The therapeutic or working alliance is a common element of all types of psychological treatments, and is generally considered as a 'non-specific' factor. There are grounds to modify this view in working with traumatized and tortured patients from different cultural backgrounds. In cases where patients have experienced humiliation and evil, and now live in exile, the establishment of a relation of trust in fellow human beings is the first aim of the treatment. The article argues that the professional's compassion constitutes a primary factor in the therapeutic process in such cases. The risks of overinvolvement in the treatment of heavily traumatized patients are well described in the literature, and have also appeared in this study. In psychotherapy research, strong personal commitment is seldom mentioned by therapists for fear of its being considered unprofessional or unethical. However, a strong commitment can be of value, not only for the patients, but also for the therapists and interpreters themselves. The results of this study suggest that deep compassion on the part of the professionals is widespread in the treatment of traumatized patients, and that it is considered as a healing factor by most patients, interpreters, and therapists.

Objective: This study investigated and compared the prevalence of psychological difficulties among Danish, immigrant, and refugee children. Methods: We enrolled 332 children between the ages of 8 and 18 years (148 Danish children, 81 immigrant children, and 67 children with refugee backgrounds), all from low-income areas of residence. The Health Behaviour in School-aged Children Symptoms Checklist, the Strengths and Difficulties Questionnaire, and the Revised Children's Anxiety and Depression Scale were applied. Results: We found significant differences among the groups, with Danish children reporting lower levels of conduct problems than both immigrant children (P < .01) and refugee children (P < .05). Refugee children also reported more peer problems (P < .05), more symptoms of obsessive-compulsive disorder (P < .01), and more separation anxiety symptoms (P < .05) than the Danish children. No significant differences with regard to age or gender were found among the groups. Conclusions: Our data suggest that, although immigrant children had higher levels of conduct problems than ethnic Danish children, they did not suffer from higher levels of internalizing psychological difficulties. However, refugee children were at higher risk for psychological difficulties associated with both externalizing and internalizing.