Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T04:42:29.163Z Has data issue: false hasContentIssue false
  • English
  • Français

Asylum-Seekers' Experiences of Trauma-Focused Cognitive Behaviour Therapy for Post-Traumatic Stress Disorder: A Qualitative Study

Published online by Cambridge University Press:  16 July 2012

Felicity Vincent ,
Helen Jenkins ,
Michael Larkin  and
Sue Clohessy
Felicity Vincent
Affiliation:
Child and Adolescent Mental Health Service, Birmingham, UK
Helen Jenkins*
Affiliation:
University of Oxford, UK
Michael Larkin
Affiliation:
University of Birmingham, UK
Sue Clohessy
Affiliation:
University of Oxford, UK
*
Reprint requests to Helen Jenkins, Oxford Doctoral Course in Clinical Psychology, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Trauma-focused CBT (TFCBT) is an evidence-based treatment for post-traumatic stress disorder (PTSD), but little is known about whether it is an acceptable and effective treatment for asylum-seekers presenting with PTSD. Aims: This study considers the acceptability of TFCBT for asylum-seekers with PTSD by exploring their experiences of this treatment. Method: Seven asylum-seekers who had received CBT involving a TFCBT component were interviewed using a semi-structured schedule. The transcribed interviews were analysed using interpretative phenomenological analysis (IPA). Interpretative themes were developed iteratively to closely reflect participants’ common and distinct experiences. Results: Six super-ordinate interlinking themes are discussed: Staying where you are versus engaging in therapy; Experiences encouraging engagement in therapy; Experiences impeding engagement in therapy; Importance of the therapeutic relationship; “Losing oneself” and “Regaining life”. Conclusions: Participants described their ambivalence about engaging in TFCBT. Such treatment was experienced as very challenging, but most participants also reported finding it helpful. Various experiences that appeared to encourage or impede engagement are outlined. These preliminary findings suggest that fear of repatriation can impede engagement in TFCBT, but that some asylum-seekers with PTSD still report finding TFCBT beneficial. The clinical implications are discussed, including the special importance of the therapeutic relationship.

Keywords

Asylum seekercognitive behaviour therapyPTSD
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 5 , October 2013 , pp. 579 - 593
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Basoglu, M., Ekblad, S., Baarnhielm, S. and Livanou, M. (2004). Cognitive-behavioral treatment of tortured asylum-seekers: a case study. Anxiety Disorders, 18, 357–369.CrossRefGoogle ScholarPubMed
Beck, A. T., Freeman, A., Pretzer, J., Davis, D. D., Fleming, B., Ottaviani, R., et al. (1990). Cognitive Therapy of Personality Disorders. New York: Guilford Press.Google Scholar
Bettelheim, B. (1980). Surviving and Other Essays. New York: Vintage Books.Google Scholar
Brewin, C., Dalgleish, T. and Joseph, S. (1996). A dual representation theory of post-traumatic stress disorder. Psychological Review, 103, 670–686.CrossRefGoogle Scholar
Burnett, A. and Fassil, Y. (2002). Meeting the Health Needs of Refugees and Asylum-Seekers in the UK: an information and resource pack for health workers. London: Department of Health.Google Scholar
Cienfuegos, A. J. and Monelli, C. (1983). The testimony of political repression as a therapeutic instrument. American Journal of Orthopsychiatry, 53, 41–53.CrossRefGoogle ScholarPubMed
Drozdek, B., Noor, A. K. and Lutt, N. (2000). Differences in general medical services between treated and non-treated traumatised asylum-seekers with chronic PTSD. In Proceedings of the 3rd World Conference for the International Society for Traumatic Stress Studies (March 16–19). Melbourne, Australia: Abstract 8.Google Scholar
Ehlers, A. and Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.CrossRefGoogle ScholarPubMed
Fischman, Y. and Ross, J. (1990). Group treatment of exiled survivors of torture. American Journal of Orthopsychiatry, 60, 135–142.Google Scholar
Grey, N. and Young, K. (2008). Cognitive behaviour therapy with refugees and asylum-seekers experiencing traumatic stress symptoms. Behavioural and Cognitive Psychotherapy, 36, 3–19.Google Scholar
Herman, J. L. (1992). Trauma and Recovery: from domestic abuse to political terror. London: Pandora Books.Google Scholar
Home Office (2010). Control of Immigration: quarterly statistical summary, United Kingdom, April-June. Available at http://www.homeoffice.gov.uk/rds/pdfs10/immiq310.pdf (accessed 17 October 2011).Google Scholar
Mezey, G. and Robbins, I. (2001). Usefulness and validity of posttraumatic stress disorder as a psychiatric category. British Medical Journal, 323, 561–563.Google Scholar
Miller, W. R. and Rollnick, S. (1991). Motivational Interviewing: preparing people to change addictive behaviour. New York: The Guilford Press.Google Scholar
Neuner, F., Schauer, M., Klaschik, C., Karunakara, U. and Elbert, T. (2004). A comparison of narrative exposure treatment, supportive counselling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72, 579–587.Google Scholar
Neuner, F., Kurreck, S., Ruf, M., Odenwald, M., Elbert, T. and Schauer, M. (2009). Can asylum-seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study. Cognitive Behaviour Therapy. Published online 8 October 2009. Available at http://dx.doi.org/10.1080/16506070903121042CrossRefGoogle Scholar
NICE (2005). Post-Traumatic Stress Disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. Clinical Guideline 26. London: Gaskell and the British Psychological Society.Google Scholar
Rees, M., Blackburn, P., Lab, D. and Herlihy, J. (2007). Working with asylum-seekers in a clinical setting. The Psychologist, 20, 162–163.Google Scholar
Refugee Council (2010). Refugee Council Glossary. Available at: http://www.refugeecouncil.org.uk/glossary (accessed on 17 November 2010).Google Scholar
Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centred framework. In Koch, S. (Ed.) Psychology: the study of a science. Vol 3. Formulations of the person and the social context (pp. 184–256). New York: McGraw-Hill.Google Scholar
Shearing, V., Lee, D. and Clohessy, S. (2011). How do clients experience reliving as part of trauma-focused cognitive behaviour therapy for posttraumatic stress disorder? Psychology and Psychotherapy: Theory, Research and Practice. Published online 18 May 2011. Available at http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8341.2010.02012.x/full (accessed on 18 October 2011).Google Scholar
Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V. and Steel, Z. (1997). Anxiety, depression and PTSD in asylum-seekers: associations with pre-migration trauma and post-migration stressors. British Journal of Psychiatry, 170, 351–357.Google Scholar
Smith, J. and Osborn, M. (2003). Interpretative phenomenological analysis. In Smith, J. (Ed.), Qualitative Psychology: a practical guide to research methods (pp. 51–79). London: Sage.Google Scholar
Smith, J. A., Osborn, M. and Jarman, M. (1999). Doing interpretative analysis. In Murray, M. and Chamberlain, K. (Eds.), Quantitative Health Psychology: theory and methods. London: Sage.Google Scholar
Steel, Z., Silove, D., Brooks, R., Momartin, S., Alzuhairi, B. and Susljik, I. (2006). Impact of immigration detention and temporary protection on the mental health of refugees. British Journal of Psychiatry, 188, 58–64.Google ScholarPubMed
Summerfield, D. (2001). The intervention of post-traumatic stress disorder and the social usefulness of a psychiatric category. British Medical Journal, 322, 95–98.Google Scholar
Tribe, R. (2002). Mental health of refugees and asylum-seekers. Advances in Psychiatric Treatment, 8, 240–247.CrossRefGoogle Scholar
Van der Veer, G. (1992). Counselling and Therapy with Refugees: psychological problems of victims of war, torture and repression. New York: John Wiley.Google Scholar
Webster, A. (2002). Clinical Guidelines for Working with Refugees. London: South London and the Maudsley NHS Trust.Google Scholar
Webster, A. and Robertson, M. (2007). Can community psychology meet the needs of refugees. The Psychologist, 20, 3, 156–158.Google Scholar
Weine, S. M., Kulenovic, A. D., Pavkovic, I. and Gibbons, R. (1998). Testimony psychotherapy in Bosnian refugees: a pilot study. American Journal of Psychiatry, 155, 1720–1726.Google Scholar
Submit a response

Comments

No Comments have been published for this article.