Psychotherapy can be used to effectively treat immigrants and refugees who are culturally, racially and ethnically diverse. A number of possible treatment interventions are available for these groups. Selection of any intervention should be based on the client's needs and what will best support their treatment plan.
Currently, the best established evidence suggests using brief supportive therapy, narrative exposure therapy (NET) and eye movement desensitization and reprocessing (EMDR) to support the mental health of immigrant and refugee populations.
One of the therapies that has been well documented is actually EMDR which is Eye Movement Desensitization and Reprocessing. This is a therapy that tries to integrate the emotions and memories that are connected to the traumatic event using eye movement in order to reintegrate the traumatic experience, reduce the difficult emotions and the difficult affect that this traumatic experience engenders. There's lots of documentation around it but it's generally a therapy that is acceptable to refugee populations because it seems to speak more to some of the culturally held ways of understanding healing because it's the kind of therapy that integrates both the organic, because it uses eye movements, it uses the body in a way, or one of the most important senses, as well as integrates emotional cognitive and souvenirs of the traumatic event.
Narrative exposure therapy or NET is about re-telling our story. Each one of us has an individual story about our past, our present, what our future will be. We have a story about our community. When we have experienced significant, repetitive, historical trauma, our narrative, our stories, both personal and community, may become over-focused on the traumatic aspects as if all aspects of our lives are actually reduced to the trauma that we have experienced and everything is interpreted from the lens of this trauma which means that we will continue to suffer and experience negative consequences from the trauma that we have lived. So what NET tries to do is include that trauma, recognize the harm, keep it as part of the narrative, but open up that narrative and include all the other positive, resilient aspects of our past, present and future individually and also by the community. The idea is to reconstruct a narrative that is more constructive, more positive, more rich, more nuanced than just limiting our entire life, our entire being to the traumatic incidents that we have experienced. By doing that, by re-telling stories that include the hurt and the trauma, but also include a variety of other experiences and factors of resiliency, we think the individuals as well as the communities will gradually heal and the traumatic experiences will be there, and always be part of their story, but their impact will not be as negative and create as much suffering. These traumatic experiences will become part of the narrative and not lived as if they are still being experienced today in the present.
It's very important I think to incorporate religious and spiritual beliefs into conventional assessments as well as therapy. One of the things we know is that if you don't specifically ask about these things they may not come up. So it is an important part of a psychiatric assessment to ask those questions and discuss them with patients in a way that makes them feel comfortable and also can provide a lot of helpful information about their social networks, about their beliefs, about the things that are very important to them and sometimes deeply personal. I was reading an article by Rob Whitley called: "Religious competence as cultural competence." I fully subscribe to that idea and I think it's sometimes an under emphasized part of the psychiatric assessment to be asking about people's religious and spiritual beliefs. There's some debate and discussion about whether that's good information to have at the outset of an assessment when you're collecting information about the identifying data like what country people came from, what ethnic or cultural group they may be from, what language... But where I find that it happens more naturally and more effortlessly is further down in the mental status examination or when you're doing your history of present concerns asking about suicidal ideation, hopelessness, or reasons for living, that can be a good time to say: "Do you belong to any religion or faith?" or: "Do you have any spiritual beliefs that keep you going during hard times?" and then see what people answer. And when they do answer: "Yes, you know, I could never commit suicide because my faith would not allow it." That can be a very good protective piece of information to know moving forward and then you can work with people to try to enhance and connect even further to their religious supports.
Occurs through the use of mobile, video and Internet technology to provide mental health assessment and treatment at a distance to deliver services to remote and under-served communities.
Examines patterns in relationships, capacity for intimacy, and current relationships.
Working with a client to help them heal using traditional healing approaches that are culturally relevant to the client.
A method that involves helping clients tell their story of traumatic events until they no longer cause anxiety.
Program that matches refugees with volunteers who introduce and connect newcomers to activities in the community.
An interdisciplinary treatment where a therapist supports participants to talk, explore and express issues through creativity.
Important individual and community resources that can significantly affect one’s physical, mental, spiritual and psychosocial health.
Providing participants with accurate and reliable information, while teaching them coping and problem solving skills and helping them develop a support network