New research has proposed taking a new ‘cultural models’ approach to mental health treatment for asylum seekers and refugees, to improve care.
Work led by researchers from the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC) has looked at migrants’ experiences of mental health services in the UK, and how these might be improved.
Although there is significant research on the mental health care challenges of migrants, particularly refugees and asylum seekers, the treatment approach for this group has not received enough attention.
By analysing migrants’ experiences of mental health care in the UK, this study aimed to explore whether refugees and asylum seekers with various pre- and post-migration traumatic experiences might need different therapeutic approaches.
Twenty-five refugees and asylum seekers living in the North East of England and Northern Ireland were interviewed for the study. They had each used at least six sessions of talking therapy provided by the NHS or voluntary/charity organisations during the last three years.
What is the issue?
Refugees and asylum seekers experience a higher rate of mental illness around the world.
A considerable number of studies have investigated the accessibility and effectiveness of mental health services for migrants to identify potential barriers and challenges.
However, these studies do not address the impact of the therapeutic approach. A therapeutic approach is the way in which a psychologist or counsellor might frame how their client/patient views their personal experiences and relationships – and then support them to work through the issues that occur for that client/patient throughout their lives.
Previous studies also do not propose what relevant treatments could be identified and adopted for migrant clients or how to identify them.
This study looked at how employing a ‘cultural models’ approach in mental health treatment could contribute to understanding clients better – so that the therapist can discover more about the underlying assumptions and expectations of a client in order to provide more relevant and effective treatments for them.
What do we mean by a ‘cultural models approach’?
Cultural models are the ways that a group of people with similar life experiences think about or organise knowledge about particular issues or events. The ‘cultural models’ approach implies a specific sense of culture. It is different to multicultural psychology, which implies that a nation or ethnic group has a ‘set’ or distinct culture. Instead, the ‘cultural models’ approach assumes that cultures are complex, consisting of commonalities and consistencies as well as contests, disagreements, conflicts, and changes.
Cultural models can shape a person’s view of the world, and can influence how someone interprets events, and behaves.
In the context of therapy, this would mean a therapist would use the idea of cultural models to explore the context in which a clients’ emotions occur, the ways in which they perceive and evaluate events, and the coping strategies that they use to process the emotions that they experience.
Lead researcher Dr Mohaddeseh Ziyachi, a Research Fellow with the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC) based at Durham University, said:
“Refugees and asylum seekers present to Western countries with a specific set of mental health challenges that require a more nuanced therapeutic awareness and approach. The ‘cultural models’ approach can provide the necessary framework and method for making key therapeutic decisions.
“This approach is a major advance over, but also generally aligned with, the values of multiculturalism, social justice, liberation psychology, and trauma-informed frameworks.
“Our research suggests that if therapists use a ‘cultural models’ approach, they would be more able to build therapeutic alliances with clients and therefore provide more relevant and appropriate treatments for them.”
Follow this link to read a plain language summary of this research.
Read the full research paper: The International Journal of Environmental and Health Research – May 2024