Middle Eastern individuals represent a heterogeneous group comprised of different nationalities, languages, and religious identifications. Yet, Middle Eastern Americans are widely underrepresented in the psychotherapy literature. Extant literature appears to focus on professional opinions about what psychotherapists should do when working with this population, including understanding cultural factors, such as incorporating family in treatment and acculturation status. Considering cultural communication patterns among this population, emotion in generally understood to be inhibited or suppressed, as disclosing personal problems and expressing emotion outside the family sphere can be viewed as disloyal and/or shaming. Thus, one of the many areas mental health clinicians should consider when working with Middle Eastern clients is how to recognize emotional communication patterns and identify and assist their clients with emotion regulation and/or dysregulation in a culturally sensitive manner. To address the need for research on how emotions are expressed and regulated in psychotherapy with Middle Eastern clients, this study qualitatively analyzed three psychotherapy cases from a university's community counseling center's archival research database. More specifically, the researchers used an inductive content analysis approach with emotion, emotion regulation and InVivo codes to observe themes of emotional expression, regulation and dysregulation that emerged from the gathered data from a course of psychotherapy with these Middle Eastern American clients to further classify the observable phenomena (Elo & Kyngäs, 2008; Hsieh & Shannon, 2005; Saldaña, 2009; Weber, 1990). Consistent with previous literature, results indicated that negative emotions were coded more frequently in psychotherapy sessions that positive emotions, as was the emotional regulation strategy of Experiential Avoidance. Surprisingly, data emerged revealing positive emotion regulation strategies (e.g., acceptance and emotional identification) that were not identified by literature describing this population. By obtaining a better understanding of how Middle Eastern American clients expressed and utilized their emotions in treatment, this study may be useful to the future work of clinicians and researchers targeting treatment of these individuals in a culturally sensitive manner and in an approach that emphasizes positive emotion regulation strategies.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Middle Eastern Americans -- Psychology; Emotions; Cross-cultural counseling

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Hall, Susan;