International humanitarian careers

Psychologists are increasingly leveraging their skills to aid international humanitarian and development efforts in partnership with nongovernmental organizations (NGOs) and other institutions. Expertise in crisis intervention, cultural competency, research methods, and clinical practice gives psychologists a unique perspective on how to help millions affected by war, poverty, and disaster. In these roles, they are aiding victims of circumstances, as opposed to psychologists working on human rights, who seek to protect and promote human rights through psychological research and practice.

[Related: Bringing a human rights focus to humanitarian work]

In years past, well-intended providers arrived quickly on the scene after emergencies, such as the 2004 Indian Ocean tsunami, with Western interventions that may have unfortunately done more harm than good. But today, that approach has largely changed, said psychologist Amy Nitza, PhD, executive director of the Institute for Disaster Mental Health at the State University of New York at New Paltz. Instead, psychologists who want to help are focusing more on training local providers and building capacity for mental health services, she said, “with the ultimate goal of working ourselves out of a job.”

“How can Western psychology add value for the people who are already on the ground and doing this work from an Indigenous perspective?” Nitza said.

Those working in the field share guidance on how to shape a career around humanitarian aid, including skill building, finding job opportunities, and getting support for professional challenges.

A principle central to humanitarian work: Do no harm. But would-be helpers can inflict great harm if they fail to recognize, affirm, and show appreciation for local cultures, said Michael Wessells, PhD, an emeritus professor of clinical, population, and family health at Columbia University who has provided psychosocial support to children and families in more than 30 war zones throughout his career.

“It is deeply disrespectful to go into a war zone [and] assume Western psychology can be applied off the shelf and that all you need to do is to diagnose the problem and apply a preidentified, evidence-based intervention,” he said.

Instead, it is imperative to adopt an attitude of humility and curiosity, which includes critically examining one’s frame of reference. For example, some Indigenous groups in Colombia view well-being as a fusion of land, water, sky, and humans—so simply translating the language of a standard diagnosis of depression plus cognitive behavioral therapy is unlikely to resonate or help, Wessells said.

Conducting qualitative interviews with cultural interlocutors—people who can share their experience of living as a woman, man, child, or person from a marginalized group in their society—can also provide invaluable insight.

“Every nation state has its own Indigenous ways of being and wisdom, and if that is applied, you have much better results,” said Anjhula Mya Singh Bais, PhD, a psychologist and chair of the international board of Amnesty International.

Psychologists must do focused work to explore how their worldview might impact their efforts in humanitarian settings, Nitza said, because Western ideas about support and healing may differ significantly from local beliefs. For example: How are tragedy and loss understood? What are acceptable ways to express distress? How does one make meaning of a terrible event? What does justice look like?

“There are a lot of assumptions we make about psychology and mental health that we have to check at the door when we show up,” she said.

Harm can also occur when well-intentioned organizations provide support without proper clinical oversight, such as an NGO that uses Western-trained providers to give one-off counseling to children and families exposed to traumatic events, said Zeinab Hijazi, PsyD, global lead on mental health for the United Nations Children’s Fund (UNICEF). “There are a lot of good-intended generalists out there who have been trying to engage in this work but in the process causing harm,” she said.

Psychologists should aim to work with local providers to build interventions, mental health systems, and long-term capacity. For example, Nitza and her colleagues have worked for nearly a decade in Haiti, where very few mental health care providers have master’s degrees. In one project, Nitza’s team partnered with an organization led by a Catholic priest to design a group intervention that local bachelor’s-level clinicians could use with children rescued from domestic servitude.

Local expertise was critical to the program’s success. For example, the team initially used the term “group leader” to refer to the facilitator but soon learned that children interpreted the Haitian Creole word for leader to mean “boss”—and felt afraid to speak up. When Nitza and her colleagues started calling the facilitator an “animator,” the group began to function as intended.

“A psychologist must sustain their integrity and the integrity of the science while coming up with creative solutions in the local context to address a variety of issues related to mental health, including access to services,” said clinical psychologist and policy expert Abir Aldhalimi, PhD, who works for the consulting firm Greenleaf Integrative, which provides contracting services to the U.S. Agency for International Development (USAID) to advance global mental health and the rights of marginalized communities. She emphasized the importance of a grassroots understanding of local contexts that can support local organizations to develop—and ideally lead—their own programs.

The development projects Aldhalimi works on tend to span a longer time frame than humanitarian aid efforts. She and her colleagues seek creative ways to address gaps in services in low- and middle-income countries. For example, she has helped build capacity in local mental health organizations, as well as supported ministries of health in integrating mental health considerations and programming.

There is a place for Western psychological knowledge, and a significant part of the art of international humanitarian work is learning how to interweave local culture with those ideas. When Wessells began working with the NGO ChildFund, he was unsure whether he had the skills needed to help children who had been displaced, recruited into armed groups, or targeted by gender-based violence amid the civil war in Angola.

“My question was: What can a Western-trained psychologist who understands very little about Angola really claim to know? But it turns out that a lot of Western psychology is relevant,” he said.

Through a process of listening and co-learning with an Angolan team who had a rich understanding of the local culture and context, Wessells used his psychological expertise to evaluate and enhance ChildFund’s support programs. His contributions ultimately helped secure additional funding for the programs, including incorporating Angolan rituals related to mourning and healing.

“This was a cultural practice that enabled addressing one of the biggest needs for returning child soldiers: stigma,” he said. “The program benefited from the insights from Western societies, but it wasn’t just an imposition of approaches from outside that may not apply to the local context.”

Wessells helped adapt a program for reintegrating child soldiers so that it included both psychotherapy and a cleansing ritual, through which a traditional healer formally welcomed children who were considered spiritually “clean” back into their communities.

Trauma- and crisis-focused interventions are essential tools for psychologists working in conflict zones or with those who have faced human rights abuses. Narrative approaches, including writing exposure therapy and memory specificity therapy, helped Sayed Jafar Ahmadi, PhD, now a research scholar at Bard College in New York, support girls who survived suicide attacks while attending school in Afghanistan.

Indirect narrative approaches can also be used to great effect, said Nora Sveaass, PhD, a lifelong human rights advocate and a professor of psychology at the University of Oslo. She has drawn on the work of psychiatric social worker Michael White, PhD, a pioneer of narrative therapy, to help survivors of torture heal without retelling stories in their entirety.

“You don’t necessarily need to hear the whole story, but you can work with narratives and metaphors, and provide a lot of input to the person without them reliving the entire trauma story,” said Sveaass, who was the first psychologist to serve on the UN Committee Against Torture and established the first international human rights committee for psychologists.

That approach can work well in a therapeutic setting, said Sveaass, but some circumstances call for a full reporting or retelling of human rights abuses—for example, to initiate a formal investigation. The UN Istanbul Protocol: Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishmentopens in new window provides psychologically informed guidance on how to conduct such interviews with consent and trust.

For psychologists interested in exploring humanitarian work, those with experience in the field offer guidance on how to get started and build a meaningful career.

Develop your strengths

Before seeking work abroad, especially in conflict zones, Sveaass recommends learning to provide crisis-focused mental health care well where you are—for instance, by working in a hospital or community clinic.

“A colleague of mine says, ‘people can easily bring chaos into chaos,’ and that should not happen,” she said. “Psychologists should be well trained and have some experience before working with people exposed to so much crisis and insecurity.”

In the United States, opportunities abound for working with people from a variety of cultural, religious, and economic backgrounds. Those experiences provide a critical foundation for crisis intervention or other work in humanitarian settings.

Volunteering to aid disaster relief efforts with your local chapter of the American Red Cross is another way to gain experience with circumstances that bear similarities to international humanitarian crises, Nitza said.

“Starting out responding to a local emergency like a house fire is a great way to get your feet wet and figure out if this kind of work—which requires a lot of cognitive flexibility—is for you,” she said.

Expand your knowledge and expertise

There is no single path to a career in international humanitarian psychology, but there are some key skills psychologists can sharpen.

Training in interventions such as Psychological First Aid and Skills for Psychological Recovery, or becoming a Red Cross international disaster responder, can help build a foundation for working in humanitarian contexts, Nitza said.

Those still in school might choose electives that can help lay the groundwork for humanitarian activities. These could include courses on trauma, human rights, organizational psychology, and equity, diversity, and inclusion. Nitza also suggests that clinicians-in-training gain deep expertise on group-based interventions.

“Most of the world comes from collectivist cultures where individually based interventions don’t make a lot of sense,” she said.

Enrolling in such courses is also a good way to connect with experts working in the field and to identify potential mentors and job openings, Hijazi said. Continuing education opportunities are available through Fordham University’s Institute of International Humanitarian Affairs and the Centre for Global Mental Health.

“Build your network and knowledge by finding existing courses that help you make links to people who are already doing this work,” she said.

Explore humanitarian work at home or abroad

Fellowships, including those offered by the American Association for the Advancement of Science and USAID, are one key way to gain training and experience abroad.

Opportunities may also exist closer to home. Alfonso Mercado, PhD, a licensed clinical psychologist and an associate professor of psychological science at the University of Texas Rio Grande Valley (UTRGV), has done humanitarian work through his collaboration with community leaders at refugee camps near the U.S.-Mexico border. In McAllen, Texas, and Reynosa, Mexico, he partners with local legal aid organizations to conduct psychological evaluations, which can bolster requests for asylum.

“The immigration crisis is a humanitarian crisis, and our data highlights the significant trauma exposure and rates among this population, often with no trauma-informed care,” Mercado said.

Focus on helping the helpers

For psychologists who want to get actively involved in humanitarian crises around the world, one great way to do so while minimizing harm is providing support for local mental health workers.

“A really clever option for psychologists who want to help is to figure out how to support the mental health providers on the ground,” Aldhalimi said. “Do we all need to go to Ukraine and see patients? No. But do psychologists in Ukraine need support right now? Absolutely.”

That may include addressing secondary traumatic stress through debriefing and helping local providers find ways to maximize the impact of the services they provide, she said. The latter could involve collaborating with local service providers, academic institutions, and community leaders to find out where they need help and fill gaps—for instance, by assisting with training initiatives.

Transition throughout your career

Because humanitarian work falls outside of traditional teaching, research, and practice activities, psychologists who walk this path have a number of options for shaping a fulfilling career.

Partnering with an academic institution is one way to build a platform for the work, conduct relevant research, and maintain a stable salary. At UTRGV, Mercado helped establish a bilingual, multicultural clinical psychology doctoral program that provides special training for working with immigrants, refugees, and Latine communities. He has also maintained a strong relationship with the Texas Psychological Association, where he served as president in 2022 with the theme of assisting disadvantaged populations.

On the clinical side, providers often combine private practice with pro bono or volunteer work in order to make a decent living, Sveaass said. And after working on the front lines for more than a decade, Hijazi shifted into consulting and advocacy while pursuing additional training in clinical psychology. She now works with UNICEF to scale up global mental health support for children, young people, and caregivers at the policy and programming levels.

Leverage this opportunity for growth

Humanitarian work is challenging and requires sacrifice—psychologists doing crisis response, for example, may need to spend time apart from their loved ones. But the work can also be incredibly rewarding, Hijazi said, and can broaden one’s perspective in ways that are life- and career-changing.

“It might be uncomfortable, and it might not be for you,” she said. “There are psychologists who will dip in and out of this world, but if they approach this work with humility, they go back to their path and aspirations with a broader, more rooted experience of the world to take with them.”