Int J Adv Counselling (2008) 30:167–178

DOI 10.1007/s10447-008-9054-0

ORIGINAL ARTICLE

Stress and Coping in the Lives of Recent Immigrants

and Refugees: Considerations for Counseling

Oksana Yakushko & Megan Watson & Sarah Thompson

Published online: 25 July 2008

# Springer Science + Business Media, LLC 2008

Abstract Recent immigrants and refugees experience great amounts of stress. Literature on
immigration and stress has focused primarily on the stressors directly related to immigrants’
adjustment to a new culture (i.e., acculturation stress). This manuscript discusses stress and
coping in the lives of recent immigrants and refugees within a framework of stress theories
proposed in psychological literature. In addition, an overview of stressors encountered by
recent immigrants is provided. Implications for clinical work, research, and advocacy are
discussed.

Keywords Immigration . Stress . Coping

Introduction

Over 100 million immigrants and 13 million refugees have moved across borders
worldwide within the last several decades (Potocky-Tripodi 2002). Immigration is
undoubtedly among the strongest forces that have shaped recent history, and current global
changes account for unprecedented movements of individuals across the world in search of
better opportunities and conditions (Marsella and Ring 2003). The visibility of recent
immigrants in counseling literature is growing. However, there are evident gaps in
knowledge about recent immigrants and refugees (RIR), their adjustment to new
environments, and their unique needs (Hovey 2000; Pernice 1994; Yoshihama and
Horrucks 2002). One of these unexplored areas is the distinct ways that RIR experience
stress and cope with the challenges of adjustment.
Building on the existing literature, this manuscript first provides an overview of major
theories of stress. Second, there is an examination of distinct stressors RIR face during their
pre- and post-migration experiences. Lastly, suggestions regarding clinical practice with this
population are made.

O. Yakushko (*) : M. Watson : S. Thompson

235 TCH, Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln,
NE 68588-0345, USA
e-mail: Oyakushko2@unl.edu
168 Int J Adv Counselling (2008) 30:167–178

Theories of Stress

Definitions of stress vary a great deal, and literature on stress emphasizes that stress is a
highly subjective experience (Selye 1982; Somerfield and McCrae 2000). Scholarly
definitions of stress highlight that it is a combination of psychological and physical
reactions to events that evoke individual responses (Franken 1994). Humans have many
diverse physiological and psychological reactions to stress ranging from increased heart rate
to racing thoughts; the causes of stress are even more numerous (Selye 1974).
Research on stress has focused on the physiological expression of stress and its impact
on the individual as well as on models of interaction between the environment and the
individual coping and resilience (Franken 1994; Somerfield and McCrae 2000). Immediate
physiological responses to stress involve reactions from the autonomic nervous system,
which is believed to allow a person a chance to react quickly to perceived danger (Mitchell
and Everly 1996). Subsequent to the immediate fight or flight response, other physiological
reactions include such longer lasting stages such as the Alarm phase, Resistance phase, and
Exhaustion phase (Selye 1974).
Physiological responses linked to stress include the release of hormones, compro-
mised immune system functioning, and physical illness. Responses to stress may
include such psychological states as excitement, fear and anxiety (Selye 1974;
Somerfield and McCrae 2000). Among the general population, higher levels of stress
have been shown to impair one’s cognitive resources (Glass and Singer 1972), increase
strain on the immune system (Cohen and Herbert 1996), and lead to the development of
learned helplessness and depression (Seligman 1972). In addition, stress is thought to
contribute to many diseases such as arthritis, PTSD, heart disease and diabetes
(Somerfield and McCrae 2000).
Many factors have been shown to play an important role in determining the outcomes of
an individual’s experience of a stressful event. One of these factors is the duration of the
stress (Bernard and Krupat 1994). For example, acute and chronic forms of stress have been
shown to have different impacts on individuals. Specifically, chronic stress has been shown
to have greater impact on physical health than acute stress (McEwan and Lasley 2005).
Cultural and individual differences may shape what events are perceived as stressful, what
coping strategies are available and acceptable, and what resources may be in place to turn to
for assistance (Bonnano 2004).
Several theoretical models have attempted to describe the dynamics of stress in people’s
lives. The Transaction model of stress highlights the role of the individual in determining if
an event is stressful (Lazarus and Folkman 1984). This model highlights two differential
paths in experiences and reaction to stress-evoking events. Initially, the primary appraisal
determines if an event is a threat. A secondary appraisal follows and includes the
determination individuals make about whether they have the resources to deal with the
stressor (Lazarus 1993). According to Lazarus, an event is only stressful if it is relevant to a
person’s well-being. This model has proven beneficial in health education and disease
prevention (e.g., Glanz et al. 2002).
The Biopsychosocial Model of Stress (Bernard and Krupat 1994) examines the
interaction between critical events and people’s experience of them. Specifically this
model examines three components of stress: the role of the environment in creating stress,
the individual’s neurological and physiological reactions to stress, and the interaction
between the environment and the individual. This model emphasizes the process in which
an individual’s interpretation of the environment leads to varying activations of mental and
physical reactions to stress. Research based on this model has explored processes of mental
Int J Adv Counselling (2008) 30:167–178 169

and physical activation such as the body’s immune reaction to stressful events like
bereavement (e.g., Bernard and Krupat 1994).
Lastly, the Diathesis Stress Model emphasizes levels of vulnerability and availability of
coping resources in those experiencing a stress-evoking event (Struwe 1994). This model
specifically emphasizes the sources of resilience in individuals as well as those factors that
may predispose individuals to higher risk of negative reactions in response to stressful
experiences. In addition, the model’s particular utility is its emphasis on the context and the
chronic nature of stressors, as well as the effect of an individual’s perception of the events
on the levels of distress. Recently scholars have examined human resilience in the face of
trauma and the importance of protective factors in preventing illness (Bonnano 2004).
Bonanno’s work attempts to explain the phenomenon of stable and healthy functioning in
the face of typically stressful events such as loss or trauma, and provided a review of
research on predictors of hardiness.
In conclusion, scholarship on stress and its impact on human functioning reveals
tremendous variety in the sources of stress and individuals’ responses to the stressors. A
brief overview of this scholarship on stress in general and on stressors in particular suggests
that stress in the lives of RIR is likely to be profound in its scope and its effects. The
stressful stimuli RIR encounter range from the individually based, such as a personal need
to learn a foreign language, to larger, systemically based stimuli, which may include having
to adjust to an environment that is hostile to foreigners. One of the key sources of stress for
many immigrants is obtaining legal status in their new host country. Because legal status is
so significant in RIR relocation and adjustment processes, we provide a brief overview of
the different statuses an immigrant will typically face in most settings.

The Legal Aspects of Immigration

The RIR experiences of stress and coping would seem tied somewhat to their immigration
status. Three overarching patterns of immigration are typical and, although these presented
are based primarily on the US immigration system, they are similar to the regulations found
in other Western nations. The three broad categories of relocation are: (1) legal
immigration, (2) refugee relocation, and (3) undocumented or “illegal” immigration.
Legal immigration refers to relocation of non-citizens who are granted legal permanent
residence by the government. Legal permanent residence provides the right to remain in the
country indefinitely, to be gainfully employed and to seek the benefits of citizenship
(Mulder et al. 2001). A different type of immigration status is granted to individuals who
are considered refugees. Refugees are defined by the 1967 United Nations Protocol on
Refugees as those people outside their country of nationality who are unable or unwilling to
return to that country because of persecution or well-founded fear of persecution (Mulder et
al. 2001). The third category of immigrants represents individuals who seek to relocate to
other countries in search of employment and better living conditions outside the permitted
regulations. Often referred to as the illegal or undocumented population, the unauthorized
migrant population consists primarily of two groups, (1) those entering the new country
without inspection and (2) those entering with legal temporary status but staying beyond the
time allotment of their visas (Mulder et al. 2001).
The differences in legal status are clearly significant to the RIR experiences of stress and
their needed coping resources. Certainly, a fear of deportation because of the lack of
documentation can create enormous anxiety in those who are attempting to provide for
themselves and their families by seeking employment. However, even those RIR who have
170 Int J Adv Counselling (2008) 30:167–178

legal permanent residence or refugee status may express fears about the ongoing legality of
their position or their legal rights (Yakushko 2008).
Their legal status, although significant, is only one of the multiple stressors RIR may
face. Prior to relocating into a foreign land RIR may call a “new home,” they may
encounter challenges that strain their individual resources. These pre-migration challenges
then can be magnified by post-migration experiences.

Pre-Migration Stressors

Pre-migration experiences and resources are significant to an understanding of the wide range
of factors that influence immigrants’ levels of stress and coping (Ben-Sira 1997). Voluntary
migration, optimistic expectations, language skills, and availability of support are associated
with more positive outcomes for immigrants (Escobar et al. 2000; Hondagneu-Sotelo 1994;
Salgado de Snyder 1994).
These positive scenarios, however, are often the exception. For probably the majority of
immigrants, the decision to relocate may be prompted by a host of tremendously
challenging and stressful personal experiences (Yakushko and Chronister 2005). Even if
an event is perceived as positive (i.e., a desire to gain access to positive resources for
themselves and their children), relocation involves a tremendous amount of planning and
pressure. As well, this often irreversible move brings with it a number of significant losses
of connections with family and friends in the home setting (Berger 2004).
Individuals may also relocate because of experiences of threat in their home environment. RIR
may believe that both they and their families face economic, political or cultural restrictions that
are insurmountable. Individuals may experience the social structures of their home countries as
unsupportive or worse, potentially injurious (Marsella and Ring 2003). For a typical immigrant,
whether documented or undocumented, these pre-migration struggles are undoubtedly stressful.
However, the pre-migration stress that is experienced by refugees is especially challenging.
Refugees who seek shelter from experiences of war or political persecution, often come
under a great number of life-threatening stressors for themselves and their families. Their
pre-migration traumas and stress may be extensive and their coping strategies challenged to
the limits (Prendes-Lintel 2001). RIR from countries that are war torn or have had
repressive political regimes often suffer extensive family loss or personal violence such as
torture. Specifically, stressors may include witnessing war trauma, physical and emotional
torture, imprisonment in concentration camps, loss of family members to displacement,
death or disappearance, and fear for personal safety (Keyes 2000).
Furthermore, refugees may have witnessed or experienced rape, torture, bombings,
fighting, death of family members and neighbors, loss of property, hunger and
homelessness (Bemak and Chung 2005; Prendes-Lintel 2001). A number of refugees
resettled in Western countries have often previously suffered high levels of exposure to
organized violence. For example, 80% of Cambodian refugees have reported losing a friend
or family member, 20% of Vietnamese refugees have reported exposure to major trauma
with 5.5% reporting imprisonment or torture, and 60% of Indochinese refugees reporting
some form of trauma with over one fourth reporting having been tortured (Sinnerbrink and
Silove 1997). Many arrive in their new locations with health difficulties due to these
experiences or from unsanitary conditions in their home country or from resettlement
camps where hygiene is problematic. The most commonly encountered medical diagnoses
are malnutrition, parasites, hepatitis B, dental caries, depression, and posttraumatic stress
disorder (Barnes 2001).
Int J Adv Counselling (2008) 30:167–178 171

Anticipation of war devastation on one’s way of life and the threat to family safety, the
secrecy and tension associated with planning an escape, and the careful monitoring of assets
to buy passage while avoiding discovery are all elements of chronic stress inducement that
pre-date the step of actually leaving one’s country. Moreover, the uncertainty that
accompanies flight, as well as real or imagined dangers en route, can contribute
substantially to distress (Saldana 1992). Stressful refugee camp conditions have been
found to exert a significant, if at times transient effect on depressive affect levels in the
early years subsequent to refugee resettlement (Barnes 2001).
Some RIR experience stressors because of their ethnic minority status within their country
of origin environment. These minority groups may have encountered discrimination in their
daily lives, such as inhibited access to career choices, as well as pressure and intimidation
when trying to obtain exit visas (Prendes-Lintel 2001; Yakushko 2006). These extreme pre-
migration conditions are often associated with long-lasting emotional consequences that are
often masked by a brief period of post-traumatic numbness or sense of relief over having
survived horrific experiences (Aroian and Norris 2003). The nature and degree of traumatic
exposure experienced before flight puts refugees in a high risk group in terms of future
mental and physical health problems. Central to the dynamics of their traumatic stress are
often the dimensions of helplessness and powerlessness (Lie 2002).
In conclusion, even prior to relocation the majority of RIR may have experienced stressful
events that may range from mild to extreme. Their coping resources may be further challenged
by a lack of resources that eventually push them to leave their home location. Many immigrants
imagine that their host community will be a “paradise” that provides a safe haven from the
stressors of life (Yakushko and Chronister 2005). Unfortunately, post-migration stressors,
although different, may still be severe.

Post-Migration

Stressors experienced by RIR continue to be significant after relocation. It is important to

note that immigration challenges are stronger producers of distress in immigrants than are
normal stressors of living or demographic variables. Age, gender, marital status,
employment and education have all been associated with depression in RIR. However,
these demographic variables are compounded when the demands of immigration are taken
into account (Aroian and Norris 2003). Scholars have discussed several sources of
continued stress for RIR. These include the stress of relocation itself, challenges brought on
by physical and emotional distress, acculturation stress, and, where it exists, a prejudicial
host environment.

Stress of Relocation

Migration in itself is a highly stressful experience that impacts RIR well-being. Rumbaut (1991)
states that “migration can produce profound psychological distress among the most motivated
and well prepared individuals, and even in most receptive circumstances” (p. 56). RIR may
experience post-traumatic stress, mourning and grieving of multiple losses, acculturative stress,
loneliness, loss of self-esteem, strain and fatigue from cognitive overload, uprootedness and
perceptions that they are unable to function competently in the new culture (Espín 1997, 1999;
Garza-Guerro 1974; Yakushko and Chronister 2005). As highlighted earlier, refugees often
undergo severe psychological duress as a result of their traumatization history and ‘forced’
relocation (Cole et al. 1992). Their migration process may be in itself tremendously stressful in
172 Int J Adv Counselling (2008) 30:167–178

that they may experience relocation camps, uncertainty about where their new home will be,
and separation from family members, among many other difficult events (Saldana 1992).

Mental and Physical Health Challenges

Migration places significant strain on RIR emotional and physical functioning. Depression
and anxiety have been cited commonly as symptoms experienced by RIR (Bhui et al. 2003;
Romero and Roberts 2003). A study from a Swedish context showed that rates of suicide
are significantly higher for first-generation immigrants than for the native-born population,
and that the suicide rate remains higher than average for second-generation immigrant
individuals and children adopted from foreign countries (Hjern and Allebeck 2002). Studies
on depression and suicidality among immigrants within the USA similarly show higher
rates of attempted and completed suicides than in non-immigrant populations from the same
ethnic backgrounds residing in the USA (Hovey 1998; Hovey and King 1997; Patel and
Gaw 1996; Sorenson and Golding 1988).
A meta-analysis conducted by Fazel et al. (2005) found that one in ten adult refugees in
Western countries had Post-Traumatic Stress Disorder, about one in 20 had major
depression, and about one in 25 had a generalized anxiety disorder. Refugees based in
Western countries may be about ten-times more likely than the age-matched general
population to meet a diagnosis of Post-Traumatic Stress Disorder (Fazel et al. 2005).
Studies have shown that RIR present for help with multiple somatic complaints (see
Bemak and Chung 2002 for review). Barnes (2001) indicated that RIR physical health
difficulties result in economic costs, such as lost workdays, lost productivity, and lost
educational opportunities. Moreover, long-term exposure to unpredictable and uncontrollable
events may lead to the development of an impaired capacity to accurately assess one’s own
physical or psychological safety (Asner-Self and Marotta 2005). Reactivation of trauma can
also occur as a response to negative, threatening or disturbing life events, including seeing
violent images on the television (Kinzie 2004).

Acculturation Stress

Acculturation, or the process of adopting the values and behaviors of a new culture, is the most
common factor used in discussing immigrants’ processes of coping with a new culture (Flannery
et al. 2001; Hays 2001; Ortega et al. 2000; Salgado de Snyder 1994). The effects of
acculturation are complex, which may have led to inconsistent findings concerning what
acculturation levels, for what immigrant individuals and groups, and in what countries may lead
to positive outcomes. A number of researchers have attempted to identify predictive factors that
may explain the level of acculturative stress (see Kosic 2004 for a review). These factors can
broadly be divided into two groups: features of the original and host societies (cultural,
economic, political, social) and individual characteristics (Ritsner et al. 2000). Among the
individual characteristics, potential influence is affected by a number of demographic variables
(age, gender, marital status, education, length of sojourn), characteristics of personality (self-
esteem, locus of control), and socio-cognitive and motivational factors (coping strategies,
acculturation strategies, social support, and the need for cognitive closure; Kosic 2004).

Relational Stress

Relational factors include experiences that occur in nuclear and extended families due to
relocation, and may profoundly affect immigrants’ experiences of stress and coping.
Int J Adv Counselling (2008) 30:167–178 173

Women, who are viewed in many traditional patriarchal societies as keepers and
transmitters of cultural values, may experience increased pressure to focus on their families
after relocation, often at the expense of their own well-being (Espín 1999; Narayan 1997;
Simons 1999). Immigrants frequently encounter intergenerational conflict between children
and older family members (Darvishpour 2002; Perilla 1999). Evolving family power
dynamics that occur after relocation also may result in increased incidences of domestic
violence. The US-based National Council for Research on Women (1995) documented that
nearly half of immigrant women surveyed experienced domestic violence and that this
violence had intensified after their relocation.
Stress and ability to cope with it may be at the root of what contributes to the volatility
of familial relations. Scholars have suggested that an escalation of stressful experience can
have a profound effect on the functioning of families (Bemak and Chung 2002).
Furthermore, expectations that both individuals and families must function just as well
(or even better) as before relocation and within their home culture, can increase the level of
stress and create a sense of low self-efficacy through difficulties in being able to meet those
expectations.

Social Status and Social Contact

Among the other difficulties that RIR must deal with is the typically demanding job search
process and the construction of a new social network, which may be particularly stressful.
RIR are disadvantaged, not only by higher demands than previously encountered, but also
by heightened individual vulnerability towards stress because typically they have to deal
with the loss of not only their jobs, but also of social support from former colleagues,
friends and relatives (Schwarzer et al. 1997). An additional risk factor is often the loss of
professional status and social prestige, which may affect the self-esteem of immigrants and
often prompts distress, depression and anxiety (Ritsner et al. 2001).
For many RIR their environmental change also changes many aspects of their day-to-day
living: such as, self-care, productivity and leisure. Interferences can be seen for many in
self-care activities, such as dressing, eating, meal preparation, doing laundry, shopping,
housekeeping, and childcare. Frequently, personal preferences and cultural values are
different from those of the new dominant culture and decisions have to be made as to what
is best for the family. Many RIR spend less time socializing due to the experienced loss of
the community in which they once participated (Connor Schisler and Polatajko 2002).

Oppression

Immigrants around the world experience multiple sources of social oppression. These
forces include, but are not limited to, xenophobia, racism, sexism and discrimination based
on poverty and employment (Marsella and Ring 2003; Yakushko 2008). For instance,
societal prejudices against immigrants advance the idea that they are poor, uneducated and
desperate to live in Western countries (Portes and Rumbaut 1996). Contrary to stereotypes,
research shows that those who are immigrating to the USA, for example, have higher
education levels than the national average, have strong work ethics, and also often have a
desire to return home (Guarcnaccia 1997; Portes and Rumbaut 1996). Additionally,
undocumented immigrants have no legal rights and are often emotionally (e.g.,
harassment), physically (e.g., poor working conditions), and economically (e.g., no
consistent pay or health benefits) abused or neglected by their employers, government or
social service systems (Yakushko 2008). Without the right to vote and stay in the USA
174 Int J Adv Counselling (2008) 30:167–178

legally, undocumented immigrants also have little or no power to change oppressive social
structures.
Cultural values and prejudices also influence how immigrants are represented in medical
and behavioral health sciences. Societal intolerance has led many practitioners and
scientists to narrowly conceptualize immigrants as oppressed and helpless (Darvishpour
2002) and to disregard their strengths, resilience, resourcefulness and community networks
(Cole et al. 1992). In addition, structural barriers to receiving services and support, such as
the availability of trained interpreters, may create significant stressful perceptions that help
may not be available when needed. Such systemic forces of oppression and discrimination
play a powerful role in contributing to immigrants’ levels of stress and their ability to cope.

Implications for Counseling

One of the key areas of addressing the stress in immigrants’ lives involves the provision of
culturally relevant mental health services to this population. Both intervention and
prevention practices may serve to help immigrant individuals cope with their transitions
(Yakushko and Chronister 2005). As stated earlier, immigrants are a vastly heterogeneous
group and many of their mental health needs may be best served with attention to particular
aspects of their identity that are most salient to their psychological needs (e.g., a domestic
violence support group for immigrant women, drop-in services for migrant farm workers).
Prevention efforts may be the first steps in providing services and can involve distribution
of information about how appropriate mental health services may benefit immigrant
individuals and what are the parameters of such services. For example, individuals from
many countries would not have a concept of confidentiality and would, therefore, fear that
their private struggles would be recorded and turned over to authorities. Prevention efforts
may also include work on the part of clinicians or clinical groups to make their practices
immigrant-friendly and to establish connections with immigrant communities or those who
already serve them (Pinto 2002).
Intervention work with immigrants must include consideration of the psychosocial
factors that influence immigrants’ experiences of stress and coping (Bemak and Chung
2005; Prendes-Lintel 2001). These factors may differ for individual immigrants because
even within small psychosocial units such as the family immigration decisions may benefit
one partner more than the other and individuals may be adjusting at different rates.
Recognition of the environment of discrimination and prejudice by counseling practitioners
may also help them structure their services. For example, helping immigrant clients to
transition into work and careers in their host country may include provision of information
about dealing with employment discrimination based on national origin, religion, gender,
race, sexual orientation or language (Yakushko 2006). Lastly, immigrant adaptation may
closely resemble the process of minority identity development. For example, immigrants
may initially struggle to recognize the significance of their cultural heritage in their new
environment and seek to emulate the values of the host culture. However, with time, they
may be able to develop a positive sense of pride about their ethnic background and its place
within their host cultural context. Practitioners can pay attention to whether immigrant
clients have internalized the notions that being a foreigner results in deserving their lower
status or that “becoming Western” and fitting in by losing one’s cultural identity is an
ultimate goal.
Through assessment, service providers must evaluate immigrant and refugee families’
resources for social, economic and cultural integration; discriminate between realistic and
Int J Adv Counselling (2008) 30:167–178 175

unrealistic expectations; evaluate families’ problem-solving abilities, both past and present;
explore family functioning within the context of the refugees’ heritage; identify the
transferability of work skills; and, most importantly, gauge families’ learning capabilities
and motivation for adaptation (Segal and Mayadas 2005). Refugee resettlement policies,
programs and practices that aim to enhance economic adaptation should target those
demographic characteristics that have the greatest influence on economic adaptation
(Prendes-Lintel 2001). Gender, disability, education, and household composition have been
found to have the greatest influence in whether RIR families succeed and cope with
stressors of migration. Among these, education is the one variable that is much more
amenable to intervention than the others. The accumulated data clearly indicate that
refugees can substantially improve their economic status by advancing their education.
Similar to minority clients who are native-born to Western countries, RIR clients will
also be resilient in their transition to a new culture and may have unique ways of coping
with stress. For the majority of immigrants, moving to a new culture is often seen as a
difficult but hopeful choice toward their goals of safety, prosperity and well-being for
themselves and especially their children (Yakushko 2008). Zajacova (2002) wrote about the
optimistic outlook for the future that immigrants may have in constructing their own reality
of immigrant life in Western nations. Clinicians can assess the levels of optimism and
achievement motivation and help their immigrant clients to build on their existing internal
and external resources in dealing with stress. Furthermore, immigrant women and men may
rely even to a greater degree on their ethnic communities while in the host country or
remain in close contact with families and friends in their homelands. Such social contexts
may assure more positive ways of coping with stressors inherent within a host culture and
must be viewed as an asset to clinical work with this population (Schnittker 2002).
Lastly, services for immigrant individuals and groups can be guided by the multicultural
service delivery models proposed in the counseling literature (e.g., Atkinson et al. 1993).
These models emphasize the importance of professional integration in service delivery that
can include such prevention and intervention components as provision of outreach,
consultation, facilitation of self-help or indigenous support groups, policy work, and
community advocacy. Deen (2002) provided an example of using various treatment
modalities, such as education, counseling, and community work to help newly arrived
immigrants to develop a “survival kit” for their new culture (p. 3). Responsive clinical
services can help RIR address their experiences of stress and enhance their coping.

Conclusion

Immigration will continue to change the face of nations. Stress experienced by RIR is
often severe and chronic. Theories and empirical investigations on stress in the general
population can inform research and clinical practice with those who relocate.
Understanding the experiences of stress and coping in RIR can in turn enrich physical
and mental health professions. Vera and Speight (2003) in their contribution on social
justice in psychology proposed an excellent framework for viewing counseling work as a
platform to empower clients. Specifically, they suggest that clients experiences must be
viewed within a cultural context, and that counseling should seek to help clients gain their
voice and find ways toward more fuller representation within the larger society. Greater
understanding and attention to stress and coping in the lives of RIR can help empower
them in their new environment toward becoming fully functioning contributors to their
host societies and the world.
176 Int J Adv Counselling (2008) 30:167–178

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