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Hey folks, welcome back to The Testing [00:01:00] Psychologist. I’m glad to be here with you in this new year, 2025. I know this isn’t the first episode of 2025, but it’s the first one that I’m recording, so there we go.
Hey, I’m back with a clinical episode and I’m back with a return guest. Dr. Mariela Shibley is here. She’s a clinical and forensic psychologist, psychoanalyst, and expert in conducting immigration evaluations, which we’ll talk a lot about today.
She has a private practice in San Diego, California, where she also trains and supervises mental health professionals. Dr. Shibley is the founder of the online training program PsychEvalCoach, which trains clinicians to conduct immigration evaluations. She authored the book, Conducting Immigration Evaluations: A Practical Guide for Mental Health Professionals published by Routledge in 2022. That was also the topic of her previous podcast episode, discussing the process of writing the book.
Additionally, she serves as the Director of Mental Health at the University of California San Diego Student-Run Free Clinic and holds an [00:02:00] adjunct faculty position at the California School of Professional Psychology. Her latest endeavor involves establishing a non-profit organization to increase access to low or no-cost immigration evaluations by training mental health providers and partnering with attorneys and legal nonprofits to facilitate these services to individuals in need.
As you can tell, Mariela is back today to talk about immigration evaluations. We’ve talked about immigration evaluations before on the podcast, and she is back because this discussion is very timely given some of the changes and potential changes in our immigration system over the next months, days or years.
So we talk about how important immigration evaluations are going to be in the foreseeable future. Mariela talks about her personal experience as an immigrant [00:03:00] and mental health professional. We talk about a little bit of the historical context of immigration in the U.S., the current climate within immigrant communities, and we go into the various types of evaluations that might be needed for different immigration cases.
We do talk through appropriate batteries and myths surrounding immigration evaluations. The idea here is that you will have plenty to take away if you choose to go this route. There’s a real opportunity for clinicians to both provide helpful services to the immigrant community and expand their businesses.
Before we get to our full conversation, I think at this point in time, there may be one or two spots left in each of the cohorts of my mastermind groups. There’s a beginner group for folks starting out; an intermediate group, which I call the get your life back group for solo [00:04:00] practitioners who are overwhelmed, and there’s an advanced group for group practice owners with larger practices. They start in early February, and like I said, there may be a spot or two left in each one. So if you’re interested, reach out at thetestingpsychologist.com/consulting. You can schedule a call and we can talk about if it’s a good fit for you.
But at this point in time, we are going to jump to my conversation with Dr. Mariela Shibley.
Mariela, hey, welcome back.
Dr. Mariela: Thank you. Glad to be back.
Dr. Sharp: I’m glad to have you. We talked last time about your adventures in writing a book, and now you’re back to talk about immigration evaluations, which is a timely topic right now.
Dr. Mariela: Indeed.
[00:05:00] Dr. Sharp: Yes. I will start with the question that I always start with which is, why this and why now? Why is this important? Why spend your time, energy, life on this particular topic right now?Dr. Mariela: As a mental health professional, my goal from the get-go was to help people and to improve their quality of life. The way that I got involved in immigration evaluations was partly personal background. I’m an immigrant myself and I was undocumented for a few years. And so I know what it’s like, how hard it is, the whole process.
Basically, I got contacted by immigration attorneys who knew my husband, who was an attorney and they asked me to do these evaluations. And the reason for that is because these evaluations can be so [00:06:00] helpful for a client’s case.
The issue is that the U.S. immigration system is quite biased. It’s biased against the foreign nationals who want to settle, make a life, reside here lawfully. It’s very hard for someone who’s from another country to be able to get a green card to stay here, to visit even some countries, just to get a visa to come here can be really difficult.
The rules in many ways, they’re very arbitrary. So they say you need to serve a penalty outside the country. You need to leave the country for 10 years unless you can prove that a loved one will suffer extreme hardship. Okay, what’s extreme hardship? What defines extreme? There’s no guide.
And [00:07:00] so this is where we come in as evaluators. We try to bring a little more objectivity to this very subjective system with objective data, opinions, facts that we can provide as mental health professionals. Give it that psychological look at the situation, at the client so that it can substantiate their claims, their cases.
Dr. Sharp: That’s fair. I don’t know if you know the answer to this question as you get into this topic. Do you know much about the history of immigration here in the country? Has it always been ambiguous and tough to go through this process or has it ebbed and flowed over time?
Dr. Mariela: That is so interesting that you bring that up. I don’t know if I told you, but I did start writing a second book.
Dr. Sharp: You [00:08:00] did. Yes.
Dr. Mariela: It may not be published for a long time because I put that on hold because I have so many things to do, but chapter one is already written and chapter one is exactly on that. It’s on the history of our immigration system.
So I’m not going to read the chapter, but I will tell you that yes, it dates back many years, but it’s always been inherently biased that they would ban groups of people in particular, Asians were not allowed to enter the country. They were very discriminatory. The categorical, it was from the get-go biased against foreign nationals who didn’t fit the ideal of a U.S. resident in their mind.
Dr. Sharp: I see. Just to be [00:09:00] super clear, we’re talking about lawful and unlawful entry for lack of a better term. Is that right? Am I reading that correctly?
Dr. Mariela: Yeah. So the U.S has had a long and complicated history with immigration. In the early days, immigration was pretty much unregulated. People came from all over looking for freedom, opportunity, but then things changed and as the country grew, there were economic anxieties and social tensions, and they led to the first restrictive laws.
We saw things like the Chinese Exclusion Act, which was based on race and national origin. Basically, it banned Chinese people from coming in for a long time. And then later there were laws that limited people from certain countries, especially from Europe.
They had quotas that were very restrictive. They basically limited how many people could come from each country. And they weren’t fair. They were based on the 1890 [00:10:00] census, which meant that countries with more people of European origin from that time got bigger quotas. And so this meant that people from Southern and Eastern Europe, and basically anyone who wasn’t from Western Europe, had a much harder time coming to the U.S. So it was really about trying to keep the country more white, which, of course, it’s a really unfair and discriminatory thing to do.
So then things shifted again, the 1965 Immigration Act was a really big deal. It got rid of those old quotas and it started focusing more on family reunification. That’s when we saw a lot more people coming in from Asia, Latin America and other places but there’s always been this push and pull.
There were concerns about how all these changes were affecting the country, the economy, even our culture. So we saw laws that would make it harder to come in, made it easier to deport people and things like that. Even today, it’s still a really [00:11:00] complex issue. They’re trying to balance things like security and the needs of our economy.
Ideally, we would want to welcome people who want to come here for a better life but it is a constant work in progress. And with each administration, we see new trends. And now we have an upcoming administration where pretty much everybody’s frightened. Nobody knows what’s really going to happen.
There are some messages out there about what they anticipate will happen, whether that actually ends up happening or not, we don’t know. I think a lot of these goals are somewhat unrealistic and impossible, but nonetheless the fear is very real. The fear in these communities is palpable.
Dr. Sharp: I wanted to ask about that. [00:12:00] I don’t want to turn this into a highly political discussion necessarily, but it’s hard to avoid that. I am curious when you say there’s fear in these communities and obviously you work with these attorneys and a lot of folks involved in the community, can you say more just about the vibe, what people are worried about, and what’s making its way around?
Dr. Mariela: The message is they’re going to deport all people who are here undocumented, which is a lot of people. A lot of these people live in families where one or more family members are actually U.S. citizens or lawful permanent residents. So this isn’t just affecting the foreign national and by any means, it’s affecting entire families, entire communities. This is your coworker, or this is the person the [00:13:00] you hire for help. These are your teachers. It’s everywhere.
I’m seeing a repetition of what we saw in 2016. I work at a free clinic. It’s a UCSD-free clinic. It’s staffed by medical students and volunteers, and pretty much all our patients are undocumented. They’re individuals who don’t have insurance. We provide their services free of charge.
And what happened back in 2016 is people were afraid to leave their homes because there was literally border patrol circling around their neighborhood and just picking people up. And that happened. That was real. And so a lot of people stopped going to work. They wouldn’t come to the [00:14:00] clinic.
We had a support group. There was this thing about, they were advised to not congregate in groups because they’d be easily targeted. It was sad because now they’re anxious, they’re afraid, they’re suffering, and they’re all alone.
So I anticipate something similar to that, unfortunately, at least at the beginning until we find out what’s going to happen. It’s also the uncertainty, you don’t know if you’re going to be allowed to stay or not.
Dr. Sharp: Sure. We all know the stress of having a huge, I think of it as like an unclosed loop in your mind, this huge question, uncertainty.
Dr. Mariela: There are hundreds of thousands of people in the U.S. who are here under temporary protected status, which is, the government [00:15:00] says because of the situation in your country, the political upheaval or natural disaster for whatever reason, you’re allowed to come and stay in the U.S. temporarily until things get better. These are renewable, so they’re for a certain amount of time, and then they get renewed until the circumstances improve in their native countries.
So what happens is that once that protective status is lifted, then all those people have to leave. A lot of them have been living here for quite a few years, perhaps they already have children who were born in the U.S. Some of them were able to adjust their status to permanent residents, which is great, but some of them weren’t.
And so now with this threat that they’re going to terminate temporary protective status for a lot of these countries, you can imagine these families who are just like, I can’t make long [00:16:00] term goals. I don’t know what’s going to happen. We can’t go back to our country, so where are we going to go?
That’s a real source of stress that will keep you up at night, that will permeate into every aspect of your life. It is going to take a toll on people’s mental health and physical health, unfortunately.
Dr. Sharp: Of course. It’s unimaginable. It’s terrible. So just to spell it out, how does that influence or impact our practice or the practice for clinicians who might offer these evaluations?
Dr. Mariela: The evaluations can actually bring a little bit of that objectivity into this playing field because they’re saying, in order to stay, to avoid deportation, you can prove that a loved [00:17:00] one, who’s not just any loved one, it has to say a spouse, a child or a parent, in some situations, children don’t even count, they have to demonstrate that they would suffer exceptional and extremely unusual hardship. That’s for it to avoid deportation. Okay, can you define that for me what that is?
Dr. Sharp: It’s tough.
Dr. Mariela: And they don’t have a clear definition other than something along the lines of beyond what’s typically expected. Okay, what’s typically expected? It’s very up in the air. It’s very up to their discretion. And so the more evidence that the applicant has to show, that USCIS wants to see, the stronger their case is.
They’ve always been pretty critical [00:18:00] of, they look at every piece of information, but I anticipate that with this new administration, they’re going to scrutinize everything that comes through their desks or that’s presented in court. And so the stronger their case is, the likelier they are to have a favorable outcome of their case. In other words, to be allowed to stay in the country.
Dr. Sharp: It stands to reason that there are going to be an increase in referrals for these evaluations or an increase in need.
Dr. Mariela: Yeah. I’ve already started seeing it. Another issue is that we don’t know which programs are going to stay on or not. So right now we have a program that’s called a provisional waiver that is for families where one person’s married to a U.S. citizen or lawful permanent resident, but they’ve been here [00:19:00] unlawfully for a certain number of years.
In order to adjust their status, they need to waive this ground of inadmissibility that’s called unlawful presence, meaning they were here unlawfully for a long time. The only way to waive that is if they can prove that their spouse or a parent, U.S. citizen or lawful permanent resident, would suffer extreme hardship if they had to separate or if they had to relocate.
And you do that while you’re here in the U.S. Whereas a lot of these waivers pardons, people are already separated. So one person’s abroad, the other one’s here. So this came out in 2013, mainly to keep families together because these waivers were taking months, if not years, to get adjudicated. So in order to avoid that temporary family separation, they would apply for them here. So the families still stay together, apply, [00:20:00] wait. Nowadays, it’s taking 4 years to adjudicate that waiver alone.
Dr. Sharp: Oh my gosh.
Dr. Mariela: 4 years of limbo, of you don’t know what’s going to happen. And then if that’s approved, then at that point they can leave the country to go to their consular interview in their country of citizenship, which is, your typical interview for the green card where they go and they’re asked questions, they verify that it’s a legitimate marriage, et cetera.
And then luckily they come back unless they find another ground of inadmissibility. They bluff. They make a mistake in their interview. They say something, so many reasons why they get denied. But at any rate, that program, the provisional waiver, we don’t know if it’s going to stay or not. Nobody knows [00:21:00] really.
So what’s happening now is I’m getting flooded with referrals because attorneys are telling their clients, do it now, get it in because even as they remove the program, they’re not going to cancel, whoever’s already in is staying in that path. So let’s get it in as soon as you can. So we’ve seen a significant increase in referrals for that program, for example.
Dr. Sharp: I see. This might be a good time, since we’ve already mentioned two different circumstances, programs, waivers, et cetera, to do a quick overview of the different types of “immigration” evaluations because we hear this term and even for myself, I’m not an expert. I don’t think I could tell you the types with any accuracy. So that would probably be helpful here before we dive in deep.
Dr. Mariela: Sure. I can start with those that I already mentioned. So the provisional [00:22:00] waiver or the waiver for that matter where the person that you’re evaluating is not actually the foreign national. It’s a U.S. citizen or a lawful permanent resident who’s coming in who needs to demonstrate to USCIS that they would suffer extreme hardship if they were to be separated or if they had to live abroad in order to stay together with her loved one.
And so those people will come to us and we do a very thorough evaluation. What’s tricky about those evaluations is we’re speculating because they’re not separated already. So this isn’t about how you’re doing right now. It’s about based on how you’re doing right now, based on your history, your personality characteristics, the quality of your emotional bonds with your loved ones, we can anticipate how you will [00:23:00] fare in the face of separation from this person who also needs to demonstrate what they mean to you.
Are they your main source of support system? Do you have already a family that’s built around perhaps specific roles? So one’s the breadwinner, the other one’s in charge of the family. So what would happen if one of the two has to leave? So those are the waiver. Some people call them the hardship waiver evaluation.
Similarly, you have the cancellation of removal, which is pretty much the same referral question; what would happen if they had to separate? The difference is here they’re not separating for 10 years, they’re separating forever. If they’re deported, they’re not allowed back. This isn’t a temporary ban as with the other types.
And the bar is set much higher in terms of what they need to prove for their suffering but for us, [00:24:00] it’s the exact same thing. In terms of evaluation, we’re evaluating the U.S. resident, U.S. citizen. There are some cases where we’ll evaluate the foreign national, but those are more specific in terms of what the referral question is. So it would be for a cancellation or removal, but it’s something more specific like rehabilitation or anything like that.
And then you’ve got all the evaluations for cases of immigration relief. For example, asylum, people who are applying for asylum. That’s another thing; we don’t know what’s going to happen with asylum with this new administration, we don’t know what the requirements are going to be, if they’re going to even allow it, we really don’t know.
There’s different types of asylum cases. And so in that case, we’re evaluating the foreign national. With asylum, for example, it could vary. It could be to document the [00:25:00] harm that they suffered as part of the persecution in their country of origin because that’s why they grant asylum, is they need to prove that they suffered persecution or they fear future persecution in part of the government or a group that the government is unable or unwilling to control. And that’s based on a number of race, gender, sexual orientation, et cetera.
So in those cases, you are evaluating the foreign national, but the purpose of the evaluation might be to assess issues around credibility. So not so much about the harm they sustained but perhaps there were some inconsistencies in their testimony because a lot of these are handled in court, there were some things that perhaps the judge or the government attorney didn’t find them credible.
I had one [00:26:00] recently where they said, “Well, every time he talked about it, he laughed.” And so they interpreted that as like oh, he thinks it’s funny. So it takes a mental health professional to be able to explain like, no, this is what happens when somebody’s recalling a trauma that’s really uncomfortable. Sometimes this anxiety gets manifested in nervous laughter that has nothing to do with something being funny or not funny.
And then there’s other things like, for asylum, you need to apply within the first year of arriving to the country. So some people couldn’t do that, and so they need to demonstrate that there was a valid reason. It’s more specific but I’m summarizing it, that there was a valid reason that they didn’t apply on time. So we can explain that from a mental health perspective.
Then you have evaluated victims of crimes [00:27:00] that occurred in the U.S. Those are called U visas victims of domestic violence under the under VAWA, Violence Against Women Act. It says women, but it applies equally to men, women and same sex relationships, marriages. So for those, we’re evaluating the foreign national who needs to substantiate their claim that they were victims of extreme cruelty at the hands of their spouse, their U.S. citizen or lawful permanent resident spouse.
And then lastly, we have T visas. T visas are very popular recently. They changed the regulations last year. [00:28:00] And so they made it slightly easier for people to qualify for a T visa. It’s for victims of human trafficking.
What’s interesting is that U visas, for example, have a cap of 10,000 per year. There is a waitlist of over 10, 15 years now because they always meet that cap really quickly but with T visas, the cap is 5,000 a year. As of now, they’ve never met that cap.
That’s why, if they change the regulations, now all these attorneys are flooding, they’re just saying you qualify, let’s do this right now, let’s get in, before the waiting list develops and grows. So I think that’s another reason why we’ve been getting a lot of requests for those.
And each evaluation is quite different in terms of what you need to focus on [00:29:00] and what you need to be mindful of. So you could include certain details that might seem monoecious to you as an evaluator, but that could jeopardize the client’s case.
Dr. Sharp: Can you think of an example right off hand where we might be doing the best that we can and inadvertently put somebody in jeopardy?
Dr. Mariela: Yeah. For example, you are trying to show how much a person suffered as a result of this intimate partner violence or a crime, et cetera, and the person discloses to you that they’ve had suicidal thoughts, no plan or intent, but passive suicidal ideation. You would think that’s great because that strengthens the report. It shows how much they’re suffering.
It just so happens that if you mention suicide in a report to [00:30:00] USCIS, that’s going to trigger a need for clearance. They’re going to have to prove that they’re not a danger to themselves or others to immigration. So they’re going to get a letter, a request for more evidence, that says the doctor here is saying that you’re having thoughts of suicide. You need to prove to us that you’re not going to kill yourself.
So very innocuous, very standard that you’re like, yeah, the more the better in terms of how we demonstrate how they’re doing. Something like that could really jeopardize a client’s case. At worst, it could also happen that the attorney catches it and says no, you can’t say that.
They say that to the evaluator, the evaluator is like, I’m sorry. I wrote it. It’s what I wrote. It’s what I had to do. And so the attorney is going to say, okay, thank you, then we’re not going to use the report because we’re not going to jeopardize the client’s case. So then this [00:31:00] client came in, spent a bunch of money, time, and was hopeful about this helping and they’re not even going to use it, and the attorney is never going to refer a case to you again.
So this is why it’s so important to know these little intricacies. Immigration law is the second most complex law in the country after tax law because it changes all the time. It’s constantly changing and so people need to keep up to date with the recent trends with regulations so that we don’t make these mistakes unknowingly.
Dr. Sharp: Of course. Out of all the types of evaluations that you mentioned, at this point, which ones do you feel are the most in need or most in demand, most popular, if you want to think of it that way?
Dr. Mariela: It depends [00:32:00] on the referral sources. So if you’re getting referrals from a legal nonprofit, you might get a lot of asylum requests. I think for the most part in general, I don’t even know if they have these statistics, but in my experience working about 17 years doing these evaluations, it’s the waivers that are the most popular because there are so many grounds of inadmissibility.
There are so many reasons why the government will say you’re not allowed to stay or to enter the country and you need to cure those grounds of inadmissibility by proving certain things. And cancellation of removal. So what I anticipate now is cancellation of removal up to the roof, for sure.
[00:33:00] Dr. Sharp: That makes sense. Maybe we dive into those. I’m thinking it would be helpful to provide some details, talk about what those look like, how to do a good evaluation, things like that.Dr. Mariela: For cancellation of removal, they need to prove this hardship to a qualifying relative, and that relative has to be either a son, daughter, spouse or parent, all of whom are U.S. residents or lawful permanent residents, U.S. citizens.
What I get a lot is children. I get a lot of children’s referrals because it’s quite easy to prove that a child will suffer if you remove their parent, believe it or not. I’m being [00:34:00] sarcastic.
Dr. Sharp: It makes sense.
Dr. Mariela: It’s ridiculous that they need that. And so what I anticipate is that we’re going to be seeing a lot of these cases. I forgot your question, oh, about what these cases are like.
Dr. Sharp: Yeah, diving a little deeper into what these evaluations look like, how to do them well, characteristics, details that we might need to know as practitioners if folks are out there like, hey, I’ve done two of these, I want to do more, or, oh, I see this huge need and opportunity, how do I get into that?
Dr. Mariela: Yeah. There’s a lot of different types of mental health assessments that we do. Perhaps we’re used to going for a diagnosis, prognosis and recommendations. And in these immigration cases, sometimes the diagnosis is not as [00:35:00] important, or let me phrase it a different way; it’s very important if there is one, but sometimes there isn’t one.
So you’re evaluating a child who’s happy-go-lucky. Parents are shielding them from what’s going on politically and with their immigration status, and they may not be at least consciously aware of what’s going on. So a child is not particularly anxious just yet, so they’re not going to meet the criteria for a diagnosis but there is so much you can say about this child if you start looking into their attachment style, their history; they had separation anxiety when they were little, all right, that’s a very good predictor for decompensating emotionally more so than they like to say the average person, if [00:36:00] they’ve separated from a parent.
So is being able to focus on the referral question and honing in on that without adding extra information that’s unnecessary and that can cause these potential pitfalls that can jeopardize the case. I don’t know how much deeper you want me to go into.
Dr. Sharp: Maybe we take almost like a big-picture overview of what the evaluation process looks like. So you get the referral from the attorney, presumably, and they say, I don’t know. What do they say?
Dr. Mariela: First of all, it’s unlikely that you’ll get the call from the attorney. Yes. Typically, the client here is a person that’s coming in to see you. [00:37:00] And so the attorney referred them to you, but they’re the ones who are calling to schedule an appointment.
And a lot of them don’t understand. They don’t know what it is that they need. For instance, I have an office manager here and she is very well-trained on all the different types of evaluations because she has to discern over the phone what type of evaluation they need. Is it for a VAWA? Is it for a cancellation of removal? Is it for a U visa? So she needs to know to ask the right questions because clients oftentimes have no idea. They will say, “My attorney told me to call and I need a letter.” It’s not a letter, it’s a report.
And so once you figure out what type of case this is for, if it sounds weird and complicated, we end up calling the attorney and asking clarifying questions like what exactly do you want me to evaluate here? But that’s not the [00:38:00] norm. These attorneys have hundreds and hundreds of cases going at the same time and they usually have a sheet with check boxes; these are all the things that you need to get me, your fingerprints, your documents, your blah, blah, blah, and psychological evaluation. Here’s the number. Here’s the list of numbers to call and schedule it.
So they would come in. I have them do a bunch of different tests and questionnaires, pencil and paper here in the office because I like to go over them with them afterward. So I like them to be done ahead of time before the interview. So they will do those.
Dr. Sharp: Great. I was just clarifying the process. So this is happening before the intake, so to speak, for the interview.
Dr. Mariela: Exactly. They come in and this is the first thing that they will do in addition to their consent forms et cetera. They will do a symptoms [00:39:00] checklist. A lot of people use back inventories or the SCL90, whatever it is that you want to use. We all have our preferences.
And so it’s not overwhelming by any means. Of course, we have them in whatever languages they come in and those are the ones that we use meaning translate tests that are not originally in that language.
I say that because we’re evaluating even in the cases where it’s a lawful permanent resident or a naturalized citizen, oftentimes they are immigrants themselves who just happen to adjust their status and they might prefer their native language. So we do those.
And then they would come in for the interview which is around 2 hours long depending on the case. It’s [00:40:00] very focused on what’s going to be on the report because otherwise you would be here for hours on end. For instance, I’m not asking a lot of questions about their educational history, how they did it and what was their favorite subject. You don’t even go near there. It’s so irrelevant.
That’s the interview. You want to have the referral question be the guide; how am I going to answer this referral question? What do I need? I think some people look at it as like everything’s coming from the client. They have all the information. I’m just going to organize it.
The reason they come to us, mental health professionals, is because we can do a lot more than just regurgitate what the client is saying or even translate it into [00:41:00] some jargon. We can look beyond; we can connect the dots.
You can say this person has this background, so that predisposed them to suffering later on. In particular, they have a propensity to compensate when they’re feeling abandoned or distant from a loved one. And that is super relevant to the referral question.
Or this person, they’re telling you stories about their childhood. What they say in the interview, they give me a lot of information, but what I end up writing in the report is more concrete, it’s more specific. They might give me these instances of how when they were little, a kid stole something, stole their lunch, and they complained, and then they were the ones to get in trouble, and so from then on, they never spoke up for themselves again, because they knew that they would be the ones to get in [00:42:00] trouble.
And now that person here is a victim of trafficking. And so you’re trying to explain how this impacted them. You can go back and connect the dots and say, this is a person who early on in life learned that speaking up for themselves was not only not going to do them any good, it could actually get them in trouble.
So if your referral question is why didn’t they report this to the authorities? Well, here’s why. And that’s not something that if I were to ask the client, why didn’t you report it? And they’re going to say, “Oh, because when I was little, this happened.” They don’t make that connection.
So it’s for us to realize these questions that might seem not that relevant, perhaps to the client, like why are you asking me about my childhood if what we’re here to talk about is what this person did to me two years ago? Then that’s why they come to us, [00:43:00] the mental health professionals, who know how to understand this.
Dr. Sharp: Sure. This is a different flavor than I was anticipating with these evaluations. It is super interesting.
The question that’s coming up for me, I’ll try to ask it in the right way is, just hearing you describe it, it sounds hard because you’re really looking pretty deeply and making connections that may or may not be obvious and certainly in this case of the specific evaluations, you’re projecting forward and guessing what someone might feel like. That just feels hard. I’m curious how it feels for you or if I’m off on?
Let’s take a break to hear from a featured partner.
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Dr. Mariela: Sure. To me, at this point, it feels very second nature. I might add that I think I have the extra help of the fact that I’m a psychoanalyst. And so for me, [00:46:00] connecting the dots in the past and the unconscious is something that I’m very keen on.
I think what’s really hard, to be honest, is staying objective and neutral, which is so important because here I am saying the U.S. immigration system is biased. Okay, I can’t be biased. I’m the one who brings the objectivity to the playing field.
Dr. Sharp: It seems very hard.
Dr. Mariela: Yes, it is hard, but it’s so meaningful, so important for these cases. I have research to back me up. We went to school for this, the officer reading the report didn’t and so we’re educating them in a way, but it’s very tactfully and in a way that we don’t come across as [00:47:00] advocates, because if you come across as an advocate, then the report loses its weight.
Dr. Sharp: How do you do that? That seems very challenging.
Dr. Mariela: It is challenging. It’s something that I’m constantly working on. What I do is I’m constantly in communication with immigration attorneys. I go to AILA conferences, which is the American Immigration Lawyers Association, to learn about new trends and what’s happening.
Just to give you one example, we had in-house training from an immigration attorney on T visas because they’re so new and we’re trying to do a good job. She explained to us why it’s so important to not put so much background information on these reports, to not describe the trafficking in detail, which might be counterintuitive.
Dr. Sharp: That seems [00:48:00] counterintuitive.
Dr. Mariela: Exactly, but she had a very valid explanation. I’m explaining it. The client is writing it in their declaration. We have other evidence. We don’t need you to repeat it, especially if that’s going to open the door to inconsistencies because they will latch on to any inconsistency to basically say were you lying then or are you lying now? That’s the attitude.
The important thing, the reason we come to you is not for you to tell what happened, but to talk about how it impacted the person that only you as a mental health professional can do. You can have that perspective.
Dr. Sharp: I’m just noticing the admiration and respect for clinicians who do this, because it seems like that takes so much self-awareness and monitoring because as human nature, what I’m gathering from [00:49:00] the way you describe this is like the USCIS, their vibe, so to speak, is to be pretty detail-oriented, they scrutinize and they’re not coming at this from a place of trying to help people really, it’s how can we screen out these individuals and get them out of the country?
And so I think it’s human nature to want to push against that and do a counterbalancing approach. You just said if we come across as too much of an advocate, that’s going to set off alarm bells as well.
Dr. Mariela: Exactly. They’ll say that you’re biased.
Dr. Sharp: Yes.
Dr. Mariela: How do we know you’re not exaggerating? How do we know that you took everything into consideration? A lot of these cases are not adjudicated in court. [00:50:00] They’re decided administratively. So you never get to talk to the adjudicator. The client never gets to talk to the adjudicator. It’s all paperwork. So you really have to get your point across.
One thing that I always say is you need to be two steps ahead. You need to think like the reader and think what is a reader going to argue? Yes, but, and address it. Jump right into it and address it before they have that argument that might at best elicit a request for more evidence, which delays the whole process and costs more money, and at worst they can just decide against the case.
Dr. Sharp: These evaluations seem like they are also rife for our own confirmation bias, mainly. The individuals are coming in, [00:51:00] you want to be an advocate, you want to be helpful. I’m curious how you work against that as well. It’s a similar question to how you stay objective, but I wonder, does anyone come in and you actually say, I don’t see any hardship here? I don’t see any evidence for that.
Dr. Mariela: Thankfully, they’re properly screened. The attorneys that we work with, I created this screener that they can give to their clients to see if they would benefit from a psychological evaluation. And so some of them give it to them.
They know that it costs money and it takes time. And if attorneys are sending them, they’re usually pretty good attorneys who know that a psychological evaluation would help. So it’s not as common as you would think, but it is.
As a matter of fact, we had one [00:52:00] yesterday. One of my clinicians called me and she’s like, “I don’t know what to do. This guy is a total pro-Trumper who’s saying they need to build a wall and keep everybody outside except for his wife.” He went on a rant of 45 minutes and it was like, oh, wow, okay we can talk about it.
I don’t have any more details about it, but I don’t know how good of a case this might be. And then in that case, we might end up either not writing the report and telling them that it’s not going to be in their favor or we might shift gears in that instead of addressing that referral question, we might turn it into a psychodiagnostic evaluation and let the attorney use it however they want to use it.
So if we’re diagnosing this person suffers from anxiety and they need treatment, this is what’s going to happen if they don’t get treatment or whatever it is that they want us to do and then let the attorney work their skills into [00:53:00] fitting it in and making it helpful for their case. That’s not our job. The attorneys are the ones who know what to do.
But for the most part, you’d be surprised because there’s so much secondary gain, but there’s very little malingering in this population. There’s some exaggeration, but we need to understand that the exaggeration is from a place of desperation because this is so unfair; how do I prove to you that this is going to hurt me, to ruin my life in some cases?
So we need to look beyond that and not say he exaggerated, he was malingering. There’s not even need to mention that because you understand what that means and you can look beyond. That’s why all the self-report measures and stuff, they add that “objective” evidence. There’s nothing objective about a self-report measure, [00:54:00] but it looks good on paper.
Ultimately, it’s your clinical judgment, in having years of working with human beings and understanding how their minds work, how their defenses pop up, how they react in the face of fear, in the face of uncertainty, and the aftermath of trauma, et cetera.
Dr. Sharp: We haven’t talked much about the battery. You bring up self-report measures. We talked about the interview, the consult, and then the interview, what does the actual testing look like or the assessment process maybe?
Dr. Mariela: Everybody’s different. I think some people don’t do any testing at all. It depends for the type of case. In general, I do the SCID, [00:55:00] the semi-structured clinical interview for DSM-5 disorders.
I have a system where I give them a questionnaire of symptoms that I developed, that I came up with, and then based on their answers to that, then during the interview, I ask them more follow-up questions to get to the root of it. So you’re saying, I’m feeling sad, tell me more about that sadness. Is it more days than not? The flow chart of the SCID interview.
I also give them an attachment measure to assess their attachment style in cases where it’s about the relationship. I like the projective testing because of my background, so I like sentence completion. You’d be surprised, I get so much from those responses. Just reading through, I notice some themes. I see what’s important to them, what their values are.
[00:56:00] Of course, you’re not going to base any conclusions on any one test. And no test is going to taint the rest of the information that you have. So you take it all in the aggregate, and you look at it qualitatively as well. Are they second-guessing themselves a lot? Yeah, it says nothing about what they’re writing on the actual questionnaire, but it tells me something about them as a person, and their personality.In the “bigger” tests, I like the PAI, the Personality Assessment Instrument, because it talks more about their strengths or weaknesses, and their ways of relating with others. I find it to be quite accurate. I’ve done others, for instance, the MCMI, because it was normed in a clinical population, it tends to over pathologize or to [00:57:00] accuse people of minimizing denying when they’re totally okay and the PAI doesn’t do that.
So that’s one that I really like. If I’m assessing trauma, the TSI, the Trauma Symptom Inventory-2. I really like that one. Both of those have validity scales as well that make them a lot more objective. I like that one because it goes beyond just symptoms. It talks about how they cope, how they see themselves, et cetera. So those are the two biggest ones, the longest ones that we give, I would say.
Dr. Sharp: That’s fantastic.
Dr. Mariela: And then I didn’t say, it doesn’t end with the interview, then we write the report for that. Then the clients, when they leave and then we write the report. I always follow the same [00:58:00] format. That’s just the stylization. There isn’t one way to write it.
And then we can either send it to the client or they can sign a release and we send it directly to the attorney, which 99% of people prefer that just because they want to keep it all together in one place. I don’t know, they just prefer that.
Dr. Sharp: Sure. That makes sense to me. So this is all happening essentially in one or two days and then you write the report.
Dr. Mariela: Yeah. So people vary. Some people like to have separate interviews. Listen, I’m an analyst. I see people four times a week. So for me, the more the merrier. But for this population and for these cases, I’m also a forensic psychologist, so I go to jails and evaluate people in just one sitting and that’s enough. It’s enough for the court. That’s enough to answer the referral question.
[00:59:00] So this is the same thing with the exception of some situations where they’re re-traumatized. It’s really hard to get through, or perhaps something happens that we need to interrupt and continue on a different day. I typically just do it in just one sitting.The reason that I do this is not for me, but more for them. Because these are people who are all typically working, or if they’re not working, they’re caring for a child, so coming to see me takes a big effort. They have to take time off work, they have to have somebody watch their children, they have to make their way down here, perhaps they don’t have transportation. And so I just want to make it easier on them.
If it were up to me, yes, I’d stretch it out as long as I could, but I’m confident that I can get the information that I need to [01:00:00] answer the referral question in just one sitting. Why? Because I know what I’m doing. I know what I’m asking. I know what I’m looking for.
Dr. Sharp: That makes sense. Well said. So maybe we start to close. This has been incredibly helpful. I wonder if we start to close with some myths around these evaluations because clinicians may be thinking about getting into this work. I think there are some myths that are worth addressing. Can you speak to this?
Dr. Mariela: Some of the things that I hear a lot is they think that they have to be bilingual to do this type of work. First of all, you’re working with immigrants from all over the world, so you should be, what’s the word for people who speak more than five languages? I forget what it is, but anyway that’s impossible. Absolutely not.
First of all, a lot of the evaluations are conducted in English because the people speak [01:01:00] English, especially the cancellation of removal or the waivers because it’s the U.S. citizen or U.S. resident that’s coming in to see you. So those are carried out in English.
And then there’s also the use of interpreters. I have a lot to say about interpreters because I used to be an interpreter many years ago. And so I like to meet with them ahead of time, train them because this is very different than what they’re used to.
Interpreters typically go to doctor’s offices, go to court. They’re are listening to some traumatic story that might elicit some feelings in them like their own trauma history because if they’re speaking the same language, it’s also likely that they come from the same region, especially if it’s a dialect. So very important to know how to work with that interpreter, but they are extremely helpful. You can do very good [01:02:00] interview with the aid of an interpreter.
So yes, you don’t have to be bilingual. Of course, it helps if you speak another language. I speak Spanish and Portuguese and it’s great because a lot of the referrals that I get are in Spanish, but I also get referrals, people who speak Arabic, Vietnamese, Chinese or all kinds of different languages.
Dr. Sharp: Great. I wonder if that’s another myth is that all of these evaluations are with Spanish-speaking individuals.
Dr. Mariela: That’s definitely a myth but it depends on where you live. I’m in San Diego. We’re right next door to Mexico. So we do get a lot of Spanish speakers, absolutely. But we also have a very large Middle Eastern community here. So we have one interpreter who speaks Arabic and we work with her consistently. She’s almost part of the team because we’re working with those people so much.
So depending on where you [01:03:00] live, it could be Punjabi, it could be Chinese, Portuguese, wherever you are, that might be the referrals that you get more of.
Dr. Sharp: I see. So being bilingual, that’s a myth. What else? Are any other myths that you are seeing coming up? What about testifying? Are you going to court a lot?
Dr. Mariela: Oh, yes. Okay, good. So the interesting thing about these cases is a lot of them are not adjudicated in court. So like waivers, a U visa, a T visa, they’re not going to court. So there’s absolutely no risk of testifying.
And even those that do go to court like cancellation of removal and asylum, it’s not like in the criminal system where you get a subpoena and you have to go or you get deposed. It’s not adversarial like that at all.
[01:04:00] Usually, what ends up happening, which I think is going to happen a lot more now, the attorney wants to cover all their bases and say you wrote a great report but just in case they have a question about it, I want to have you there as a witness. If they have any issues, I want to be able to say, oh, let’s call her in and she can testify.Or they may have gone in for a hearing and there were some issues with the report, with your opinion. And so the government attorney or the immigration judge might say we need some clarification on some things. And so they’ll invite you. You don’t get a subpoena.
Again, I want to help my client’s cases. So yeah, you [01:05:00] would just go. It’s somewhat adversarial in the part where you know what deer that they do for any type of testimony where they try to demonstrate what qualifies you as an expert and then the opposing side is going to try to poke holes on that. So that’s not super pleasant but at the end of the day, you’re being very objective. You have the information that you got, you have your knowledge, and that’s what you’re speaking to. You’re not speaking for the client you’re, you do the best you can.
And they’re bringing you in as the expert, as the one who knows about something that they don’t know about. Even with that, I have to say, I’ve testified about five times in my entire career. I’ve even signed off on more than [01:06:00] 2000 evaluations.
So it’s not very common but I don’t know what’s going to happen this year with this administration. I don’t know if they’re going to want us there just in case, or if judges are going to be like, no, I want to talk to this doctor. I don’t want to just read the report. I really have no idea. So maybe we can meet back in a year and I can give you an update.
Dr. Sharp: Yeah. I’d welcome that. Things are changing in the moment. Yes.
Dr. Mariela: Yeah. And then along those same lines, if you’re a person who’s like, absolutely not, the thought of going into a courthouse frightens me, just don’t take cases that are adjudicated in court.
Dr. Sharp: Sounds easy enough.
Dr. Mariela: And then you’re good to go. Tell attorneys, “Hey, FYI, I’m doing this evaluation, I’ll write a great report but don’t ask me to testify, I can’t testify.” And they might say, “No, this case is pretty straightforward, we’re good.” Or they might say, “Okay, then maybe I’m going to go with [01:07:00] somebody else, just in case.” Either way, you don’t have to testify.
Dr. Sharp: Great. Well said. Gosh, we have covered a lot of the logistical and philosophical or emotional components of this whole process. I think it’s incredibly timely, like you said, and for better, for worse, nothing else, clinicians can look at this as, hey, there’s a real opportunity here to do some good.
Dr. Mariela: The cool thing about this work is that I train people and many of the people I train are perhaps clinical social workers, professional counselors, or MFTs and they never thought that they could get involved in the forensic field because they don’t have that training. But if you get the [01:08:00] adequate training for doing these evaluations, you have the training, the education, the knowledge, that’s all you need to qualify as an expert, it doesn’t matter what your degree is.
Dr. Sharp: That’s important.
Dr. Mariela: That’s what I really like about this is that it doesn’t close the door to other types of mental health professionals who want to do this work that’s very rewarding emotionally which again, don’t let that come across in the report, but it is rewarding. You’re doing a very good job.
And quite frankly, it can’t be lucrative. It’s a great way to diversify your practice to instead of being dependent on or seeing number of patients per week, you might say, instead of so many patients, I might supplement with an evaluation. You don’t have to dedicate yourself to just do this. By all means, this is not all I [01:09:00] do.
Dr. Sharp: That’s a great point. It has to be financially sustainable.
Dr. Mariela: Right.
Dr. Sharp: Nice. This is awesome. If people want to reach out, want to learn more, what is the best way to do that?
Dr. Mariela: They can go on my website, which is psychevalcoach.com, and there I have a free guide. If they want more information on specific cases, what they entail, what this work looks like, I have a free guide, Introductory Guide to Immigration Evaluations, that they can download and learn a bit more about it.
Dr. Sharp: Love it. We love free stuff. Thank you. No, I really appreciate it. It was great to connect with you again and talk through something that is super timely and important for our country right now. Great to see you again.
Dr. Mariela: I agree. You too, Jeremy. Thank you.
[01:10:00] Dr. Sharp: All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes so make sure to check those out.If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes, Spotify, or wherever you listen to your podcasts.
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