Psychotherapy motivation in refugees: The role of alexithymia, stigmatization, self-esteem, and psychotherapy expectations.

Schlechter, Pascal; Wagner, Ullrich; Morina, Nexhmedin; Hellmann, Jens H.

doi:10.1037/tra0001167

Cited by 12 publications

(15 citation statements)

References 46 publications

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“…Consistent with this, refugees in Germany reported knowledge of the health care system, stigmatization, and communication difficulties among the most significant barriers to psychotherapeutic treatment (Boettcher et al, 2021;Schlechter, Wagner, et al, 2021).…”

mentioning

confidence: 53%

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

Dumke¹,

Wilker²,

Kotterba1³

et al. 2022

Preprint

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Access to psychotherapy is critical to improving mental health, but only a small proportion of refugees receive treatment in the regular psychotherapeutic care system in high-income countries. In previous research, outpatient psychotherapists reported several barriers to more frequent treatment of refugee patients. However, it is unclear to what extent these perceived barriers contribute to the poor provision of services to refugees. In a survey of N = 2002 outpatient psychotherapists in Germany, we collected data on perceived barriers to treatment of refugees and on the integration of refugees into regular psychotherapeutic practice. Half of the psychotherapists reported not to treat any refugee patients. In addition, therapies provided for refugees were, on average, 20% shorter than for other patients. Regression analyses showed direct negative associations between psychotherapists’ overall perception of barriers with the number of refugees treated and the number of sessions offered to refugee patients, even when controlling for sociodemographic and workload-related characteristics. Correlation analyses on the level of specific types of barriers further revealed that particularly language-related barriers and lack of contact with refugee patients are negatively correlated with the number of refugees treated and the number of sessions for refugees. Our findings indicate that the integration of refugees into regular psychotherapeutic care could be improved by measures to connect psychotherapists with refugee patients as well as professional interpreters and to ensure coverage of costs for therapy, interpreters, and related administrative tasks.

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mentioning

confidence: 53%

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

Dumke¹,

Wilker²,

Kotterba1³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…For such interventions, it needs to be considered that Middle Eastern refugees have specific idioms to express their distress (Hassan et al, 2015 ). Systematically evaluating and implementing interventions tailored to refugees’ sociocultural backgrounds may lead to high acceptability of interventions with a broad outreach to refugees with low psychotherapy motivation (Schlechter, Wagner et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…By adopting a transdiagnostic perspective, there is less need for extensive assessments of a nosological diagnosis. In addition, Middle Eastern refugees have specific idioms to describe their distress, different mental health conceptualizations (Hassan et al, 2015 ), and report lower psychotherapy motivation compared to Western residents (Schlechter, Wagner et al, 2023 ). Focusing on broader issues outside the boundaries of a diagnosis may engage refugees to participate in transdiagnostic programs as suggested by high acceptability of PM + among Syrian refugees (Acarturk et al, 2022 ).…”

Section: The Transdiagnostic Approach To Psychopathologymentioning

confidence: 99%

Self-efficacy and locus of control as transdiagnostic factors in Middle Eastern refugees

Schlechter

Hellmann

Morina

2023

European Journal of Psychotraumatology

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Background: Many refugees report high levels of psychopathology. As a countermeasure, some psychological interventions aim at targeting mental health difficulties in refugees transdiagnostically. However, there is a lack of knowledge about relevant transdiagnostic factors in refugee populations. Objective: To inform intervention efforts empirically, we investigated whether self-efficacy and locus of control are transdiagnostically associated with symptoms of depression, anxiety, somatisation, psychological distress, and a higher-order psychopathology factor (‘p’) in Middle Eastern refugees residing in Germany. Method: In total, 200 Middle Eastern refugees took part in this cross-sectional study, comprising 160 male and 40 female refugees. Participants were, on average, 25.56 years old ( SD = 9.19), and 182 (91%) originally came from Syria, while remaining refugees were from Iraq or Afghanistan. They completed measures of depression, anxiety, somatisation, self-efficacy, and locus of control. Results: In multiple regression models adjusting for demographic factors (gender and age), self-efficacy and external locus of control were transdiagnostically related to depression, anxiety, somatic symptoms, psychological distress, and a higher-order psychopathology factor. Internal locus of control had no detectable effect in these models. Conclusions: Self-efficacy and external locus of control appear critical in the mental health of refugees and may be important mechanisms in overcoming posttraumatic stress and resettlement stressors. Our findings support the need to target self-efficacy and external locus of control as transdiagnostic factors of general psychopathology in Middle Eastern refugees.

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“…However, a patient's view on which aspects of their problems are internally or externally caused as well as perceptions of their stability, controllability, and situational variability, may obstruct one's urge and perceived opportunities to change (Schulte, 2015). Having difficulties identifying, differentiating, and articulating feelings and emotions (alexithymia) might also impede internal attributions and has been shown to be associated with unfavorable treatment expectations (Schlechter et al, 2021;Terock et al, 2017). Furthermore, cultural norms may make it harder to seek psychological help, e.g., when psychological problems are stigmatized and perceived as weaknesses or cause embarrassment (Schlechter et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

How Treatment Motivation Predicts Favorable Outcomes in Interdisciplinary Multimodal Pain Treatment Among Patients with Chronic Primary Pain

Scheidegger

Penedo

Blättler

et al. 2023

J Clin Psychol Med Settings

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As motivation for psychological treatment at intake has been shown to predict favorable outcomes after an inpatient stay, this study aimed to further characterize the different components of psychological treatment motivation that predict favorable treatment outcomes. 294 inpatients with chronic primary pain participating in an interdisciplinary multimodal pain treatment in a tertiary psychosomatic university clinic completed a battery of psychological questionnaires at intake and discharge. Treatment motivation was assessed at intake using the scales of the FPTM-23 questionnaire, while pain intensity, pain interference, anxiety, and depression were assessed both at intake and discharge. After treatment, pain intensity, pain interference, anxiety, and depression were significantly reduced. While higher levels on the FPTM-23 scale of suffering predicted smaller decreases in anxiety after treatment, higher scores on the scale of hope, i.e., lower levels of hopelessness, predicted lower levels of pain interference, anxiety, and depression after treatment. None of the scales of treatment motivation predicted pain intensity levels after treatment. Above and beyond providing symptom relief, reducing hopelessness and fostering hope regarding the treatment process and outcome might help clinicians treat patients with chronic primary pain more effectively.

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Psychotherapy motivation in refugees: The role of alexithymia, stigmatization, self-esteem, and psychotherapy expectations.

Cited by 12 publications

References 46 publications

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

Self-efficacy and locus of control as transdiagnostic factors in Middle Eastern refugees

How Treatment Motivation Predicts Favorable Outcomes in Interdisciplinary Multimodal Pain Treatment Among Patients with Chronic Primary Pain

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