“I didn’t understand their system, and I didn’t know what to do”: Migrant Parents’ Experiences of Mandated Therapy for Their Children

Racialized Immigrants' Encounters of Barriers and Facilitators in Seeking Mental Healthcare Services in Ontario, Canada

Racialized immigrants have low rates of accessing mental healthcare services. However, there are notable differences among immigrant groups (e.g., refugees, international students, dependants). The aim of this study is to understand racialized immigrants' experiences of accessing mental healthcare services at both systemic and individual levels. Through a qualitative descriptive methodology, interviews were conducted in English with 16 racialized immigrants to understand barriers and facilitators encountered. Additionally, focusing on how cultural and social conceptualizations ideas shape mental healthcare services. Interviews were analyzed through Braun & Clarke's six-step method to reflexive thematic analysis in identifying factors. Three major themes were identified: structural constraints, individual influences, and appraisal of services. With the first, racialized immigrants signaled to issues related to the systemic level that included affordability, wait times, and trust in the system. Individual influences highlighted factors of mental health literacy, social supports, stigma, severity of the issues, and awareness of services themselves. Lastly, extending on the previous theme, appraisal of services was reflective of how social and cultural ideals shaped attitudes towards the appropriateness of the provider or services themselves. The findings from this paper emphasize that racialized immigrants are not homogenous in their experiences and attitudes towards mental healthcare services. While there were similarities across different groups in the individual and systemic factors identified, there were key distinctions driven by appraisal of services themselves and if they were congruent based on their needs, more specifically, what was contributing to their negative mental health status.

Refugees' and asylum seekers' experiences of individual psychological therapy: A qualitative meta-synthesis

PURPOSE

The current review aimed to synthesise qualitative literature exploring adult refugees' and asylum seekers' experiences of individual psychological therapy.

METHODS

A comprehensive systematic search of the following databases led to the identification of eight studies for inclusion in this review: PsycINFO, PsycARTICLES, MEDLINE, EMBASE, CINAHL and Academic Search Ultimate. All selected studies used qualitative methodology to explore refugees' and asylum seekers' experiences of individual psychological therapy. Studies were appraised using an adapted version of the Critical Appraisal Skills Programme (CASP) Tool. The data from these selected studies were then synthesised using a meta-ethnographic approach.

RESULTS

The synthesis of selected studies resulted in the development of five themes; (i) the importance of recognition and validation within therapy, (ii) building a human connection within the therapeutic relationship and the importance of cultural competency, (iii) revisiting trauma, managing difficult emotions from therapy and regaining hope, (iv) the value of practical interventions, (v) 'one should not wake up the djinns (demons)'-cultural stigma and accessing therapy. These themes illustrated the complexities of working therapeutically with asylum seekers and refugees and the vital role of building trust and safety within the therapeutic relationship prior to engagement in therapeutic work. The results also highlighted varied responses to engaging in trauma work ranging from participants finding the experience transformative to others finding it unhelpful, some participants preferred more practical interventions. Participants' cultural backgrounds and pre-conceptions around therapy impacted on engagement and the therapist's cultural competency was a significant factor in therapeutic engagement.

CONCLUSIONS

Working therapeutically with asylum seekers and refugees involves a number of factors for consideration. Forced migrants' socio-political context was seen as central to their experiences of distress and recognition of these factors was imperative for positive therapeutic engagement. This review highlights a number of clinical implications to guide practitioners working therapeutically with this community.

Sex Trafficking Knowledge and Training: Implications From Environmental Scanning in the American Midwest

Large gaps exist in our knowledge about the effectiveness of sex trafficking training. This study surveyed knowledge and training regarding sex trafficking among service providers (N = 66; i.e., social workers, law enforcement offers, and medical providers) in one Midwestern state. The study aimed to: (a) determine the goodness-of-fit between respondents' agency criteria for victim identification and established trafficking definitions, (b) assess training desired and received, and (c) examine group differences in knowledge and training by profession and position. Results suggest confusion exists in defining sex trafficking among aftercare providers despite nearly all respondents indicating they had received training on definition, identification, and vulnerability. Training gaps regarding service coordination, case development, and the legal, mental health, and medical needs of victims remain.

"Because That's the Culture": Providers' Perspectives on the Mental Health of Latino Immigrant Youth

Immigrant youth experience a combination of stressors, such as isolation and discrimination, that put them at a greater risk for negative mental health outcomes. Relying on interviews with 24 service providers who work with Latino immigrant youth, this article examines how they construct and intervene in the worlds of immigrant youth to improve youth's mental health outcomes. Inductive thematic analysis revealed providers' reliance on cultural interpretations of the psychosocial circumstances facing immigrant youth. Providers alternated between drawing on discourses that reproduced stereotypes, assumptions, and biases, while simultaneously striving to transcend sociocultural differences to focus on the lived experiences of their clients. Although providers acknowledged the importance of structural barriers, such as poverty and discrimination, they "bracketed" these issues when recommending interventions. The article highlights that as cultural competence increasingly becomes part of social services, this professional discourse may distract providers' attention from more relevant targets of intervention.

Learning About Parenting Together: A Programme to Support Parents with Inter-generational Concerns in Pune, India

Rapid developments in the last few decades have brought about dramatic changes in Indian social life, particularly affecting new middle-class families. Inter-generational conflicts, high academic pressures, and modern anxieties lead to stress both in parents and in children. There is a need for parenting programmes that respond to these specific concerns, in order to reduce parenting stress and improve family well-being. This study aimed to develop and evaluate a parenting programme in Pune, India, based on a ‘theory of change’. In this pilot programme, parents were encouraged to learn in a group format about fostering autonomy in children, promoting academic potential in a stress-free manner and remaining in connection with adolescents. Facilitated by a psychologist, parents participated in four sessions involving ‘creativity and play’, ‘self-awareness and bonding’, and ‘communication’. The intervention was based on validated psychotherapeutic approaches and parenting methods to support parents in their learning. Some 16 in-depth interviews were conducted with parents before and eight interviews after the intervention to understand their learning experiences. Additional feedback was gathered from observation notes and debriefings after each session. The results show that the attention for playful quality time helped parents to (re)gain a more creative and flexible attitude towards spending time with their children. Second, parents learned to reflect on their frameworks of meaning (rooted in their own upbringing), listen attentively and communicate more mindful with their children. Furthermore, this study shows that an activity-based approach, connecting parents in co-creating new parenting paradigms, while supporting them with stress-reducing tools, is a useful way of engaging this target group. The study concludes by offering new perspectives for counsellors working with families in countries undergoing rapid change.