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Principles of social work practice in the Muslim Arab world.

THIS ARTICLE EXAMINES SOCIAL WORK in the Muslim Arab world, with particular reference to research that we have undertaken with Muslim Arab peoples in Palestine, Jordan, Egypt, and the United Arab Emirates. Much of the proceeding analysis is based on English language social work scholarship; future research could profitably consider innovations as considered in Arabic and other language social work literatures. English language traditions and literatures, as we subsequently point out, have been important to the Arab world's development of social work. Such diverse and loosely defined social groupings as "Northern" and "Muslim Arab" are fraught with dangers of reductionism, simplification, and essentialism. Their advantage, on the other hand, is the possibility of considering broad patterns at this early stage in the literature's evolution. Consequently, the generalizations that we present are intended as nothing more than a beginning point: as one scholar describes such enterprises, as "signposts for future research rather than as definitive conclusions," for further reflection and for application in more precise and defined geographic, historical, national, and other contexts (Salem, 1997, p. 11). Insofar, therefore, as generalizations may occur, we argue that this social work epistemology remains a largely Northern conception, but is nonetheless beginning to add space for other perspectives, including the Arab world--where social work, as we argue, has been a product of colonialism. Historically, many aspects of social work have fit poorly with Arab cultures and social structures. Polygamy and blood vengeance are excellent examples of culturally embedded practices for which social work theory and methods had, until recently, little to say. As we also argue, there are three important areas where social work in the Arab world has been enhanced: conflict resolution, collaboration with religion and with traditional healing, and strategies for working with families. Ultimately, we advocate an integration of social work as it is presently conceptualized in the Muslim Arab world, with principles derived from Arab cultural and religious practices; this process may lead to a more locally responsive, culturally appropriate model of professional intervention.

INFLUENCE OF THE NORTH ON THE PROFESSION OF SOCIAL WORK

At the turn of the twentieth century, the social work profession emerged in Western Europe and North America (hereafter the North) and in the interwar period was transplanted to colonized countries (hereafter the South) inside and outside the Arab world. In the post-World War II era, the profession was globalized, as schools of social work proliferated across the South--invariably with cultural assumptions originating in the North (Healey, 1999; Midgley, 1981). As a result, scholarship now widely concurs: social work in the Arab world, as elsewhere, is incompatible with cultural, economic, political, and social realities (Healey, 1999; Midgley, 1981, 1999; Ragab, 1990). The profession's growth has been characterized as "academic colonialization" (Atal, 1981) mirroring political and scientific colonization (Clews, 1999). In their transmission to the Arab world, social work knowledge and practice retained Northern assumptions regarding human nature and the nature of social problems (Ragab, 1990; 1995). These persist to the present time.

Examples of Northern biases in teaching, research and practice in the Muslim Arab world, are legion. In the early twentieth century, the profession of social work emerged in the North, with strong assumptions regarding the primacy of the individual: for example, Maslow's hierarchy of needs, with self-actualization as its pinnacle; Mahler's notion of separation, individualism and autonomy; and Erickson's ideas on the importance of autonomy in the development of individuals. These and other currents of helping professional theory are strongly grounded to Northern, individualistic cultures. The Muslim Arab world, in contrast, is more collectivist than individualist. No concept captures this better than the individualism/collectivism (IC) continuum. IC refers to the degree to which a person's worldview encourages, fosters, and facilitates the needs, wishes, desires, and values of an autonomous and unique self over those of a group (Mead, 1967; Triandis, 1972). Individualists may perceive themselves as separate and autonomous individuals. Collectivists, in contrast, may conceive of the individual in far less isolation from others within the same community--they may see themselves as fundamentally connected with others (Markus & Kitayama, 1991). In individualist worldviews, personal needs and goals take precedence; in collectivist worldviews, they may be secondary to the goals of a group. Social work, steeped in individualism, has fewer theoretical or practical insights into how to work with people who are strongly collectivist.

Muslim Arab peoples may view psychosocial problems differently than other communities, and may have distinct ways of accessing professional care and of articulating problems. Among Muslim Arab peoples, al-junin (being possessed by the jinni or spirit) is comparable to the Northern notion of mental illness, and may be conveyed in everyday life (Al-Issa, 2000). Religious terminology may be used to describe psychosocial problems; possession by a spirit, experiences of sorcery and magic, the temptation of the devil--these and other culturally bound expressions are common (Al-Issa, 2000; Al-Krenawi & Graham, 1997).

The first author portrays, in vivid detail, his experiences trying to reconcile his social work training within Northern-based universities, on the one hand, with his own lived experiences as a practicing professional and community member of Bedouin-Arab society, (Al-Krenawi, 1998a). His father compelled him, through culturally constructed analogy and metaphor, to integrate, rather than overlook, the thinking and practices of his home community. This, perhaps, was the most germane advice the author received (Al-Krenawi, 1998a).

It is important to stress that these experiences are not peculiar to the Muslim Arab world alone, but also include colonized peoples in Asia, Latin America, and Africa. In the post-colonial 1960s and 1970s, the South (e.g., Asia, Latin America, Africa) advocated a localized knowledge that would provide people with the relevance, meaning and cultural knowledge adequately to address their economic and social needs (Chau, 1995; Deer & Erdoes, 1998; Freire, 1998). For example, some scholars call for a social work knowledge base and profession that is variously African (Osei, 1996), or Indian (Nagpaul, 1996). The historical domination of Northern social work thought is increasingly challenged not only in the South (Henry, Taro, Mattis & Rees, 1995; Midgley, 1997; Schiele, 1996), but also in the North (Asamoath, Healy & Mayadas, 1997; Ragab, 1990). For example, a model of multicultural and anti-oppressive social work (Al-Krenawi & Graham, 2003; Mullally, 2002) is now more prevalent--and appropriately so, given the diverse nature of most Northern societies. Since the late 1980s, some in the North have also called for the 'internationalization' of social work education, in which domestic and international curricula are no longer separated, but converge towards a global perspective (Asamoath, Healy & Mayadas, 1997; Midgely, 1981).

DEVELOPMENT OF THE SOCIAL WORK PROFESSION IN THE ARAB WORLD

Ragab (1995) traces the historical development of social work as a profession in the Arab world: it is a product of both French and British colonialism. This discussion concentrates on Egypt, an especially influential part of Arab world social work history. In 1935, Egypt became the recipient of a predominantly American model of social work education and practice. Beginning in the 1960s, other Arab countries designed and implemented their own social work education programs (e.g., Saudi Arabia, Libya, Iraq, Syria, Kuwait, Qatar, United Arab Emirates) often with the assistance of Egyptian-trained social work educators. The proliferation of social work as a profession in the Arab world was juxtaposed with the struggle for independence and an end to colonialism. It is important to stress the influence of Northern social work programs in two respects. The first is how Northern assumptions have boon important in Arab world social work programs. This occurs through historical inertia already referred to, and into the present day with widespread incorporation of Northern texts, theories, and methods into Arab world social work training (Ragab, 199S). The second is the influence upon students who study social work in the North and return to an Arab world community to practice. In both instances, graduates retain Northern assumptions that are implicit in their training.

The past 40 years has brought about two significant processes for the development of social work education and practice in the Muslim Arab world. The first is localization, already referred to. The second, which is closely associated with the first, is an Islamic reorientation of social work. One proponent argues that Islam should transform social work, such that the profession is no longer a "simple transplantation" from North to South (Hakim Sarker & Ahmadullah, 1995, p. 373). Another social work scholar calls for an "Islamic reorientation of social work" in the Muslim Arab world, describing it as "the ultimate indigenisation stance ... to correct the traditional bias against religion in the social work profession" (Ragab, 1995, pp. 282-3). In order to localize social work within Muslim communities, Ragab (1995) argues that Islamic theology and worldviews should be integrated with "the best of behavioural/social sciences" and "rigorously verified observations and generalizations" (p. 291).

But social work theory has yet to elaborate how to extend and apply this agenda. Indeed, the existing literature on Islam and social work is sparse. Arabic language (Abdul-Hadi, 1989) and English language (Al-Dabbagh, 1993) book chapters consider some basic principles of Islam that could be adapted to Northern assumptions of social work and psychotherapy (Abdullah, 2002). More comprehensive research has been undertaken, but it is limited in number and scope. To date, only a few journal articles examine the influence of Islam upon social work in relation to prayer (Al-Krenawi & Graham, 2000a), traditional healing (Al-Krenawi & Graham, 1999a, 1996a, 1996a), social transformation (Haynes, Eweiis, Mageed, & Chung, 1997), and Islamic conceptions of charity/social welfare (Azmi, 1991). These, along with several book chapter publications that call for the localization of Islam and social work (Hakim Sarker & Ahmadullah, 1995; Ragab, 1990, 1995), constitute the sum total of the literature.

GLOBALIZATION, LOCALIZATION

How, then, to localize social work theory and practice? That is, how can it be more consciously adapted, in theory and methods, to the cultures and geography in which it is applied (Drower, 2000; Ragab, 1990)? Localization includes both the adaptation of imported ideas and practices (i.e., Northern knowledge and technologies) and the development of now ways or the revisiting of local ideas, processes and practices (Osei, 1996). Some are justifiably critical of simply "adapting or adjusting (the American model of) the profession in accordance with the conditions and requirements of the society in which it is being practiced" (Osman et al., 1994). Perhaps a solution rests with the development of new ways of incorporating local ideas, processes and practices (Ragab, 1990).

The co-anthers have been longstanding writers on social work in the Muslim Arab world. Our primary experiences have been with the Bedouin-Arab. This society in many respects remains close to the cultural/religious values that differentiate it from the North. Such considerations are particularly important to the Bedouin-Arab, who are undergoing a remarkable period of change. As we concluded early in our research careers: surely, in the clash between totalizing globalization versus localization, social work has a role to affirm an indigenous community's lived destiny, however subtle and dynamic particular cadences between globalization and localization might be. But, as we also concluded: only if its knowledge base and practices cultivate sensitivity to, and knowledge of, those cultural aspects that are of enduring importance to Muslim Arab peoples.

Our earlier work, in the tradition of psycho-ethnography, was published in social work and allied disciplinary journals and dealt with the significance of traditional healing to mental health and social service delivery in the Middle East (Al-Krenawi & Graham, 1996a, 1996b, 1999a; Al-Krenawi, Graham & Maoz, 1996; Graham & Al-Krenawi, 1996). That research quickly led us to identify the need for research on Islam, as we found traditional healing to be strongly referenced to religion (Graham & Al-Krenawi, 1996) and the particular manifestations we examined, to Islam (Al-Krenawi & Graham, 1999a). Our later research was on the implications to professional helping activity of blood vengeance (the retribution of one tribe/hamula towards another) (Al-Krenawi & Graham, 1999b), divorce (Al-Krenawi & Graham, 1998), and polygamous family structures (A-Krenawi, Graham, & Al-Krenawi, 1997). This research also led us to identify the need for more comprehensive work on Islam, as we found that most Muslim clients constructed problems and their solutions with strong reference to religion.

While recognizing the diverse aspects of Muslim Arab life, as well as the community's presence in virtually all countries, we have been able to extrapolate principles of social work practice with Muslim Arab people that could have common, transnational applications. We take a person-in-environment perspective that promotes the view that all clients bring to their encounter with a social worker the sum total of their life experiences, with the knowledge, values, and skills that those experiences imply and often strongly anchored to a client's culture (Al-Krenawi, 1998c, 2000). Ultimately, we advocate a more locally responsive, culturally appropriate model of professional intervention; an ongoing evolution of social work theory and methods that is neither Northern nor merely a modest adaptation of Northern social work, but rather an integration with local practices and norms, creating a more culturally competent model of social work for the Arab Muslim world. As part of this broader enterprise, the next section analyses such cultural considerations as polygamy, blood vengeance, conflict resolution, traditional healing, and family involvement, as strategies for understanding how to work with Muslim Arab clients based upon previous analysis of social work processes in Northern and Muslim Arab worlds (Al-Krenawi & Graham, 2000b).

POLYGAMY

Polygamy has been defined as "a marital relationship involving multiple wives" (Kottak, 1978, cited in Low, 1988, p. 189). Polygamy's prevalence in the Muslim Arab world implies that it "is an expression of a way of life which is deeply embedded in religious and cultural obligation" (Ohadike, 1968, p. 360). Attitudes about polygamy vary among cultures in which it is practiced and even between men and women who practice it 0Viburugu & Adams, 1994; Low, 1988; White, 1988). Family stress and mental illness among women in polygamous marriages are problems identified by researchers (Al-Krenawi, 1999, 1998b; Al-Krenawi, & Graham, 1999d; Makanjuola, 1987). In fact, a greater prevalence of mental disorders was reported among women in a polygamous marriage when compared to those in monogamous marriages (Leighton et al., 1963). Women in polygamous marriages, when compared with the general population, have been found to be more likely to become psychiatric outpatients (Chaleby, 1987) and inpatients (Chaleby, 1985). Polygamy has been associated with somatization disorders (El-Islam, 1975), depressive and anxiety disorders (Ghubash et al., 1992), and low self-esteem (Al-Krenawi, 1999; Al-Krenawi, Graham & Izzeldin, 2001) among psychiatric patients.

Jealousy and competition among co-wives, and an uneven distribution of household resources have been reported as problems among women in polygamous marriages (A1-Krenawi, 1998b; Al-Krenawi & Graham, 1999d; Borgerhoff-Mulder, 1992; Kilbride & Kilbride, 1990; Ware, 1979). For many, polygamy is associated with greater capacity for love and propensity of choice. Hence, second and subsequent wives often experience an elevated position within the marriage with respect to economic resources, social support, and attention (Al-Krenawi, 1998b; Al-Krenawi, Graham & Al-Krenawi, 1997). Differences have been noted concerning senior and junior wives in a polygamous marriage. For example, junior wives, compared to senior wives, often perceive themselves as having a better relationship with their husbands (Al-Krenawi, 1999). Senior wives may attribute their marital dissatisfaction to their husband's remarriages (Chaleby, 1985). In a series of studies examining psychiatric symptoms and treatment in Kuwait, Chaleby (1985, 1987) compared senior and junior wives in polygamous marriages. He found a greater number of senior wives reported psychiatric symptoms and were under psychiatric treatment than their junior counterparts.

Practicing with clients from polygamous families can present challenges for many social workers. Al-Krenawi, et al. (1997) identified a number of ways in which social work practice in this context can be more effective. The first consideration for improving practice is for the social worker to become knowledgeable about the cultural and personal significance of polygamy to family members. The women in polygamous marriages face unique life transitions (e.g., from sole wife to second wife, or from junior wife to intermediate wife) that may be traumatic. In many Muslim Arab communities, men may favor the most recent wife and her children, with differential instrumental and emotional support afforded to them. These dynamics lead to significant relationship implications between wives--who may also live with their children in separate accommodations from the other wives and their children.

The need to appreciate the significance of polygamy for children's functioning (social, academic, and mental health) is a second theme that is important for social workers to consider. Children of different wives may embrace mutual antipathy. The fewer economic resources associated with senior wives may negatively impact the scholastic performance of their children. These factors, combined with their mothers' lower social and mental health functioning, provide conditions in which the development of social problems among their children is more likely.

Finally, social workers should also consider making children in polygamous families as a target system for intervention. These children can serve as the one common flame of reference between the husband and wives. Parents have a vested interest in the healthy functioning of their children as their social status and future economic well-being may be tied to both the size and success of the family (Al-Krenawi, et al., 1997).

BLOOD VENGEANCE

Blood vengeance, the obligation to kill in retribution for the death of a member of one's family or tribe, is a culturally distinct aspect of social work in the Muslim Arab world. Much of the following considerations are from Al-Krenawi and Graham (1997b & 1999b). We argue that blood vengeance is an essential component in much of social work practice among Muslim Arab peoples. It is a type of collective guarantee provided by a given group to all of its members in a society where communal duty is paramount (Jabbur, 1995). It evolved, in part, from the needs of a nomadic people in the sparsely populated desert, that made one vulnerable to attack by others. It therefore provides a system of justice in the absence of the formal apparatuses, the legal specialists, or the police forces that are common to some Northern societies (Al-Krenawi & Graham, 1999b). It arises when a misunderstanding occurs between one major social group and another, be it a family, a hamula (extended family), or a tribe. The key point is its re-establishment of symmetry between social relations.

Thus, unlike other English language words, such as spite, malice, vindictiveness, envy, or rage, the Muslim Arab conception of vengeance is more than an emotional response to a perceived wrong: it is based on a perception of being in the right, of restoring symmetry to an imbalanced social exchange (Al-Krenawi & Graham, 1999b). And so, if a man in one hamula is killed by someone from a different tribe, an affluent may be perceived to have been committed against that entire hamula. Blood vengeance would require that a member of the offending hamula be killed, in order to remove the assault on the Ar, or pride, of the murdered man's hamula. The concept of At, indeed, is key to understanding blood vengeance. Numerous rituals precede the carrying out of vengeance, and likewise there are rituals that can occur between tribal members to avert vengeance. These are beyond the scope of the current article but are covered fully in Al-Krenawi and Graham (1997b). To that extent, social work may play a key role in arranging for locally based responses to a vengeance situation.

Blood vengeance is most significant to the field of child welfare practice. Say, for example, that a man has been put on death row because a third cousin within his tribe killed a member of a differeent tribe. The aggrieved tribe seeks vengeance against the man, who with his family flees his immediate community and with his family lives in the most extreme form of isolation and poverty. Blood vengeance therefore puts children at risk (Al-Krenawi & Graham, 1997b). A different study describes children's experiences of blood vengeance as being similar to living in a war zone. Compared to a control group, children exposed to blood vengeance exhibit higher scores of such symptoms as high anxiety, depression, obsessive compulsion, somatization, and paranoid ideation (Al-Krenawi, Slonim-Nevo, Maymon, & Al-Krenawi, 2001). Also relevant, however, are children's coping strategies, including various games that they play, help that they provide one another, and strengths that they cultivate.

The role of social work is particularly significant within a blood vengeance situation. Al-Krenawi and Graham (1999b) outlined a number of strategies for clinical and child welfare practice that include "non-authoritarianism, strategies to form a positive helping alliance, and culturally sensitive assessment and (in their various forms) intervention" (p. 283). It is difficult to not be (and not be construed to be) an authority figure. It would be helpful in developing a positive helping alliance to base the relationship on acceptance, respect, trust, and validation of the family's current situation.

Cultural sensitivity in appreciating the ecological context of and significance to family members of, blood vengeance is important for building a constructive working relationship with family members. It is also important to consider family members' perception of their circumstances, problems, and resources. Social workers should be very responsive to children's needs--who may be under considerable psychological distress and social need. Encouraging an identification and positive helping alliance with children of vengeance families will increase the effectiveness of any intervention. To that end, playing games with children is a powerful way of connecting and establishing trust. It is important that the practitioner not impose culturally inappropriate techniques; for example, insisting that the family make office appointments rather than continuing to make home visits. It may be useful to use mediators within Arab communities to resolve or reduce tensions associated with blood vengeance conflict (and as discussed in the proceeding section). Providing concrete services for meeting the family's basic needs may also be very useful.

CONFLICT RESOLUTION

The resolution of individual, familial and group conflicts through mediation practices is common in the Muslim Arab world (Faour, 1997; Salem, 1997). Among Muslim Arab peoples, the sulh (settlement) is a major reconciliation ritual, in which other traditional mediation functions are involved: the musalaha (reconciliation) the tahkeem (arbitration) and the wasta (patronage-mediation) (Faour, 1997; Irani, 1999; Khadduri, 1997). According to Islamic Law, the sulh is a contract (akd) legally binding on the individual and community, the purpose of which is 'to end conflict and hostility among believers,' and to promote Islamic norms of harmonious individual and community relations (Khadduri, 1997, p. 845). The Jordanian government recognizes the sulh in its legal codes, and among Arabs in Israel, Palestinians, Lebanese, and Syrians, it is widely practiced (Abu-Nimer, 1996; Irani, 1999; Salem, 1997).

Typically, people implementing such traditional forms of conflict resolution are not required to have specific training credentials. Although mediation tasks are not typically part of social work education and practice, mediation can be applied to areas conventionally analogous with social work and human service fields (Kruk, 1997). The potential exists for the utilization of mediation as a social work practice model, and the informal incorporation of mediation skills into everyday social work practice, especially with interventions in Arab conflict resolution.

Based on the wasit tradition, the co-authors developed a model of cultural mediation in child welfare. Our pilot program utilized the assistance of approximately 35 senior members of various male elders in a large Arab city over an 18 month period, none of whom had any social work training but all enjoyed community respect and all had skills in traditional mediation. When social workers undertook various child welfare interventions collaboratively with a select mediator, interventions were rendered more culturally appropriate, gaps between the cultural and professional canons were bridged, and social work's role was promoted in a society that had a limited understanding of, and experience with, the profession (Al-Krenawi & Graham, 2001). The importance of cultural mediators in the community is their ability to encourage the empowerment of different groups that are deprived of access to the power centers in society (Schellenberg, 1996). Thus, cultural mediators are not perceived as a neutral third side but rather are expected to operate for the sake of social justice in the community and for the sake of cultural sensitivity. The community mediators were important teachers to social workers, conveying culturally appropriate ways of interacting with people in their community, and helping social workers, many of whom were from the community, to unlearn some of the problematic assumptions that they had acquired during their social work training. The community mediators also became important ambassadors of social work, learning from practitioners and conveying back to the community various principles related to women's health, children's health, and healthy family functioning (See Al-Krenawi & Graham,2001).

TRADITIONAL HEALING AND RELIGION

A different consideration for social work practice is traditional healing, which remains profoundly embedded in Muslim Arab cultures. Healing rituals are fundamental to the community's cultural canon, are inextricably linked with an Islamic basis of living, and are an unstigmatizing and legitimized aspect of its natural helping systems and traditional forms of physical and mental healing. Muslim Arab peoples who are illiterate or not verbally skilled might prefer traditional healing rituals to modern, more discursive counselling techniques. To many they have greater community sanction than Northern forms of helping (Al-Krenawi & Graham, 1996a). The following comments are taken from Al-Issa (2000), Al-Krenawi and Graham (1997a, 1997b, 1996a, 1996b), and Al-Krenawi, Graham and Maoz (1996). Different healers occur in different Arab countries (Al-Issa, 2000; Al-Krenawi & Graham, 1996b; El-Islam, 1982; Okasha) 1999). Their names may vary--but their functions may be similar: among them, dealing with such psychosocial problems as depression, anxiety, or problems with interpersonal relationships. They often recommend rituals for helping people; these, as research has concluded, often have strongly therapeutic components. Examples include the Zar ritual, the Dhkir, or visiting a saint's tomb (Al-Issa, 2000; Al-Krenawi & Graham, 1996a; Boddy, 1989; Crapanzano, 1973; Kennedy, 1967).

Cultural and religious rituals are transformative in nature. They can function in several ways--integrating parts of oneself as well as binding individuals to their communities and to their histories (Hoch-Smith & Spring, 1978). Rituals provide form, structure, meaning, and unique opportunities for communicating, ventilating, and appropriately acting out problems. Social workers who appreciate rituals can use them to support "their client's ability to work out their own solutions to problems" (Frey & Edinburg, 1978, p. 89). Social workers can use rituals in the same way in which they function in other aspects of their client's life (Rando, 1985).

For many people, religion also provides a milieu in which to experience, conceptualize, and articulate psychosocial problems. In our studies on Islam, we articulate how religion provides individual catharsis and psychological relief, self-actualization, natural forms of social support, conflict resolution, familial and marital mediation, and group cohesion and support (Al-Krenawi & Graham, 1996b, 2000a).

Traditional healers, religious personnel, and nuclear and extended families are part of the complex help-seeking processes in Muslim Arab cultures. Family members can influence both the perception and the selection of resources chosen in the help-seeking process. Both informal and formal sources of assistance are fundamental within Muslim Arab cultures. Depending upon the circumstances and the problem that needs resolving, informal sources of help (e.g., extended family, religions leaders) may be sufficient, while other times more formal (professional) help may be necessary. The sequencing of informal-formal sources of help may be prior to, concurrent with, or subsequent to each other (Al-Krenawi & Graham, 1999c, 1999d, 1999e).

Given that informal and formal sources of help may be intertwined in Muslim Arab cultures, it is desirable to promote a mutual understanding between social work and traditional healers. However, caution should be exercised in how this occurs. There can be a great deal of variability in the ways and levels at which an individual engages with a traditional healer. Whether the precipitating problem is somatic, psychosocial, psychiatric, or a combination of these elements, the presenting problem will be the primary level of engagement between the individual seeking help and the traditional healer. However, beyond the problem is a shared level of understanding and connection between them. One level of shared understanding is cultural, since the healer incorporates rituals familiar to the community. This shared cultural background promotes trust and enhances the helping process (Al-Krenawi & Graham, 1996a). The interpersonal is another level of connection, as the healer is known personally or by reputation. Some rituals enjoy community sanction or are related to rituals that are known to promote wellness. Informal discussions between modern practitioners and traditional healers could provide insight into their respective roles (Al-Krenawi & Graham, 1996a). Creating opportunities for mutual referrals between traditional healers and social workers could provide opportunities for client good. Social worker should be vigilant in respecting the domains appropriate to traditional healing. However, opportunities exist for professionals to learn from traditional healers about how to create and sustain effective helping alliances (Al-Krenawi & Graham, 2000a).

FAMILY INVOLVEMENT

The family's involvement in individual helping may be considerable, and could make the social worker's tasks more complex. In Muslim Arab communities, many are raised to consider the family unit as a continual source of support. Extended family members may be highly valued as well. They may be expected to be involved and may be consulted in times of crisis. When a family member experiences a problem, its restoration may be of concern to many other members. Many principles of access to health care also apply to access to helping professions writ large. As pointed out by Meleis and La Fever (1984), although Muslim Arab peoples may "value privacy and guard it vehemently ... their personal privacy within the family is virtually non-existent ... Decisions regarding health care are made by the family group and are not the responsibility of the individual" (p. 76). In some cases, when an individual is in distress, the family may intervene on behalf of the identified client, and may try to control a social work interview by answering questions directed at the client while withholding information that may be perceived as embarrassing. To work most effectively within these structures, social workers do well by reading a family's ecological map, by determining power relationships within the family, and by collaborating with powerful and influential family members on behalf of an identified client (Al-Krenawi, Graham, & Sehwail, in press).

If social work theory is applied without cultural competence, involvement with Muslim Arab families could be characterized as "over involvement," "over protection," "blatant co-dependency," or "enmeshment" (all common terms in mainstream social work theory) when compared with family involvement in other cultures (Badman et al., 1992). In the Muslim Arab social construction of family, to be less involved could be considered neglect and even abandonment of the family member in need. Social workers can use the cultural constructions of family; by educating themselves about Muslim Arab family values, professionals can carefully familiarize family members regarding the essential elements of a workable helping relationship. This principle applies to Arab and to non-Arab practitioners, given the continued Northern biases in so much of contemporary social work theory.

CONCLUSION

Northern-based social work theory and methods have historically been aloof to such concerns within Muslim Arab societies as culture and religion, family structure and group orientation, and cultural and religious strategies for dealing with psychosocial problems. The literature has made some strides in making social work less culturally oppressive, but much remains to be done. The examples we raise can profitably integrate social work with indigenous cultural practices. This is not to ignore the historic presence of social work, nor the considerable refinements and sophistication it can represent. Rather, we advocate a balance between cultural practices and social work--an integration of paradigms, which the social worker carries out in practice methods and which could lead to the ongoing emergence of a newer social work epistemology, better anchored to the needs and realities of the Muslim Arab world. Within Muslim Arab communities, there are religious and culturally bound strategies and personnel that can be used to enhance social work practice. This may well occur as a dialogue between local practices and the global forces of social work, which in the best instances could bridge gaps between local and global conceptions of helping. Social work in the Arab world, like other aspects of colonialism, has left significant residues. The suspicions of social work and its sometimes tenuous relationship with Arab cultures introduce an imperative of localizing knowledge bases. Social work may indeed be a useful conduit for conveying social problems, for developing a social conscience within the Muslim Arab world for their resolution, and for the development of social services for vulnerable peoples. But only if social work's theory and practices continue to evolve in a manner that are culturally respectful.

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Alean Al-Krenawi is Associate Professor, Department of Social Work, and Director of the Center for Bedouin Studies, Ben Gurion University of the Negev, Israel. John R. Graham is Professor and Director of the International Social Development Unit, Faculty of Social Work, University of Calgary, Canada.
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