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Diaz Maldonado A, Simon A, Barry C, Hassler C, Lenjalley A, Giacobi C, Moro MR, Lachal J. Adolescent attendance at transcultural psychotherapy: a retrospective cohort study. Eur Child Adolesc Psychiatry 2022; 31:1-8. [PMID: 33751239 DOI: 10.1007/s00787-021-01760-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/11/2021] [Indexed: 11/27/2022]
Abstract
Migrant adolescents in therapy for psychological problems are at risk of poor attendance or even of dropping out. Transcultural psychotherapy has been developed in France to take cultural diversity into account in psychological treatment and to deal with the specific difficulties encountered in the psychotherapeutic treatment of this population. This study aims to assess adolescents' attendance rates to this form of psychotherapy and to explore the association of these rates with demographic, cultural, and clinical variables. We conducted a retrospective clinical cohort study of 148 adolescents aged from 11 to 20 years treated between 2008 and 2018 at two transcultural psychotherapy centers in Paris. Statistical analyses tested demographic, cultural, and clinical hypotheses. The main result was the high attendance rate at transcultural psychotherapy sessions among adolescents (77.8%). Attendance rates were not associated with age, gender, family size, generation of migration, or cultural area of origin, but were significantly linked to support in therapy, specifically, the presence at the first transcultural psychotherapy session of the first-line therapist, an interpreter, or both. Transcultural psychotherapy appears to be an effective method for addressing the complex symptoms experienced by migrant adolescents. Better attendance at sessions is statistically significantly associated with factors favoring a therapeutic alliance, specifically, the presence of the first-line therapist or an interpreter in TPT sessions and the existence of support from a social worker. The holistic approach of transcultural psychotherapy to adolescent care may explain the high attendance rates observed.
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Affiliation(s)
- Andrea Diaz Maldonado
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
| | - Amalini Simon
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
- Assistance publique-Hôpitaux de Paris (AP-HP), Université de Paris 13, Hôpital Avicenne, service de psychopathologie, 3413, 93009, Bobigny cedex, EA, France
| | - Caroline Barry
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Christine Hassler
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Adrien Lenjalley
- Centre Hospitalier de Niort, Unité Pour Adolescent, 79000, Niort, France
| | - Carole Giacobi
- Groupe Hospitalier Littoral Atlantique, Service de pédopsychiatrie, 17019, La Rochelle, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Jonathan Lachal
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France.
- CHU de Clermont-Ferrand, Service de Psychiatrie de L'Enfant Et de L'Adolescent, 63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
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Grau L, Carretier E, Moro MR, Revah-Levy A, Sibeoni J, Lachal J. A qualitative exploration of what works for migrant adolescents in transcultural psychotherapy: perceptions of adolescents, their parents, and their therapists. BMC Psychiatry 2020; 20:564. [PMID: 33243219 PMCID: PMC7690022 DOI: 10.1186/s12888-020-02970-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Migrant adolescents are at a higher risk than their native-born counterparts of psychiatric disorders, and their care is a public health issue. In France, transcultural psychotherapy is a treatment provided by a group of therapists designed to meet the specific needs of these patients when usual care appears ineffective. The objective of this study was to explore the therapeutic elements at work in transcultural psychotherapy. METHODS We conducted a qualitative study crossing the perspectives of adolescents receiving transcultural psychotherapy, their parents, their first-line therapist (FLT), and the transcultural therapists. The families were chosen by purposive sampling. Data were collected during semi-structured individual (for FLTs) and group (families and transcultural therapists) interviews that explored the therapeutic elements involved and effective in transcultural psychotherapy. We used interpretative phenomenological analysis (IPA) to examine the data. In all, 44 participants were questioned: three adolescents (2 girls and 1 boy, all aged 18 to 21 years) and their parents (3 mothers and 1 father), three FLTs (2 child psychiatrists and 1 psychologist), and the 34 therapists participating in the three transcultural psychotherapy groups. RESULTS The analysis uncovered three themes: (1) the perceived effectiveness of the group's functioning; (2) the recounting of the individual, family, and cultural history to allow for complexity and nuance; and (3) the personal investment by therapists, made possible by the group. CONCLUSIONS Our results show some therapeutic elements at work in transcultural psychotherapy that enable it to meet the particular needs of some migrant adolescents that are unmet in standard therapy. Continuing to study transcultural psychotherapy and assess its effectiveness is essential for promoting and optimizing psychiatric care for migrant adolescents.
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Affiliation(s)
- Léa Grau
- UFR des Lettres, des Sciences de l'Homme et des Sociétés Unité Transversale de Recherche Psychogenèse et Psychopathologie, UTRPP EA4403, Univ. Paris 13, F-93430, Villetaneuse, France
| | - Emilie Carretier
- UFR des Lettres, des Sciences de l'Homme et des Sociétés Unité Transversale de Recherche Psychogenèse et Psychopathologie, UTRPP EA4403, Univ. Paris 13, F-93430, Villetaneuse, France
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France
| | - Marie-Rose Moro
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
- Université de Paris, PCPP, F-92100, Boulogne-Billancourt, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, F95100, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, F95100, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Jonathan Lachal
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France.
- Université de Paris, PCPP, F-92100, Boulogne-Billancourt, France.
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Carballeira Carrera L, Lévesque-Daniel S, Radjack R, Moro MR, Lachal J. Clinical Approaches to Cultural Diversity in Mental Health Care and Specificities of French Transcultural Consultations: A Scoping Review. Front Psychiatry 2020; 11:579147. [PMID: 33192718 PMCID: PMC7652727 DOI: 10.3389/fpsyt.2020.579147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/02/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. We conducted a scoping review on psychiatric services adapted to cultural diversity, to compare these models of care to the French Transcultural Psychotherapy model. Methods: Systematic electronic search of databases (PubMed and PsycINFO), manual search of archives of journals dealing with transcultural psychiatry, and consultations with international experts, to identify all papers describing clinical models devoted to psychiatric care for migrants, published between January 1990 and October 2018. Narrative synthesis of the included articles. Results: The study included 29 papers. The specificities of psychiatric services for migrant families are linked to the host country's migration patterns and citizenship model. In English-speaking countries, specialized services for ethnic minorities offer ethnic matching of the therapist and patient. In Canada, indirect transcultural consultation services have existed since the late 1990s. Australia emphasizes the networking of consultation services and professional training in cultural competence, while the Nordic countries (Sweden, Finland, Norway, and Denmark) focus management on trauma. In France, psychotherapy services, with flexible numbers of therapists involved according to the situation, have existed since 1990. Discussion: Most initiatives place emphasis on training and supervision, in an indirect approach not specifically focused on the patient, or offer cultural matching of patient and therapist. The French transcultural approach, on the contrary, makes the family's culture and its cultural diversity an integral part of the therapy process.
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Affiliation(s)
- Laura Carballeira Carrera
- Alicia Koplowitz Short-Term Fellowship, Madrid, Spain
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
| | - Sarah Lévesque-Daniel
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Centre integré universitaire de santé et de services sociaux de l'Est-de-l'île-de-Montréal (CIUSSS) du Nord-de-l'Île-de-Montréal, Université de Montréal, Montréal, QC, Canada
| | - Rahmeth Radjack
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
| | - Jonathan Lachal
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
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