Immigrants are people who leave their country of birth to live in a different country, most often on a permanent basis. Currently, people are immigrating to the United States by the thousands, hoping to find work and a better or safer life. The Office of Immigration Statistics reports that, in the United States, in 2005 alone, 1,122,373 people became legal permanent residents, which was a significant increase from 957,883 in 2004. Countries that are frequent contributors of immigrants are Mexico, India, and China. In light of this information, mental health professionals must be prepared to work with the increasing immigrant population of color in the United States.

Brief History of Immigration

Up until 1875, the United States did not restrict immigration. However, later the exclusionary sections of the Immigration Acts of 1875, 1882, and 1891 barred people from entering the United States who were deemed unsavory, including convicts, prostitutes, the mentally insane, those who could not provide for themselves, polygamists, and those who suffered from contagious diseases. The Chinese Exclusion Act of 1882 singled out people from China, preventing their immigration. To enforce these acts, stations, as on Ellis Island, were set up for the purpose of checking, rejecting, or accepting immigrants and processing their papers.

There was a lag in immigration during World War I, but after the war was over, immigration increased to the point where a national origins quota system was developed to limit the number of people from each country who were eligible to immigrate, as instituted by the Johnson-Reed Act of 1924. Passports, which were used in World War I for security reasons, became the norm and were necessary to enter the country.

During this time, eugenicists, who believed that intelligence and morality are determined by race, were influential and were asked to speak at congressional hearings. Eugenicists advocated that the races should not be mixed because they felt that other races were less intelligent, inferior, and degenerate. This line of thinking in the social sciences bled into the immigration policies, and people who were considered “White” had an easier time of getting into the country.

In 1924, Mexico was exempt from the quotas, and states like California and Texas welcomed Mexican immigrants into the labor force. Another factor that increased Mexican immigration was that Mexicans were considered “White” because of their ancestry and not because of their actual skin color. In 1929, the State Department made the decision to restrict Mexican immigration, but illegal immigration at the U.S.-Mexico border was not strictly monitored, and immigrants continued to cross the border at unofficial points. To enforce the quota system, Congress implemented the U.S. Border Patrol to apprehend illegal immigrants, and the Immigration and Naturalization service was born in 1933 to deal with immigration processing demands and sanctions.

As time went on, Congress became more lenient in its immigration policy. For example, in 1943, Congress repealed the Chinese Exclusion Act. Also, due to the Displaced Persons Act of 1948 and the Refugee Relief Act of 1953, many refugees displaced by World War II, who would otherwise be unable to immigrate under the national origins quota system, were able to enter the United States. During the 1950s and 1960s, Presidents Dwight Eisenhower, John Kennedy, and Lyndon Johnson used their executive powers to relax existing U.S. immigration laws. Consequently, political refugees such as Hungarians and Yugoslavians (Hungarian Refugee Act of 1956), Hong Kong Chinese (the Refugee-Escapee Act of 1957), and Cubans (the Cuban Adjustment Program of the 1960s) were also granted political asylum and, later, immigrant status.

With the aid of the U.S. Congress, President Johnson enacted President Kennedy’s proposal to abolish the national origins quota system, which appeared to be based on ethnic discrimination. Congress instituted a preference system in the Immigration Act of 1965, which admitted immigrants on a first-come, first-served basis. Unification of families was the goal of the major preferences, which covered 74% of the preference slots. For example, the largest single preference (24%) was for brothers and sisters of naturalized citizens. Encompassed in the third preference (10%) were professionals or persons of exceptional ability in the arts and sciences. The sixth preference consisted of skilled or unskilled labor for which a shortage of employable and willing persons exists in the United States. Although the national origins quota system was removed, in 1978 a worldwide ceiling of legal immigrants annually allowed was implemented.

While Congress encouraged immigration by instituting programs to help refugees, illegal immigration was vigorously deterred. The Immigration Reform and Control Act of 1986 instituted sanctions against employers who hired undocumented workers, and individuals found to be working illegally were deported. To further discourage illegal immigration, under a 1996 welfare bill, illegal immigrants became ineligible for most federal and state benefits, such as food stamps and Supplemental Social Security Income, with the exception of emergency medical care, immunizations, and help with disaster relief. On the other hand, refugees and asylum seekers are able to become legal residents after 1 year of living in the United States. Legal immigrants, who are permanent residents and green card holders, are eligible to apply for citizenship after they have lived in the United States for 5 years and have completed English language and civic tests.

The dramatic rise in immigration to the United States in the past 30 years has resulted in about 3 million non-native-born children and 10.8 million children who were born in the United States and have non-native-born parents. These new immigrant families are more ethnically, linguistically, and socio-economically diverse than previous immigrant populations, who were mainly from Western Europe. These immigrant populations have resulted in schools in many cities across the United States serving a growing number of immigrant students of color. To fail to address the counseling needs of immigrant students is to ignore the social, psychological, linguistic, and academic difficulties these students encounter in their acculturation process.

Therapists must be aware of the history of immigration in the United States and the current immigration policy when working with immigrant clients. For example, an immigrant who is living here illegally will have a different set of concerns than a legal immigrant with a green card. The acculturation adaptation process of immigrants holding green cards differs from that of political refugees who enter because of circumstances such as fleeing war, ethnic cleansing, political oppression, or religious persecution in their countries of origin.

Challenges Immigrants Face

Financial Stress

Ruben G. Rumbaut reported that immigrants may be more likely than natives to be poor and to work in low-status jobs. This finding is not necessarily indicative of immigrants’ lack of skills; rather, it illustrates the societal factors that bar immigrants from obtaining ideal employment. Francisco L. Rivera-Batiz talked about how many immigrants (86.8%) were employed in blue-collar occupations, and few (25.45%) had schooling beyond 10 years, which makes it difficult for illegal immigrants to succeed economically. It can be difficult, even for educated immigrants, to obtain desired jobs, as the training they received in their native country might not be accepted in the United States and they may not seek respecialization to obtain U.S. licenses and certifications. Immigrants who enter the United States illegally are vulnerable to exploitation by employers who pay lower wages because illegal immigrants are not protected by the government and if they complain, they risk revealing their illegal status and deportation. To illustrate the payment gap, men who are legal immigrants are reported to receive 41.8% more for pay than illegal immigrants. Illegal immigrants also do not receive many of the benefits that legal immigrants do, and they may experience stress from being unable to access services for themselves and their families.


Upon entering the United States, many immigrants face prejudice and discrimination based on both their immigrant status and ethnicity. U.S. citizens have expressed a fear that immigrants will take jobs away from citizens because they are willing to work for less money, and there are pervasive negative stereotypes about immigrants being lazy and criminal in their conduct. In an effort to curb illegal immigration, certain states have passed propositions that severely limit illegal immigrants’ access to services such as health care, welfare, and education (i.e., Proposition 187 in California, which was directed mostly toward illegal Mexican immigrants). There is evidence that people who were in favor of these legislations exhibited more prejudice toward immigrants and were concerned about the economic implications of immigration. Prejudicial attitudes like these create an uncomfortable and unwelcoming environment for immigrants, both legal and illegal, and add to their acculturation adaptation difficulties and psychological distress.

Psychological Distress

Many immigrants experience psychological distress, but are less likely to seek treatment, due to cultural attitudes as well as a lack of health insurance. Even if immigrants are in treatment, there is a chance that they will be incorrectly diagnosed. Somatization as a symptom of psychological distress is relatively common and unlikely to be detected by Western mental health professionals, which may result in under-diagnosis of disorders in immigrants. Somatization is particularly prevalent in collectivistic, context-dependent cultures in which the expression of emotional distress is inhibited or when individuals from these societies have an acute sense of the mind-body connection at times of stress. Thus, identifying individuals as suffering from somatization may be difficult, particularly because immigrants often seek medical help from doctors as opposed to mental health professionals, and they frequently reject psychiatric consultation.

Family Difficulties and Conflict Due to Immigration

Parent-Child Acculturation Differences

Immigration is a stressful process for the family partially because the members may each adapt differently to the host or new society. For example, young elementary school children adapt more easily than adults as they are not yet set in their cultural customs and are more easily influenced by new customs and values learned in school. As a result, conflict may arise when children’s American values clash with their parents’ more traditional ones. However, it is not always the parents who adhere to traditional values. Immigrant families sometimes do not immigrate together; sometimes, one or both of the parents go to the United States first to secure jobs, leaving the children with relatives in their native country. It may be years before the parents are able to bring the children over to live with them. As a result, some children may be more traditional than their parents and may be offended by their parents’ behavior. They also may be reluctant to obey their parents when they have lived apart from them for so long. All these dynamics of age and time of entry can threaten the family structure and cause stress for immigrant families. Thus, the therapist needs to be aware of the many different immigrant family dynamics.

Difficulties of Immigrant Children

Gargi Roysircar delineated difficulties that many immigrant students face, including lack of family and social supports, trauma from war or refugee camp experiences, poverty, and health concerns. One major stress experienced by immigrant students is the language barrier. However, children may gain more English skills than their parents, thus making the students responsible for interpretation and helping their parents understand the American educational system. Not only does language “brokering” by children present awkward role reversals within families, it also makes immigrant students solely responsible for their own learning within the education system, a heavy burden for any student to bear, not to mention one who is transitioning across cultures. These difficulties can cause many different conduct problems and confusion in immigrant children, such as acting out or being silent, having somatic complaints, showing poor attendance at school, and experiencing difficulty making friends. The immigrant students’ native-born counterparts and teachers are most often completely unknowing and unsuspecting of these difficulties and their effects on the immigrant students. The consequent sense of isolation, loneliness, and harassment from other students becomes a common barrier that impedes immigrant students’ successful transition to a new school environment.

Increasing Help-Seeking Behaviors in Immigrants

Help-seeking behavior is a major barrier to immigrants receiving support. Often, the cultures from which many immigrants originated do not have the same formal help structures (such as counselors and social workers) and rely mostly on informal structures (such as family, friends, and spiritual leaders). More than simply teaching immigrants how to utilize the resources available in school and the community, counselors (especially those in the school system) can help students and teachers appreciate the cultural differences in help-seeking preferences and potential stigmas and taboos about seeking help. Teachers, who are in frequent contact with immigrant students, become allies in helping direct students to appropriate resources in the school. Along with teachers, school counselors can serve immigrant students through small group work on transitioning and bicultural issues or through a buddy or mentor system. The purpose is to provide information and ease the inhibition of seeking help. Surrounding immigrants with a support network builds a protective system that enables them to develop and broaden their cultural, linguistic, and emotional hardiness so that they can be successful in school and in their personal lives.

Counseling Immigrants

When counseling immigrants, there are many factors to consider. Family structure, experience of prejudice, legal status, and reasons for immigrating are only a few of the facets of the immigrant experience. It is helpful for counselors to be familiar with these factors when counseling a client, as they will affect how the client adapts to the new culture and how he or she responds to counseling and other available help resources. Because of the rapidly changing face of U.S. communities and schools, counselors must consider seriously the societal dynamics created when new immigrants enter educational, employment, and neighborhood environments. The introduction of greater plurality in U.S. communities and schools can be seen as an opportunity to broaden the educational experience of all members of a community rather than forcing the re-education and assimilation of immigrants.


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