CULTURALLY SENSITIVE THERAPY WITH ULTRA-ORTHODOX PATIENTS - THE STRATEGIC EMPLOYMENT OF RELIGIOUS IDIOMS OF DISTRESS

The article deals with the problem of administering therapy in multicu ltural settings where the therapist and the patient hold divergent exp lanatory models in regard to the patient's symptoms. Different concept ualizations of the universal structure of symbolic healing stress the importance of therapist-patient compatibility for therapeutic success. In order to reach this compatibility, strategic therapists seek to jo in the patients' explanatory models and employ metaphors and symbols d erived from their cultural world. From a psychodynamic perspective, st rategic techniques are often presented as superficial treatments limit ed to the symptomatic level. In order to deal with this argument, we p resent a case study of an ultra-orthodox patient with a major depressi ve episode and describe the treatment which was based on a strategic, culturally sensitive approach. We use the case to discuss theoretical issues arising in the context of multicultural therapy such as the tra nslatability of culturally divergent idioms of distress and the possib ility to bring about significant, nonsymptomatic changes through strat egic employment of culturally congruent metaphors and symbols.