CASE STUDIES ON SUPPORTING ETHNIC MINORITIES WITH MENTAL HEALTH NEEDS
# 4 SAMAIRA: TRADITIONAL PARENTS VS CONTEMPORARY CHILDREN (MINOR)
BACKGROUND
Samaira is a 38-year-old married female from Pakistan. She has been living in Hong Kong for almost 16 years, and came here after her first marriage. She separated from her first husband when her daughter was about 2 years old and brought her up single handedly. However, Samaira got in a relationship again, got married and has two kids from her second marriage 4 and 2 years old and her eldest daughter is 13 years now.
After her second marriage, her husband had visa issues and as he was deported back to Pakistan. Samaira has been living in Hong Kong with her 3 children by herself as her husband has not yet been granted a visa for Hong Kong. Unfortunately, Samaira doesn’t have any immediate support system in Hong Kong. She must single handedly bring up 3 children and look after them physically, emotionally and financially. She has a few friends in HK and her children are mainly taken care of by household help as Samaira is a working mother.
She especially struggles with her eldest daughter as she is extremely defiant and doesn’t pay any attention to what Samaira says. Samaira is concerned about her dressing style, her choice of words that she uses as she feels her religion prohibits them from using such words and wearing such clothes. She also feels that her daughter doesn’t take on any responsibility at home and instead spends excessive time on her phone. They often get into arguments and as a result her daughter is becoming rebellious. She doesn’t focus on studies, keeps her room untidy and doesn’t get involved with her younger siblings. Her daughter often complains of Samaira being demanding, authoritative and dictating which upsets her. Samaira expressed her desire for her to follow religious studies, be involved in prayer and wear certain types of clothes but her daughter refused to do so. She also wished to have better communication with her daughter and if she could get her to follow the right behavior. When she tries to find time with her it mostly turns into an argument, and she is unable to adhere to Samaira’s demands.
Samaira is experiencing extreme stress and anxiety regarding her future as her husband is struggling with his visa issues. Samaira is finding life really meaningless and wished to give up on life. She feels exhausted taking care of kids and feels very low on energy, sad and lonely. She finds herself struggling with her daughter who is becoming more defiant every day. Her husband often gets into arguments with her for not having enough time for him or attend his calls when he wants to talk, and Samaira feels she is so occupied that she is not able to prioritize him at times. She feels helpless that she must meet everyone’s demands and no one understands her emotional state.
Samaira felt she was not able to focus on work, had constant fights at home and her relationship with her daughter became really strained. She feels sad and stressed all the time. She had a chance to speak to a social worker about her struggles with her elder daughter after a parental talk organized by an NGO and the social worker sensed that she may need some more counselling support and has offered her the support.
ISSUES FACED BY CLIENT
• Anxiety regarding future as husband is not able to get visa for HK
• Meeting expectations of husband and children
• Stressed about managing children, household and finances independently
• Parenting issues
• Concerns regarding daughter’s behavior and attitude
• Religious and cultural expectations towards daughter
• Feeling exhausted and blamed for not doing enough
• Being blamed by daughter for not understanding her values
Improves the lives of Hong Kong’s ethnic minorities by reducing suffering and providing opportunities
Improves
INTERVENTION THAT CAN BE HELPFUL FOR THIS CLIENT
• Emotional management
• Exploring and working on unhelpful thought patterns if any
• Identifying a support system
• Awareness of her parenting style
• Integrate traditional and modern styles of parenting and tailoring it the way that suits the child’s need.
• Understand the transition phase of children yet try to instill religious and cultural values finding common theme of interests.
• Assertive communication style, boundary setting etc.
• Using reinforcements like providing tuition fee for teaching siblings, setting screen time limits if desired behavior like tidying her room, cleaning her pet etc. has not been done.
• Encouraging Self-care, hobbies, taking some time out for self, exercise, involvement in the community
• Creating support system
• Family centered approach of counselling
• Encouraging Individual counselling for the teenage daughter
CHALLENGES FOR THE SOCIAL WORKER
• Difficulty in understanding and dealing with the client’s religious and cultural belief
• Challenging the parenting style (as parenting is also largely influenced by culture, difficulties in understanding and addressing the parenting style)
• Resistance from the client to open up as the social worker/ counselor is from a different cultural background
• Readiness of the client/daughter to receive any counseling help
• Streamlining the expectations from individual and family therapy perspective
• Building an immediate support system
SUGGESTIONS FOR ADDRESSING THE CHALLENGES
1. Ensure confidentiality
Example:
‘’ You might be worried about others knowing about your problems, but rest assured that the information discussed in this session will not be told to anyone, unless there is any emergency situation like some risk of selfharm/harm to others.’’
2. Give time and show readiness to listen and understand
Example:
“I am here to listen and see how I can help you. Would you like to tell me what has been bothering you?”
3. Empathetic responses
Example:
“I’m sorry to hear that you have been dealing with these. I understand that it is not easy for you.”
4. Understanding of cultural and religious beliefs
Examples:
• Use of TZF anti-discrimination tool kit (link) – to get yourself more aware about clothing and some religious practices
• Enquire about the practices
• ‘’ I may not understand in detail, but I am ready to listen and understand what your expectations are from your daughter in terms of clothing/ following religious practices ‘’
the lives of Hong Kong’s ethnic minorities by reducing suffering and providing opportunities
Improves the lives of Hong Kong’s ethnic minorities by reducing suffering and providing opportunities
5. Explaining the advantage of involving family members in the therapy
Examples:
• Identifying sources of conflict and anxiety among family members
• Reestablishing communication between family members
• Giving family members an understanding of each other’s perspectives through their own experiences
• Understanding and respecting the points of view and opinions of other family members
• Allowing family members to value each other’s wants and needs
• Instilling a deeper sense of empathy towards one another
6. Exploring the support system with the client including family/ relatives/ friends/ organizations/ religious groups / NGO etc.
REFERRALS TO OTHER SERVICES
• Psychiatrist consultation if the symptoms persist
• Legal consultation to clarify visa issues
ACKNOWLEDGEMENT
Thank you to Shilpa Patwardhan, Priya Agrawal and Rabia Siddiqi from the Ethnic Minority Well-being Centre team for developing the case study series and Caroline Longley and Mel Pikul for editing it.
ABOUT THIS CASE STUDY SERIES
The case study series is part of the capacity building work of The Zubin Foundation’s Ethnic Minority Wellbeing Centre. The aim of the series is to raise awareness of the common issues ethnic minorities have that trigger their mental health issues and to equip mental health practitioners on how to better support them by presenting some common challenges practitioners may face when supporting ethnic minorities and our learnings from the Ethnic Minority Well-being Centre in addressing these challenges. For the full set of case studies and other useful materials, please go to the Mental Health of Ethnic Minorities Online Resource Platform for Professionals: https://www.zubinfoundation.org/mental-health-resources/
ABOUT THE ZUBIN FOUNDATION ETHNIC MINOTIY WELL-BEING CENTRE
The Ethnic Minority Well-being Centre is a joint project between The Zubin Foundation and the Department of Psychiatry of The University of Hong Kong, funded by Lee Hysan Foundation and Croucher Foundation. It offers free one-to-one counselling service to South Asian from low income families in Hong Kong. The service was provided by ethnically South Asian counsellors who understand the South Asian cultures and speak English as well as Hindi, Urdu or Nepali, native languages of many South Asian individuals. The counselling team also delivered talks and workshops to raise awareness in the community.
For more information about the Centre, please visit: https://www.zubinfoundation.org/our-work/ethnic-minority-well-being-centre/
THE ZUBIN FOUNDATION
The Zubin Foundation is a registered charity in Hong Kong (IR 91/12344), named after Zubin Mahtani Gidumal. We aim at improving the lives of Hong Kong’s ethnic minorities by reducing suffering and providing opportunities. We do this by outreach in the community and driving systemic change.
For more information, please visit: www.zubinfoundation.org .
CONTACT US
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Email: info@zubinfoundation.org
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Improves the lives of Hong Kong’s ethnic minorities by reducing suffering and providing opportunities