Contributed by Deborah Valentine, Program Director FIGT

There are many challenges and phases in the world of globally mobile individuals and families. A wealth of resources exist in the world and Families in Global Transition (FIGT) is but one of the many communities worldwide offering and providing support. FIGT has been doing so since 1997. It has evolved since its start with Ruth van Reken discussing Third Culture Kids and the book she had written with sociologist David Pollock, Third Culture Kids: Growing Up Among Worlds – which itself evolved over time, and is now in its third edition.

The discussions around this globally mobile life have also evolved. The community has expanded and continues to expand. FIGT is delighted to continue to be a part of this evolving ‘world’. – as it hopes to show, and share during its upcoming Forum, entitled “Momentum: Moving forward together”, online, on 20 and 21 April 2024.

A gathering of people, ideas and the community

Covid has influenced all our lives, and what was once an annual in-person three day gathering has become an online event over two days. The online format provides an opportunity for more people to participate from anywhere in the world. The additional ‘community’ space, for attendees to gather, meet, laugh, exchange ideas and continue conversations is also a part of our annual event in the form of Kumospace.

While we may miss gathering in person, technology has given us chances to explore this change as well. Feedback from past event attendees on Kumospace was extremely positive. Given the importance of community and connection, FIGT would not have considered planning an event without a ‘community’ space. If you’re not familiar with Kumospace, then take a moment to listen to a short presentation recently done by one of our members – on FIGT’s Forum rooms in Kumospace or read some of the testimonials from past Conference attendees.

Session topics and speakers

Our keynote speaker is Dr Hossein Hassani, a highly accomplished and skilled data scientist, academic, and researcher with over 15 years of extensive experience working with national, international, and multicultural organizations, research institutes, and academia. Dr Hassani will take us on a journey to explore the fascinating — and sometimes unsettling — world of Artificial Intelligence. This fast developing field may not seem to be directly relevant to our ‘globally mobile’ community per se, but it is and it will continue to impact our lives.

As well as Dr Hassani, the #FIGT2024 Forum will feature:

  • a speaker talking about unplanned transitions — preparing for and living through mobility changes without the preparation that so many of us make when moving from one place to another;
  • a speaker who will share tips for handling trauma in our lives and in the lives of those around us, helping us reach feelings of safety;
  • a panel discussing challenges for people who move without their families and how we can best support them;
  • a presentation on the value of advocating for neurodivergent children and children with special needs at international schools;
  • a session about the challenges faced by migrating families — proving an increased need for improved understanding of different cultures and countries, and;
  • a session that focuses on the strengths and skills associated with a globally mobile life.

A brief description of each of these Sessions can be found here, with an overview of our speakers and their experience and backgrounds, here.

Join us!

The Forum will take place over a two-day period – scheduled to accommodate different time-zones as best we can, but for those who may have difficulties attending the sessions live a recording of each presentation will be made available to registered attendees for 6 months following the event. Early BIrd (US$ 90) Registration is now open, but closes on 6 April 2024, when the full-rate (US$104) will be applied.

Contributed by Shauna Larson

Living as an expatriate or global nomad offers exciting opportunities and fosters a diverse cultural identity. This group includes third culture kids and international expatriates who grow up in different cultures. Their experiences create a global mindset, but their nomadic lifestyle can also lead to mental health challenges, such as adjusting to new cultures and feeling displaced. Acknowledging these struggles is vital to offering the appropriate support and ensuring their psychological well-being.

Understanding Third Culture Kids (TCKs) and International Expatriates

Third Culture Kids (TCKs)

Third Culture Kids (TCKs) are born into a reality shaped by their parents’ international careers in diplomacy, military, or corporate roles. This exposure to diverse cultures from a young age molds their unique cross-cultural identity.

International Expatriates

International Expatriates choose to live outside their native countries for reasons like career growth, economic incentives, a better quality of life, or cultural exploration.

Psychological Impact and Coping Mechanisms of TCKs and Expatriates

Cross-Cultural Identity Formation

Cross-cultural identity formation is complex for expatriates, global nomads, and TCKs as they integrate aspects from multiple cultures into a unique identity.

This multicultural identity affects mental health in significant ways, including:

  • Anxiety and Stress: The continuous adaptation to new environments, languages, and social norms can generate high levels of stress and anxiety, intensifying the struggle to feel “at home.”
  • Potential Identity Confusion: A fusion of cultural influences can lead to a sense of not wholly belonging anywhere, causing identity confusion and feelings of cultural homelessness.
  • Emotional Strain: Dealing with regular goodbyes and transitions, coupled with the pressure of ‘fitting in,’ can exert an emotional toll, fostering feelings of isolation and loneliness.

Grief and Loss

Frequent cultural transitions bring grief and loss as individuals say goodbye to loved ones and familiar places. These experiences significantly impact mental health, particularly:

  • Depression and Anxiety: Frequent separation from loved ones triggers sadness and loneliness, predisposing expatriates and TCKs to depression and anxiety disorders.
  • Coping Mechanisms: Effective coping strategies, like maintaining connections and forming new relationships, moderate the impact of loss. Maladaptive methods can worsen mental health issues.
  • Unresolved Grief: Lack of support leads to unresolved or complicated grief, an intense form that hinders normal functioning in individuals facing recurrent loss.

Cultural Adaptability

Cultural adaptability is crucial for TCKs and Expatriates, enabling effective functioning in diverse cultures. It cultivates global citizenship and cultural competence.

However, high cultural adaptability has both advantages and disadvantages:

  • Resilience: Enhanced cultural adaptability can bolster resilience, enabling individuals to cope with change and navigate unfamiliar contexts with increased confidence and flexibility.
  • Struggles with feeling out-of-place: Despite successful adaptation, individuals may grapple with a persistent sense of alienation, feeling neither entirely at home in their original nor host culture.
  • Cognitive Flexibility: Encountering and adjusting to diverse cultural norms can foster cognitive flexibility, a key factor in problem-solving and creative thinking.
  • Identity Conflict: High adaptability may lead to frequent shifts in behavior and attitudes to blend into different cultures, possibly sparking inner conflicts about one’s core identity.

Mental Health Vulnerabilities and Belongingness

TCKs and Expatriates’ mental health vulnerabilities are linked to their nomadic lifestyles, impacting their sense of belonging and increasing disorder susceptibility.

Key areas of concern include:

  • Higher Rates of Anxiety and Depression: The inherent challenges of expatriate life, such as recurrent transitions and separation from loved ones, may contribute to heightened levels of anxiety and depression.
  • Feelings of Displacement: The frequent changes in living environments can result in feelings of displacement, causing a sense of not wholly belonging to any one culture, often referred to as ‘cultural homelessness.’
  • Quest for Belonging: Amid their layered cultural identities, TCKs and Expatriates often embark on a lifelong quest for a sense of belonging, which, if unfulfilled, can exacerbate feelings of isolation and disconnection.

Resources and Strategies for Mental Health Support of TCKs and Expatriates

The Role of Community and Peer Support

Community and peer support play a pivotal role in bolstering mental health among expatriates and TCKs. Expat communities offer a sense of belonging, while school counselors provide tailored guidance. Peer groups provide empathy and comfort, reinforcing resilience and promoting psychological well-being.

Teletherapy and Online Resources

Teletherapy provides flexible and consistent mental health support regardless of location. Coupled with online resources like self-help websites and support groups, it fosters a digital community for expatriates and TCKs, offering valuable information, shared experiences, and coping strategies tailored to their unique needs.

Culturally Sensitive Counseling

Counselors, by acknowledging and appreciating the diverse cultural tapestry shaping their identities, can deliver personalized, effective support. This approach fosters better rapport, mutual understanding, and more fruitful therapeutic outcomes, thus enhancing overall mental wellness.

School-Based Interventions

Effective school-based interventions include the provision of culturally sensitive counseling services, implementing transition programs to ease adaptation, and assisting a supportive and inclusive school climate. Such measures can significantly improve students’ welfare  and academic performance.

Parental and Family Support

Parents serve as the frontline responders, providing reassurance and stability. Equipping families with resources like cultural transition workshops and support groups fosters a supportive home environment, benefiting their child’s mental health.

Self-Care and Coping Strategies

Maintaining routines, practicing mindfulness, and nurturing cultural connections help expatriates and TCKs cope with stress. Engaging in hobbies, physical activities, and health checks reinforce resilience for a balanced global lifestyle.

The Takeaway

The cultural journeys of Third Culture Kids and International Expatriates bring enrichment but also pose distinctive mental health challenges. The complexities involve cultural adaptability, identity formation, grief, and displacement. Effective solutions encompass community support, teletherapy, culturally sensitive counseling, school interventions, parental involvement, and self-care strategies.

However, further research is crucial to better understand and address their mental health landscape. Accessible online and offline resources must be developed to provide targeted support. Recognizing and meeting the mental health needs of TCKs and Expatriates is essential for cultivating a global society that embraces diversity and inclusion.

Author: Shauna Larson

Shauna Larson, a passionate mental wellness advocate. For the last five years, she employs her personal experience and deep understanding of mental health to illuminate the complexities and challenges that many face every day. Her thoughtful insights and relatable narratives have been featured in a variety of publications, cultivating a loyal readership that values her authentic voice and practical advice.

Contributed by Lauren Wells

There’s a conversation that seems to keep repeating; a training that has been continually requested in the past couple of years. It’s on a topic that we recognize is a growing global challenge, but in our Third Culture Kid community seems to be even more weighty. 


As practitioners, we know how anxiety presents and often how to treat it. However, at TCK Training we’ve found underlying causes that are more unique to the TCK community. We believe understanding those causes can help implement an effective treatment plan. At the very least, it can help the TCKs we’re serving to have language for and understanding of the anxiety they’re facing. 

We’re not entirely surprised by the growing rates of anxiety in TCKs. Our 2021 research study on Adverse Childhood Experiences (ACEs) in the TCK population surveyed 1,904 Adult TCKs. In that data set, we found 21% of ATCKs had high ACE scores (four or more out of ten). That’s in contrast to 12.5% of the American control group (a CDC Kaiser study). For highly mobile TCKs who moved locations more than 10 times, the number increased to 32%.

Higher ACE scores are associated with higher rates of mental illness. It was found that “…an ACE score of four or greater was associated with 7.3 higher odds of anxiety or depression compared to those with less than four ACEs.” (Elmore AL, Crouch E.)

So the fact that TCKs experience higher rates of anxiety is not a surprise, but why might this be the case? What about those high ACE scores and the TCK life might lead to the symptoms of anxiety? 

We’ve noticed three trends. 

  1. Settling feels unfamiliar and thus breeds anxiety. We’ve found that TCK anxiety tends to increase when their highly mobile life is halted and they are in one place, with the same people for a longer period of time. This may make it difficult for a practitioner to find a source of anxiety because it might appear that everything is finally settling down in the TCK’s life. There may be more predictability, consistent relationships, opportunity to maintain hobbies, etc. However, for TCKs who have been highly mobile (either they relocated often or the people around them constantly came and went) it is that stable feeling that feels so uncomfortable and that uncomfort can present in feelings of anxiety. The adrenaline that they frequently experienced from huge life upheavals feels familiar, even if they express that they despised the constant change. Their body is used to it and their body responds when the familiarity of upheaval is gone. The COVID pandemic also made this settledness a forced experience for many TCKs and their families and that brought in additional emotions because it was unexpected, laced in fear, and often filled with many unknowns. 
  1. Close, long-term relationships. Even if the TCK you’re working with didn’t relocate frequently, it’s likely that there was a revolving door of people coming in and out of their life because of the transient nature of the expatriate community. This means that TCKs become experts at the first stage of a relationship. They’re often very good at getting to know people and are experts at navigating the getting-to-know you phase. Because of this rhythm, they get used to short-term relationships being the norm and with every new relationship a mental alarm clock begins to tick. When the relationship begins to have longevity, anxiety often surfaces. Sometimes, this anxiety leads them to subconsciously sabotage the relationship. Other times, they’ve come to you because of anxiety and haven’t been able to pinpoint a cause. If they’ve had longer term friends, or have been in a romantic relationship longer than past relationships have typically lasted, that could be an underlying source of anxiety. 
  1. A tall Grief Tower. I’ve written about the compounding nature of TCK grief in my books The Grief Tower and Unstacking Your Grief Tower. We see that TCKs who don’t “unstack” losses and traumatic experiences along the way through processing, often come to a point when they begin to experience symptoms of a tall or crashed Grief Tower. This most often presents as Complex PTSD. They may not have any major big “T” traumas in their life, but instead have a constant stream of losses and grief-inducing experiences that have stacked up. One of the body’s responses to this is often anxiety. In the two books mentioned, I walk through the methodology of creating a Grief Tower Timeline. Many practitioners have found that process to be a very effective way to reduce the symptoms of unprocessed grief, including anxiety. 

How you treat TCK anxiety may not differ significantly from how you would treat non-TCK’s anxiety, but we’ve found that it can be soothing and normalizing for TCKs to have a better understanding of how their unique life could be connected to how their body is emoting. Most importantly, they need to hear that the cause of their anxiety is not their fault AND the management of it is their responsibility. It is unhelpful to look at the TCK life, blame it as the source of anxiety, and stay stuck in the anxiety. But it can be so healing to help your TCK client understand their anxiety, come to terms with how their upbringing may have impacted them, and learn tools for how to live into the wonderful parts of their TCK upbring while managing anxiety in healthy ways. 


Elmore AL, Crouch E. The Association of Adverse Childhood Experiences With Anxiety and Depression for Children and Youth, 8 to 17 Years of Age. Acad Pediatr. 2020 Jul;20(5):600-608. doi: 10.1016/j.acap.2020.02.012. Epub 2020 Feb 22. PMID: 32092442; PMCID: PMC7340577.

Recorded Workshops: 

TCKs and Anxiety

Understanding Your Anxiety as an Adult TCK

Our Counseling TCKs Therapist Training is offered online each spring and fall and is eligible for 6 NBCC CEUs. 

Author: Lauren Wells

Lauren Wells is the founder and CEO of TCK Training and author of Raising Up a Generation of Healthy Third Culture Kids, The Grief Tower, and Unstacking Your Grief Tower. She is an Adult TCK/MK who spent her teenage years in Tanzania, East Africa. She sits on the board of the TCK Care Accreditation as Vice Chair and is part of the TCK Training Research Team focusing on preventive care research in the TCK population. She lives in Georgia, USA with her husband and two daughters. 

Contributed by Tina Quick

Third culture kids/global nomads have typically interacted with two or more cultures during their developmental years—those years that shape who they are as human beings. As they go about living their normal highly mobile, cross-cultural lives, they have no clue as to how they are being impacted. But one day they have an experience that wakes them up to the fact that they are different from others. This commonly takes place upon repatriation for college or university when they are surrounded mostly by those who have never ventured away from their home country or culture. What results is the feeling of cultural imbalance, not fitting in, inability to connect with their home-country peers. They feel like a “fish out of water” in their own country.

In 2009 Tina Quick wrote her groundbreaking book, The Global Nomad’s Guide to University Transition, to help these students understand what takes place in re-entry and/or transition and give them the tools and strategies they need to not only survive but to thrive in the adjustment. This was the first book written to and for students who have been living outside their “passport” countries but were either returning “home” or transitioning on to another host country for college/university. Highly popular with teens, parents, educators and counselors, it addressed the common issues students face when they are making the double transition of not only adjusting to a new life stage but to a cultural change as well.

Tina just announced her new and updated second edition of The Global Nomad’s Guide to University Transition has just been released and is now available on Amazon in paperback and Kindle versions.

The Four Pearls: Tina addresses in detail the four most common stumbling blocks TCKs) face in the transition to college/transition that can come as a huge surprise. She strongly believes if all students were aware of them, they would smoother transitions.

  • The transition cycle—Involvement, Leaving, Transition, Entering, Re-involvement
  • TCK identity development—the search for congruence in the sense of who they are as TCKs
  • Unresolved grief—from multiple losses and separations
  • Relationships—how global nomads relate differently from their domestic peers

New in the Second Edition:

  • Articles by guest authors –
    –   Amanda Bates, M.B.A., M.Ed. on diversity, equity, inclusion, and belonging and building a career;
    –   Lois Bushong, M.S. on mental health issues and finding a counselor;
    –   Lauren Wells on dismantling your grief tower and romantic relationships
  • Updates and new stories brought about by 10 years of cultural change and a pandemic.
  • Expanded Parents’ chapter addressing the fallout of common parenting strategies as well as how parents can come alongside their students, prepare them for the journey, and support them throughout this major transition.

Praise for The Global Nomad’s Guide to University Transition, Second Edition

“This book has been written with TCK students and their parents in mind. However, it should also be required reading for senior school counselors, educators, transition-team members and all university personnel – admissions, counselors, academics, educators and carers. Filled with the perspectives of those actually making the university transition, namely TCK students, there are important insights, ‘truths’ and ‘pearls’ to inform optimal transitions-care programs and practices in schools and universities. The updates and inclusions in this second edition are timely and provide an authentic, empathetic and practical resource; a safe place for TCK students to probe, prompt, plan and prepare, and a place to gain perspective and agency to proactively pilot a healthy university transition.”

Jane Barron
Director of Training & Consulting
Safe Passage Across Networks (SPAN)

“Accessible and wide-ranging, this book is an excellent resource for international school students and Third Culture Kids (TCKs) as they prepare for their transition to higher education. Tina provides a comprehensive overview of the intersections between transnational youth, culture, identity and belonging, and provides practical tools that students can use to prepare for and undergo one of the greatest transitions they will ever experience. With real life stories embedded throughout each chapter, this book brings to life the challenges and opportunities faced by young people today. I know from my work that this book has already had a significant impact on TCKs and international students around the globe and I would highly recommend this second edition to students, parents, guidance counsellors, and international student services personnel.”

Katie Rigg
International Advisor for Student Well-being
Council of International Schools

Tina Quick has struck a marvelous balance between practical ‘how-to’ guidance and the reason(s) why it works. The book prepares TCK students and parents approaching the transition to university, but it is every bit as useful to folks who didn’t have the time, opportunity, or awareness to get ready for this type of change. Whether you devour this new edition cover-to-cover, or use parts of it for quick reference, it is a fantastic resource for TCK students, parents, educators, and counselors. I always have a couple copies in my office, and they get used… A lot.”

Brian D. White
Associate Dean of Students and
Director of International Students & Scholars, Lewis & Clark College

“Effective TCK care during the university years is critical for a healthy transition into adult life. Tina Quick has gathered a great deal of wisdom over her years of raising TCKs and helping others to make the jump to university, technical school, or other tertiary endeavors. The second edition of The Global Nomad’s Guide to University Transition is a timely release with extensive collaboration and should be on the ‘must-read’ list for third culture secondary grads!”

Michael V. Pollock
Co-author Third Culture Kids: Growing Up Among Worlds, 3rd ed.
DARAJA Director, TCK Author, Educator, and Specialist

Author: Tina Quick

Tina Quick is an author, cross-cultural trainer, and international speaker who has worked closely with international schools and universities around the world. She has also authored Survive and Thrive: The International Student’s Guide to Succeeding in the U.S. She is passionate about bringing to the forefront issues facing students in global transition and helping them understand how to confront the unique challenges a globally mobile lifestyle can bring.

If there is anything the past year has shown us, it is that culturally competent therapists are needed more than ever. A global pandemic, bruising political elections, a social justice reckoning and uncertain economic landscape have brought us here and made it clearer than ever.

Contributed by Lauren Wells

In my years of working with TCKs, and being a TCK myself, I have experienced the TCK life at all stages. As I walked with families through their globally mobile life, the question that always lingered between myself and the parents with whom I worked was, “is there a way to help the TCK’s trajectory?” It seemed that the natural route for TCKs was to struggle during the transition to life overseas, thrive for a while, struggle during high school, have some serious challenge during young adulthood, and then see many negative manifestations of their upbringing during mid-adulthood. Seeing this pattern over and over caused me to wonder what more could be done to help them to grow into healthy adults who can maximize the many benefits of their overseas upbringing. It became clear that preventive care was the key. Looking at the challenges that statistics show most TCKs face in adulthood and tracing them back to the points in their life when those challenges were birthed can help us to prevent them from manifesting negatively in adulthood.

My Book, Raising Up a Generation of Healthy Third Culture Kids looks at how parents and organizations can provide practical, preventive care for TCKs during their globally-mobile lives.

In the book, I talk about the TCK life being like an ampersand (&). Thinking about my own experience, it is the best way I have found to answer the question, “What was it like to grow up overseas?” It was an ampersand, a both/and. It was both wonderful and difficult, both joy filled and grief filled, both so good and so hard. For each challenge, there was a contrasting benefit that could be birthed out of the difficulty.

My goal in publishing this book is to provide a practical resource and guide for how to maximize the benefits and decrease the negative effects of the many challenges of raising kids in another culture. In essence, I hope to address both sides of the ampersand. I’ve noticed during my years in this field, that people tend to focus on one side or the other—pointing out all the challenges from a fairly hopeless perspective, or not acknowledging that the challenges exist and only promoting the benefits. Having lived this ampersand life, I know that the experience is not at all black-and-white. It is a complex array of blended colors that include just as many complex emotions.

Most importantly, I wrote the book from a place of hope. I believe that we can raise healthy kids outside their passport countries and that these kids can grow up to be incredible contributors to our world. I also believe that we need to take seriously the challenges that so many face because of their unique lifestyles and be proactive about preventive care for Third Culture Kids. Raising Up a Generation of Healthy Third Culture Kids is filled with practical, encouraging, and easy-to-implement ideas that I pray give families and caregivers a sense of hope and direction as they love and support Third Culture Kids throughout their ampersand lives.

Author Lauren Wells

Lauren is the Founder and Director of TCK Training, Director of Training for CultureBound, and author of Raising Up a Generation of Healthy Third Culture Kids. She specializes in practical, proactive care for TCKs and their families. Lauren grew up in Tanzania, East Africa, where she developed a love for smokey chai and Mandazis (African doughnuts). She now lives in the US with her husband and two children.

Contributed by Myra Dumapias, MSW

Discovering my third culture kid identity as an adult has been like a predestined romance waiting to happen before I had the language for it. Yet throughout this love affair, realized in the process of claiming a tribe, I’ve noticed a missing piece: acknowledgement about privilege variances as a tribe.

The intense feeling of being different without a language to internally process it or externally name or explain it has impacted me significantly. I felt like a misfit whenever I attended a school without other third culture kids (TCKs). The consciousness of knowing I was different grew more distinct after I left the international school system: in college, I told a roommate that moving around so much as a kid influenced who I was romantically compatible with, but couldn’t explain why. The longer I was away from my TCK-filled past, the more I felt an isolation I didn’t know how to talk about. I felt like I found myself in an abandoned city with signs of fresh activity but no one there to talk to  (as described in Where Everybody Is: TCKs and the Twilight Zone).

The answers didn’t come until my 30’s, when a colleague called me a “third culture kid”, which led me to The words “third culture kid” were keys that opened new doors for me, most importantly of understanding. As I illustrated in “the significance of words” (page 4 of “Refusing to Be Erased”), discovering the term that explained my experiences and that I was not alone validated that it was an identity I was experiencing and not an abnormality I had to fix.

More personally, the career dream I wrote about in my college applications was to help people who grew up moving around like me. I knew there was a need before I knew there was a language for it. In 2011, within six months after I discovered the term, TCKid, an online community forum created by Brice Royer, became a bridge to that dream when he passed onto me the online community three years after he created the forum. I formalized it as a 501(c)3 non-profit organization. Today, the organization, which now goes by TCKidNOW, has continued helping more TCKs connect and expanding its global reach, and provides trauma-informed educational outreach as part of community care services under development. 

TCKidNOW addresses the question after the initial discovery of the TCK identity: “Now, what?”- the space where intersectionality and privilege are relevant. There have been great discussions around the common TCK experiences, ie. finding home, being a hidden immigrant, etc., but as a tribe, we tend to go back to our individual identity compartments when it comes to aging, sudden disability, racism, economic struggle, etc. Yet our global nomad background can have as much relevancy on these matters as it does on “Where is home?” TCKidNOW recognizes being an adult TCK intersects with other identities, ie. race, gender, class, aging, passport country, citizenship status, etc. TCKidNow designs its services mindful of how the intersection of identities ties into varying levels of access to resources, or privilege.

Privilege – the uncomfortable but necessary conversation:

Privilege can be an uncomfortable topic that can easily cause a little tension or division, but it doesn’t have to.  In expat communities, we do not all usually enjoy the same luxuries, such as paid private school tuition, luxury cars or rich neighborhoods. It’s part of what expats sign-up for. The differences in privilege themselves aren’t a cause for tension. What can be is when a majority of resources, events, accolades, and standards and recognitions of admirable accomplishments and leadership do not acknowledge or include a true diversity of TCKs by the time we’re all adults, such as:

  • individuals from developed as well as developing countries,
  • people who with working or lower income class experiences as well as those from consistently upper middle class or higher background,
  • people of color from all over the world as well as the universally perceived face of the Western World,
  • community-focused work under leadership that has an understanding of the multiple intersections of struggle and marginalization, as well as the cosmopolitan entrepreneur who symbolizes a successful jet-setter lifestyle, and
  • individuals who identify fluidly across these spectrums.

Clarifications on increasing access:

Setting a price for services, having a successful small business, or recognizing a person’s accomplishments aren’t, of course, negative. What would be negative is if we in the field of TCK work don’t collectively work together to widen access to resources, recognition and inclusion. Individuals with experiences from less privileged backgrounds in roles with program and research design decisions and leadership can open new windows of insight.

The professional practice that validates our approach:

Social Work is guided by the core values of: service, social justice, dignity and worth of the person, importance of human relationships, integrity and competence ( TCKidNOW follows these core values along with the systems theory, which explains human behavior as influenced by multiple subsystems, ie. an individual’s school, family, economic class, cultural identity, friendships, etc., that operate interrelatedly within a larger system. Addressing an individual’s problem would then require looking at how the various subsystems are affecting each other as well as the individual directly.

How you can help – the TCKidNOW Community Mental Health Network:

Informed by my less than economically-privileged seasons in my life and stories from other TCKs about limitations in accessing resources, I conducted a survey designed to measure certain privileges. The results of this first community needs survey confirmed class variances within the TCK population, usually thought to be mostly upper middle or upper class. The below  infographic shows some findings and an overview of the TCKid Community Mental Health Network, which aims to gather TCK/cross-cultural focused mental health service providers willing to charge sliding-scale fees according to income/cost-of-living context for TCKs who cannot afford standard rates. Please consider joining the network. We are also seeking donors and businesses interested in sponsoring this program who would like exposure on our TCK and Cross-Cultural Kid social media platforms. Please see more details/register here-

In closing, I want to say that I am so grateful to see how far we’ve come as a tribe since the days when TCKs were still not considered a “valid population”. We all as a tribe did this! The International Therapist Directory has played a major role in healing and I hope that this network will provide an avenue for us all to worker together to spread even more love!

Author: Myra Dumapias, MSW

Myra Dumapias, MSW, (BA English and World Literature) is the CEO of TCKidNOW – please follow them on Facebook or Instagram.  Myra is a 2nd generation TCK, daughter of a 2nd generation career diplomat, and mother of a domestic and international TCK and is a social entrepreneur, writer, photographer, film geek and volunteer first responder. She grew up in in China, Malaysia, Ohio, Indiana, Manila, Germany and Romania and during college years, in South Korea. As an adult, she also lived in Bahrain.


Contributed by Ruth E. Van Reken

I would guess most of you listed in this directory have heard some version of the following story in your work as international therapists:

You meet a new client and begin the conversation. “Good afternoon. What brings you to my office (or screen) today?”

“Well, people think I have a lot of friends, but inside I’m lonely. I just don’t feel like I fit in anywhere.”

“I’m sorry to hear that. Can you tell me something more about your story?” you reply.

“H-mmmm. Like what?”

“Like from the beginning.” You respond. “Who your parents are, where you were born, where you’ve lived, and maybe even how you got here.”

“Well, I got here by car but I guess that’s not what you mean.” And you see the twinkle in her eye and think ‘Well, at least she has a sense of humor!’

“OK, then,” and a more serious look comes on her face. “Let’s see. My mom was born and raised in Country A, my dad is a citizen of country B but grew up in 3 countries himself, I was born in Country C, but moved between 7 other countries before I was 18. I enjoyed living in so many places and seeing so many things. I enjoyed my life and have friends all over the world. So why do I often feel this deep sadness or loneliness?”

And from these facts alone, and before you know why she has moved so much, you hopefully already know the basic story: you are working with a cross-cultural kid (CCK)—someone who has lived among, and meaningfully interacted with, various cultural worlds in his or her first 18 years of life.

“So what’s the big deal about that?”, some (not you, I trust!) would ask.

A therapist I met in 1995 in Australia might have an answer for that question.

In those early days, my focus was primarily on trying to learn more about third culture kids (TCKs)—a specific sub-group of what we now call the larger cohort of CCKs. TCKs grow up outside their parent(s’) passport countries primarily because of the parent(s’) career choices. That particular evening I talked on the benefits and challenges of being a TCK and the factors creating these characteristics. An adult TCK (ATCK) brought his therapist along and both asked insightful questions during the discussion.

Afterwards, this therapist approached me and said, “Tonight I learned something. For months, I have treated my ATCK client for PTSD. It is the only method that has worked with him, but I have never understood why. How can he have classic PTSD symptoms, yet not have any of the usual types of trauma my other clients have? Now I understand how, despite the many benefits he also received, the cycles of separation and loss inherent in his TCK experience can create significant trauma in way I never considered before.

“And I think I learned something else. For years therapists and psychologists assumed if a baby was adopted at birth, there would be no different issues for that child than If he was the parents’ birth child. Now we know that the minute we learn that our client is an adoptee, there are certain things we must look for. After hearing about the TCK Profile tonight, I believe it’s the same with those who have grown up in a globally mobile lifestyle. Once we know this is part of their story, there are certain things we must look for and pay attention to.”

What are some of these things to consider when someone with what Donnyale Ambrosine has called a ‘culturally fluid’ story sits before you?

To begin, we can consider the TCK model as something of a ‘petri dish’—a place where for many years we have studied the impact of cross-cultural mobility during childhood. If we understand what we have already learned as basic issues, we can see how what we have learned here might apply in other situations in our changing world, even when the details of the experience are not identical.

As I’m sure you know, there are two basic hallmarks for a traditional TCK experience: a cross-cultural upbringing and a life filled with high mobility, whether it is their own or living in a community whose members also frequently come and go. It is the intersecting of these two factors that create the often paradoxical list of benefits and challenges that David Pollock developed and described as The TCK Profile (now Section Two of Third Culture Kids: Growing Up Among World, 3rd edition). Certainly, this pattern of chronic disruption in the traditional way children formed a sense of identity in a more mono-cultural experience leads to questions of identity and belonging for many TCKs. In addition, the repetitive cycles of separation and loss due to mobility patterns result in matters pertaining to attachment and unresolved grief. Both of these outcomes and why they happen are also explained at length in Section One of Third Culture Kids.

Applying Lessons Learned

Today’s therapists, however, need to consider how the TCK experience has, in fact, turned out to be what sociologist Ted Ward predicted in 1984—a prototype for the future ‘normal’. That time has come. As the world is changing, our understandings and applications of what we know must keep growing with it. Where are some of the new realities therapists must consider?

The Cross-Cultural Kid Model ©Ruth E. Van Reken, 2002, Used by permission.

First, we must remember the many types of cross-cultural childhoods there are in today’s world. The diagram above lists a few of them, but many more exist. For example, foster children or children of divorce who navigate between different family cultures could also be included. Many CCKs ask the basic questions of “Who am I?” and “Where do I belong?” we have heard for years from traditional TCKs.

Second, remember that CCKs are often in multiple categories at the same time. A traditional TCK may also be an international adoptee. In addition to common TCK characteristics, therapists must also look at known themes adoptees also face. Refugee children undoubtedly experience questions about identity and issues related to major loss but what are the traumas related to war they might also know? Often they become immigrants and live as minorities in a new land while going to school in a very different culture from what they know at home. Often such groups also face racism and bullying as they settle in and become immigrants. This growing cultural complexity is a new but often unrecognized ‘new normal’ in today’s world. How do you as a therapist look at the whole picture?

Third, globally mobile adults who began life in a more monocultural situation often present with issues that overlap with those we know from a traditional TCK experience. In the past, we have presumed that they had already established their sense of identity before beginning global pilgrimages so they would not share similar questions about that as TCKs often do. It seems that may not have been an accurate assumption. Many of these adults also seem to arrive at a state of feeling so changed by the experience, they too ask “So who am I now?” “Where do I belong?” In other words, the issues of identity, belonging, and hidden losses are often present for globally mobile adults as well as for their children and, without understanding or resolution, lead to a nagging sense of “What is wrong with me?”

Fourth, never forget that the shifting cultural contexts across our globe are leaving fewer and fewer places as the ‘monocultural’ communities we knew in the past. That means the skills and understanding you have acquired as ‘international therapists’ have put you ahead of the curve for normalizing and giving language to how global changes are affecting local communities around you as well. You have much to offer! May you find joy in expanding what you already know and do to be more effective than ever in our changing world—not only your sake and your clients’ sake but for your profession as well.

Author Ruth E. Van Reken

Ruth Van Reken is a US citizen who grew up in Nigeria as a second generation third culture kid (TCK)* and raised her three daughters in Liberia For over thirty years Ruth has traveled extensively speaking about issues related to global family lifestyles. Currently, she is seeking to understand how lessons learned from the TCK experience can transfer to others raised among many cultural worlds for various reasons. Ruth is co-author of Third Culture Kids: Growing Up Among Worlds,3rd ed., multiple other writings and co-founder and past chairperson of Families in Global Transition.  

Contributed by Katarina Gaborova, MSc

It was a lovely Dutch morning, as I was driving my older daughter to school, who was 7 at the time. On the way there, we were singing and laughing in the car at some of my “lost in translation stories” related to expat life. I dropped my girl off, wiping off some milk crust from her breakfast residue as I was kissing her on her soft cheeks.

Then continued driving to my practice. I picked her up, later that afternoon. “ So what was the best experience of your day-today?” I asked, my usual question that I adopted from positive psychology. My daughter looked at me, suddenly bursting into tears, telling me that it was the WORST DAY OF HER LIFE. We sat down and chatted about her day, and broke her day into different much smaller parts. When I realized that her day went actually great up until about 10 minutes before I went to pick her up. That was a point when she ended up having an argument with her best friend (a classical cognitive distortion).

Shifting Attitudes

How had she gone from a positive morning experience to such a negative outlook? Well, as therapists we know that we have been given this evolutionary capacity to emphasize the negative rather than the positive (known as negativity bias). It is our inborn critical survival skill to be aware of and to avoid danger. Did you know for example that negative experiences or the fear of them has a greater impact on us compared to positive ones? Or that our attitudes are more heavily influenced by negative news as opposed to the positive? According to a prospect theory (Kahneman & Tversky), we even tend to make choices mostly based on avoiding losses rather than focusing on all the wonderful gains.

Well, coming back to my story, as I was sitting there with my daughter, it suddenly hit me and I got an idea of creating a deck of cards and a book for my daughter where I could show her these tricks that our mind plays on us. More importantly, I could show her some remedies how we can play back by turning the awareness of our own thoughts and feelings into our own benefits. I also thought of how useful it would be if other children, or adults could use these tools as an extra support with whatever they would be going through.

We human beings, can certainly train our mind to consciously start noticing and focusing on the positives in our environment. This is of course not to make someone naively look at the world through pink glasses, but rather sticking to the facts at hand. Not letting our bias opinions create a cloudy view. It takes practice and effort but the result is surely worth it. I do not need to even point out what benefits it brings to our resilience, mood, immune system or relationships within our environment.

So, that is how our See Bee Tee journey started. I met a great artist from Romania Roxana Macovei, who beautifully painted each card by hand for the memory card deck. We researched how to make them interesting, colourful and full of fun (See a couple of examples below).

I was also cooperating with a Slovanian visual artist and a pedagogue Nataša Gruden Pižmoht who illustrated the book (See below).

And then my dear colleague, Ekaterina Evdokimova of PsyCompass, a child psychologist and Expat herself, currently working and living in the Netherlands, tested the tools in her practice when working with Expat children and their families. This is what she wrote about the book & cards as she reviewed them:

“In this interactive tool for children, their parents and professionals, Katarina (psychologist, manages to bring together the essence of two widely-known approaches to therapy: cognitive behaviour therapy (CBT) and mindfulness. The book gives a very clear indication of how the negative thought patterns work, and presents the reader simple exercises to ensure that positive thinking becomes their natural reaction to destructive thoughts and unfortunate events.

The tool has two parts: the book “See Bee Tee” and a memory game card deck with the same title. Both are based on the story of a bee called Tee who was temporarily unable to fly. The story tells how she manages to overcome despair and sadness, and even benefits from the situation with the help of her friend, a wasp called Kevin. The story demonstrates in clear, rhythmic language how Tee’s thoughts developed, how they changed while she was talking to her friend, how new hope arose, and how she ultimately found a way to enjoy the time and new opportunities while she was unable to fly. The story provides a clear model for children and equips them with practical tools to help them deal with their own difficulties. Children also learn how to be less dependent on other people’s opinions and how to be kind to themselves and to others.

At the end of the book and in the instructions to the memory game, there are manuals for parents. The guide is written in clear language and leaves no doubt about how valuable positive thinking is when it comes to dealing with the past, overcoming difficulties in the present or going through desperate times of loss and grief. The manual is rich in information which is useful to both children and their parents. Both the book and the card game have well-balanced combinations of text and illustrations. The colours also correlate with the story and reflect the feelings the characters are experiencing.

The book and the card game can be used by professionals such as psychologists, teachers and care-givers who work with children suffering from anxiety, fear, depression, post-traumatic stress disorder (PTSD), as well as children with special needs and children dealing with the challenges of an international move. Playing with the memory cards, reading the story or colouring the pages of the book can be used by professionals to discuss with children various events in their lives, the effects of certain ways of thinking and possible coping mechanisms. Information presented through play is easier received by children and repetition of the same message ensures that it is instilled in children’s ideas and behaviour. Children also learn other skills: appreciate the smaller things in life, value and maintain friendships, talk about their feelings, focus on the present, and have the courage to step out of their comfort zone.

As a child psychologist I already started using the tools in my practice working with children who have difficulties with self-esteem or who have challenges with emotional recognition.

See Bee Tee is a valuable resource in any practitioner’s toolkit.”

Today my daughter is already 10 years old. Of course that she is still going through her natural ups and downs which are an inevitable part of any cycle of life. However, since then I honestly have not heard her labelling her days as the WORST IN HER LIFE :).

Sending you all warm greetings from Netherlands.

Author Katarina Gaborova, MSc

Katarina Gaborova was born and raised in Slovakia. She studied psychology & psychophysiology in Australia. Currently she works in her practice in the Netherlands. Where she is a licensed psychologist and NLP (neuro-linguistic programing) life coach and member of the ACCESS Counselling Service Network. Her specialties include positive psychology, integration challenges, stress management and more. She is a published author of V!VA Tools for well-being and See Bee Tee products. You can find out more on ;

Contributed by Tina Quick of International Family Transitions

It’s that familiar time of year again. Spring is in full bloom and difficult to voice emotions are being felt by secondary students all over the world. Graduation is looming large and with it come feelings of exhilaration, excitement, and anticipation about their upcoming adventures, but they may also be feeling sadness and experiencing a sense of loss. They may be feeling some distancing or even exclusion as they give up roles and responsibilities they held as high school seniors and turn them over to underclassmen as they move forward toward graduation and leaving. With those responsibilities also go the status, position and identity they enjoyed in their last years of high school. They are most likely reflecting on what it will be like to leave friends and family behind as they head off to college/university. Parents may notice their student’s mood swings between still wanting to be coddled like an infant and screaming for more independence.

All graduating students are firmly implanted in what the late Dr. David Pollock called the ‘Leaving Stage’ of his transition model, but for Third Culture Kids (TCKs) it can be a very conflicting time. A lot of denial may actually be going on as they find it difficult to imagine that they really are going to be leaving the place they have called “home” for so long. The leaving stage is characterized by a loosening of emotional ties and distancing from family, friends, and relationships. This behavior is quite unconscious and is a form of self-protection – from their own feelings – and it will be displayed in a variety of ways. I watched as each of my three daughters went about this typical withdrawing in their own style.

My normally jovial, sweet, loving, eldest daughter became so irritable and downright annoying that I was convinced she was demon-possessed. She must have, somewhere in the deep recesses of her mind, thought that by acting out, her family would be relieved to see her finally leave home to go off to college, thereby, making her departure easier on us.

My middle daughter handled it quite differently. She spent the entire summer before college hanging out incessantly with her friends. She didn’t loosen any ties with them, only her family. In fact, if anything, she and her secondary school buddies became even tighter over the summer than they were in the years they spent together before graduation. She was pleasant enough when she was around, but that wasn’t very often.

My youngest became a recluse at home. She came home from school or sports practice and went directly to her room. Her only appearance to spend time with family was mealtime. I would always find her in her room reading or doing homework. She used to sit at the kitchen table to do homework so we could chat as I prepared dinner. When I pointed out her long absences, she sighed and replied with a hint of sadness, “I’m sorry. I don’t mean to be distant.” I then realized this was her way of disengaging and separating from us, her parents.

A TCK’s globally mobile lifestyle (whether they are the ones who are moving around or the one who is always staying put) means that they have experienced a lot of separations and loss. When we lose people and things we need to be able to grieve them. Leaving a beloved host country is no exception. Dr. Pollock used to say that “TCKs need to grieve well to leave well.” Grief validates all the good in our lives. Grieving well means:

  • Recognizing and naming the loss(es).
  • Mourning the loss(es) – however that may be for the student, i.e. journaling, art, music, poetry, photography. (Some of the most amazing pieces of art I have seen were done by TCKs dealing with grief.)
  • Accepting the loss.
  • Coming to closure, and
  • Moving forward to the next developmental stage.

Dr. Pollock also used to say that “In order to enter well, one must leave well.” In other words, how a person leaves one place will have a profound effect on how well he enters the next.” He went on to develop a model anyone going through transition could use to help them leave well. He used the RAFT acronym which stands for Reconciliation, Affirmation, Farewells, and Think and Talk Destination.

Reconciliation – Do not leave a place with broken relationships, undone issues or unfinished business. Try to resolve issues and resentments and reconcile your relationships. Think about who you need to say “I’m sorry,” to or who you may need to apologize to. Broken relationships can hinder making new ones.

Affirmation – Just as giving and receiving forgiveness liberates and heals you, so does affirming people that have been important to you. Telling others (friends, teachers, coaches, pastors, mentors) how much you appreciate and respect them makes you and them feel better about saying good-bye.

Farewells – Saying proper good-byes helps bring closure. Be sure to say good-bye not only to people but also places, pets, and your possessions!

Think and Talk Destination – Find out as much as you can about the college/university you will be attending, the town or city it is in, the state and the country before you get there. Even if it is your ‘home’ country, treat it as a new one! Find someone you can ask questions of. And think about all the things you will need to bring with you. Plan ahead and be prepared so you are not caught totally off guard.

Some third culture kids will be going back to their home or passport country but it may not really feel like home to them. Some will be continuing on to another host country/culture for the university experience. Regardless, all TCKs will be stepping out of that ‘third culture’ or expatriate culture they have been enjoying for so long and may not take into consideration how their international experiences have made them different. They often do not discover they are different until they hit their campuses and are suddenly surrounded by people with whom they have no shared experience. In all the TCK interviews I did for the book, “The Global Nomad’s Guide to University Transition” the most common concern I heard was, “I don’t fit in…I don’t belong…I can’t connect with anyone.” It’s because the TCK’s life experiences have been very different from someone who grows up in a basically stable, traditional, mono-cultural community. I always encourage them to remember they have not had the same experiences as their peers so they need to find common ground on which to connect. I also tell them Naomi Hattaway’s “I Am a Triangle” story. It’s too long for me to write about it here but it is a foundational concept that truly explains the TCK experience. I encourage every reader to read about it at Wishing you and your students every success in their upcoming adventure.

Author: Tina Quick of International Family Transitions

Tina Quick, author of The Global Nomad’s Guide to University Transition and Survive and Thrive: The International Student’s Guide to Succeeding in the U.S. is a cross-cultural trainer, writer and international speaker. She is an adult Third Culture Kid (ATCK) and has raised her own TCKs across four cultures and continents. She has served as Program Chair on the Board of Directors of Families in Global Transition (FIGT) and on the Advisory Board for TCKid. Tina works closely with colleges and universities, domestic and international schools.

Contributed by Ava Senaratne of TCK Town, Multicultural Stories from Around the Globe

I’ve had this conversation with a few times with some friends already (and you might have too): not one country really does mental health “well”. From what I’ve seen through my journey as a TCK, we still haven’t cracked the code.

In Tokyo, the record is abysmal for healthy working practices. On the way to work on rainy days, it became second nature to leave earlier than usual because desperate salary men and women threw themselves in front of trains when the weather turned grey. And don’t even get me started on how harmful gender stereotypes are over there. From what I’ve experienced from the older members of my family who grew up in Sri Lanka, there really hasn’t been much awareness at all about good mental health practices to pass down to our generation (my grandfather’s favourite phrase, unfortunately, is “steel your mind!!”). In Melbourne, although there is some relief (my friends, colleagues and I can openly talk about issues regarding anxiety, depression and seeing our therapists), it’s not good enough yet. I am still haunted by our ridiculous “vote for gay marriage” questionnaire that would have shattered the mental health of many who have already struggled for years under the many burdens that come with LGBTQ+ identities.

Despite the downfalls and disappointments, I have learned. One of the invaluable traits of being a TCK is my ability to sort through the chaff and store away the golden pieces of wisdom I’ve found. I’ve developed the skill of adopting ways of thinking that suit me best without being prejudiced by where those ideas came from.

Here’s my TCK collection of good mental health practices that I hope serves you as well as they have served me:


When you’re not okay, and someone asks, “How are you?”, tell the truth. I’ve made a big effort to commit to this over the last two years and have found that the people around me have been receptive and supportive every single time I haven’t answered with, “Fine! You?”

If you’ve been feeling lethargic and unmotivated for more than a week or so, check in with your GP, and see if you need to get on a mental health plan. In the same way you can’t fix a broken leg on your own, you need the support of a therapist when something doesn’t feel right. Motivational internal dialogue and ‘sucking it up’ can patch the problem up but it won’t fix it. In the same way that letting that leg ‘heal on its own’ instead of putting it in a cast could have you limping for the rest of your life, not addressing the state of your mental health now will have repercussions later, and how you’re feeling is not just going to ‘go away with time’.

Ask your friends for help. It can be for big things like, “Can you help me pack before I move?” Or, “Can you check in on me over the next few days? Need a bit of support.” It’s embarrassing, but if you have good people in your life, it will never go astray. (If you’re not sure if you have good people in your life, this is a great way to get rid of the crap ones!)

Show up. Is your friend upset and stressed out about law exams? Is someone you know having a hard time with their family? Make them dinner, ring their door bell, drop the food off and say you wanted to do something to help them out through this difficult time. Or catch up for a 20 minute coffee in the morning before work. Calls and texts in this time of connectivity are awesome but in my experience, it can mean we take the necessity of intimate and genuine connection for granted.


Grooming is not a form of vanity, it’s a form of self care. While you don’t have to put on a full face of makeup or wear a suit before you head to work, make time for applying nourishing oil on your skin after your morning shower, or a bit of wax in your hair to elevate your look. It will make a difference to how you start your day.


Get away from the city whenever you can. I’m not a hiker and I don’t drive so trekking through mountains or cross-country road trips were never an option. I’d visit temples with dense foliage to block out the busyness of Tokyo, or huge gardens like Shinjuku Gyoen, where you can only see the tops of neighbouring buildings. New environments will help you gain new perspectives, especially if something has been worrying you for a while.

Food is nourishment. Whether it’s nourishing your soul (put your take-out on a nice plate, grab you cutlery and pour yourself a glass of wine next time you order dinner) or your body (make the effort to add one serving of something healthy to each meal), showing up for yourself in small ways reinforces that you are worthy of love and nurturing. As lovely as some humans can be, we are still not very good at practicing these sorts of kindnesses for ourselves, which in turn affects the way we treat others. Start small, and it will eventually spill over into other areas of your life.


If you only take one thing away from this article, try and make it this: Practice mindfulness. No, that doesn’t mean sitting in the lotus position and humming in your bedroom. On the way to work, when you’re getting dressed, when you’re flicking through Instagram, check in with yourself. The digital communication era has given us a million ways to numb ourselves to what’s going on internally, and I think many of us have subscribed to more of it than we think. Here’s an easy way to start:

How am I feeling physically? – “My feet are cold on the bathroom floor. My hands are wet and my lips are tingling from the toothpaste. The back of my shoulder blades are a little tense.”
Look at your physical experience in more detail – “I think my shoulder blades are tense because I’m a bit stressed out.”

Look again – “Why am I stressed out while I’m brushing my teeth?! Oh, because of the presentation I have to do at lunch.”

Look again – “I’m uncomfortable because I misinterpreted the brief yesterday and I don’t want to be on the wrong track with this preso again today. That would be really embarrassing.”

Sit with how you feel for a bit and don’t try to ‘resolve’ it – “Yup, it makes sense that I’m nervous. I’ve only been working here six months. And I tend to be pretty hard on myself when I mess up.”

I find that bringing the subconscious into the conscious and then practicing acceptance about how I’m feeling (instead of “don’t worry, it will be fine!”, which is a great way to negate your experience) often acts like a release. I’ve acknowledged what’s wrong and that means my body and mind are not internalizing the stress. It’s out in the open so that I can get on with my day instead of holding all of it in. With practice, you’ll get much faster at it and be able to work through this train of thought anywhere.

What small (and big) mental health practices have you learned from your countries? Comment below. I’d love to learn more and add to my collection!

[Note: This piece has been re-posted from TCK Town with permission from the author. Comments are open on the original post.]

Author: Ava Senaratne of TCK Town, Multicultural Stories from Around the Globe

Ava Senaratne is the Editor-In-Chief of, a journal which celebrates cross-culturalism with raw and real stories from around the world. Ava is from Australia, was born in Sri Lanka, grew up in the Middle East and has lived in Tokyo too. Her many homes have made her a passionate advocate for diversity and connection, values she tries to live everyday.

Contributed by Clara Blázquez Booth

“To have another language is to possess a second soul.”
– Charlemagne

If you asked people whether they would like to be bilingual I think most people would say “Yes” without even thinking about it. Bilingualism is now generally considered something positive and highly desirable but this has not always been the case.

Until relatively recently it was thought bilingualism could be detrimental to a child´s learning and general development and there are still many myths surrounding the subject. Some people might think “how confusing for a child to have to learn two languages, poor thing!”

However, recent studies have painted quite a different picture. It has become obvious that a child can cope with two (or more) languages and even adults can learn and use a language other than their mother tongue, although, unfortunately, as we all know, this entails a bit more effort. As we also know, we live in a globalised world, where speaking more than one language is becoming ever more necessary, with thousands of people studying languages, high mobility rates within countries and many mixed couples bringing up their children bilingually. It may well be that in the future being bilingual will be a common occurrence, which hopefully will lead to a better understanding of the issue.

So what has changed in recent years, what do we now know about bilingualism? There have been a series of studies which have helped to see bilingualism in a more positive way.

Even though it is not yet known exactly how the brain stores different languages, recent studies have shown how bilingual people perform in different tasks. It seems bilingualism promotes the individual’s creativity and ability to solve problems, by enhancing mental flexibility, and enables situations to be perceived in a different way. It is thought that increased metalinguistic awareness creates a way of thinking that is more open and objective. However this improved mental flexibility that
develops in bilingual people influences more than their problem solving or linguistic skills; language appears to change the way the world is perceived in individuals that speak different languages.

What is more, new research explains how speaking more than one language may translate to better mental health as some recent studies have correlated bilingualism with the delayed onset of dementia for as long as 5 years. It could be that being bilingual can offer protection from the symptoms of dementia and this would also suggests that the increasing diversity in our world populations may have an unexpected positive impact on the resilience of the adult brain.

From a cultural and social point of view the advantages are also obvious. It is not just speaking more than one language; it is also the opportunity to participate in different cultures, being able to speak to people from different parts of the world and also the understanding of their literature, songs, cinema or traditions. This means that bilingual people are usually more open-minded, listen better and are more appreciative of different cultures; think of all the things you can access by not having that language barrier when travelling abroad.

It is also clear that nowadays speaking more than one language can be very useful when searching for a job either in your own country or for finding work opportunities abroad. It has become an asset which makes a candidate stand out from the rest and in other cases it is an essential requirement for the job.

Although there are many positive aspects about being bilingual, undoubtedly it is not always easy to achieve, especially when a family is not bilingual and a child does not learn another language from an early age. Even in the case of bilingual families we must remember that language is something that is alive, dynamic, constantly changing and expanding but unfortunately it can just as quickly deteriorate or be forgotten if not used. Language depends on the circumstances and situations you find yourself in and the need to use it. So if you are bilingual it is important to continue to reinforce all your languages and if you are not,
why not start learning a new one! Remember,

“If we spoke a different language, we would perceive a somewhat different
– Ludwig Wittgenstein

Author: Clara Blázquez Booth

Clara Blazquez-Booth is a Speech Therapist working at Sinews Multilingual Therapy Institute. Her multilingual upbringing has permitted her to acquire English, Spanish and French at home from birth and has given her a special insight into language acquisition as well as an understanding of the needs of children exposed to more than one language from a young age.

Contributed by Lauren Wells

I first heard the term Third Culture Kid or “TCK” in high school, and simultaneously found out that I was one. While many reject being labeled, I personally found much solace in finally feeling like something explained the rootlessness and lack of belonging that I felt. I have always worn the TCK label proudly and have, for better or for worse, lived up to the typical TCK expectations- moving often, having difficulty developing deep friendships, feeling restless, not wanting to settle down. However, three years ago, my husband and I moved to Portland, Oregon. This three year stretch has been the longest period of time that I have lived in one place since elementary school, and the scariest part? We have no intention of leaving anytime soon.

I write a lot about TCKs and settling. I have said that, “The healthy TCK realizes that they have a need for change and knows that they are more comfortable with the adapting process than with the settled life. However, they have learned how to control the need for change instead of letting it control them. They are willing to be somewhat uncomfortable so that they can live a settled life in the necessary areas.”

In the past three years, I have learned to “settle in the necessary areas.” I believe that this has made me a healthier and happier individual, but, it has also brought a deep, unknown fear to light- the fear of becoming less of a TCK. 

This fear surfaced when we bought our house about a year ago. While I knew it was the best decision for us, in the back of my mind I kept thinking, “But TCKs don’t do this!” I would remind myself that we were calling it a “5 year house” and could go anywhere in the world after that (even though 5 years still seemed like a ridiculously long time). Part of me felt like the purchase of our house signaled the death of part of my TCK identity.

Shortly after buying our house, my husband and I were at a craft fair and found this little wooden sign that said “Home” with the “O” in the shape of Oregon. Something inside me said, “You need to buy this. You are learning to settle.” So we purchased the sign and it now sits on a shelf in our living room. Every time I look at it, I feel a slight pang of guilt. “TCKs don’t have a home. Especially not one in America. I am loosing my TCK-self.”

I recently came across a quote from David Pollock and Ruth Van Rekken that says, “While parents may change careers and become former international business people, former missionaries, former military personnel, or former foreign service, no one is ever a former Third Culture Kid. TCKs simply grow into being adult Third Culture Kids because their roots grow out of the lives planted in and watered by the third culture experience.”

I think that perhaps, for many adult TCKs, the fear of settling doesn’t just stem from the uncomfortableness of wading into that uncharted water, but also from the fear of loosing part of their TCK identity. We subconsciously think, “If I can see myself happily staying in one place (especially in my passport country) for a long period of time, I must not be a TCK anymore.” Thankfully, I have found that this is not entirely true.

My life overseas shaped me in countless ways, many of which are similar to the tendencies of other TCKs. Those experiences will always impact my life, but as I am learning to settle, I am learning that I need to let go of some of my TCK identity. The part that says, “You will always be rootless”, “You will never have a home”, “You will never have deep friendships with non-TCKs.” In the past three years, those beliefs have begun to be chiseled away at bit by bit. Allowing myself to settle here in Oregon is not betraying my TCK-self, nor does it make me less of a TCK. In fact, as I look around my house, I can see fingerprints of my overseas upbringing in so many places- my world map on the wall, my cupboards full of African foods and Indian spices, my African-themed guest room, the shuka (Masaai fabric) that I take as a play-mat/picnic blanket/towel/blanket for nearly every outdoor activity, African carvings and books in Swahili all around my living room. My third culture experience has played a role in shaping the way that I think, the things that I enjoy, the areas that I am passionate about, and what want to spend my life pursuing.

Settling and adapting does not undo my TCK identity, it just allows it to show up in different ways. In many ways, it surfaces in healthier, less destructive patterns. I am learning to let go of my fear of being less TCK, and learning to let the ways that my TCK-self comes out change and shift as I grow and learn to adapt and to settle.

[Note: This piece has been re-posted from the TCK Training Blog with permission from the author. Comments are open on the original post.]

Author: Lauren Wells

Lauren Wells is a Third Culture Kid (TCK) who grew up in Tanzania, East Africa. Her experience as a TCK fuels her passion for working with globally mobile families. Lauren is the TCK Program Director for Worldview Ministries in Portland, Oregon. In her role at WorldView, she developed and now runs a program for children and teens that equips them with the skills they need to learn new languages and embrace new cultures when they move overseas with their family. She blogs regularly at

Contributed by Liz Rice

I was nine months old when my American family landed in Seoul, South Korea, in 1966, the youngest of four children. My parents were social justice oriented people, called to divided places. They moved to South Korea as missionaries to try and help a country that had lived through a devastating century.

I was too young when we arrived to go through culture shock or deal with acculturation as my parents did. I was too young to know what it meant that we were leaving the country of my passport behind. Going to Korea is something I don’t remember. I woke up to life there. And over sixteen years, Korea, its history and its ways, became my reference point.

I learned to speak Korean as I learned to speak English. For the first four years of my life, as my parents were attending language school and beginning to work, I was in the daily care of Koreans, soaking up language, culture and the customs of one of the most Confucius and homogenous cultures in the world. I went to Korean nursery school, soaking up even more. Up until the age of five, when we first visited the US, Korea was all I remembered and knew. My family was American, but the US was a foreign country. For the next sixteen years, Korea was, simply, home.

And if the story ended there, it would be a story of a complicated and rich childhood in a place of contrasts and contradiction, in a humble, ancient nation far away from the home of my ancestors. A story of a girl, part Korean, part American, and always something in between. But something happened after my family left Korea.

It was in the U.S. that I first learned what culture shock felt like. I began to suffer from depression and a feeling of deep dislocation. We lost contact with the lady we called Ajumoni, a woman as dear to me as a grandmother. I began to grieve the loss of all of it as if I was grieving a death. Without any language to understand my situation, I went through that grief alone. I lived life as a half-self, trying to start from scratch in a culture I didn’t fully understand but was expected to. I didn’t feel American. And I didn’t look Korean. And I was beginning to understand that in leaving Korea, life as I had always known it was over.

While psychologists at that time understood concepts like culture shock and acculturation for adults who moved “overseas,” few understood the effects of reverse culture shock, especially for children who had been raised away from their passport countries. These days there are numerous books and resources for something called “Third Culture Kids” – children who are raised in a culture other than their parent’s culture for a significant number of their development years. Third Culture Kids are said to carry the influence of their parents’ culture and the culture of the country or countries in which they were raised, but don’t have full ownership of any one culture. TCKs, it turns out, often experience some period of cultural rootlessness when they return to their passport countries.

Eight years ago I began to write Rituals of Separation as a love song to a cross cultural childhood and as an exploration of the complexity of issues of loss, belonging, and cultural identity. I wrote to give a voice to people with complicated cultural identities, who have lived stories we can’t always see in their faces. As novelist Chimamanda Ngozi Adichie says, “There is a danger in telling a single story…to show a people as one thing, and only one thing over and over again, and that is what they become…The consequence of the single story is this: It robs people of dignity.”

Writing the book was a “ritual of separation” for me – not to separate from Korea – but to memorialize that time, to make record of and acknowledge the lasting impact of Korea and its history and people on my identity – to say the names of those that I could not forget – the people I carried with me from Seoul to Middlebury to Boston to Seattle. I wrote to record and remember what happened in Korea at that pivotal juncture in the country’s history, when Korea was recovering from a horrific war that divided the nation into two, industrializing at a rapid pace, and seeing the burgeoning of a democracy movement that would eventually lead to the toppling of a line of dictators. I wrote to understand the deep impact of my parents’ involvement in the Korean democracy movement on my understanding of the world. And I wrote to help me better understand from what matter I, and we, are culturally formed –  and the role of Korea, and my hidden bicultural identity, in that struggle. Over eight years, with each chapter, I peeled away another onion skin of belonging.

As I state at the end of the first chapter of Rituals of Separation, “After we left Korea, I balanced precariously between two lives, unsure how to go back and unable to move forward. I had to come to terms with all I had seen in those years. I had to look into the ways of the people and places that formed me and find myself, like a pebble sorted from rice. And I learned to pick up the pieces of an unrooted adulthood time and time again. For what is lost can’t always be recovered. Sometimes the only way to move on is to learn to let go, to be deeply grateful for what we had, to know we will never be the same for what we have seen. To learn that maybe, just maybe, our fractured parts do, after all, make a whole.”

Writing allowed me to begin to fully answer the seemingly simple question that so many global souls come to dread…“Where are you from?” With each chapter I took one more step in finding healing and answering that question.

Author: Liz Rice

Elizabeth spent most of her first sixteen years in Seoul, South Korea as the youngest child of socially progressive Presbyterian missionaries. After her family moved to the U.S., she received her undergraduate degree from Middlebury College and a Masters in Public Administration from the University of Washington. She spent many years working in the NGO sector, serving as administrative director for a public health nonprofit for immigrants and refugees in the Twin Cities and working in grassroots community development organizations and nonprofits in Seattle, Mississippi and Zambia. Elizabeth is currently living between Costa Rica and Vermont. Rituals of Separation is her first book.

Harriet Cannon is a licensed Marriage and Family Therapist and Mental Health Counselor with 25 years experience in the US and internationally. She helps individuals, professional groups, and organizations create satisfying connections in their intercultural relationships, and success in their professional environments. I had a chance to interact with her recently about some of her exciting work. What follows is our brief interview…

Josh Sandoz: Harriet, you have an extensive history working as a mental health therapist in the United States and in other parts of the world. Can you share a little about your background in that work?

Harriet Cannon: I believe that insight about how our historical-cultural-socio-political context affects us is key to our relationship success. My parents were from diverse regions and religious backgrounds, although they were both born in the US. My family experience greatly affected my choice to become a marriage and family therapist and to be involved in intercultural work. I have over 25 years experience as a therapist in the US and in South America. In the last 15 years I have been working primarily as a therapist with people in multiethnic and multicultural relationships in private practice and with corporate clients expatriating and repatriating all over the world.

JS: In recent years you have transitioned into providing services as a consultant and trainer specializing in multicultural, multiethnic identity, and relationship dynamics. What is that work like, and how is you enjoying it?

HC: Raising my own daughter in Chile for some years peeked my empathy for immigrant parents. We lived on the economy with very few native English speakers to interact with. About 10 years ago, I decided to do some anecdotal research. I interviewed 47 immigrant mothers and their adult daughters looking to get insight on mother’s experiences raising a daughter in a culture not her own. I was so taken by the stories that I gave a presentation on my findings at the annual International Family Therapy Congress in 2005. That was the beginning of my shift to a focus on presenting, teaching, and writing about multicultural relationships. I am having a blast.

JS: From your experience, who might best make use of your services, and how would they go about contacting you?

HC: I take referrals for individuals, couples, and families in cultural transition; expatriating and repatriating. I also give presentations for mental health professionals, individual or group consultation for mental health professionals, schools, and community groups. I will create a training tailored especially for a group.

JS: Do you have any upcoming seminars on the horizon?

HC: Yes there are three full day workshops with CEU’s for mental health professionals.

My colleague, Rhoda Berlin, M.S., LMFT, and I have two upcoming trainings for mental health professionals in 2012:

‘Family History and the Immigrations Story in Therapy’

May 19, 2012 in Renton, Washington

‘21st Century Faces; Multiethnic Families and Identity’

September 21, 2012 in Seattle, Washington

I also  have a solo training:

‘Global Families and the Immigration Story’

October 17, 2012 in Santa Barbara, California

To contact me:



Telephone: +206 780 3843

JS: As we finish up, are there any exciting resources you often find yourself recommending to others who are interested in developing their thinking around multicultural, multiethnic identity, and relationship dynamics?

HC: My favorite recommendation is to choose the genre of fiction you most enjoy and read books where the story theme is intergenerational relationship dynamics or multicultural relationship dynamics. For example, anything by Amy Tan. Her books take into account many perspectives rather than MY story memoirs. Memoirs are great but don’t have a variety of relationship perspectives. Also movies, for example: ‘Real Women have Curves’, ‘Grand Torino’, ‘Lost in Translation’.

For non-fiction, a few favorites are:

‘Working across Cultures’ by John Hooker

‘American Nations: the history of 11 Rival Regional Cultures of North America’ by Colin Woodard

‘The Geography of Thought’ by Peter Nisbett

‘Cosmopolitan Communications: Cultural Diversity in a Globalized World’ by Norris and Inglehart

Rhoda Berlin and I are working on a book on Multicultural couples. We’ll let you know when it is ready for publication. Hopefully before the New Year.

JS: Thanks Harriet, for the work you are doing and for sharing more about it with us today.

As the number of families and individuals who live outside of their passport culture(s) continues to grow, the arena of Cross-Cultural Transition Consulting is a needed and developing area of focus. Like with any subject matter, some professionals active in the work really stand out as champions in their field. Libby Stephens is one such consultant.

I’ve had the privilege of working alongside Libby for a number of Third Culture Kid Transition Seminars over the years, and we recently took the opportunity to swap interviews. You can follow this link to a short video with the two of us from this past Spring, and then keep reading what follows to listen in on a few additional questions I asked of Libby right here. Enjoy!

Josh Sandoz: Can you share with us what kinds of services you provide for the TCK and internationally mobile community?

Libby Stephens: Josh, my goal is to be able to help anyone in the globally mobile community understand and humanize their transition experience. This includes individuals, schools and businesses. For example, I regularly visit international schools around the world working with departing students and conducting in-service programs for their faculty and staff. Each summer I am involved in two weeks of orientation for teachers who are new to living internationally and working in international schools. And of course, one of my favorite assignments is teaching alongside you Josh as we work with TCKs who have returned to the US for university or high school! The rest of my year is pretty much a non-stop research project around all aspects of transition and TCKs so that I ensure I am relevant the rest of the year.

JS: How did you become so passionate about TCKs and matters concerning transition?

LS: I grew up highly mobile. Though I never left the US until I was 17, I always knew what it was like to be the new kid in school. Along with that, my parents often hosted international students and TCKs, though we never knew there was a name for them, in our home. I loved hearing their “and then we went to” stories and often felt some of the same sadness when they talked about missing all the places where they had lived.

Shortly after my university studies in Behavioral Science and Counseling, I began a job at a boarding school in Europe. And that was it. I was hooked. TCKs became my passion. I met David Pollock in my second year there and began working with him at Transition Seminars every summer. Even now, after returning to the US in 2002, I look forward to working with TCKs every summer as they begin life in the US.

JS: Are there any exciting projects or initiatives you have been involved with recently or have coming around the bend?

LS: This past Spring I was involved in a three day Think Tank on Third Culture Kids. The small group of about 12 people began thinking through the TCK Profile and the issues TCKs face in the 21st century. I am looking forward to refining some of our thoughts and findings. This of course means more research needs to be done.

Another exciting project that I have the honor to be a part of is The Transition Institute. This initiative is still on the drawing board but I have great hopes that along with author Debra Rader (New Kid in School) and Shabbi Luthra of the American School of Bombay we will conduct transition and TCK training for educators. We are planning this for the summer of 2012 in Tuscany.

JS: If a group or organization would like to hire you as a speaker or consultant, how can they be in touch?

LS: Josh, it is my passion to come alongside schools, businesses, governments, families and individuals on issues surrounding transition, the Third Culture Kid and cultural adjustment. Anyone who is interested can go to my website,, check my calendar for availability and book me through a simple form there.

JS: Libby, thanks so much for sharing some thoughts with us here today. As we finish up, I wanted to ask, what makes you such a strong advocate of the International Therapist Directory?

LS: I am a strong advocate of the International Therapist Directory. It is important to mention that people can get help with some of their cross-cultural adjustment issues, TCK issues, and family adjustment issues without having to return to their passport country. Many times the struggles that are faced in the first year can be dealt with quickly if they just have someone to talk to. For far too long, parents have felt helpless when trying to find help for their families. Marriages have suffered as couples have tried to successfully live internationally. I am so very glad you had the vision to put the International Therapist Directory together. What a gift for the international community!

JS: Thanks Libby! Those are kind and thoughtful words. All the best in your work!

Tina Quick is a cross-cultural trainer and international speaker. Founder of International Family Transitions, she specializes in helping students who have been living outside their passport countries successfully manage their transition to university, whether they are returning to their home country or going on to another host country. Tina also works with individuals, families, schools, agencies, and organizations that support TCKs and international students through providing seminars and consulting services.

Accordingly, Tina has written an excellent book, published in the spring of 2010, called The Global Nomad’s Guide to University Transition. I highly recommend her book, as it is full of thoughtful anecdotes and sound practical advice, a fun and informative read. I recently had the honor of asking Tina a few questions about her work and her experience writing, and you can find her interview here after the break:

Josh Sandoz: Would you mind sharing a little about how you came to be so passionate and thoughtful about the TCK experience?

Tina Quick: Sure! A good friend who is a psychologist that works with transitioning missionary families first indicated that I might want to pay attention to my family’s upcoming repatriation since it is sometimes more difficult going back home than going abroad. She reinforced what I had heard years earlier about TCKs through the tutorial she gave me. That’s when I read Pollock and Van Reken’s Third Culture Kids: Growing Up Among Worlds for the first time. Once we were back in Boston I began running into many TCKs I had known from our family’s overseas postings who were attending the various colleges and universities in the area. I was hearing the same familiar, but sad themes over and over again from these bright, talented and gifted students – feelings of not fitting in, not connecting with their peers, feeling like a fish out of water, alienation, isolation and sometimes severe depression.

JS: You’ve recently written a book, The Global Nomad’s Guide to University Transition, published summer of 2010. Great book! What convinced you that this book needed to be written?

TQ: In talking with one TCK college student after another, I was woken up to the fact that these kids really are very different from their home country peers. They often don’t realize they are different until they step out that third culture where they enjoyed a sense of belonging with others of shared experience. They don’t realize it is their life experiences that make them different from most of the people they are surrounded by on their college campuses. Once they understand this they are then able to embrace their differences and use them in positive ways in their lives, on their campuses and in their futures.

JS: What was the writing process was like for you?

TQ: I did a lot of research, reading and talking to the experts before starting my business and taking transition/re-entry seminars into international schools. Sadly, the seminars were not as well-attended as I and the school administrators had hoped. Many students truly felt they did not need to be told how to go “home.” So I decided to put my seminar into a book that parents or others could place in their students’ hands as they were leaving for college. It would serve as a useful handbook for their transition whether they read it in full or only turned to when in dire straits. Since I already had the seminar in full swing, the first draft went rather quickly.

JS: Who do you hope reads this book and what do you hope they come away with after reading?

TQ: There are several categories of people that would benefit by reading this book.

–       My hope is that students who have been living outside their passport country and are returning for college or even high school will read it. While it goes into a lot of the practicalities of college life, the psycho-social/emotional issues are relevant to both high school-aged and college-aged students.

– Students who have been living outside their passport country but are transitioning on to another host country for college will have the same experiences because of the fact that they have stepped out of that third culture and will be surrounded mostly by those with whom there is no shared experience.

–       Even students who are moving to a new culture for the university experience will find this useful as they will go through the same stages of transition as TCKs and the book will help them understand that the stages are predictable and normal.

–       There is a chapter that has been written specifically for the parents to help them  prepare and support their global nomads in the university transition.

–       And lastly, my hope is that institutions that either send or receive these students on either side of their transition will read it to understand what their challenges are and how they can help students either leave or enter well, whichever the case may be.

JS: Outside of writing, in what other ways are you involved in the lives of TCKs and the internationally mobile?

TQ: I spend a lot of my time trying to spread awareness of the TCK experience amongst institutions of higher education, international schools, agencies that send families abroad and mental health counselors by giving talks and workshops as well as presenting at conferences. Another sphere of my work involves serving as a resource consultant for relocation companies that give cross-cultural training to families that are either expatriating or repatriating. I am often called in to talk about international parenting and third culture kids. And lastly, I am serving, along with you, Josh, on the advisory committee of TCKid, a non-profit community of over 21,000 members dedicated to help Third Culture Kids connect and find a sense of belonging.

JS: Thanks Tina! It’s an honor to know and work with you. I wish all the best to you and International Family Transitions as you continue working to serve the global TCK community.

In my last post, I highlighted IMHPJ, a professional support network for expatriate mental health therapists living and working in Japan. Since I believe that quality support networks are important for mental health therapists, I wanted to highlight IMHPJ as a network that has established a good working model for others who may wish to develop something similar in their own part of the world.

A shining example, Shanghai International Mental Health Association (SIMHA), is one such group! Founded in 2008 by Dr. Lauren Muhlheim, SIMHA has directly modeled their association after IMHPJ, having adopted the same Constitution, Code of Ethics, and Mission Statement.

To my delight, SIMHA’s founder, Dr. Lauren Muhlheim, and current president, Barbara Shaya, agreed to answer a few questions, that we may all be enlightened by their experiences with leading SIMHA. Further, Lauren is listed here and Barbara is listed here in the ITD.

The interview follows:

Josh Sandoz: How did SIMHA get started?

Lauren Muhlheim: I arrived in Shanghai in January 2008, and by February I had started working part-time at the community center. In May, I also took a job with Parkway Health. My appointments were booked by a call center so I couldn’t screen my clients to make sure that they were appropriate for my practice. I tried to identify other English-speaking clinicians in the community with whom I could consult or refer patients to.  Every school and organization had a different list of clinicians and most of the lists were out of date due to the high turnover of expats. I met other clinicians both through my affiliation at the community center and randomly at other events such as my child’s soccer game and a pearl stringing class. I became preoccupied with creating an accurate and thorough list of who was really practicing psychotherapy in Shanghai. At the same time, I was working with a student at an international school who was moving to Japan. The school counselor at that school stumbled upon the IMHPJ website and told me about it. I convened the first meeting of therapists practicing in Shanghai on October 29, 2008. The turnout was great; 17 practitioners who were all excited to connect. We then formed a steering committee to build the organization.

JS: What are the core purposes of SIMHA?

Barbara Shaya: To improve the quality and accessibility of mental health services to the international community in Shanghai by: verifying to the extent possible the credentials of professionals, providing a forum for networking and professional workshops, maintaining an up-to-date database of practicing mental health professionals in Shanghai.

JS: How important was your interaction with IMHPJ as you began your process?

LM: Our interaction with IMHPJ was critical. First of all, it gave us a model for our organization. I doubt that we would have formalized the organization beyond a networking group if we didn’t have their lead to follow. In addition, they were very supportive of our efforts and shared their advice and 10 years of experience. Lastly, they allowed us to copy and modify for our own use their mission statement, constitution, and ethics code, which saved us a lot of work.

JS: What is your vision for SIMHA’s future?

LM: It is my hope that SIMHA will continue to be a resource to the foreign community in Shanghai. By helping clinicians get integrated into the counseling community and make them available to clients who need their support.

BS: Having other professionals with which to connect is critical in our field. Working in isolation is detrimental to the ability to provide continuing care to the community. SIMHA helps clinicians ‘hit the ground running’. My personal experience is that when I was preparing to move to Shanghai, I found the SIMHA website and contacted Dr. Lauren Muhlheim. She encouraged me to join SIMHA and referred me to some select individuals within the community so I would get an idea of what needs and resources were in the community and how I might best fit in. By the time my shipment arrived and I got my office set up, I had referrals waiting. I jumped right in.

JS: Any advice for other expatriate therapists in other parts of the world who may wish to establish their own local network of mental health professionals?

BS: Yes, you don’t have to start from scratch. There are others (like IMHPJ and SIMHA) who have gone before you and are willing to help you get started. Within the expat communities there is a significant need for mental health services – the faster people can find you, the better!

JS: I want to thank you both, Lauren and Barbara, so much for your time, thoughtfulness, and generosity in engaging these questions. SIMHA, along with IMHPJ, have set a standard, and I’m grateful for your leadership and ongoing example.

As practicing clinicians, we at the International Therapist Directory know firsthand the importance of having a supportive professional network of fellow practitioners available to grow alongside while engaging in clinical work. However, for therapists living the expatriate lifestyle themselves, finding such a network can be a real challenge.

In light of that reality, International Mental Health Professionals Japan (IMHPJ) have been pioneers in developing a professional support network for expatriate mental health therapists living and working in Japan.

Though the wonders of the Internet, I had the opportunity to interview Reggie Pawle, a past IMHPJ president and member since 1999.  Reggie is also listed here in the ITD.

Josh Sandoz: Reggie, in brief, how did IMHPJ first come to be formed in 1997?

Reggie Pawle: IMHPJ was formed as a result of services provided by psychotherapists to victims of the Hanshin Earthquake in Kobe, Japan, in 1995. During the process of assisting people in need, which continued for quite a while after the earthquake, psychotherapists in the area came in contact with each other. They realized their services would be improved by an organization that would facilitate continuing education, case discussions, and networking.

JS: What are IMHPJ’s core purposes?

RP: According to the IMHPJ website, they are:

– Maintaining an up-to-date database of professional therapists
– Providing a forum for discussing and making co-ordinated joint efforts related to important issues or events
– Encouraging a high standard of ethical and professional performance for mental health professionals
– Providing opportunities for continuing education for members
– Facilitating peer support and networking among members and with related Japanese mental health organizations

JS: What have been some of the benefits of establishing and maintaining IMHPJ over the last 14 years?

RP: One of the prime benefits has been to create a community of English-speaking therapists in Japan, so therapists are not isolated while working in a foreign country. Another benefit is expanding a referral network for both receiving clients and referring clients with specialized needs to qualified professionals. A third benefit is to provide credibility and standards for English-speaking clients who are seeking qualified, ethical psychotherapists. A fourth benefit is having a website, which really helps both therapists and clients find each other and coordinate services in this internet age.

JS: What have been some of the challenges?

RP: One of the challenges has been ethics, as some psychotherapists in Japan had been practicing with ethics that created problems with clients. Another challenge has been motivating psychotherapists to participate and contribute efforts to the functioning of the organization. A third challenge has been trying to decide what defines a “qualified” psychotherapist, because the standards of certification vary greatly around the world.

JS: What advice would you offer expatriate therapists in other parts of the world who might wish to emulate your association by establishing their own network of mental health professionals?

RP: I would say be gentle and persistent, and don’t compromise on your standards. It is important to offer benefits, like a website that helps get clients, and to offer quality psychotherapy events that draw people to attend and participate.

JS: Reggie, thank you. We appreciate your time and the efforts of IMHPJ. When it comes to establishing expat therapist networks, IMHPJ is an inspiration. Thank you for helping the rest of us to learn from your experiences.

Since launching the International Therapist Directory, I have interacted with many professionals who have services to offer the internationally mobile community outside the scope of mental health therapy. One such service is the field of international educational consulting, and one such consultant is Rebecca Grappo (M.Ed., C.E.P.).

Rebecca has been an educator for over 20 years and has been an active supporter of the International Therapist Directory. In addition to her native United States, she has lived in Italy, Switzerland, Luxembourg, Costa Rica, Nicaragua, Portugal, Jordan, Oman (twice) and the United Arab Emirates. She speaks English, Italian, Spanish, Portuguese, French, and German.

I had an opportunity to ask Rebecca a few questions via email recently to gain a broader understanding of how international educational consultants can be of support to both internationally mobile families and therapists alike. Here is how that conversation went…

Josh Sandoz: For those who don’t know, what is the role of an educational consultant?

Rebecca Grappo: The international education scenario is unique in various ways that all of us who are expats know and understand. By working almost exclusively with TCK students and families on a wide variety of issues related to making informed educational choices, this is a population I understand well. Many of these challenging issues include working with kids who struggle, whether it is academically, socially, or with a mental health issue.

I can help a family to evaluate various schools and programs that meet the student’s individual needs, from traditional boarding schools, boarding schools with learning support, or therapeutic schools and programs. I have visited several hundred schools and programs around the United States and approach each student’s situation as one that is unique.

JS: In what ways can an international educational consultant be of service to TCKs and the internationally mobile community?

RG: Very often, the resources available for learning support and/or mental health support in the international setting are extremely limited. Or, I see kids who have been in the hands of an excellent therapist but the issues need more support than is available in the international school setting. After all the options overseas have been tried, if things are not improving, then we need to look elsewhere. Relying solely on the Internet for a complex situation can be downright dangerous.

So families and therapists alike rely on the experience and guidance of someone who has visited or placed students in various schools and programs. Furthermore, when I have a student in a program, I remain in touch with the program therapist over the course of the treatment. Therefore, I have many opportunities to discuss the characteristics of TCKs, and suggest probing questions that the therapist might use with a student to help understand the complexity of issues they are facing.

JS: How can it be helpful for a practicing mental health therapist to know about the services that international educational consultants provide?

RG: Many of my students are referrals from other mental health professionals. We work as a team to understand the situation and issues, then help the family to make informed decisions about what might be best for the child or adolescent. It’s not imperative, but I think it’s in the best interest of a client if we all remain in touch during treatment, share information, and work together towards the best possible outcome for the individual. Of course, professional standards of confidentiality are respected at all times.

JS: Are there any other resources you would point someone toward to learn more about your services?

RG: For further information, I have information on my website for mental health professionals as well as blogs and articles about my visits to therapeutic schools and programs. I invite therapists to follow me on Facebook and Twitter for information related to raising and educating kids overseas, and that includes raising awareness about the importance of mental health issues.

JS: Thanks so much Rebecca. I appreciate all you are doing for the internationally mobile community. And thank you for taking the time to share with us here about your services.

To Readers: If you have specific questions or comments for Rebecca, you are welcome to leave them below. Also, I would like to specifically invite other international educational consultants to list your services here by leaving a comment that contains a link to your website and/or contact information.