Therapist Doubles as Asylum Advocate

Sahil Sharma, a third-year student in the Wright Institute’s Doctor of Clinical Psychology (Psy.D.) program, is spending his training year developing not only his clinical and assessment skills, but also learning to compose asylum evaluations for many of his clients. Placed at Partnerships for Trauma Recovery, a relatively new Bay Area nonprofit founded by a graduate of the Counseling Psychology program, Sahil works with people who were forced to flee their countries of origin.

“Our clients include refugees, asylum seekers, and victims of human trafficking and other atrocities,” he explained. “At my placement, we provide free mental health services and work closely with local legal agencies to provide asylum evaluations for court to help our clients remain legally in the country.”

As his clients’ therapist and advocate, Sahil’s role is distinct from that of an expert witness but still potentially extremely influential.

“It is understood by the courts that I am also my clients’ therapist, so it is not my job to assess whether someone is telling the truth about what happened to them,” he explained. “Instead, my role is to evaluate whether someone truly has the symptoms they say they have and show how the traumas they experienced in their countries have affected them.”

One of the requirements for gaining asylum is that a person must apply within one year of arriving in the country, so part of the evaluation is to help justify why a client was not able to file within that time frame. In his reports, Sahil must use clinical language to describe the symptoms his clients were exhibiting that inhibited them from following the law.

“Common symptoms I see include: sleep disturbance, anxiety and depression, flashbacks, general fearfulness, being easily startled, social isolation, mistrust and all other symptoms of post-traumatic stress,” he said.

Sahil’s clients hail from virtually all over the world. “We have a lot of clients from Central America—fleeing wars, gangs and other forms of persecution—as well as Asia, many African countries and the Middle East,” he said.

Sahil applied to this site in particular because of his passion for working with people who have undergone serious trauma.

“I knew I wanted to work with survivors of trauma in a psychodynamic framework, but when I applied to this practicum site, asylum evaluations was not even listed as a formal part of the work,” he said. “Had I known, I would have been even more enthusiastic about applying here.”

A major obstacle to the therapeutic process in this setting is that many of Sahil’s clients don’t even know what therapy is or why they are there.

“Most of our clients were referred by their lawyers or doctors who saw signs of PTSD, but it is our job to show them that we are trustworthy and here to help,” he said. “Universally, people understand words like ‘stress,’ ‘worry, and ‘nerves,’ so I often start by describing the symptoms people who have faced trauma often experience. When I go through the assessments, people often feel relieved hearing the questions because they know they are going through something but may not realize why or that these are normal reactions from people who have endured what they have.”

Something else Sahil has noticed is that clients often come in to talk about their legal cases, and through that process realize that they are feeling better just from talking about what happened to them to someone willing to listen empathically. “That will often keep them coming back for therapy, even when the legal case is over,” he said.

While Sahil finds the work extremely fulfilling, he said hearing his clients’ stories can also weigh on him and his colleagues.

“It’s mind boggling hearing about the experiences some of my clients have had, but it speaks to their resilience,” he said. “And when you think about it, the people we see are only a small fraction of the people in the world going through this. It’s crazy to think that there are still so many people in the world going through the things they tell me about—many of who will never escape their countries.”

Although it is only his third year as a trainee, Sahil believes his work at Partnerships for Trauma Recovery will influence his career as a psychologist long-term.

“An immigrant myself, I was compelled by psychological work that includes helping people through their acculturation processes and being with people in their experiences of restarting somewhere new. It really brings to light the universality of human experience,” Sahil said. “This year, I am really enjoying the dual impact I can have as both a therapist and an advocate, and I can see myself doing this kind of work throughout my career.”

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