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Engaging Refugee Families in Therapy: Exploring the Benefits of Including Referring Professionals in First Family Interviews*
The possible benefits of including referring professionals in the first family interviews are being explored as a way to engage refugee families in therapy. Families in exile confront a number of problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in a context of therapy. We will describe first family interviews in which referring professionals are interviewed about their
reasons for referrals, and where the families are invited to discuss these considerations. The conversations permit families, referrers, and therapists to reflect upon differences in positions and perspectives. Their experiences suggest that agreements or contracts based on these joint interviews are less ambiguous and more clearly formulated than contracts based on interviews with families alone. Finally, these experiences are discussed as a potentially valuable approach in a cross-cultural context.
Fam Proc 40:95-114, 2001
REFUGEE clients are often referred to psychotherapy when their lives are in turmoil because of pre- and postflight factors (Allodi, 1998; Dahl, 1989). Unclear working relationships and psychotherapeutic conversations may be experienced as unfocused by therapists and by clients. Helpers in the system have often initiated the referral process in the hope that a psychiatric service may find solutions. There is often a notable discrepancy between the problems as perceived by the referring professional and the problems as framed and experienced by the referred person (Egli, Shiota, BenPorath, & Butcher, 1991; van der Veer, 1995; van Willigen, 1992), and cultural and linguistic differences make this a difficult topic to explore.
Despite stories about severe trauma, psychotherapy is often not regarded as needed or desired by the refugees, and many of the referred clients are not ready to work with these events within a context of psychological or psychiatric treatment (Varvin & Dahl, 1997). In addition, the daily lives of refugees include stresses at many different levels, leaving limited space for working with complicated, psychological issues (Arenas, 1997; van der Veer, 1992; 1995; Westermeyer, 1991). Even when clients directly ask for psychological help, ongoing,...