Counseling and psychotherapy in palestine: Between occupation and cultural colonialism

The Palestinian Occupied Territories are the areas to the West of the River Jordan which were occupied by Israel in 1967. As of 2010, the total population of the Occupied Territories (Palestinian Central Bureau of Statistics [PCBS], 2010) is 3.935 million with 54.4% of the population under the age of 20 years and 9% above 50 years of age. Approximately 60% of the population is living in 400 villages and 27 refugee camps1 (PCBS, 2010). Arabic is the official and main language and Arabs constitute the main ethnic group. Religious groups include Muslims and Christians in addition to a very small Jewish minority (the Samaritans in the Nablus district). The Palestinian territories are still under Israeli military control in spite of the fact that a Palestinian Authority (PA) is in place and is trying to manage the daily life of the people in those areas. The PA is very dependent on foreign aid. Consequently, the quality and availability of mental health services in Palestine are affected by the donor’s policies. Counseling, psychotherapy, and psycho-social programs are used alternatively in this chapter to describe the existing therapeutic, preventive, or developmental interventions of a psychological nature. The terminology used to describe the services alternates depending on what ideologies surrounding human nature are involved; however, alternations are mostly due to funding purposes. Psycho-social programs became a term used in Palestinian society to describe programs implemented by paraprofessionals and organizations whose mandate is not particularly in psychological interventions or mental health. Women’s organizations, youth clubs, or human rights organizations added psycho-social programs to their work with no clear mandate or proper training in order to receive funding (Giacaman, 2004) There are many definitions for counseling and psychotherapy, some of which capture the content, others the form, and others the degree of intrusiveness in the role of the counselor/therapist (Gilliland & James, 2002). An interesting definition is given by Adler who defines counseling as the younger sibling of psychotherapy with an inferiority complex, while psychotherapy is the older sibling with a superiority complex (Flanagan & Flanagan, 2004). It is the same in Palestine as it is in other places, where counseling refers to psychological interventions which take place outside clinical settings, such as in schools, protective shelters for women and children, courts prior to divorce, community centers, or detention centers. Psychotherapy, on the other hand, is connected to clinical settings and is geared to treat people with clear pathologies as described in the Diagnostic and Statistical Manual (DSM). In the Palestinian context, counseling is a more socially accepted term, because it implies normalcy. In other words, they are interventions provided to individuals or groups who are “imbalanced” temporarily due to external forces such as war but are otherwise “normal.” As we will explain later, the field of counseling and psychotherapy is a young one in the Occupied Palestinian Territories and has not been investigated yet. Most of the sources used in this chapter are based on interviews with key persons, planning and reporting documents (that have not been published), and the literature that has been written about this issue. A lot of our reporting and suggestions is based on our impressions and experiences in the Palestinian field. Nonetheless, the small community of counselors and psychotherapists in Palestine (about 4,000 people) has helped us identify tendencies and trends easily.