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Providing Culturally-Relevant Psychotherapy to Arab American Women

Internet Editor’s Note: Ms. Laila Abdel-Salam and colleagues recently published an article titled “Experiences of gender among Arab American women: A qualitative study” in the Journal of Counseling Psychology. Purchase the article for $11.95 here.

Arab Americans are not officially recognized by the United States government as a minority group, which has resulted in not only a failure to accurately document increasing occurrences of discrimination (Awad, 2010), but also in a lack of knowledge about this ethnic group. The juxtaposition of mounting negative media visibility with a general lack of knowledge about this ethnic group has caused Arab Americans to be among the most misunderstood ethnic groups in the United States (Erickson & Al-Timimi, 2001). Shaheen (1991/2003), who has analyzed the representation of Arabs in comic books and movies, found that Arab men were chiefly portrayed as brute murderers, sleazy rapists, religious fanatics, oil-rich dimwits, and abusers of women.

These negative stereotypes have translated into risk of physical and psychological harm. For instance, the 2002 Zogby International poll, which surveyed trends surrounding the September 11th terrorist attacks, revealed that one in three Arab Americans reported being subject to discrimination; 40% conveyed knowing a victim of discrimination; and 78% reported experiencing greater racial profiling since 9/11 (Zogby, 2002). Also, the most recent United States presidential election denotes a significant moment in the Arab American experience. Of the eight countries targeted by President Trump’s Muslim bans in 2017 and 2018, half were Arab (ACLU of Washington, 2018; Washington Post, 2017). Similarly, as reiterated in the 2018 Arab American Institute report, anti-Arab hate crime incidents increased by 38% in 2016 (Arab American Institute [AAI], 2018).

Race and Racialization

Arab Americans have a unique experience with race in the United States, particularly, due to the change of their position in the United States’ social hierarchy (Cainkar, 2015). In 1943, Arab Americans achieved White status and were as such not moved to make a claim to minority status during the Civil Rights era. This proved to be disadvantageous at the start of the 1970s, in which Arab Americans began to face structural exclusion (Carinkar, 2015) as a result of intensifying anti-Arab sentiments in the United States. Subsequently, the September 11th terrorist attacks, as well as the recent Muslims bans represented a turning point for discrimination against Arab Americans. As such, Arab American activists are struggling for Arab census recognition (NPR, 2018). The proposal would codify the Middle Eastern North African (MENA) category. Nonetheless, despite mounting lobbying efforts, the Census Bureau announced in 2018 that it did not plan to add a MENA category to the 2020 census (AAI, 2018).

Bringing a Focus to Arab American Women

As stated, Arab American men are frequently depicted as terrorists and oppressors of women, but what of the rendering of Arab American women themselves? An examination of stereotyping reveals common portrayals of Arab American women as veiled, oppressed, or in need of saving (Read, 2003; Stephan & Aprahamian, 2015).

Stephan and Aprahamian (2015) labeled gender and sexuality as a point of “crossfire” (p. 117) of culture, ethnicity, and religion for Arab American women. According to these authors, being an Arab American woman involves feeling pressured to embrace American culture while simultaneously attempting to preserve one’s Arab heritage.

Key Themes when Counseling Arab American Women

To provide multiculturally competent services to Arab American women, some key themes are important to consider. These themes are derived from the psychological literature, as well as from Arab psychotherapists’ first-hand practices.

Racial Ambiguity

Arab Americans have been described as being phenotypically and racially ambiguous (Abdel-Salam, Rifkin, Smith, & Zaki, 2019; Naber, 2000). Identifiable Arab Americans may experience discrimination; at the same time, other Arab Americans may find themselves facing the question “What are you?” (Abdel-Salam et al., 2019). Zopf (2018) found that Arab American women were often believed to be South Asian. This experience of being misidentified or queried about racial identity has been described by Pirtle and Brown (2016) as an “identity interruption” (p. 598). They described identity interruptions as an indisputable example of microaggressions: although seemingly mundane, they can bring about psychologically harmful stressors.

Religion and Religiosity

Concerning Arab American religiosity in the United States, unlike popular misconception, 77% of Arab Americans identify as Christian, not Muslim. Religiosity, which has been defined as the extent to which individuals are tied to their faith, (Read, 2003), plays a key role in the lives of the majority of Arab Americans (Erickson & Al-Timimi, 2001). Particularly, regarding Arab American women, religiosity often guides their choices in intimate relationships (i.e., whether or not to engage in premarital sex).

The intersectionality of racial ambiguity and religion is particularly relevant for Arab American women. Specifically, the conflation of Islam and Arabness (a) renders Christian and non-religious Arab Americans invisible and (b) leads Arab American women who do not wear the hijab, which has become a distinct symbol of Arabness, to feel invalidated and invisible.


Family plays a central role in the life of Arab Americans (Haboush, 2007). Family in Arab culture does not simply pertain to the nuclear family but encompasses the extended family (Erickson et al., 2001). The significance of family is highlighted by the inclination to give priority to family obligations over individual needs (Haboush, 2007). On the experience of Arab American women specifically, although family functions as a great source of support, it also operates as a tool of social control in Arab culture (Aprahamian, 2015). Not only are Arab American women considered to be responsible for ensuring their family’s adherence to cultural norms (Cainkar, 1994), they are also typically held accountable for maintaining their family’s honor (Stephan & Aprahamian, 2015).

Gender and Sexuality

Arab American women often feel pressured to find a balance between their Arab and American identity (Abdel-Salam et al, 2019). Also, in discussing their sexuality, Abdel-Salam et al.’s (2019) participants emphasized that feelings of obligations towards maintaining family honor were often confounded by their fear of being judged by other Arabs. They expressed that while they felt that the Arab interviewer could relate to them, they tended to be more forthcoming with non-Arabs about their sexuality. In addition, participants stated that they would have been far more cautious in their disclosure if the interviewer had been wearing the hijab or had seemed more “traditional.”

Recommendations for Counseling

  1. Add an Arab American category to intake forms to ensure the inclusivity of Arab American women and to reaffirm multicultural sensitivity.
  2. Understand the centrality of family in Arab culture and how that cultural value may affect Arab American women’s comfort and/or willingness to discuss familial issues. Additionally, due to their frequent occupation of a caregiving role, individuation from family as a therapy goal may be an inappropriate focus for treatment.
  3. Emphasize the confidential nature of therapy to assure Arab American women that session material will not find its way into their community. This is particularly important when discussing experiences such as intimate relationships, the consumption of alcohol, and other issues that are typically tied to family honor.
  4. Understand that discussing sex and sexuality is largely taboo for Arab American women due to its connection to the preservation of family honor. A strong therapeutic alliance must be built before most clients will be more likely to talk about such topics.
  5. Be mindful that for some second-generation Arab American women who are in the process of deliberating their gender roles, working with an Arab practitioner might be less comfortable due to the fear of judgment.
  6. Be thoughtful of clients’ intersectional identities. The literature suggests that it is not religion itself, but rather the degree of religiosity, that has an effect on an Arab women’s traditionalism (Read, 2003). It has also been demonstrated that less educated, more conservative, and more recent immigrant Arab American women are most likely to preserve traditional gender roles (Read, 2003).
  7. Be mindful that for many Arab Americans the Palestinian-Israeli conflict is of great importance and a source of psychological distress, especially given the United States’ political stance on this matter.



Laila Abdel-Salam is an advanced doctoral student in Teachers College, Columbia University's counseling psychology program. She is a founding member and the secretary of the first-ever American Arab and Middle Eastern Psychological Association (AMENA-Psy). She is currently externing at a general hospital in the Bronx r, where she provides psychotherapy for individuals with acute and serious mental illness, as well as testing. She is also externing at Baruch's College Counseling Center. She is passionate about social justice and providing culturally-relevant treatment for her patients.

Cite This Article

Abdel-Salam, L. (2019, October). Providing culturally-relevant psychotherapy to Arab American women. [Web article]. Retrieved from


Abdel-Salam, L., Rifkin, R., Smith, L., & Zaki, S. (2019). Experiences of gender among Arab American women: A qualitative study. Journal of counseling psychology66(3), 255- 268. doi:10.1037/cou0000329

ACLU of Washington (2018). Timeline of the Muslim Ban. Retrieved from:

Arab American Institute (AAI). (2018, September 1). AAI issue Brief: Hate Crimes. Retrieved from

Arab American Institute (AAI) (2018, January 26). AAI Responds to Rejection of the “Middle Eastern or North African” Category from the 2020 c. Retrieved from

Awad, G. H. (2010). The impact of acculturation and religious identification on perceived discrimination for Arab/Middle Eastern Americans. Cultural Diversity and Ethnic Minority Psychology 16(1), 59-67. doi: 10.1037/a0016675

Cainkar, L. (1994). Palestinian women in American society: The interaction of social class, culture, and politics. In E. McCarus (Eds.). The Development of Arab-American Identity. Ann Arbor: The University of Michigan Press.

Cainkar, L. (2015). Race and racialization: Demographic trends and the process of reckoning social place. In M. Amer and G. Awad (Eds.). Handbook of Arab American Psychology. New York, New York: Routledge Press.

Erickson, C. D., & Al-Timimi, N. R. (2001). Providing mental health services to Arab Americans: Recommendations and considerations. Cultural Diversity and Ethnic Minority Psychology, 7(4), 308-327. doi: 10.1037/1099-9809.7.4.308

Haboush, K. L. (2007). Working with Arab American families: Culturally competent practice for school psychologists. Psychology in the Schools, 44(2), 183-189. doi: 10.1002/pits.20215

NPR. (2019, July 29). “No Middle Eastern or North African category on 2020 census, bureau says.” Retrieved from:

Pirtle, W. N. L., & Brown, T. N. (2016). Inconsistency within Expressed and Observed Racial Identifications: Implications for Mental Health Status. Sociological Perspectives, 59(3), 582-603.doi: 10.1177/0731121415602133

Read, J. G. (2003). The sources of gender role attitudes among Christian and Muslim Arab American women, Sociology of Religion, 64(2), 207-222. doi: 10.2307/3712371

Shaheen, J. G. (1991). The comic book Arab. The Link, 24, 5, 1-11.

Shaheen, J. G. (2003). Real bad Arabs: How Hollywood vilifies a people. The Annals of the American Academy of Political and Social Science, 588(1), 171-193. doi:10.1177/0002716203588001011

Stephan, R., & Aprahamian, M. (2015). Gender and sexuality: Treading complex cultural challenges. In M. Amer and G. Awad (Eds.).  Handbook of Arab American Psychology. New York, New York: Routledge Press.

Washington Post (2019; April 30). “I think Islam hates us”: A timeline of Trump’s comments about Islam and Muslims. Retrieved from:

Zogby, J. J. (2002, July). Profiling and prejudice: Arab American attitudes and behavior since September 11. Retrieved from:

Zopf, B. J. (2018). A different kind of brown: Arabs and Middle Easterners as anti-American Muslims. Sociology of Race and Ethnicity4(2), 178-191. doi:10.1177/2332649217706089


  1. A Abou-Taleb

    How insightful, I really enjoyed reading this article.

  2. Denise Marie

    Wonderful article and very helpful. Thank you.


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