
    • develop adaptive coping mechanisms

Wrapping Up

Therapy is indeed crucial for pregnant refugee women to ensure a healthy pregnancy and safe childbirth. However, several barriers hinder their access to proper healthcare, such as: 

    • language barriers
    • cultural differences
    • discrimination and prejudice
    • biases and stereotypes
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Federal funding cuts, the time-sensitive nature of perinatal care, and limited resources paired with refugee influxes could also pose additional challenges. As we begin to recognize other determinants of health, mental well-being, alongside physical well-being, is becoming just as important. Thus, maternity services should incorporate therapy and develop trauma-informed care to:

    • promote a culture of safety
    • form trusting relationships between pregnant refugee women and healthcare providers
    • support the needs of these vulnerable women and their children properly

The multi-layered barriers that refugee women face can make their pregnancy even more challenging. So, developing programs and interventions that will provide them with adequate healthcare services is essential. Health, after all, is everyone’s fundamental right, including refugees.

Help For Refugees: Trauma Counseling For Healing And Recovery


Source: globalgiving.org


Approximately five million South African people make up 10% of the whole population – that are currently affected by PTSD to the degree that could be considered and must be treated by a psychologist or other mental health professionals. Someone who has gone through rape, abuse, violent crimes, hijacking, vehicular accidents, or chronic disease could be inflicted with longstanding effects from their experiences.

The aftermath of trauma surpasses the victim, negatively affecting families as much as their communities. The South African Depression and Anxiety Group states that the hidden cost to the country’s economy due to several behavioral and medical issues that complement PTSD is estimated to be at a whopping amount of R40 billion annually.

Trauma And Crisis Differentiated

Experts define a crisis as an ‘event decision point,’ while trauma is the actual process of experiencing the event.

A crisis is a real point in a period of time when a crucial decision has to be made concerning a particular event. Additionally, a decision made in the moment of crisis would most likely have a permanent effect on an individual, society, or community as a whole. The outcome of a decision taken during a crisis point would almost always signal progress or a visible decline of the circumstance from that period onwards. Hence, a crisis is considered a turning point.

Trauma is the process of going through a situation or event. It frequently has a longstanding harmful effect on someone, a group of persons, society, or the community as a whole.


Essentially, trauma can be likened to a deep mental wound, one that has a significant impression on the emotional state and daily functioning of the person who is suffering. Frequently, feelings and opinions become consumed by the traumatic event, making focus almost impossible, coping skills weak, and decision-making imprecise. Responses, which often include detachment, shock, anxiety, depression, and misperception, can vary from minor to major to worst and can continue for months or years after the initial encounter.

Source: thelondoneconomic.com

The Outcome Of Trauma

One of the most prevalent outcomes of trauma is PTSD or posttraumatic stress disorder. PTSD is a specific range of responses that could manifest in people who have gone through trauma. Those who suffer frequently feel intensely afraid, like the fear they felt when experiencing the event itself. It is also common for those who have gone through PTSD to manifest other mental health challenges. Anxiety disorder, addiction, or depression can emerge directly as a reaction to PTSD or a traumatic encounter.

The Effect Of PTSD And Trauma

PTSD does not choose age, race, social status, or gender. Its effects are not just limited to those who have been directly affected by the traumatic event. Researchers report that PTSD and trauma have a gamut of outcomes.

  • Traumatic events typically exhaust the family’s efforts, money, and time, interrupting working, growing, and learning. As a result, families have an even greater difficulty performing their daily tasks and withstanding the vital beliefs and traditions used to bind them together.
  • When stress gets too overbearing, couples may have difficulties dealing with intimacy and their feelings, communicating effectively, resulting in a greater chance of separation.
  • Trauma resonates across societies and communities, and this damages the very core of a functional society. It could also affect many generations, building a legacy of endless distress. If unsettled, the overwhelming trauma of culture loss, forced removal of communities and families, and genocide become some ‘mental baggage,’ constantly being recreated and done by generations to generations.

Trauma Counseling

Managing emotional damage that almost always goes with trauma is not easy, especially without professional help. Truly, the functions of a certified counselor are even more crucial when one realizes that if not managed appropriately, the aftermath of trauma can go on indeterminately. In fact, they can totally affect the lives of refugees and other sufferers and the people around them as well.

How It Works

The principle that one size fits all does not apply to trauma therapy at all. Still, counselors efficiently deal with individuals, families, and communities to learn positive ways of dealing with emotions and behavioral patterns that have grown due to trauma. This could also entail assisting them in regulating strong feelings and learning to trust again.

Trauma counseling offers an avenue for people to open up and talk about their feelings and encounters. It also enables people to practices techniques for managing the current challenges that they’re confronted with. Trauma counselors give compassionate and effective support to their clients without getting too emotionally tangled or engrossed in their situations.

Source: infomigrants.net

Counseling In South Africa

Activists and healthcare professionals continually urge government leaders to address the extreme cases of psychological trauma where a large proportion of the country’s population suffers. The distressed need for more counselors in the field of trauma in South Africa can’t be overemphasized. Without the vital services these trained counselors offer, there is little chance of getting rid of the country’s existing pain and ending its tenacious damage.

Trauma counseling is customized to each circumstance.

Because there is no other comparison to the pandemic lockdown, its complete physical, mental, and emotional impact remains unclear. But the abrupt and severely damaging events can stimulate a traumatic reaction in people and communities. Hence, the prolonging experience of the lockdown, such as in adults and children in South Africa, will most probably heighten the requirement for trauma counselors across the globe.




The present rhetoric concerning refugees talked about by the media has been a brutalizing reaction to the continuing unrest in Syria that has added to the biggest refugee catastrophe since the old wars. The other countries are confronted with unparalleled encounters of caring for thousands of people in dire need. The course of refugee immigration to the United States is not quite the same as the pictures exemplified in the media through words like swarms or outpouring of people crossing boundaries in the wee hours of the night, those who may pose a danger or cannot be inspected.

Source: ct.counseling.org

The truth is, refugees, go through several background inspections, health assessments, and multiple interviews before getting accepted and allowed to travel to the United States, according to America’s Citizenship and Immigration Services. Normally, this could take two years at least – two years where their lives are put on pause, primary needs are only met via donations, and outsiders and external organizations make the crucial decisions.

The United Nations High Commissioner For Refugees is the organization tasked to interview individuals who flee violence and identify whether these individuals possess a rightful fear of persecution. It reports that 1% is endorsed to a third country for relocation. These are frequently classified as the most exposed and as those with no other stable solution. Refugees themselves don’t opt to be relocated or where to be relocated. The country that the refugees are relocated to then follows security rules and health evaluations. If the refugees family is cleared, it is endorsed to the appropriate organization for resettlement. The resettlement organizations identify which local partner to endorse the family for reception and relocation services. The partners welcome the new refugees, offer education, case management, introduction, and counseling while connecting with the local communities to enable integration.

Refugees After Resettlement

The rising crisis overseas should provoke the concerned professionals’ obligation for social justice and diversity. Ban Ki-Moon, the UN Secretary-General, once a refugee himself, said that refugees might have lost their homes, but they should not be robbed of their futures. Counselors can help refugees after resettlement and towards a successful future. Relocation work in the initial months is done through non-profit groups in affiliations with the government and frequently with incomplete resources. Some refugees who arrive have family members or friends in the community, and others do not have a single acquaintance in the country refugees are relocated to.

Refugees having fun on a festival day.They originated from various backgrounds, religions, languages, and capacities.

Source: infomigrants.net

The first three months can place a profound burden on a family whose expectations are not yet met. Anxiety can cause loneliness, and family roles may be overturned. It is a course that involves welcoming the new members to the community and assisting them in their journey through self-sufficiency. It will be of great help if counseling professionals are present during this event. It is not just a humanitarian responsibility but also a chance for countries to take advantage of the skills and potentials of these new refugees. Counselors are tasked to accelerate coordination, self-sufficiency, and professional success for them so that refugees and the country can reap positive benefits. Refugees originate from various backgrounds, religions, work experiences, languages, and capacities. The counselors’ skills are suitable for evaluating their clients’ different histories and match them to the country’s needs that they settle in, guiding them through a profession instead of a job that merely helps them sustain.

Different Ways To Help Refugees 

There are a lot of ways that a counselor can help refugees succeed in their new country. To introduce refugees to the goals and strategies of achieving their aspirations amidst stressful situations requires a harmony of roles. This may be dealing with finances, discussing junk mail issues, introducing social norms, or promoting various opportunities. Counselors may:

  • Assist in relief efforts and relocation organizations.
  • Communicate with resettlement agencies and provide consultation.
  • Take action against the negative rhetoric concerning immigration and cultural organizations that contribute to stress, fear, seclusion, and discrimination. The immigrants and host countries benefit from a kind, welcoming, and open to helping others learn about their culture.
  • Support educational programs for refugees, hundreds of whom have had their education disrupted by travel and war.
  • Oversee the services provided and assess how available and efficient they are to refugees and immigrants. Relocation organizations aim to support new immigrants, but they also have to incorporate them into society and endorse them to other agencies. The accessibility of these agencies to the refugees population depends on the cultural competency of those offering them.

Source: pri.org

The Counselors’ Helping Hand

What do counselors need to be aware of refugees? They can and must help them. As an individual leaves his home, he has to settle in a new home somewhere else, including procuring a job and an education. Counselors possess the capacity to tackle the trauma of this disruption, educate the refugees to the economic and cultural environment, enable the client in planning for his future, and promote equal opportunities for all of them.



Frequently Asked Questions For People Dreaming Of Offering CBT Counseling

I had always known that I was different from the other kids I played with at the park. While they had their hair running wild and free, mine was kept hidden in a hijab. While most of my classmates had delicious snacks and fancy lunchboxes, I always had an apple in a plain tin box. It did not help that I noticed some parents not wanting to let me play with their kids, although no one would say why. I initially thought it was because of my family’s lack of excess money. When I asked my parents about it, they were hesitant to tell me that it was more because of where we were from.

“I was born here, right?” I asked them innocently.

“Yes, you are, honey,” Dad assured me. “But your mother and I came here from Iraq to seek asylum when you were still not born. It’s only a few years ago that we became citizens of the United States.”

Source: pixabay.com

“So, why would people treat us differently because of that?”

“We don’t know, honey,” Mom said, shaking her head slowly. “Perhaps they don’t understand our circumstances.”

Instead of getting angry at everyone and becoming a rebellious kid, I knew early on that I had to work hard to give my parents a better life. They had a rough life before coming to the US; they suffered a little more due to some people refusing to provide them with jobs they were meant to have. So, I got straight As and one scholarship after another in college to ensure that my parents won’t need to worry about sending me to school. It was especially necessary since I wanted to become a cognitive-behavioral psychologist and therapist and was required to get a Master’s and a doctoral degree before practicing.

1. What is CBT in Counselling? 

 Cognitive-behavioral therapy (CBT) is one of the most common forms of psychotherapy that aims to help patients improve their thinking or behavior once they face various life challenges. It involves assessing an individual’s thinking pattern, given that many studies reveal that thoughts dictate actions.

For instance, if you think of awful things about someone, you may scrunch up your nose when you see them and even act rudely around them. However, if you give them the benefit of the doubt at the least, you will be open to listening to whatever their explanation may be. With the latter way of thinking, you will understand why someone acts a certain way.

2. What is CBT, and how does it work? 

 CBT is technically a talk therapy that psychologists recommend to people with depression and anxiety. It is a short-term and practical treatment that encourages patients to face their issues head-on and teaches them how to improve their views. This way, they will know how to deal with the situation better if they ever find themselves in it again.

CB therapists have unique treatment plans, but it typically starts with the patient revealing their therapists’ problems. In the goal-creation process, both parties will work on it, not just the latter. That serves as the basis for how many sessions the patient may need. Then, every succeeding session will be similar to a classroom setting, in which the therapist discusses the result of the previous one before moving on to a new topic. There will most likely be homework to be submitted when the patient meets the therapist the next time.

Source: pexels.com

3. Can you do CBT on yourself? 

 Yes, you can perform CBT on yourself. It is effortless to find CBT books and online guides these days, so it is highly possible, especially when you have already experienced it and know your therapist’s process. However, if you have never done CBT before, it is still best not to self-medicate and see a licensed therapist instead.

4. Which is better, CBT or Counselling? 

 It depends on what issues you have. In case you are dealing with stress, relationship loss, miscarriage, and other sudden problems, counseling may be more suitable for you than CBT. The counselor can listen and empathize with you until you feel better.

However, if you have been diagnosed with depression, anxiety, and other disorders, your psychologist may suggest CBT. Though a CB therapist may also listen and empathize with you, their approach is directed to changing your perception and behavior to help you cope with or reduce your mental illness symptoms.

5. What are the four types of talk therapies? 

  • Cognitive-behavioral therapy (CBT): It is a suitable treatment for people who have clear mental health goals to achieve. It also challenges the patient to recognize negative thoughts and alter them for the better.
  • Dialectic behavior therapy (DBT): It is a combination of meditation exercise and CBT. The patient may also do it one-on-one with a therapist or as a part of a group.
  • Psychodynamic therapy: In this form of talk therapy, the therapist assesses how your current behavior, thoughts, and emotions have been affected by early experiences. Thus, it may require you to go back down memory lane.
  • Humanistic therapy: This type aims to work on the patient as a whole instead of just focusing on their mental processes. It helps the individual notice their interpersonal and intrapersonal relationships and figure out how to make them better.

6. Can counselors do CBT? 

 Yes, counselors can do CBT, provided that they have acquired certification and training to do so. However, keep in mind that counseling and cognitive-behavioral therapy requires different training and licenses. Because of that, if you only have the qualifications to provide counseling, that’s all you can do. 

If you genuinely want to offer CBT, you should look for programs that will take you a step closer to that goal now.

7. What is an example of cognitive-behavioral therapy? 

 Let’s say that a patient wants to do CBT because they cannot handle work-related anxiety. A CB therapist may initially teach deep-breathing techniques to the patient to calm down even when the therapist is not with them. Then, the patient may learn some self-affirmation chants, such as, “I can do this,” “I am in a safe place,” and “I am just repeating what I have already done in the past.” Therapists may also help the patient find a useful distracting tool, like an online game, a fidget spinner, etc.

Source: pexels.com

8. How long does it take for cognitive behavioral therapy to work? 

 Cognitive-behavioral therapy lasts between 12 to 20 sessions. If you have a minor mental disorder, you may notice that it is already working after a few sessions. However, for severe conditions (e.g., major depression and anxiety), the effect may not be visible until you reach the treatment end.

9. What are the three main goals in cognitive therapy? 

Cognitive therapy aims to do the following:

  • To provide mental relief by stabilizing symptoms and solving issues.
  • To teach various coping mechanisms to patients.
  • To alter the patient’s way of thinking for good to keep them from relapsing.

10. What are the CBT skills? 

 Before a mental health professional can perform cognitive-behavioral therapy, they need to develop a few skills, including:

  • Having extensive knowledge regarding the treatment
  • Creating programs that will cover all the patient’s issues
  • Discussing the problems, examples, and possible treatments for the patients
  • Showing nonjudgmental, assertive, and collaborative traits
  • Building a sense of connection with patients quickly

11. How do you set goals in CBT? 

  • Goal Identification: The first step is to determine what goals you want to achieve in CBT. For instance, you wish to stop exploding in anger immediately, be able to sleep without worries, walk in the middle of a crowd without hyperventilating, etc.
  • Starting Point Identification: This is where the patient lets the therapist know how far the former has achieved the said goals. The patient should practice honesty concerning the matter because the therapist needs this information to assess how long the treatment should be and what techniques may work.
  • Goal Breakdown: The therapist and the patient’s initial goals initially agree on the need to be broken down into smaller goals and achieved chronologically. In doing so, you may be able to predict the likely hindrances to the CBT success.

Only when you complete the three steps above that the therapy can begin. 

12. What is the focus of cognitive-behavioral therapy? 

 Cognitive-behavioral therapy’s primary focus is to help individuals alter the negative thoughts that may fill their heads whenever they are in a specific situation. Such thoughts often prevent their mental health from improving.

13. Why is CBT so popular? 

 CBT started gaining popularity in the 1990s as it had been used not only for treating mood and anxiety disorders but also for dealing with chronic physical illnesses. One of the possible reasons why it remains popular up to this date is that the process is easy to understand for everyone. After all, cognition genuinely causes people to behave in a certain way. If you modify the patient’s thinking process, their behavior will most likely change, too.

14. What is CBT for anxiety? 

  Exposure therapy is the most common form of cognitive-behavioral therapy for anxiety. The reason is that this mental disorder is not like depression or any illness that can be treated by merely talking to the patient. The therapist will need to expose the patient to their fears in a safe and structured manner until they learn how to manage the symptoms.

Source: pexels.com

Final Thoughts

Last 2014, I finally received my license to practice CBT in three different states. At that point, the stigma and prejudice that my parents and I experienced in the past were already gone. All that people saw was an elderly couple with a successful daughter, which was how it’s supposed to be.


Frequently Asked Questions About Marsha Linehan And DBT

Refugees go through tough situations. Aside from the actual migration, they have to face challenging pre-migration conditions. Most have to deal with separation from their families, poor housing, or even wars. Due to these, refugees need special attention. They must receive the proper treatment to help them recover from the traumatic events they had to endure as much as possible.

Source: pexels.com

Luckily, Marsha Linehan came to create Dialectical Behavior Therapy (DBT). At the age of 17, Marsha Linehan was experiencing a difficult time with her mental health. She was inaccurately diagnosed with different disorders. Because of that, Marsha then got worse. 

One night, when she was kneeling to pray, Marsha felt this rush in her as she looked up at the cross. She went back to her room and whispered, “I love myself.” She indeed adored herself. But it was the first time when she had truly felt it. She felt so proud. At this same time, she realized the vital role that acceptance plays in the healing journey. Then she discovered Dialectical Behavior Therapy. 

From then on, Marsha continued to help better the human mind by sharing this knowledge of hers. Currently, she is a Professor Emeritus of Psychology in the Department of Psychology at the University of Washington and is Director Emeritus of the Behavioral Research and Therapy Clinics. Marsha has also spent her time researching and developing new treatments for severe disorders. 

Furthermore, Dr. Linehan created The Linehan Institute to educate and research DBT, Behavioral Tech, giving DBT and Behavioral Tech Research training. 

Marsha Linehan received several awards, including the Lifetime Achievement award from the Association for Behavioral and Cognitive Therapies in 2016. The American Association of Suicidology also created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. 

If you want to know more about her, here are some FAQs. 

Did Marsha Linehan have BPD?

Dr. Marsha Linehan, who developed dialectical behavior therapy (DNT), has previously had a borderline personality disorder (BPD).

At 17, she stayed in a seclusion room in a clinic because she tended to cut and hurt herself. As BPD wasn’t discovered yet at that time, she was diagnosed with schizophrenia. The treatment she received was a heavy Thorazine and Librium medication and undergoing electroconvulsive therapy (ECT), which wasn’t successful.

What are the six main points of dialectical behavior therapy?

The six main points of DBT distinguish periods in the therapy sessions where change will occur. It involves pre-contemplation, contemplation, preparation, action, maintenance, and the last is achieving mindfulness.

It starts with the patient’s unawareness, followed by the realization in the contemplation period. What follows after these two points are the therapy procedures that will cause a change in the patient’s condition. Upon processing and accepting these changes, the final point is achieving mindfulness.

What is DBT therapy good for?

DBT was initially a therapy intended to treat BPD. However, over the years, it has also been found effective for treating other mental health conditions. It includes conditions such as depression, anxiety, trauma, eating disorders, substance abuse, etc. DBT works for these conditions as the procedure helps people regulate emotions and become mindful of their thoughts and actions.

Do borderlines have empathy?

Research has shown that borderlines have reduced brain activity in regions that support empathy. The reduced brain activity in the brain of a person with BPD affects their comprehension of other people’s feelings. This brain activity may be why people with BPD often have unstable moods and have trouble maintaining their relationships.

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What triggers a person with a borderline personality disorder?

The triggers of BPD often vary from patient to patient. However, there are types of triggers prevalent in the condition that may intensify their symptoms.

One of the most common BPD triggers is relationship-related triggers. Since people with BPD are more sensitive in nature, they experience intense anger and fear when abandoned. The feeling of neglect from a relationship may lead to impulsive actions, such as self-harm and thoughts of suicide.

Is BPD a brain disease?

Researchers still haven’t found a definite cause of BPD. However, it has often been linked to a history of abuse and neglect, genetics, or brain abnormalities. There is substantial evidence that BPD patients can pass on the condition. Research findings suggest that the brain abnormalities involved in BPD are a gene consequence in the brain’s development.

How is DBT different from CBT?

DBT is a specific type of CBT. Hence, DBT stems from the foundations of CBT but focuses on regulating harmful and destructive behaviors. It doesn’t only work to recognize problematic thoughts but also on accepting and managing emotions. The desired result of DBT sessions is mindfulness.

What was Dr. Linehan’s approach to developing DBT?

Dr. Linehan developed DBT as a variation of traditional CBT with a combination of acceptance and mindfulness. It integrates contradictory philosophies that allow a patient to come to terms with change and acceptance. Dr. Linehan developed DBT as a result of her condition.

What does it mean to think dialectically?

The word “dialectical” refers to the balance between contradictory views or points. Its central premise is that these opposing views can coexist rather than being categorized as one or the other. Hence, thinking dialectically means having no one absolute idea. When incorporated in DBT, it allows patients to understand and apply change and acceptance in their life.

How long does DBT therapy take to work?

The duration of DBT varies for different patients. However, it generally takes around six months for most patients to finish. It involves completing the four DBT modules, which are: emotional regulation, distress tolerance, core mindfulness, and finally, interpersonal effectiveness.

Is DBT effective for depression?

Since DBT incorporates comprehensive therapy elements, research has found that it can be effective for treating depression. Its cognitive-behavioral, mindfulness, and acceptance-based therapy approach is successful for addressing common symptoms of depression. In this process, patients can practice acceptance and management of emotions to develop efficient coping skills.

Is DBT good for trauma?

Most traumatic experiences show up later in life as unwanted emotions. DBT’s approach can help address trauma with its emotional regulation techniques and mindfulness strategies. This way, it helps people with trauma work towards acceptance and developing coping skills in facing their trauma.

Does DBT therapy really work?

Studies have found that the DBT procedure is successful for individuals of diverse demographics and backgrounds. However, for the best results, the patient themselves must be willing to undergo recovery. Like other therapy methods, the effectiveness of DBT may vary depending on different patients’ circumstances.

What can I expect from DBT therapy?

During DBT, you can expect to undergo the therapy’s main components: group skills training, individual therapy, and phone coaching. It involves learning behavioral skills, applying them in real-life events, and getting adequate support to boost motivation.

How effective is DBT for a borderline personality disorder?

DBT has been developed specifically for treating BPD, targeting three behavior categories of the condition that may hinder recovery. It includes life-threatening behaviors, therapy-interfering behaviors, and quality-of-life-interfering behavior. Hence, it addresses the present challenges and harmful behaviors that the patient is facing and their recovery behaviors.

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Marsha Linehan has struggled so much during her teen years. She had to put through different kinds of pain because of the misdiagnosis of her mental health condition. Fortunately, Marsha has figured a way to fix the problem. In return, she has not only helped herself but many other individuals as well. She paved the way to learn more about the illness. But more importantly, Marsha led the way to discover a useful treatment, which is Dialectical Behavior Therapy (DBT).

Dr. Linehan’s DBT aims to bring peace to others by reflection onto self. It is a mix of different strategies that include acceptance, emotion regulation, and mindfulness. The goal of DBT is to teach how to savor at the moment, control emotions, build good relationships with others, and develop healthy coping mechanisms. It is initially for those with Borderline Personality Disorder (BPD). But over the years, studies show that it can help with other mental health conditions too. 

The effectiveness of DBT has been proven through years of research and study. However, this therapy cannot fully succeed without the full cooperation of the patient. The desire to change should start from within. The only way to achieve mindfulness is by acknowledging that there is something that needs to change. 

In the case of Dr. Linehan, after admitting that she loved herself, she started to begin to change. She put it in the conscious effort and focused on finding a way to keep that positive mindset. Lo behold, she did it. And because of that, she developed DBT.

Currently, DBT is an effective treatment for different conditions such as anxiety disorder, post-traumatic stress disorder, and depression. These are common conditions among refugees, which means that too they can benefit from DBT.

In Focus: Refugees And Their Mental Health


Source: pxfuel.com


For years, refugees and asylum seekers have gone through intensely stressful situations due to religious or political oppression, resettlement, war, and migration. It’s not easy to define every kind of event they have experienced, as refugee trauma frequently precedes the stressful situations that push them to flee. But before this happens, they might go through torture, imprisonment, physical abuse, rape, unemployment, property loss, or malnutrition. What’s worse is that these refugees are often separated from their loved ones during their flight, or they are forced to kill or witness torture or withstand very cruel environmental circumstances. Possibly, the most relevant outcome from all the encounters that refugees withstand is being betrayed by either their friends or their enemies.

Indeed, refugees have had significant emotional and occasionally physical recovery encounters that should be meticulously evaluated and treated. Needless to say, the mental health of refugees is often at stake and must be discussed.

Refugees And Mental Illness

Studies have proven time and again that mental health disorder is the primary source of disability across the world. It comprises more than 10% of the global problem of disease and accounts for over 30% of the number of years survived with disability. It is projected that individuals who have serious mental disorders like bipolar disorder, severe depression, and schizophrenia have a higher likelihood of dying earlier than those who don’t suffer from them.

The issues concerning mental health are widespread, and it impacts people around the world. Additionally, there are significant economic outcomes of this widespread occurrence. The cost of mental illness-related evaluations and treatments was estimated to be about $16 trillion from 2011 until 2030.

Source: pxfuel.com

The official definition of a refugee or an asylum seeker is someone “who is often afraid of being victimized because of race, nationality, religion, member of a political or social group, is outside his own country and is not able, unwilling to access protection of his country, or does not want to return to it because of fear or apprehension.”

Presently, the obligation of mental health support for refugees and asylum seekers is shared by a group of organizations such as the United Nations High Commissioner for Refugees, World Health Organization, and non-profit and government organizations. Most of the refugees are inflicted with PTSD because of the various devastating situations they are confronted with that inevitably affect their way of life.

Posttraumatic Stress Disorder (PTSD)

This mental health disorder is defined as enduring, distracting, and repeated flashbacks or memories of someone who has gone through trauma, including detachment symptoms, sleep disturbance and amplified startle response. PTSD is thought of as a single major mental disease that might have a clear cause. Responses such as horror, helplessness, and fear can be described as the individual’s integrity becoming vulnerable. Problems in cognitive function, relationships, emotional management, hopelessness, and somatization may happen because of extreme stress due to overwhelming situations and unpleasant experiences.

The presence of traumatic experiences is not uncommon. In fact, over two-thirds of individuals in the general populace can encounter a major traumatic situation at some point in their lives. Several studies on asylum seekers in the western part of the country revealed that almost 10% of refugees had PTSD, and about 5% suffered from depression. These pieces of evidence suggest that most of them require counseling. In other studies that delved into the biological impact of PTSD, the findings revealed:

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  • Decreasing volumes of the anterior cingulate cortex and hippocampus suggest the development of substance abuse and depression.
  • Increased heart rate in response to unexpected loud tones, suggesting central sensitization.
  • The dorsal anterior cingulate cortex and amygdala are hyperactive, while the ventral medial prefrontal cortex region is hypoactive in PTSD, suggesting attentional bias towards abnormal emotional regulation.
  • Alterations in the brain, particularly brain volume, in PTSD.

The above information revealed that cognitive-behavioral therapy specific to trauma or eye movement desensitization and reprocessing must be considered in people with PTSD. One should also consider psychological evaluation and treatment to decrease PTSD symptoms. Finally, mental healthcare programs should be incorporated into policy planning like psychotherapy, counseling, psychosocial treatment, and pharmacotherapy.

Refugees And Healthcare Professionals

Psychiatrists, social workers, medical doctors, and other healthcare professionals must be aware of the important elements that influence refugees and asylum seekers’ mental health.


  • The incidents they are exposed to in their own country or the evacuation camps have stayed in.
  • The experiences they have on the way to their host country and their new life in the new country they are in.
  • Their health is also impacted by neurological conditions, chronic diseases, cancer, and infectious conditions that could lead to polymorbidity.
  • Infections
  • The consequence of starvation, which may include paresthesia, epilepsy, and ataxia.
  • Psychological concerns.
  • Communication, attention, and intercultural difficulties.

Source: pxfuel.com


A clinical trial on mental health needs in a group of asylum seekers in Malaysia revealed that these asylum seekers and refugees stressed their worries about providing opportunities for permanent relocation and concerns about their capacity to survive financially. Service providers must pay attention to their mental well-being. Coping techniques and strategies should be integrated while assessing their basic needs, whether they are staying in temporary locations.




Helping A Family Of Refugees Settle In The Community

I live in a close-knit community where everyone practically knows each other from birth. I married my childhood sweetheart, my best friend’s house is only at the end of the road, and my parents stay next door. The other folks in the neighborhood have similar life stories, too.

Then, sometime in 2012, we saw a new car pull up at the only apartment complex in town. At first, we thought that the landlord owned it, but a dignified-looking man I had never seen before came out. Two adults and three kids followed him. Even from afar, it was possible that they were a family from the Middle East. The man led them in the apartment and went out alone after a few minutes.

Source: wallpaperflower.com

As curious as I was, I kept myself from barging in the complex and demanding to get to know my new neighbors. But I had the chance to say hello to them when the new family went to the park where my kids typically played one afternoon. That’s how I learned that they were refugees from Iraq and that they fled from the country after the school they worked at got bombed.

I could not fathom the anguish and fear that this family must have experienced. It pushed them to move to a foreign country and leave everything they had behind. The least we could do to help them settle in the community were:

Make Them Feel Welcome

The first thing I did was introduce the family to our neighbors. The town is too small for people not to get acquainted, so it’s better for them to have a formal introduction now instead of later. And once the others have heard the reason why they have become refugees, their expressions transform from mere curiosity to sympathy, too.

Source: pikist.com

To make the family feel welcome, we decided to throw a little picnic party at the park. Everyone chipped in and brought homemade dishes and drinks. Although it was a small gesture, our new neighbors were teary-eyed while thanking us, saying no one had ever been too kind. This statement made me want to cry for them, but I held it in because pity was the last thing they needed.

Avoid Asking Too Many Questions

After several conversations, we learned a few things about the Middle Eastern family. For instance, Abdul (the father) served as a high school principal in Iraq, and Alia (the mother) taught pre-school kids. When they fled, they stuffed as many belongings as possible in two suitcases.

Source: pikist.com

However, seeing how sad the adults were whenever they talked about it, we tried not to ask too many questions regarding life back home. I figured that they would open up once they were emotionally ready to do it. At the moment, the family should focus on familiarizing themselves with the community that they might live in permanently.

Offer Mental Help Support If You Can

Since we met the refugees at the park regularly, we noticed that they would get jumpy when a car door closes loudly, or someone honks too much. Adult or not, their reactions were the same. Even if I was not a psychologist, I could quickly tell that the family was most likely suffering from post-traumatic stress disorder (PTSD). From what I gathered, this condition was common among victims of war and violence, which they clearly were.

Source: defense.gov

I talked to my husband (a psychologist) about my observation, and he agreed to offer mental help for free. So, I asked the family to come over at our house so that they could converse in a safe space. The more group counseling sessions they had, the less affected they were by external noises that reminded them of what they ran away from.

Find Out What They Need But Still Don’t Have

Another act of kindness that we did was finding out what other things this family needed but did not know how to get. It would not be acceptable to give them hand-me-down clothes or money, after all. Though they were refugees, they were not homeless people or charity cases. They could even afford the rent at the apartment complex without the help of the government.

Source: flickr.com

When I asked them what else they needed, Alia said, “Abdul and I need to look for teaching jobs. Our savings would suffice for a year or so, but we need a stable income source.” Hence, I brought them to my kids’ schools and introduced them to the principals. After a few meetings, they agreed to hire the couple.

Final Thoughts

It won’t be an exaggeration to say that the Middle Eastern family lived happily ever after. They felt awkward at first, but they managed to get back on their feet. Even the kids were doing well and trying different extracurricular activities. It was as if they had been living in town all their lives. Hopefully, every refugee gets to settle in their chosen communities as smoothly as they did.

What We Can Do To Help Protect Refugees During The Pandemic


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The coronavirus outbreak is unreasonably affecting the world’s most susceptible. Among them are the 70 million displaced people – the internally displaced, asylum seekers, and the refugees – and this included undocumented migrants and migrant workers. Most of these women, men, and kids are staying in regular as well as irregular camps, detention centers, and reception facilities. Some are living on the streets in some informal home arrangements. Still, others do not have access to essential needs, like proper healthcare and sanitized water. Lastly, a lot of them do not have any legal status at all.


The pandemic aggravates and is worsened by unpleasant living situations.

In settings like the ones mentioned above, even precautionary measures are not always doable. It is difficult to tell them to protect themselves when they do not have access to clean water or soap. How can we tall them to self-isolate when they are staying in crowded tents, along with ten others? Indeed, physical distancing is not easy to do at all for these people who live in small, jam-packed homes with several family members. And worst is, they need to line up to get water and food, which undeniably heightens their risk of getting infected.

In many setups, refugees live in fear and anxiety, often confronted by the risk of abuse, arrest, or stigma of being disease carriers because of the existing racisms. Additionally, in a lot of regions spread across the world, the COVID-19 pandemic is being abused, using it as a reason to punish refugees and other displaced groups, even those who wish to help them. There are nearly 170 states that completely or incompletely closed borders to stop or prevent further spread of the virus, and 57 of these don’t make any exclusion for those seeking refuge.

Source: wordpress.com

If you want to help in your little ways to protect these vulnerable people, here are some things you can do.

  • You strive to work on making sure that the pandemic is not used as a reason to implement life-threatening migration control laws. You must be aware that governments should not use this global crisis as an excuse to impose further restraining migration control policies and avoid international responsibilities to these vulnerable refugees and migrants. There are serious challenges that are confronting all of us as we live with the risk of being part of those who have become carriers or worse, who have died because of it. However, protecting the wellbeing of everyone in your own country and doing your obligation towards these displaced individuals are not in any way different at all.


  • Ensure that human rights are honored. The government should not use the coronavirus emergency health guidelines to mark migrants, refugees, and migrants. All limitations related to human rights must be required and respected based on scientific proof, not enforced discriminatorily or illogically. All data related to the pandemic must be reviewed and decided upon concerning human dignity.


  • Refugees and other displaced groups that are considered high risk must be moved as soon as possible. In other countries, governments and non-profit organizations call for the evacuation of individuals and groups that are most at risk. These are the seniors and those with respiratory illnesses, diabetes, and other existing medical conditions. They are also making efforts in decongesting refugee camps or tents, along with moving unaccompanied minors and sick kids to other neighboring states. Allowing these people to stay in cramped and dirty informal homes was and will always be irresponsible.


  • Closures, quarantines, and lockdowns can’t be unreasonably and discriminatorily enforced. Measures must be applied fairly to everyone without any form of racism, discrimination, or stigma. Healthcare, basic needs like water and food, and psychological and social support must be provided to those who are quarantined. Ultimately, mass quarantines should not be allowed as much as possible.

Source: defense.gov


We all need to protect access to healthcare for everyone. The pandemic control guidelines must not apply at the expense of access to appropriate healthcare. This implies that border closures should not hinder the necessary medical and other essential supplies from entering countries. Finally, governments must make sure that those constraints in free homes, reception centers, and detention facilities do not stop refugees, and all kinds of people, for that matter, from getting the healthcare they need.





Refugee Learning: Culinary Tips And Tricks

There are a lot of exciting things in the 2019 culinary event for refugees. Some of the information is used to improve not just your cooking skills, but as well as your cooking wisdom. Some tips and tricks will help you make your dishes taste just as great as those certified master chefs. So let’s start identifying some of those tricks that can change your cooking experience.

Cooking Tips To Remember

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Never fry a piece of meat that you have just taken out of the fridge. Instead, allow it to lose all the buildup ice and let it come up to room temperature. You can do it by leaving the meat an hour or two. That way, you can cook the meat evenly. Note that it would be better to get off all the moisture if you want to have a beautiful brown crust on the fried meat. If you are used to frying your meat with oil, you might want to consider not doing it anymore. Most chefs are not using any cooking oil when cooking their meat. That is because cooking without oil helps preserve the meat’s natural juice. Besides, meat has its oil in them so you won’t have to worry about it.


If you are a lover of vegetable cream soup, perhaps you need to understand the best process in making one. So to come up with the best-tasting soup dish, fry all the vegetables separately with olive oil right before cooking your soup. Some would choose baking their veggies for 5 minutes, and that is okay as well. The process of frying helps caramelize the natural sugar in vegetables to enhance their flavors. Also, when adding water, it would be better to start with a lesser amount of cups. That way, it would be easier to correct the taste by adding small portions of water while cooking the soup.

Source: pexels.com


If you want your dish full-flavored, consider using enhanced spices. You can have it by tossing your cumin or pepper in a pan over medium heat. That way, you can toast the spices until they get the best aroma. From there, you can grind them by using a mortar and pestle or any grinder that suits your needs so that they can add more aroma and flavor to your food. However, too much of it can also ruin the natural blend of the dish. Therefore, make sure you only put enough to obtain the necessary balance of taste you need. Avoid putting spices all together as well because some ingredients do not go along with the others.


Regardless of the many recipes you follow, you need to understand that sugar is not only for additional sweetness. In fact, it is also an excellent seasoning ingredient that helps your dish taste even better. Sugar reduces every food’s natural sourness, so adding small amounts of it won’t harm your dish. Just don’t overdo it. Also, if you want to improve the taste of your marinated meat, you can use some sugar along with pepper and salt.

With all these helpful tips, you need to understand the most important one. As tasty and delicious as your freshly cooked dish appears in front of you, do not eat it instantly. Instead, allow it to cool for a bit. That is because too cold or too hot dishes can impair your taste judgment.