The Division of Health Research, Lancaster University, Lancaster, UK.
Lancashire Emotional Health in Schools Service, Lancaster University, Lancaster, UK.
Psychol Psychother. 2023 Dec;96(4):811-832. doi: 10.1111/papt.12470. Epub 2023 May 11.
The current review aimed to synthesise qualitative literature exploring adult refugees' and asylum seekers' experiences of individual psychological therapy.
A comprehensive systematic search of the following databases led to the identification of eight studies for inclusion in this review: PsycINFO, PsycARTICLES, MEDLINE, EMBASE, CINAHL and Academic Search Ultimate. All selected studies used qualitative methodology to explore refugees' and asylum seekers' experiences of individual psychological therapy. Studies were appraised using an adapted version of the Critical Appraisal Skills Programme (CASP) Tool. The data from these selected studies were then synthesised using a meta-ethnographic approach.
The synthesis of selected studies resulted in the development of five themes; (i) the importance of recognition and validation within therapy, (ii) building a human connection within the therapeutic relationship and the importance of cultural competency, (iii) revisiting trauma, managing difficult emotions from therapy and regaining hope, (iv) the value of practical interventions, (v) 'one should not wake up the djinns (demons)'-cultural stigma and accessing therapy. These themes illustrated the complexities of working therapeutically with asylum seekers and refugees and the vital role of building trust and safety within the therapeutic relationship prior to engagement in therapeutic work. The results also highlighted varied responses to engaging in trauma work ranging from participants finding the experience transformative to others finding it unhelpful, some participants preferred more practical interventions. Participants' cultural backgrounds and pre-conceptions around therapy impacted on engagement and the therapist's cultural competency was a significant factor in therapeutic engagement.
Working therapeutically with asylum seekers and refugees involves a number of factors for consideration. Forced migrants' socio-political context was seen as central to their experiences of distress and recognition of these factors was imperative for positive therapeutic engagement. This review highlights a number of clinical implications to guide practitioners working therapeutically with this community.
本综述旨在综合定性文献，探讨成年难民和寻求庇护者接受个体心理治疗的体验。
通过全面系统地搜索以下数据库，确定了纳入本综述的八项研究：PsycINFO、PsycARTICLES、MEDLINE、EMBASE、CINAHL 和 Academic Search Ultimate。所有选定的研究均采用定性方法探讨难民和寻求庇护者接受个体心理治疗的体验。使用经过改编的批判性评估技巧计划（CASP）工具对研究进行评估。然后，使用元民族学方法对这些选定研究的数据进行综合。
对选定研究的综合分析得出了五个主题：（i）治疗中识别和验证的重要性，（ii）在治疗关系中建立人际联系和文化能力的重要性，（iii）重新审视创伤、管理治疗中的困难情绪并重新获得希望，（iv）实际干预的价值，（v）“不应该唤醒恶魔”-文化耻辱和寻求治疗。这些主题说明了与寻求庇护者和难民进行治疗工作的复杂性，以及在开始治疗工作之前在治疗关系中建立信任和安全的重要性。结果还突出了参与创伤工作的不同反应，从参与者认为这种体验具有变革性到其他人认为它没有帮助，一些参与者更喜欢更实际的干预。参与者的文化背景和对治疗的先入之见会影响参与度，治疗师的文化能力是治疗参与的重要因素。
与寻求庇护者和难民进行治疗性工作涉及一些需要考虑的因素。被迫移民的社会政治背景被视为他们痛苦经历的核心，因此必须认识到这些因素，才能实现积极的治疗性接触。本综述强调了一些临床意义，以指导与这一群体合作的从业者。
