In the Shadow of the Israeli-Palestinian Conflict: Reflections on Cultural Safety and Clinical Care for Children and Adolescents in Quebec (Canada) in Polarized Times.

The ongoing Israel-Palestine conflict has significant consequences for children, youth and families from diverse communities in North America. In a time of widening social polarization, many children and youth are implicated in reiterations of the conflict at home, at school or in their neighborhoods. This divisive context has numerous indirect and direct clinical consequences requiring clinicians' awareness, attunement, and skillful response. Building on clinical experiences in Quebec (Canada), this paper questions the cultural safety of clinical interventions at three levels. First, the conflict can alter the therapeutic alliance in unspoken ways, requiring ongoing attention to cultural and contextual securitization. Second, because of its potentially traumatic impact, the conflict can influence symptom presentation in subtle or overt ways. Third, the internalization of the conflict can prompt forms of challenging acting-out, potentially eliciting stigmatizing clinical or social responses. Overall, preserving cultural safety in this context requires favouring a systemic assessment of the patient and their lived experiences, considering simultaneously the family, school and community context. Minimizing silence and avoidance by addressing the possible distress and divisions-or indeed outright divergences-within clinical and school teams may foster a respectful and safe enough environment, in spite of the differences in meaning within and across heterogeneous communities.