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Orthodox Jews with anxiety, depression, and other psychological disorders are generally underserved by the mental health system. Little has been published concerning cognitive behavior therapy with Orthodox Jews, a group of individuals who define themselves in terms of their religious lives. This chapter provides an overview of the Orthodox Jewish community and reviews the many cultural issues that affect assessment and treatment, including views of mental illness, confidentiality, family relationships, collaboration with religious leaders, therapeutic alliance, and observance of the Sabbath and holidays. Many of these issues are relevant for the treatment of individuals of other faiths; thus, much of this chapter may have utility for people from other religious groups. Clinicians have long emphasized the importance of understanding, respecting, and integrating religious and cultural beliefs in treatment. The case examples used in this chapter involve the treatment of anxiety and depressive disorders.

This chapter connects the Jewish mystical tradition of Kabbalah to the author's clinical approach and illustrates the view of transformation. It offers a perspective on psychoanalysis and psychotherapy as seen through a kabbalistic lens. Viewed from the standpoint of modern psychology, kabbalistic formulations may be understood as an attempt to express psychological concepts that did not yet exist. The kabbalistic goal of tikkun olam, repair of the world, has been taken on by many Jewish organizations as a challenge to effect social change by adding a spiritual dimension to movements such as the environmental movement and the movement for social, economic, and political justice. The chapter proposes that the notion of tikkun applies as well to the psychotherapeutic endeavor—that the therapist's aim of healing the individual is inexorably linked with the desire to make the world a better place by doing so.

After reading this chapter, students will be able to:
■ Identify characteristics and cultural factors related to Jewish individuals.
■ Identify various Jewish subcultures and groups. Describe common stressors and challenges facing Jewish individuals.
■ Recognize implications for clinical practice with Jewish individuals.
■ Apply the information learned from the chapter to clinical case scenarios.