The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.
This article presents and critically analyses an approach that is part of a specific context of health care ideologies and services in France: the ethnopsychoanalytic consultations that are practised at the Avicenne Hospital. It is one of the few places where a specific approach for immigrant clients is offered in a university hospital. We give some background information both on the history of the hospital and on the ethnopsychiatric consultation. We then discuss some of the basic principles of the French ethnopsychoanalytic approach, and describe the work in a multicultural group setting.We also give some information about the indications for this kind of therapy, on the population served and on the way the transcultural consultation co-operates with other services. A short case presentation will illustrate the description of the French ethnopsychoanalytical approach and lead to a critical conclusion analysing the strengths and weaknesses of this model.
French ethnopsychoanalytic approaches to therapy with immigrants combine the psychoanalytical interest in subjectivity with a specific concern for cultural factors and with the role migration plays as a crucial life event. Recent approaches consider culture as profoundly hybrid and use the notions of ''métissage'' and ''décentrage'' as central concepts. This article presents extracts from a qualitative study of ethnopsychoanalytic therapies with immigrant families. The authors argue that the ethnopsychoanalytic approach helps to open new ways of considering cultural hybridity and create a third space where experiences ''from the margins'' may be verbalized.
Background There is a lack of empirical evidence on the level of cultural adaptation required for psychological interventions developed in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies to be effective for the treatment of common mental disorders among culturally and ethnically diverse groups. This lack of evidence is partly due to insufficient documentation of cultural adaptation in psychological trials. Standardised documentation is needed in order to enhance empirical and meta-analytic evidence. Process A “Task force for cultural adaptation of mental health interventions for refugees” was established to harmonise and document the cultural adaptation process across several randomised controlled trials testing psychological interventions for mental health among refugee populations in Germany. Based on the collected experiences, a sub-group of the task force developed the reporting criteria presented in this paper. Thereafter, an online survey with international experts in cultural adaptation of psychological interventions was conducted, including two rounds of feedback. Results The consolidation process resulted in eleven reporting criteria to guide and document the process of cultural adaptation of psychological interventions in clinical trials. A template for documenting this process is provided. The eleven criteria are structured along A) Set-up; B) Formative research methods; C) Intervention adaptation; D) Measuring outcomes and implementation. Conclusions Reporting on cultural adaptation more consistently in future psychological trials will hopefully improve the quality of evidence and contribute to examining the effect of cultural adaptation on treatment efficacy, feasibility, and acceptability.
This paper discusses the French Ethnopsychoanalytic approach to trauma in transcultural therapy situations. The authors first describe the basic principles of the French Ethnopsychoanalytic tradition and the theoretical developments of this tradition within the last 30 years. These approaches combine a psychoanalytic understanding of therapeutic processes with a constant reflection on the social and symbolic contexts that appear in the patient's discourse. The specific way of referring to “culture” and belonging is exemplified by a detailed case-study of a therapy with a female patient who flew from West Africa in order to escape from an arranged marriage. While discussing some key moments of the therapy with this patient, the authors illustrate the co-construction of shared meanings within a dialogue about different cultural frames. They stress the need of a process-orientated and situational understanding of culture and show how the dialogue about “culture” helps to open the space for a re-interpretation of the current and past life-context of their patient. They also insist on that each comment on “culture” and “belongings” is interpreted within the therapeutic process and the relational dynamics this process implies.
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