How psychologists can support immigrant clients experiencing uncertainty, fear

For psychologists working with immigrant clients, the possibility of deportation is more than a legal stressor. It is a chronic, often hidden trauma that reverberates through entire families.

Amanda Mead, Psy.D., a psychologist who conducts immigration evaluations in several New England states, sees the toll daily.
“I most often see trauma related disorders, whether that’s PTSD, adjustment disorder, some signs of trauma but not enough to qualify for a diagnosis. And then typical anxiety, depression, maybe persistent depressive disorder,” she said.

Even when a client does not meet full criteria for a diagnosis, the uncertainty itself is corrosive. “Families often don’t have a lot of rest, certainty, or reprieve from the fear. It can be years before they are able to get clarity and grounding about their situation,” Mead explained.
Clinicians should not assume younger children are insulated from these stressors. In her experience, Mead noted, many children understand what is happening. “It’s just whether they can acknowledge it or know how to express it.”

That long-term exposure to uncertainty, she said, can mirror attachment trauma. “You’re living in this environment of uncertainty for a long time, and it shapes someone in many ways.”

For psychologists working with immigrant families, exploring children’s unspoken fears may be just as important as supporting the parents.
Culturally informed language can open or close doors in therapy. Mead said that in some cultures, “having any mental health problem may be viewed as ‘crazy.’ It can be very black and white. You either have schizophrenia or you are totally fine.”

For clinicians, this means small word choices matter. “If you use words like ‘symptoms of anxiety,’ that might turn people off. But if we talk about stress, or emotional health instead of psychological health, it helps people share their story in a way that doesn’t feel threatening.”

Alongside individual therapy and evaluations, community grounding is another protective factor psychologists can encourage. “People who have stronger ties to their community seem to cope better,” Mead said, whether through faith communities, children’s activities, or informal support networks.

This (connection) can be especially vital for clients who feel isolated. “For immigrants and their families, it’s often a hidden process, lived in silence,” Mead said. Helping families build connection can reduce that sense of invisibility.

For psychologists outside of forensic work, Mead’s insights suggest several strategies. She encourages clinicians to screen for the impact of chronic uncertainty, even when clients do not disclose immigration fears directly. Symptoms such as anxiety, sleep disturbance, or hypervigilance may be rooted in prolonged stress about deportation. She also suggests using culturally resonant language instead of clinical jargon.

Children deserve direct engagement as well. Asking developmentally appropriate questions can uncover unspoken fears, since silence does not necessarily mean a lack of awareness.

Finally, Mead highlights the importance of encouraging clients to build or strengthen ties to their community. These connections can buffer the isolation that many immigrant families experience.

For psychologists considering immigration evaluations, Mead emphasizes preparation. “These evaluations make a huge difference. They go in front of a court or a judge and can impact whether people stay or face severe consequences.”

Because the stakes are so high, she cautions against jumping in without training. “The stakes are too high for someone to start without a baseline in evaluation and diagnostics.”

Above all, Mead believes psychologists should recognize the hidden weight immigrant families carry. “If we assume immigrants should be here and enhance our community and culture, being aware of what goes on behind the scenes would be really valuable. People could feel supported and not alone.”

For clinicians across New England, that awareness begins in the therapy room with careful listening, culturally sensitive language, and recognition that deportation fears can shape a patient’s mental health just as much as past trauma.