Case Study of Sawsan - Chapter 9

Sawsan, a 17-year-old girl, was brought by her father to counseling because she had withdrawn herself from family meetings and activities during the past 2 months, instead spending most of her time listening to music in her bedroom. Lately, she had complained about headaches that lasted all day with no relief, despite the use of painkillers.

The family's medical doctor had told Sawsan's parents that she may be passing through a stressful period and referred them to counseling. At the initial intake meeting with Sawsan and her father, the father dominated the conversation, and Sawsan displayed approval of his views. The father described her as a perfect girl who always met her parents' expectations in school and in social behavior.

The change in her behavior made her seem to him as "not her." He tried to attribute this change to "bad friends" or "bad readings." He also denied that Sawsan was experiencing any stress and emphasized how much the family loves Sawsan and cares for her needs. He said, "Nothing is missing in her life.

We've bought her everything she wants. She couldn't be passing through any stress." Knowing that most Arab girls find it very difficult to express their feelings in front of their fathers (or both parents), after listening to the father the counselor asked to be allowed to have a private conversation with Sawsan, and the father agreed.

At the beginning of this conversation, Sawsan continued to go along with her father's views, describing how much her parents love and support her and denying any stress. Only after the counselor validated to her that she indeed has good parents was she ready to reveal a conflict that had been raised recently concerning her desire to study at a university located far from her village, which would necessitate her living in the student dorms.

Her father rejected the idea of his daughter living away from the house, far away from his immediate control. In an attempt to compensate for this, he bought her a new computer and suggested that she study at a nearby college. She insisted that she wanted to study at the university and tried to push until her father became angry, claiming that she was imitating "bad girls" who sleep away from their homes.

As she described this conflict, she continued to remove any accusation from her father, saying, "He did this because he is worried about my future," and "He is right and I should understand this." The counseling process lasted for five sessions, during which the counselor met with only the father three times in order to establish a positive "joining" with his position and worries. The counselor then revealed to the father some contradictions within his belief system regarding the importance of education, as described in culturanalysis.

After that, the counselor met with both father and daughter and encouraged Sawsan to explain to her father why she felt she needed to study at the university and to express her commitment to her family values. The counselor also encouraged the father to express his care and worry to Sawsan and then to discuss a compromise that may be accepted by both of them.

He agreed to allow his daughter to study at another university, in a city where she could live with her uncle's family. In a follow-up meeting, Sawsan and her father expressed satisfaction. Sawsan had returned to normal interaction with the family and no longer complained of headaches.

Counseling Across Cultures (Kindle Locations 6760-6784). SAGE Publications. Kindle Edition.

1. Arab Muslim parents tend to attribute bad behavior to external entities such as "bad friends" or "bad readings" or, in some cases, bad spirits. Discuss why or why not this is this something that the counselor may want to address with the parents?

2. It is often difficult for Arab children to criticize their parents in conversations with foreigners, such as Western counselors, and they typically feel the need to emphasize that the intentions of their parents are good. How should the counselor approach discussing the client's parents with the client?

3. Therapy with Arab and Muslim families should not seek to change or confront the family culture or the family structure; rather, it should be aimed at finding better solutions within the fabric of that culture. Explain how the counselor might use a family's internal resources and strengths to change this situation for the better.