Borders and Belonging

By Lygia Navarro

November 2026

Professional counselors sometimes work with clients who face complicated immigration challenges. To best support their immigrant and refugee clients, they may need to learn about the entire immigrant experience — from pre-migration planning through the grief people may feel decades after arrival.

The psychological impacts of moving to a new country often affect people in different ways depending on their age, country of origin and lived experience. For counselors, being prepared to recognize and work with common struggles of immigrants and refugees is key. These can present as trauma from oppression or violence survived during and after migration (as well as in a client’s home country), grief from missing family left behind, absence of culture and community, altered professional identity, ambiguous loss, anxiety over anti-immigrant sentiment and deportation threats, and other challenges.

Acculturation, or adapting to a new language and cultural customs, can be endlessly exhausting for many immigrants, especially those raising families that they are trying to ensure stay connected to their home language and culture.

“Acculturation for immigrants can go on for years. It’s never a done deal. And the closer you are to having immigrated, the more demanding it is,” says Patricia Arredondo, EdD, co-author of the ACA book Counseling with Immigrants, Refugees and Their Families from Social Justice Perspectives.

Douglas Valdez, PhD, LMHC, LPC, assistant professor at St. Cloud State University in Minnesota, recommends counselors thoughtfully prepare for their work with immigrants. “It is best to approach this work with a lot of self-reflection and recognize any bias the clinician may be experiencing when listening to the client’s story.”

Dania Fakhro, PhD, NCC, LCMHCA, assistant professor at the University of North Carolina at Charlotte, also urges counselors to be alert to biases in interpreting clients’ experiences. Rather than assuming immigrant clients are manifesting maladaptive or resistant behaviors, they should consider if cultural factors and political oppression are causing distress and fear. An example of this, according to Arredondo, is when exposure to constant messaging about Immigration and Customs Enforcement (ICE) and deportation contributes to hypervigilance.

Leading with Empathy

For counselors working with immigrant clients, empathy can guide both the therapeutic relationship and the techniques they use. “Put yourself in that person’s shoes,” Arredondo says. “You arrived here six months ago or five years ago. What do you imagine your life is like? What would it be like if you never got to see your parents or your siblings again?”

Nicole Silverio, PhD, LPC, LMFT, an assistant professor at the University of South Carolina, points out an ongoing challenge: “We are inundated with negative messaging around immigrants,” she says. “That ends up affecting the way we view people and can really limit our ability to be empathic.”

With this challenge in mind, Silverio recommends normalizing that clients are experiencing a difficult transition amid systemic stressors outside their control. She may point out to them: “It’s not that something’s wrong with you, but rather that you’re having a very human reaction to a really stressful situation of transition and loss.”

Mariaimeé Gonzalez, PhD, LPC, LMHC, who collaborated with Valdez on the forthcoming ACA book Conducting Immigration Evaluations and Justice: A Practical Guide for Professional Counselors, notes that cultural humility training is a powerful tool to prepare for working with immigrants. This type of training helps people open their minds to learning from other cultures and experiences and recognizing that their own worldview or culture is not superior to others.

Gonzalez also recommends liberation psychology, a framework developed in Latin America centered on listening to and empowering marginalized people who have experienced oppression. “We need to recognize that immigration-related stressors are rooted in structural inequalities rather than individual pathology,” she says.

Recognizing Strengths

Counselors can be guided by strength-based perspectives, a technique that helps clients identify and use their own strengths, rather than positioning counseling from a viewpoint of deficits, problems or dysfunction. Silverio says counselors should recognize that immigrants are a resilient population that have been forced to figure out how to navigate new situations and deal with many challenges.

She suggests paraphrasing when a client tells a difficult migration journey story, perhaps saying to them, “I hear that you are someone who’s gone through a lot and has fought tooth and nail for the safety of the people that you love.”

“If we don’t talk with clients about their strengths, highlight them and figure out how those strengths can be leveraged for their new goals in counseling, then we’re missing a huge opportunity to help them with progress toward their goals,” Silverio says.

Valdez also focuses on strength over deficiencies with clients who came from highly skilled professions before they migrated. “Counselors should honor the education and training the clients bring. Work with them in terms of identity and how they can use their skills and those strengths in their new roles and in this country — instead of trying to minimize their experiences. Help them by honoring their strength and resiliency.”

Fakhro recommends counselors encourage highly skilled immigrant clients to seek new outlets for the passion of their former professions, whether through volunteering or resuming their educational journey to work in a related area.

Ambiguous Loss

For some highly skilled immigrants, leaving behind their professional identity can lead to ambiguous loss — grief that arises when something important is absent but the loss lacks a clear sense of closure.

Fakhro is an ambiguous loss researcher who works with refugee clients. Many of them fled their homelands so quickly that they couldn’t bring their degree paperwork. One client, a neurosurgeon in his home country, is now an Uber driver. “It can be very helpful to focus on the ambiguity of these losses; it’s a type of loss that we might never resolve.”

Practicing cultural humility — or at least wanting to learn about clients’ cultures — comes into play with ambiguous loss, which can be misidentified as an adjustment disorder, according to Fakhro. “It’s putting so much on the client in terms of ‘you have to work on yourself,’” she says.

When clients work with counselors experienced in ambiguous loss, they can see that they need support post-immigration because grief comes with loss. Fakhro has seen clients shift their thinking about ambiguous loss, becoming more accepting of themselves, reaching more “aha” moments, stopping feelings of shame and participating more actively in treatment.

Gonzalez urges counselors to recognize the complex dynamic of ambiguous grief. It can arise when parents realize their children don’t speak their grandparents’ language or when people worry how to tell their children someday about the traumas they faced in their home country or when traveling to their new country.

Collectivism and Family

Many immigrants from the Global South come from collectivist societies, where community is valued over individualism. This perspective can inform counseling techniques. “You’re not just doing one-on-one counseling or family counseling; you’re doing contextual counseling with many microcultures,” Arredondo says. “All of those are ecosystems. As a counselor, you need to recognize all of those systems with which immigrants must interact.”

Valdez recommends counselors from non-collectivist cultures — such as the dominant U.S. culture — recognize that the responsibilities and needs of families may look different from what they’re accustomed to.

With his students, Valdez encourages counselors not to mislabel immigrant families as enmeshed or maladaptive. Many immigrants, including teens and college students, bear intense responsibility for being family breadwinners or sending money back home. “It is a strength. It’s not just one family unit; it’s many family units supporting and uplifting each other — and protecting each other,” he says.

In her research, Silverio has found that constant fear around deportation disrupts family systems. Counselors can delve into different family members’ experiences, paying attention to the uniqueness of kids’ worries, those of their teenage siblings and those of their parents. Many undocumented parents face anguish over whether to tell children the family could be separated. Kids may already be experiencing trauma responses related to fears about loved ones’ immigration status and the threat of ICE detaining or deporting relatives. Their responses may include bedwetting, school difficulties and nightmares.

Counselors can help clients plan for a potential parental deportation, including compiling documents for legal assistance, finances, care and guardianship for children, and family members’ medical needs. This strategizing can provide emotional relief to parents amid an overwhelming environment of insecurity and helplessness.

Building Trust and Sharing Resources

Providing immigrant clients links to local social and community services is often an essential part of a counselor’s job. Gonzalez encourages counselors to connect immigrant and refugee clients with resources such as food banks, libraries, housing, community nonprofits, LGBTQ+ organizations, disability support programs, local immigration attorneys, sports programs, community elders and medical providers. Gonzalez says this holistic collaborative approach is helpful because it encourages clients to find aid and belonging in their new communities.

Counselors can offer talks on immigrant mental health at places such as hospitals and schools, which will help develop referral networks that benefit clients.

Gonzalez recommends caution, however, urging counselors to vet community resources for safety. For example, ICE is authorized to enter places that were once off limits for conducting operations, including places of worship, schools and hospitals.

For LGBTQ+ clients who experienced oppression in their home country, connecting with groups of people from their home country or a non-affirming church could be harmful. Valdez encourages sourcing community mutual aid projects, which respond to community needs from the perspective of the community members.

While counselors should not directly ask about clients’ immigration status, Silverio says, they can let clients know that they are a safe person. For example, she might raise the topic by saying something like, “Hey, policies have been changing, and there are these things happening. How, if at all, has that been impacting your family?” That way, people can choose whether or not to share.

Arredondo advises counselors to be aware that many immigrant clients will feel distrustful of them as authority figures. “You could certainly say, ‘If I were in your shoes, I would feel very anxious, very nervous about what’s going on and not knowing with certainty who you can trust,’” she says. “You have to normalize that likelihood that they don’t trust the counselor.”

Psychoeducation about counselors’ roles and responsibilities to immigrant clients can be integrated at the beginning of the counseling relationship. Counselors can include statements on their website that they prioritize client privacy and do not voluntarily report immigration status to ICE — but avoid guaranteeing confidentiality or overlooking legally required exceptions. While building rapport, counselors can bring this up again verbally in early sessions to reassure clients.

Trauma-Informed Approaches

While not all clients will identify their experiences as trauma, Arredondo says, “You have to know that what you’re hearing from the client is a manifestation of trauma and loss, which go hand in hand. Trauma does not end.”

Gonzalez recommends counselors practice trauma-informed approaches and use the Multidimensional Ecological Comparative Approach, a culturally responsive model devised for working with immigrants.

But before deciding on treatment modalities, Silverio says counselors can help clients in crisis learn self-regulation skills. “There’s no deep processing and meaning-making that a client will make if they’re dysregulated, if their body and mind are in a state of emergency,” she says.

Valdez’s immigrant clients have struggled with physiological reactions, such as panic, headaches, difficulty sleeping and the anxiety of feeling unsafe if they leave their homes. Fakhro has found immigrant and refugee clients respond well to creative means of trauma processing, including through music. Valdez recommends learning from clients what can help them regulate their nervous systems. That may include somatic work, grounding or guided meditation, prayer or fidget toys.

Using these tools can aid clients dealing with trauma response, Valdez says, “so they can externalize some of that anxiety to then be able to process what really is happening.”