Feature

Khashayar Farhadi Langroudi came to the United States from Iran in 2009. Within just a few years, he had found a true new home—a place where he flourished, earned a doctorate in clinical psychology from the American School of Professional Psychology at Argosy University, came out as a gay man and met his husband. He had planned to make America his permanent home.

Then came the travel ban. The executive order issued by President Donald J. Trump in January abruptly—and briefly—banned travelers from certain Middle Eastern countries, including Iran, from entering the United States. A more limited version of the ban went into temporary effect in July while the U.S. Supreme Court considers its legality.

"Overnight, I became a ­second-class resident," says Farhadi Langroudi, PsyD, now a postdoctoral fellow at Kaiser Permanente in South San Francisco, who as an LGBT refugee has a green card.

He is fearful of traveling outside the country. On the advice of his attorney, Farhadi Langroudi canceled a trip to an international behavioral conference in Spain this summer, sending a video of his presentation instead. He's also not sure whether he will be able to stay in the United States long term.

Farhadi Langroudi is one of many early career psychologists and psychology graduate students affected by the proposed travel ban and other immigration restrictions. For some, it has meant canceled travel plans to attend conferences, do research or visit home. For others, it has resulted in uncertain educational and career futures.

"A lot of students are starting to think about whether they want to remain in the U.S. or go back home," says Shuangmei (Christine) Zhou, PhD, staff psychologist at the student counseling center at the University of California, Berkeley. Indeed, 40 percent of colleges reported in February that international applications were down.

And while the travel ban is a significant stressor for some international students, it's not the only one. These students also face concerns over visa changes, difficulty landing jobs and anxiety over fitting in to a new culture.

Visa worries

In addition to the travel ban, the Trump administration has changed some visa regulations and is reviewing others for more possible changes.

"The biggest challenge we have right now is that regulations are changing almost by the month," says Ayşe Çiftçi, PhD, director of training in counseling psychology at Purdue University and president of the Council of Counseling Psychology Training Programs. Moreover, "there's a lot of room for interpretation" in these regulations, she says, meaning that colleges and universities may differ in how they see these rules and give conflicting advice to students.

International psychology studentsThe shifting picture makes it difficult for international psychology students to make plans for degree programs, especially advanced ones that can take five or six years.

One change to H1-B work visas occurred in April when the government temporarily halted expedited visa processing. This had allowed employers—for a fee—to have international employee visas processed within a few weeks, rather than months. The change was announced about a month before it took place, undermining the plans of students who had relied on fast processing to be able to start postgraduate work programs.

The Trump administration also issued an executive order calling for a detailed review of the H1-B visa, though at press time no recommendations for changes had been announced.

Among those who are worried about changing visa regulations is Brazilian student Klaus Cavalhieri, who is in the counseling psychology doctoral program at Southern Illinois University. He points to uncertainty over the future status of visa programs that give students extra time for work and training, such as curricular practical training, often used for internships, and optional practical training, which can cover a postdoc year.

Meng (Mandy) Lü is in a similar situation. The third-year graduate student from China is working toward her PsyD at the University of Indianapolis. If visa policies are changed, she says, it could affect her ability to get licensed.

"It took a lot of hard work and a lot of financial sacrifices to get me here," she says. "The worries are definitely real."

Visa restrictions could also hurt graduates who are in the middle of job searches, says Zhou. "After using optional practical training for postdoctoral clinical fellowships to fulfill licensing requirements, [new graduates] will need the H1-B during their search for jobs," she says, adding that not all work sites are willing to provide this.

"If you're a clinician and you want to work at either a university or a clinic, I think the visa sponsorship becomes really difficult," she says. "A lot of centers or universities or hospitals will just say, ‘We're not going to sponsor international students.' If you can't find a job that has a visa sponsor, you are really limited."

International psychology graduate students in counseling programs face other hurdles as well. They need to complete internships and practicums before they can graduate, but their student visas restrict them to working no more than 20 hours per week. They also are ineligible for internships at government sites, such as Department of Veterans Affairs hospitals.

The restrictions can have a financial impact. Cavalhieri says he is completely dependent on the student work stipend he receives from his university since his visa prevents him from working additional hours elsewhere. And, of course, he is ineligible for the student loans, scholarships and fellowships that U.S. students can receive.

Acculturation issues

Adding to international students' stress is the cultural adjustment they go through studying in the United States. "Many students for the first few weeks go through a significant period of depression or anxiety," which is temporary, though sometimes misdiagnosed as a clinical problem, says Jeff Prince, director of the student counseling center at the University of California, Berkeley.

Sometimes students need counseling, but, depending on which country they're from, may be reluctant to seek it. In China, for example, "understanding of mental health problems is very limited," says Zhou. While Chinese psychology students may be more likely to seek help than those in other disciplines, they may not be able to find culturally competent counselors at university health centers who can understand their concerns.

Other hurdles revolve around language. Becoming fully comfortable with English and its nuances, especially in clinical settings and while writing academic papers, can be difficult.

International psychology studentsAnd then there's the accent issue. Jerrold Yeo, a clinical psychology doctoral student from Singapore, who is interning at the Tulane University School of Medicine, says he has seen supervisors make "biased and difficult statements without any concern about cultural sensitivity," including suggesting that a student go to a speech and language pathologist to "correct your accent."

Shaznin Daruwalla, PsyD, a staff psychologist at Oregon State University and a former international student from India, says "Englishism" is a problem some international students may encounter. She says some students may run into attitudes that "ascribe lower IQ status or negative connotations" to their accents, resulting in perceptions that they are less qualified.

"I really want to challenge graduate programs to openly talk about this" and to address implicit biases, Daruwalla says.

Çiftçi agrees that training programs should support international students "against bias coming from clients or others." Sometimes, support also may include finding programs for students who wish to improve language skills, in addition to more training for clinical supervisors at the practicum sites.

Offering guidance

Universities have a critical role to play in communicating information and support to international students, particularly when challenging circumstances arise.

"Universities and graduate schools have been demonstrating a real commitment to supporting international students who face uncertainties in the current policy environment," says Suzanne Ortega, PhD, president of the Council of Graduate Schools.

"Graduate deans have been coordinating with other campus units so that they can provide information to students as quickly as possible, and many have been facilitating access to legal guidance. We also know that many have created support groups and other resources for students dealing with additional stress and uncertainty."

For example, after the Trump administration announced its plans for a travel ban, the University of Missouri created a video response, welcoming all students and declaring the school a safe space, says psychological resident Shraddha Niphadkar, PhD. In addition, the University of Missouri Counseling Center's outreach team went to a central location in the university and had the students write messages of love, support and welcome to Muslim and international student communities. The messages were displayed on bulletin boards in the counseling center and the university's main library.

Emory University held a town hall with a panel that included two immigration attorneys to answer questions. The school also helped secure summer housing for international students who weren't comfortable traveling home.

Mentors also help international psychology students address questions and concerns. Some schools offer formal mentorship programs for international students. Another useful resource is the International Mentoring and Orientation Committee of APA's Div. 17 (Society of Counseling Psychology), which pairs volunteer mentors with international counseling student mentees. This past year, about 20 people participated, says Daruwalla, committee chair. Online sign-ups are limited to once per year.

Faculty and training directors have a particularly important role to play in ensuring that international students get the support they need. According to Çiftçi and Prince, faculty should:

  • Regularly check in with international students—through in-person meetings or even email—to find out how they are adjusting and whether they need any support from the school.
  • Stay in touch with the school's international office and, if there is one, immigration lawyer to keep on top of regulation changes and other legal developments affecting international students.
  • Understand the problems that affect international psychology students, such as the constraints they may face meeting their practicum and internship requirements due to visa restrictions.
  • Destigmatize counseling by telling international students that seeking out support is common in the United States when students confront hard times. Present counseling as a tool that can help students succeed academically, rather than as a sign that there's something wrong with them.
  • Act as role models for non-international students so they can see how to interact with their international peers.

"Create a community where other students are also aware of some of the issues, so they can become allies and a source of support," Çiftçi says.

By the numbers

1,043,839

Number of international students in the United States in 2015–16, an increase of 7.1 percent over the prior year

5.2

Percentage of all U.S. college students from other countries

7.8

Percentage of international students studying social science

6.35

Percentage of psychology graduate students in the United States who are from other countries

Source: Institute of International Education, 2016 (www.iie.org/opendoors); National Center on Education Statistics, 2015 (https://ncsesdata.nsf.gov/datatables/gradpostdoc/2015/html/GSS2015_DST_13.html

Resources

Training and Educating International Students in Professional Psychology: What Graduate Programs Should Know
Lee, K.C. Training and Education in Professional Psychology, 2013, Vol. 7, No. 1

Addressing Mental Health Issues Affecting Education Abroad Participants
Lindeman, B. (Ed.), 2017

Breaking the Silence: Saudi Graduate Student Experiences on a U.S. Campus
Yakaboski, T, Perez-Velez, K., & Almutairi, Y. Journal of Diversity in Higher Education, 2017

Report of a Mental Health Survey Among Chinese International Students at Yale University
Han, X., et al. Journal of American College Health, 2013, Vol. 61, No. 1