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In an effort to examine the impact of violent political conflict on clinicians, the study compared the feelings and thoughts evoked in 78 Jewish Israeli social work trainees at the prospect of treating an Arab Israeli client1 and a Jewish Ultra-Orthodox client. Both clients represented groups that are very different culturally from most Jewish Israeli social workers; but only the Arab would have been associated with a group with whom the country is in violent political conflict. The findings, based on a quantitative analysis of the students’ written statements, show that they felt more fear, threat, and tension at the prospect of treating the Arab client, and were more inclined to express guilt feelings and less inclined to express empathy towards him. They also expressed concern that the Israeli–Palestinian conflict would impact negatively on their therapeutic encounter.

The need for clinicians to exercise cultural sensitivity in treating clients of a different ethnic or religious group than their own is a commonplace of the helping professions. Clinicians are expected to be familiar with and accept their clients’ cultures and to take the cultures’ norms and values into account. A large body of literature exists to help clinicians do this with respect to Afro-American, Chinese American, Mexican-American, and other ethic groups in the United States (Ahia, 1997; Baker, 1994; Chao, 1992; Garrett & Pichette, 2000; Kendall, 1996; Lum, 1986; Miller, 1997). There is also a fair body of literature aimed at informing Jewish Israeli clinicians about the relevant features of the cultures of the Russian (Ben-David (1995) and Ben-David (1996); Berger, 1999) and Ethiopian (Ben-David & Good, 1998; Ben-Ezer, 1992) immigrants to the country and of the country's Arab minority (e.g., Al-Krenawi (1998) and Al-Krenawi (1999); Al-Krenawi & Graham (2000) and Al-Krenawi & Graham (2001); Al-Krenawi, Graham, & Al-Krenawi, 1997; Al-Krenawi, Graham, & Maoz, 1996; Dwairy & Van-Sickle, 1996; Haj-Yahia, 1997), as well as literature aimed at helping non-religious Jewish clinicians understand the culture of the country's Ultra-Orthodox community (Bergin, 1991; Bergin & Jensen, 1990; Bilu & Witztum, 1995; Greenberg & Witztum, 1991; Heilman & Witztum, 1997; Witztum, 1999). Among the underlying assumptions of all these literatures, whether in social work, psychology, or psychiatry, is that clinicians who are unfamiliar with the client's culture are hampered by negative stereotypes and prejudices, and that better understanding of the culture will help to reduce these impediments to effective treatment (DeHoyos, DeHoyos, & Anderson, 1986; Falicov, 1995; Ivey, Ivey, & Simek-Morgan, 1993; Sue & Sue, 1990). Thus, there is also extensive literature emphasizing the importance of eliminating or reducing such stereotypes and prejudices and dilating upon means of doing so (Dyche & Zayas, 2001; Latting, 1990; Stephan & Stephan, 1992). There is much less literature on clinical practice in situations of political conflict. In today's world, where clinician and client may not only be of different cultures, but also on opposite sides of a violent political conflict, this is an omission. Such conflicts tend to be part of the fabric of everyday life in the conflict areas and to arouse strong emotions on all sides. Kilpatrick and Leitch (2004), who examined the effects of the conflict in Northern Ireland on teachers and pupils, report that many children experienced feelings of fear, anger, and hatred towards the other group. Cardozo, Kaiser, Gotway, and Agani. (2003), who examined a cross-sectional cluster sample of Kosovar Albanians, revealed that over half felt hatred and over a third feelings of revenge. Such feelings are bound to enter into clinical relationships. As Fox (1998) points out, clinical practice denotes by its very nature an interrelationship between life and work. Just as events in the personal lives of mental health professionals may impact on their work as clinicians (Korol, 1995; Mendelsohn, 1996), so too may political events. The limited evidence indicates that professionals tend to ignore political conflicts in their work. Campbell and Healy (1999) point out that the sectarianism in Northern Ireland has led professionals in the health and social care fields to avoid dealing with potentially dangerous political and social issues. Baum (2006a) found similar avoidance among a group of Jewish Israeli social workers during the second intifada (armed Palestinian rebellion), which was marked by intense violence on both sides. In another study conducted during this intifada, Ramon (2004) found that both Jewish and Arab social workers mistrusted clients and workers of the other national group, and were firmly in the stage of “shutting the issue out” (p. 300). I have found only four studies, all of them by Jewish Israeli psycho-analysts, that deal in any detail with the interaction between Jewish Israeli professionals and their Palestinian Israeli clients. Gorkin, Masalha, and Yatziv (1985) discuss how the “state of war” between the two peoples complicates both the transference and countertransference processes in the Jewish therapist—Arab patient dyad. Gorkin (1987), based on his experience as a supervisor of Jewish therapists treating Arab patients, reports a variety of common countertransference reactions. Yovell (2001), in a book chapter entitled “An enemy in the Room: War and Peace between Therapist and Patient”, describes the gradual development of a cooperative therapeutic relationship following a tense and stormy start. In a subsequent paper, he describes different dynamics with two other Arab patients that placed obstacles in the way of establishing and maintaining a productive therapeutic relationship (Yovell, 2003). These accounts, for all that they are informative and stimulating, are very few, however, and based largely on direct personal experience. The only other published paper to date on this subject is a theoretical study that tries to raise awareness of the distortions that violent political conflict may introduce into social work practice with members of the rival community, and proposes training guidelines to help reduce those distortions (Baum, 2006b). The present study examines the responses of Jewish Israeli social work students to the hypothetical prospect of treating an Israeli Arab client. In an effort to distinguish responses stemming from the intense political conflict from responses stemming from cultural differences, the study compares the students’ responses to treating the prospective Palestinian Israeli client with their responses to the hypothetical prospect of treating a Jewish Ultra-Orthodox client. Jewish Israeli clinicians may be called upon to treat clients from both these groups in a variety of settings, including regular and psychiatric hospitals and clinics, the probation services, rehabilitation centers, and others. Although efforts are generally made to assign Israeli Arab clients to Israeli Arab clinicians and Jewish Ultra-Orthodox clients to religious Jewish clinicians, such matching is often impossible due to the relative paucity of trained clinicians from these groups. As will be elaborated below, both groups are culturally very different from most Jewish Israeli social workers. However only the Arabs are associated with a group, namely the Palestinians outside of Israel, with whom the country is in violent political conflict. While some differences in responses might stem from the students’ differential views of the two cultures, the expectation was that at least some of the differences would be anchored in the perception, prevalent in much of Jewish Israeli society, of Israeli Arabs as the “enemy”.