Counselling Muslims: A Review of Current Literature.
Georgina Cardo 2014. University of Salford
The purpose of this dissertation is to systematically review current research which focuses on adapted counselling theories and specialised Islamic based counselling to suit the needs of the Muslim client. A systematic review was conducted by searching electronic databases and relevant published journals, periodicals and text books which offer, discuss and explore alternative approaches to counselling for Muslim clients. The studies were then assessed for their suitability to the search criteria and relevance to the discussion. The strengths and limitations of the eligible studies shall also be presented. Findings indicated that whilst there are some philosophical differences to most Western based approaches to counselling compared to Islamic teachings, incorporating or acknowledging Islamic philosophies and practices into the therapeutic approaches can enhance the psychological well-being of a Muslim (Haque, 2004; Utz, 2009).
Counselling an Islamic perspective
There is no one word translation for the word psychology in Arabic other than the principles of what psychology is based on and referred to as; the study of the human psyche (Nafs) in Arabic, Ilm-al-Nafs (knowledge of the self) (Ahmad, 2005). The most notable scholar that relates to the concept of the personality and purification of the self and soul was Abu Hamid Muhammad Al – Ghazali (1058-1111) whose comprehensive psycho-spiritual philosophies were based on his knowledge of the Quran and Hadith. Other notable Islamic philosophers and scholars who wrote extensively on the subject include; Al-Kindi (801-866), Al-Razi (864-932), Al-Farabi (870-950), Ibn Sina (980-1037), Ibn Rushd (1126-1198) and Ibn Arabi (1164-1240) (Abu Raiya, 2011). According to Al- Ghazali, the psycho-spiritual structure of a human is said to compromise of four; Qalb (spiritual heart), Ruh (spirit), Nafs (psyche or self) and A’ql (intellect/mind) (Al- Ghazali, 1995).
Like Western forms of psychology, psychological balance and harmony in Islam are considered achievable through awareness, change and re-alignment of the self to a natural, harmonious balance (Haeri, 1989). But what is most noticeably different between Western non-theologically based theories of psychology to Islamic interpretations of psychology is that the highest form of purification, peace and balance of the self and soul, is achievable through God consciousness, referred to as taqwa (Al-Ghazali, 1995; Murad, 2000). For Muslims this is achievable in the following way; seeking knowledge and support from Allah through consultation of the revealed guidance (Quran); also through worship such as; prayer (salah), fasting (sawm), charity (zakat) and the personal endurance of pilgrimage to Mecca (Hajj). Within the field of Tazkiyyah, Tarbiya and Tasawuuf,* which are all fields of self-development and spiritual purification, the remembrance of Allah is encouraged through supplication (zhikr), contemplation (tafkir), repentance (tawbah) and seeking personal development through education, advice and support (Abu-Raiya, 2011; Skinner, 2010;Utz, 2011). It should be noted however that the explanation of Islamic concepts of personality and psycho-spiritual existence are considered offerings towards an understanding of Quranic teachings and are in no way defined by the interpreters as definitive truths in the explanation of the Quranic verses (Al-Ghazali, 1995; Haque, 2009; Abu-Raiya, 2012). The study of the Quran and its reference to the human soul is a journey of discovery as is the nature of the human being. Muslim philosophers, scholars and students endeavour to contemplate the complexities of its formation and existence whilst bearing in mind the verse in the Quran that informs them;
‘They ask you (Muhammad swws) about the ruh (spirit). Say, the ruh is by the command of my Lord, and that you (human beings) have been given but little knowledge’ (Quran, 17;85)
With regards to mental health and well-being the Quran supports the importance of seeking balance and harmony of the self in many of its verses, for example one verse says;
‘Indeed he succeeds who purifies his own self’ (Quran, 91:9)
The Quran also supports seeking guidance and counsel and emphasises the free will of an individual to be inspired towards seeking such help;
‘ .. Allah would not change the condition of a person until they change what is in themselves’ (Quran, 8:53)
The importance of consulting others which could relate to a counsellor, is emphasised when the Prophet Muhammad (swws) said;
‘Reported by Abu Dawwud and Tirmizi from the Hadith of Abu Dardaah
said that Prophet Muhammad (swws) said to the companions one day:
“Shall I inform you on what is better than Salat, Fasting and Zakat?” The companions replied; yes please Rasoululah (swws).
Prophet Muhammad (swws) said: “Reconciling between two.”
(Al-Tirmidhi, no. 2509 as cited in Hadith al-Islam, 2014. p192)
The verses and sayings empathises the importance of psychology and counselling from an Islamic perspective. A consideration of the following research literature shall hope to identify in more detail the main approaches that could possibly support a Muslim client or indeed any other. Muslim researchers have said that the teachings of Quran or any other religious philosophies that relate to psychology could potentially enrich perspectives and advance theories for the benefit of all (Abu-Raiya, 2012).
Discussion & Conclusions
The aim of this systematic literature review was to select and thematically review eligible research papers and academic articles that focused on developed or adapted forms of counselling suitable for use with Muslim clients. The eleven chosen papers presented the opportunity to evaluate research that focused on three main areas of Western counselling/psychology; cognitive and behavioural modalities such as CBT and REBT, a humanistic modality known as Person Centred theory and psychodynamic theories from Freud and Jung (Abu-Raiya, 2012; Abu-Raiya & Pargament, 2010; Ali, 2007; Al- Thani, 2010; Carter & Rashidi, 2003; Hamdan, 2008; Hodge & Nadir, 2008). Also included in the selection were four papers that introduced some Islamic philosophies to psychology and offered theories that could support the emergence of Islamic forms of counselling (Badri, 2012; Haque, 2004; Razak & Hisham, 2012; Skinner, 2010). The main themes that emerged upon review of the subject content and research were;
- Considerations of the obstacles to the therapeutic alliance between therapist and Muslim client.
- Adaptations to techniques and narratives used in counselling modalities to suit the Muslim client.
- Integration and synthesis of Islamic philosophies withWestern theories.
The therapeutic alliance is widely accepted as a key component to successful counselling (Asay & Lambert, 1999; Beutler et al, 2004; Keijsers et al, 2000; Norcross, 2002; Rogers, 1957). Articles written by Muslim researchers highlighted points such as the client and therapist sharing similar religious beliefs, the issues of gender mixing i.e. male client, female counsellor and vice versa, also the effects of stigma and judgments in forming a congruent and empathic therapeutic alliance (Al-Thani, 2012; Ahmed & Amer, 2012; Badri, 1979; Badri, 2012; Dwairy, 2006; Hamdan, 2008; Razak & Hisham, 2012). Other researchers of different faiths, namely Christians have commented on these same considerations (Koenig & Larson, 2001; Tan, 1994). The author of this literature review considers through analysis of the available literature that, assessment of the success or failures of similar faith and non-similar faith counselling relationship would be an area of research worth investigation. This would help obtain a clearer understanding of the complexities within therapeutic relationships of difference and diversity. Suggestions have been made for the use of assessment scales and questionnaires relating to religiosity and cultural differences of the Muslim client but not so much on the beliefs and practices of the counsellor or the effects of difference in religious beliefs (Ansary & Salloum, 2012 cited in Ahmed & Amer, 2012; Abu Raiya & Hill, 2013). The author of this literature review considers that further use of such scales or questionnaires as a prerequisite to the counselling process or in research would be beneficial, although careful consideration of the intrusive nature of such intensive questions would need sensitive application, as would consideration of the authenticity of some answers. For example to ask a Muslim client about the level of their worship, such as how many times a day do they pray may be met with an unclear answer for various reasons, fear of judgment that they are not religious enough or fear of sounding too extreme (Rahiem & Hamid, 2012 in Ahmed & Amer, 2012).An example questionnaire used for research purposes can be found in the appendices section (Abu Raiya & Hill, 2013).
The adaptations to the counselling techniques reviewed included adjusting basic narratives within counselling practices such as; using metaphors that the client would understand, gaining knowledge of the clients understanding of counselling and mental health terminology and any differences or similarities to their cultural or religious understanding of these meanings (Ali, 2007; Hamadan, 2008;Hodge & Nadir, 2008). On the whole the use of CBT, REBT and Person Centred theory was seen as favourable, as was some of the philosophical ideas from the structure of personality offered by Freud and Jung (Ali, 2007; Al Thani, 2010; Abu-Rayia, 2012; Carter & Rashidi, 2003; Hamadan, 2008; Hodge & Nadir, 2008; Skinner, 2010).
The author of this literature review upon examining the research, considered the possibility of a potential merger between Western counselling modalities and Islamic philosophies and the benefits to all, not just Muslim clients. Islam promotes the advancement of science and suggests that contemplation and investigation of both scientific research and religious texts, especially from the Quran should help, not hinder the progression of scientific discovery (Quran, 96:1-5; Razak & Hisham, 2012). From an Islamic perspective, an integration of discoveries from Western counselling and Islamic concepts of personality and spiritual development could help achieve psychological balance of not only Muslim clients but potentially all clients, as long as the concepts do not contradict Islamic principles and practices (Quran, 2:1-38).
Overall research in the field of counselling Muslims is still in early developmental and explorative stages, but the suggestions so far provide a useful resource for counsellors and researchers to expand upon (Ali, 2007; Al- Thani, 2010; Abu-Raiya & Pargament, 2010; Abu-Raiya, 2012; Carter & Rashidi, 2003; Hamdan, 2008; Hodge & Nadir, 2008; Haque, 2004; Razak & Hisham 2012). There have been some noticeable limitations within the research reviewed, mainly the lack of empirical research and case study examples evaluating the efficacy of adaptations to counselling practices for use with Muslim clients. With this in mind and in order to attain some credibility within the field of science and psychology, it was concluded by the reader that new research using case studies, assessing the efficacy of adapted and specialist psychotherapeutic methodologies would be constructive (Ali, 2007; Al- Thani, 2010; Abu-Raiya & Pargament, 2010; Abu-Raiya, 2012; Carter & Rashidi, 2003; Hamdan, 2008; Hodge & Nadir, 2008; Haque, 2004; Razak & Hisham 2012).
The author of this systematic literature review concludes from the reviewed articles that an integrative approach to counselling methodologies is potentially a more flexible, adaptable way of combining therapeutic techniques to suit the complex needs of the Muslim client. However, there are points to consider which shall now be discussed. An integrative approach could include a combination of cognitive and behavioural techniques with adapted Islamic narratives as suggested by Hamdan (2008) and Ali (2007). Alternatively the use of humanistic approaches to counselling, such as Person Centred counselling with recognition of the client’s religious beliefs and practices and incorporation of these religious teachings into the treatment process, can be beneficial to the Muslim client (Al-Thani, 2010). Overall the research suggests that Western modalities such as Person Centred counselling and Cognitive Behavioural Therapy can certainly help support a Muslim client progress within counselling treatment, however counselling from an Islamic perspective means to regain psychological and spiritual balance through God consciousness, not usually the goal of Western approaches (Haque, 2004; Badri, 2000; Razak & Hisham 2012).With this in mind it would be useful for both the counsellor and the Muslim client to define their main goals and objectives to the counselling process from the start, in that way a clear distinction between what the Quran narrates as how to achieve ultimate psychological balance and what Western counselling theories suggest, is clear. The Quran clearly defines ultimate psychological balance as the achievement of the state referred to as Nafs al-mutmainnah (the serene self) and this requires understanding and integration of the religious beliefs and practices outlined in the Quran and Hadith (Haque, 2004; Badri, 2000).In contrast, Western counselling theories are accused as focusing on an individualistic outlook, with the goal of psychological balance being self-actualisation of the individual including or not including the acknowledgement and servitude to one God (Haque, 2004; Badri. 2000). It is thus assumed by the author of this literature review that the majority of the research on this topic suggests that to discount the importance of the Muslim client’s religious beliefs and practices would conclude counselling in any form, questionable (Ali, 2007; Al- Thani, 2010; Carter & Rashidi, 2003; Hamdan, 2008; Skinner, 2010).
There has been an emphasis throughout much of the literature on the therapist forming a well-educated understanding of the client’s beliefs and practices and using Islamic teachings within counselling practice (Ali, 2007; Al- Thani, 2010; Carter & Rashidi, 2003; Hamdan, 2008; Skinner, 2010). However how practical this is to fulfil remains untested. It may be idealistic to rely on the counsellor to become fully informed or even willing to research Islam in depth, especially considering the influence of cultural traditions upon religious teachings and levels of individual understanding or interpretation of the religious texts (Abu-Raiya & Pargament, 2010; Abu-Raiya, 2012; Al-Thani, 2010). This again supports the need for future research looking at whether it may be more effective to have same faith counsellor client relationships? (Al-Thani, 2010; Badri, 2012). Perhaps at least having the basics of a shared truth, in the case of a Muslim i.e. belief in God, may help in the initial formations of a therapeutic relationship, but this may not be important to all (Ahmed & Amer, 2012). Additional research exploring the pros and cons would be useful, but it is also worth consideration that onus on the Western non-Muslim practitioner to adjust their techniques or educate themselves more on the beliefs and practices of each client is only half the responsibility. The Muslim community needs to take further responsibility for their community as recommended in the Quran and Hadith. The rights and responsibility of brotherhood/sisterhood and community between Muslims and non-Muslims is considered an important aspect of faith (Quran 3:103, 49:10; Bukhari, 238). This responsibility of care can be achievable in many ways;
- Encouraging Muslims to obtain professional training in counselling, psychotherapy and psychology (Badri, 2012; Haque, 2004; Skinner, 2010)
- Training Muslim community leaders such as Imams in basic counselling skills and mental health awareness to complement their religious guidance (Abu-Ras & Abu-Bader, 2008; Ali et al, 2005).
- Offering courses drop in services and workshops at community centres and Mosques to promote mental health awareness and the availability of services (Ali et al, 2005).
- The distribution of educational material on mental health conditions and services translated in to various languages such as Arabic, Urdu and Malaysian etc. (Chen et al, 2005 Cited in Ahmed & Amer, 2012).
Enhancing awareness of mental health issues and available support may help minimise the stigmatisation of mental health as just merely due to the lack of belief and connection with Allah or Jinn possession (Amer & Ahmed, 2012; El-Islam, 1995; Islam & Cambell, 2012). There have been some positive movements within the Muslim community in the UK to address these issues and many internet resources, publications and services offering education and support are on the increase (see appendices for list of some services and links).
To conclude, an integration of counselling concepts both religious and none invites inclusion, collaboration and promotes unity, a mutual objective for both the religious and non-religious counsellor. Inclusion of a client’s feelings, thoughts and behaviour in accordance with their personal beliefs and practices is supportive of this aim. Islamic philosophies offer counsellors opportunities to gain insight in to the personal world of a Muslim client thus achieving congruent empathic understanding of their life goals. Insight in to the teachings of Islam can also provide another aspect and dimension to the counselling relationship, contemplation of the part of ourselves we forever wonder; the existence of the human soul and its relationship with the mental well-being of a person.
*Full Systematic review, research and reference list available by contacting G Cardo at email@example.com