Intersections of Gender and Refugee Experience: Through Azra’s Eyes

  • Ivana ĐuraškovićEmail author
Part of the International and Cultural Psychology book series (ICUP)


Today, the world represents a battlefield between people of diverse nationalistic groups and different political regimes, where the fight is often over access to natural resources. As a result, many women are forced to flee their countries due to the increased persecution, violence, and torture that often follow civil conflicts. Many of these women require counselling to address the psychological impact of their refugee experiences. This chapter is a story about the refugee Azra and her mental health concerns that resulted from the trauma she suffered during the civil war in Bosnia. This chapter is also a story of the therapeutic relationship between Azra and her counsellor, Dr. Ivana, including the descriptions of the initial and subsequent counselling sessions through a culture-infused counselling lens that includes social advocacy. Dr. Ivana’s personal reflections regarding Azra’s presenting concerns, counsellor factors, and the role of social justice in the counselling process are discussed. Lastly, implications for counsellors related to assessment, counsellor education, and promotion of social justice are presented. Questions for reflection and discussion as well as learning activities are introduced to help the readers orient themselves to a culture-infused counselling (Collins & Arthur, 2010a, 2010b, see Chap. 2) lens with refugees.


Refugees Refugee resettlement Refugee adaptation Cultural identity Cultural sensitivity Forced exile Trauma Acculturation Refugee counselling Common therapeutic factors Social justice 


  1. Al-Roubaiy, N. S., Own-Pugh, V., & Wheeler, S. (2013). The experience of exile-related stress among Iraqi refugee men in Sweden and its implications for counseling and psychotherapy: A qualitative study. Counselling Psychology Review, 28(2), 53–67. Retrieved from Scholar
  2. Anderson, A., Hamilton, R., Moore, D., Loewen, S., & Frater-Mathieson, K. (2004). Education of refugee children: Theoretical perspectives and best practices. In R. Hamilton & D. Moore (Eds.), Educational interventions for refugees children: Theoretical perspectives and implementing best practices (pp. 1–11). New York: Routledge.Google Scholar
  3. Anderson, H., & Goolishian, H. (1992). The client is the expert: A not-knowing approach to therapy. In S. McNamee & K. J. Gergen (Eds.), Therapy as social construction (pp. 25–39). London: Sage.Google Scholar
  4. Anonymous. (2016). Being a refugee in Turkey and Western Europe: How it affects mental health and psychosocial wellbeing. Intervention 2016, 2, 114–116.Google Scholar
  5. Arthur, N., Merali, N., & Djuraskovic, I. (2010). Facilitating the journey between cultures: Counselling immigrants and refugees. In N. Arthur & S. Collins (Eds.), Culture-infused counselling (2nd ed., pp. 285–314). Calgary, AB: Counselling Concepts.Google Scholar
  6. Bemak, F., & Chung, R. C. (2002). Counselling and psychotherapy with refugees. In P. B. Pedersen, J. G. Draguns, W. J. Lonner, & J. E. Trimble (Eds.), Counseling across cultures (5th ed., pp. 209–232). Thousand Oaks, CA: Sage.Google Scholar
  7. Bemak, F., & Chung, R. C. (2017). Refugee trauma: Culturally responsive counseling interventions. Journal of Counseling & Development, 95, 299–308. Scholar
  8. Bemak, F., Chung, R. C., Talleyrand, R. M., Jones, H., & Daquin, J. (2011). Implementing multicultural social justice strategies in counselor education training programs. Journal of Social Action in Counseling and Psychology, 3, 29–43. Retrieved from Scholar
  9. Bemak, F., Chung, R. C. Y., & Pedersen, P. B. (2003). Counseling refugees: A psychosocial approach to innovative multicultural interventions. Westport, CT: Greenwood Press.Google Scholar
  10. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology: An International Review, 46, 5–68. Scholar
  11. Berry, J. W. (2001). Psychology of immigration. Journal of Social Issues, 57, 615–631. Scholar
  12. Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29, 697–712. Scholar
  13. Berry, J. W. (2006). Stress perspectives on acculturation. In D. L. Sam & J. W. Berry (Eds.), The Cambridge handbook of acculturation psychology (pp. 43–57). New York: The Cambridge University Press.CrossRefGoogle Scholar
  14. Bochner, S. (2003). Culture shock due to contact with unfamiliar cultures. Online Readings in Psychology and Culture, 8, 1–12. Scholar
  15. Boston, P. (2005). Doing deconstruction. Journal of Family Therapy, 27, 272–275. Scholar
  16. Bruhn, M., Rees, S., Mohsin, M., Silove, D., & Carlsson, J. (2018). The range and impact of postmigration stressors during treatment of trauma-affected refugees. The Journal of Nervous and Mental Disease, 206, 61–68. Scholar
  17. Chung, R. C., Bemak, F., Ortiz, P., & Sandoval-Perez, P. A. (2008). Promoting the mental health of immigrants: A multicultural/social justice perspective. Journal of Counseling and Development, 86, 310–317. Scholar
  18. Chung Yan, M., & Anucha, U. (2017). Setting the context for human services practice with immigrants and refugees in Canada. In M. Chung Yan & U. Anucha (Eds.), Working with immigrants and refugees: Issues, theories, and approaches for social work and human service practice (pp. 1–20). Don Mills, ON: Oxford University Press.Google Scholar
  19. Citizenship and Immigration Canada. (2016). Welcome Refugees: Milestones and key figures. Retrieved from
  20. Collins, S. (2010). The complexity of identity: Appreciating multiplicity and intersectionality. In N. Arthur & S. Collins (Eds.), Culture-infused counselling (2nd ed., pp. 247–258). Calgary, AB: Counselling Concepts.Google Scholar
  21. Collins, S., & Arthur, N. (2010a). Culture-infused counselling: A fresh look at a classic framework of multicultural counseling competencies. Counselling Psychology Quarterly, 23(2), 203–216. Scholar
  22. Collins, S., & Arthur, N. (2010b). Culture-infused counselling: A framework for multicultural competence. In N. Arthur & S. Collins (Eds.), Culture-infused counselling (2nd ed., pp. 45–66). Calgary, AB: Counselling Concepts.Google Scholar
  23. Collins, S., & Arthur, N. (2010c). Future directions in culture-infused counselling. In N. Arthur & S. Collins (Eds.), Culture-Infused Counselling (2nd ed., pp. 449–466). Calgary, AB: Counselling Concepts.Google Scholar
  24. Cutts, L. (2011). Integration in counselling psychology: To what purpose? Counselling Psychology Review, 26(2), 38–48. Retrieved from Scholar
  25. Djuraskovic, I. (2014). Interrupted journeys: The experiences of refugee women in counselling. Doctoral dissertation. Retrieved from
  26. Djuraskovic, I., & Arthur, N. (2009). The acculturation of former Yugoslavian refugees. Canadian Journal of Counselling and Psychotherapy, 43, 18–34. Retrieved from Scholar
  27. Duncan, B. L., Miller, S. D., & Sparks, J. A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome informed therapy (Rev. ed.). San Francisco: Jossey-Bass.Google Scholar
  28. Foronda, C. L. (2008). A concept analysis of cultural sensitivity. Journal of Transcultural Nursing, 19, 207–212. Scholar
  29. Gkionakis, N. (2016). The refugee crisis in Greece: Training border security, police, volunteers and aid workers in psychological first aid. Intervention, 14, 73–79. Retrieved from Scholar
  30. Gray, A., & Elliot, S. (2001). Refugee resettlement research project ‘Refugee Voices’: Literature review. Retrieved from
  31. Hays, P. A. (2008). Addressing cultural complexities in practice (2nd ed.). Washington, DC: American Psychological Association.Google Scholar
  32. Kallivayalil, D. (2013). Women seeking political asylum: Negotiating authority, gender, and lost home. Women & Therapy, 36, 319–331. Scholar
  33. King, R. U., & Cheung, M. (2017). Working with immigrant women and families. In M. Chung Yan & U. Anucha (Eds.), Working with immigrants and refugees: Issues, theories, and approaches for social work and human service practice (pp. 181–199). Don Mills, ON: Oxford University Press.Google Scholar
  34. Kunz, E. F. (1973). The refugee in flight: Kinetic model and forms of displacement. International Migration Review, 7, 125–146. Scholar
  35. Kunz, E. F. (1981). Exile and resettlement: Refugee theory. International Migration Review, 15(1–2), 42–51. Scholar
  36. Lee, P. L. (2013). Making new precious: Working with survivors of torture and asylum seekers. The International Journal of Narrative Therapy and Community Work, 1, 1–10. Retrieved from Scholar
  37. Leibert, T. W., & Dunne-Bryant, A. (2015). Do common factors account for counseling outcome. Journal of Counseling & Development, 93, 225–235. Scholar
  38. Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from Babel: Toward a unifying language for psychotherapy practice. New York: W.W. Norton & Company.Google Scholar
  39. Mollica, R. F., & Caspi-Yavin, Y. (1991). Measuring torture and torture-related symptoms. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 581–587. Scholar
  40. Navas, M., García, M. C., Sánchez, J., Rojas, A. J., Pumares, P., & Fernández, J. S. (2005). Relative Acculturation Extended Model (RAEM): New contributions with regard to the study of acculturation. International Journal of Intercultural Relations, 29, 21–37. Scholar
  41. Phinney, J. (2002). Ethnic identity and acculturation. In K. M. Chun &, P. B. Organista, & G. Marin (Eds.), Acculturation: Advances in theory, measurement, and applied research (pp. 63–81). Washington, DC: American Psychological Association.Google Scholar
  42. Phinney, S. J., & Ong, A. D. (2007). Conceptualization and measurement of ethnic identity: Current status and future directions. Journal of Counseling Psychology, 54, 271–281. Scholar
  43. Silove, D., Ventevogel, P., & Rees, S. (2017). The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry, 16, 130–139. Scholar
  44. Simich, L. (2003). Negotiating boundaries of refugee resettlement: A study of settlement patterns and social support. Canadian Review of Sociology, 40, 575–591. Scholar
  45. Social Sciences Research Council Summer Seminar on Acculturation. (1954). Acculturation: An exploratory formulation, 1953. American Anthropologist, 56, 973–1000. Retrieved from: Scholar
  46. Tribe, R. (2002). Mental health of refugees and asylum seekers. Advances in Psychiatric Treatment, 8, 240–248. Scholar
  47. Turković, S., Hovens, J. E., & Gregurek, R. (2004). Strengthening psychological health in war victims and refugees. In J. P. Wilson & B. Drožđek (Eds.), Broken spirits: The treatment of traumatized asylum seekers, refugees, war and torture victims (pp. 221–242). New York: Brunner-Routledge.Google Scholar
  48. United Nations High Commissioner for Refugees. (2016). Resettlement. Retrieved from
  49. Vera, E. M., & Speight, S. L. (2003). Multicultural competence, social justice, and counselling psychology: Expanding our roles. The Counselling Psychologist, 31, 253–272. Scholar
  50. Waldegrave, C. (2012). Developing a ‘just therapy’: Context and ascription of meaning. In A. Lock & T. Strong (Eds.), Discursive perspectives in therapeutic practice (pp. 197–211). Oxford, UK: Oxford University Press.Google Scholar
  51. Wampold, B. E. (2010). The research evidence for the common factors models: A historically situated perspective. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart & soul of change: Delivering what works in therapy (2nd ed., pp. 49–81). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  52. Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14, 270–277. Scholar
  53. Ward, C., Bochner, S., & Furnham, A. (2001). The psychology of culture shock. London: Routledge.Google Scholar
  54. Wilson, J. P. (2004). Theoretical, conceptual, and sociocultural considerations: Introduction. In J. P. Wilson & B. Drožđek (Eds.), Broken spirits: The treatment of traumatized asylum seekers, refugees, war and torture victims (pp. 3–6). New York: Brunner-Routledge.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Alberta Health ServicesCalgaryCanada

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