Therapeutic Artists: Women and Men for and with Others

By Daniel Koster, doctoral student in clinical psychology, Loyola University Maryland

“The Ignatian imagination is a creative process that goes to the depth of reality and begins recreating it. Creativity might be one of the most needed things in present times—real creativity, not merely following slogans or repeating what we have heard or what we have seen in Wikipedia. Real creativity is an active, dynamic process of finding responses to real questions, finding alternatives to an unhappy world that seems to go in directions that nobody can control.”

— Adolfo Nicolás, S.J., Mexico City Speech


Ignatian pedagogy, embodied by the Jesuit core values, is in many ways distinguishable from other educational orientations by its heavy emphasis on social justice, which is activated and nurtured by a holistic well-roundedness and a focus on the whole person.

This well-roundedness resonates in Loyola’s core curriculum, where liberal arts courses demand that students play conceptual game of “connect the dots.”

As opposed to prematurely specializing, students learn to break down artificial barriers that are often constructed between academic disciplines. An orientation towards this most practical of skills grants students the efficacy to navigate, excavate, and restructure reality.

This skill is especially vital when the world calls for them to solve real world problems outside of the classroom.

Serving the Displaced

One of the most challenging moments of my life took place on the border of Mexico and the United States.

At the time, I was leading Loyola’s Center for Community Service and Justice’s (CCSJ) Project Mexico, an undergraduate service-immersion trip. Small as striving ants on the desert backdrop, our team carried as many jugs of water as we could handle. Occasionally, we would find a shady spot in which to leave a few. The hope was that displaced people traveling northbound for various regions of Latin America, often desperately thirsty, would stumble upon a bottle and drink.

We held no political orientation—only the desire to conserve human life.

At one point in our travels, I hopped over a boulder. Below me, abandoned, sat a child’s pink backpack. In it was a rolled sleeping bag. A toothbrush rested alongside it.

My understanding of this child’s possible fate has been colored by my interactions with displaced people and those serving them on both sides of the Mexico-United States border. While connecting with individuals at shelters, I continuously heard iterations of the same story: Men, women, and children were crossing the desert. Too often, a friend or a family member would not survive the trip. One man who was part of a disoriented group was rescued on the brink of death.

Daniel Koster (Photo: Lauren Goodsmith)

In these shelters, trauma is a part of life.

Fortunately, Andy Goicochea and my colleagues in CCSJ helped me to contextualize my border experiences: to attach meaning to their cause, to their effects, and to help me understand how to integrate these realizations into a budding identity as not only an active citizen, but an active professional.

This granted me the opportunity to conceptualize a societal sickness and to identify small areas that are ripe for intervention.

A Focus on Refugees

My participation in service initiatives with displaced people on both the Mexico-United States border and the Thailand-Burma border has led me to understand the extent of the displacement and often-concomitant trauma that occurs in this world.

There are various designations for displaced people, from internally displaced persons and asylees to economic or environmental migrants.

Recently, due to a series of serendipitous events, my focus has centered upon refugees. A refugee is an individual fleeing his or her home country because of war or persecution based on race, religion, nationality, political opinion, or membership in a particular social group.

At different stages of their odyssey of survival, refugees may experience and/or witness multiple forms of violence and trauma, ranging from genocide, mass killings, and forced removal to torture, rape, and other types of personal assault.

Considering the synchronous impact of overt trauma, the losses and difficulties that accompany any form of forced displacement, and the acculturation process that follows resettlement to a new country, it is intuitive that refugees as a group would benefit from mental health support… and yet they are widely underserved.

Refugees face many barriers in accessing mental health care. Some of these are tangible or systemic: lack of information about available services, lack of financial means, or the absence of appropriate language services in clinics.

Other barriers are less evident and may include inexperience among mental health providers in working with individuals from the very diverse cultures from which refugees originate.

Clinicians may also be inexperienced in treating the psychological sequelae of torture, war trauma, or gender-based violence—experiences that are all too common among refugees and asylees. An absence of appropriate resources for clinical training and supervision in these areas can prevent therapists from gaining vital competencies in working effectively with refugee clients.

In conjunction with Lauren Goodsmith and the Intercultural Counseling Connection (the Connection), I have been granted the invaluable opportunity to contribute to the process of reducing some of these barriers.

As a result, we have been able to start connecting refugee clients with mental health professionals in the Baltimore area.

Consistent with Jesuit pedagogy, the Loyola Clinical Centers (LCC) at Loyola University Maryland has contributed to meeting this need by generously donating a training space and providing support by offering continuing education credits to licensed providers who attend the Connection’s workshop series.

The Intercultural Counseling Connection

Goodsmith created the Connection with the support of an Open Society Institute fellowship grant. This initial funding went towards the planning and hosting of the Refugee Mental Health Workshop Series, a series of seven training workshops that focused on topics ranging from critical considerations in working with survivors of torture and war-related trauma to practical skills for effective collaboration with interpreters during therapy sessions.

These sessions were generously recorded, free of charge, by Loyola’s Event Services.

Mohammad Taghi Arefnia, LCSW-C, contributing to discussion on therapeutic care for refugee clients during an Intercultural Counseling Connection workshop. (Photo: Nicole Martyn)

The first series of workshops concluded in the fall of 2013, by which time the trainings had engaged 46 therapists from 32 different agencies and five private practices, and allocated 424 continuing education units, approximately half of which were provided through the Loyola Pastoral Counseling Program.

The immediate future of the program has been secured; by the end of 2013, the Connection received several grants from local foundations. This funding will enable the hiring of a part-time clinical supervisor to help provide professional guidance for participating Connection clinicians as they begin to work with referred refugee clients.

All providers will see clients on a pro bono or Medicaid-reimbursed basis, and the Connection will fund professional interpretation during these sessions.

In addition, the Connection continues to provide invaluable professional development opportunities for students.

A graduate student workgroup has been assembled that is currently focusing on generating a multi-lingual client self-report assessment tool that aims to evaluate the degree to which services received by clients were culturally responsive. Graduate students from Loyola University, Johns Hopkins University, and University of Maryland will be collaborating with Goodsmith to meet the assessment needs of the project.

The parallels between the mission of the Connection and Loyola University Maryland are evident.

The Connection seeks to promote social justice by expanding access to invaluable psychosocial support to members of a trauma-affected population that is currently highly underserved.

All the while, the Connection’s mission calls for a constant challenge to improve. The providers who enter the Connection’s world are risk-takers, innovators, and explorers. Their participation demonstrates their wish to expand their competencies in working with very diverse clients, and to better understand the worldviews that shape belief and experience beyond the American dominant culture.

Connection workshop participants confer during a session on accessing resources on refugee health. (Photo: Lauren Goodsmith)

With a spirit of inquiry and humility, these clinicians are stepping away from the Western-focused themes that systemically underscore and inform psychotherapy training throughout the multiple disciplines that generate mental health providers.

Would Father Nicolás consider this creativity?

In essence, these clinicians are restructuring their understanding of mental health counseling to be more universally inclusive, or culturally responsive. They know how injustice seeks residence in indifference; they know how it manifests by way of “the eye turned blind.”

It seems they have found an alternative to this unhappy predisposition.

Therapeutic Artists: Women and Men for and with Others

While the respective institutions and organizations from which the Connection’s mental health providers originate may employ different verbiage to explain the same phenomenon, as a child of Ignatian pedagogy, I have seen firsthand how these clinicians are women and men for and with others.

The Loyola Clinical Centers is currently offering a venue that serves as a crossroads for inter-university collaboration. Under guidance of the Connection, licensed mental health providers throughout the Baltimore and Washington, D.C. area are coming together to expand their competency to include clients and therapeutic challenges they would otherwise have neither the training nor access to serve.

Similarly, they are gaining skills that will help reduce the linguistic, cultural, and attitudinal barriers to treatment that refugee clients often face.

Jesuit Adolfo Nicolás calls for creativity that answers real questions, while excavating the depths of reality in order to counterbalance an unhappy world that seems outside of control…

Father, the Intercultural Counseling Connection is here to answer your call.


Originally from Garden City, New York, Daniel Koster received his bachelor’s degree from Loyola in 2011 and began the clinical psychology (
Psy.D.) doctoral program in 2012. Daniel’s research interests relate to mental health care for populations exposed to trauma; clinically, he is interested in pursuing further training in the treatment of trauma and its psychological sequelae, as well as psychological assessment.

Daniel has been working with the Intercultural Counseling Connection since its inception. He has participated in and helped to organize all seven of the Connection’s training workshops in addition to grant writing for this project.

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