The journey to a new country is one of the most challenging experiences a human being can endure. For refugees, asylum seekers, and immigrants — many of whom have fled war, persecution, political violence, or extreme poverty — the process of displacement involves not only physical hardship but profound psychological trauma. The loss of home, community, loved ones, language, cultural identity, and socioeconomic stability creates a complex web of grief, fear, and uncertainty that can persist long after physical safety has been achieved.
San Diego County is home to one of the largest and most diverse refugee and immigrant communities in the United States. Significant populations of Arabic-speaking, Kurdish, Chaldean, Somali, Afghan, and Latin American refugees have settled throughout the county, particularly in cities like El Cajon — sometimes referred to as the second-largest Iraqi population outside of Iraq. These communities face unique mental health challenges that require providers who understand not only clinical treatment modalities but also the cultural, linguistic, and contextual factors that shape each individual's experience of trauma and recovery.
Understanding Trauma in Refugee and Immigrant Populations
Trauma experienced by refugees and immigrants often falls into three categories that distinguish it from trauma experienced by the general population:
Pre-Migration Trauma
Experiences that occurred in the country of origin before displacement, including exposure to war and armed conflict, political persecution, imprisonment and torture, sexual and gender-based violence, witnessing death or violence against family members, forced conscription (including of children), and destruction of home and property.
Peri-Migration Trauma
Experiences that occurred during the migration journey itself, including dangerous border crossings, separation from family members, exploitation by smugglers or traffickers, detention in refugee camps or immigration facilities, hunger, dehydration, and exposure to extreme weather, and loss of fellow travelers to violence, drowning, or illness during transit.
Post-Migration Trauma
Ongoing stressors experienced after arrival in the host country, including language barriers and communication difficulties, discrimination, racism, and xenophobia, economic insecurity and underemployment, loss of social status and professional identity, separation from family members who remain abroad, uncertainty about immigration status and fear of deportation, cultural dissonance and identity conflicts, and social isolation in an unfamiliar environment.
Research published in the The Lancet and the World Psychiatry journal has consistently demonstrated that refugees experience rates of PTSD, depression, and anxiety that are significantly higher than the general population, with prevalence estimates ranging from 20 to 80 percent depending on the population studied and the nature of their pre-migration experiences.
What Is Trauma-Informed Care?
Trauma-informed care is a therapeutic framework that recognizes the pervasive impact of trauma on an individual's physical health, mental health, behavior, and worldview. Rather than asking "What is wrong with you?" — which can feel accusatory or pathologizing — trauma-informed providers ask "What happened to you?" — which validates the patient's experience and centers their agency in the healing process.
The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies six key principles of trauma-informed care: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and sensitivity to cultural, historical, and gender issues. At Palm Urgent Care, our therapists integrate these principles into every aspect of the therapeutic relationship.
Evidence-Based Treatment Approaches
Our licensed clinical therapists are trained in multiple evidence-based treatment modalities that have been validated for use with trauma-affected populations:
- Eye Movement Desensitization and Reprocessing (EMDR) — a structured therapy that helps patients process traumatic memories by engaging bilateral stimulation (typically guided eye movements) while recalling distressing events. The World Health Organization (WHO) recommends EMDR as a first-line treatment for PTSD in both adults and children.
- Cognitive Behavioral Therapy (CBT) — a goal-oriented therapy that helps patients identify and modify negative thought patterns, beliefs, and behaviors that maintain distress. Trauma-focused CBT has been extensively studied and is considered a gold-standard treatment for PTSD.
- Narrative Exposure Therapy (NET) — particularly effective for individuals who have experienced multiple or prolonged traumatic events, NET involves creating a detailed chronological narrative of the patient's life story, integrating traumatic experiences into a coherent personal history.
- Culturally Adapted Therapy — our therapists modify therapeutic techniques and communication styles to align with the cultural values, beliefs, family structures, and communication norms of each patient's background. This may include incorporating religious or spiritual frameworks into therapy, involving family members in treatment planning, addressing culturally specific manifestations of distress, and using metaphors and storytelling traditions familiar to the patient's culture.
Multilingual Therapy Services
Effective therapy requires the ability to communicate complex emotions, memories, and experiences with precision and nuance. For many refugees and immigrants, this level of communication is only possible in their native language. Research consistently demonstrates that language-concordant therapy — therapy conducted in the patient's first language — produces better therapeutic outcomes, higher patient satisfaction, and stronger therapeutic alliances.
At Palm Urgent Care, our mental health team includes therapists who provide services in Arabic, Kurdish (Kurmanji and Sorani), Chaldean (Suret), Spanish, and English. This multilingual capability allows us to serve the majority of San Diego County's refugee and immigrant communities without the need for interpreters, preserving the intimacy, accuracy, and confidentiality that effective therapy requires.
Services We Offer
- Individual therapy — one-on-one sessions focused on PTSD, depression, anxiety, adjustment disorders, grief, and other conditions
- Couples and marriage therapy — addressing relationship challenges that may be intensified by displacement, cultural adjustment, and role changes
- Family therapy — supporting family units navigating intergenerational conflicts, acculturation differences, and the impact of collective trauma
- Refugee-informed care — specialized programming designed specifically for refugees, immigrants, and asylum seekers
- Crisis intervention — immediate support for individuals experiencing acute psychological distress
Sessions are available in-person at our El Cajon and San Ysidro clinics, or virtually via Microsoft Teams for patients who prefer telehealth. All sessions are strictly confidential and protected under HIPAA.
How to Begin
Taking the first step toward therapy can feel daunting — especially if you come from a culture where mental health treatment carries stigma or is unfamiliar. At Palm Urgent Care, we understand these barriers and have designed our intake process to be as welcoming, respectful, and accessible as possible. You do not need a referral. You do not need to have a diagnosis. You simply need to be willing to begin.
To schedule a therapy appointment, call us at (619) 354-6494 or request an appointment online. We accept Medi-Cal, Medicare, and most commercial insurance plans. Self-pay options are also available.
If you or someone you know is in immediate crisis, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988 (available 24/7 in English and Spanish), or visit the Refugee Health Technical Assistance Center for additional resources and support.