There are a number of procedures, well established within qualitative research, that were originally formulated to use intersubjective confirmation as a way to bolster confidence in findings (e.g., consensus, auditing, member checks). These procedures enhanced methodological integrity by demonstrating that people from differing perspectives can examine the data and reach the same conclusions-indicating that a finding was not entirely idiosyncratic. In this article, we propose the concept of epistemic privilege as an alternate foundation for these procedures. In this approach, the recognition of differences among the histories, perspectives, knowledge, and investments of research team members creates a context in which forms of subjective knowledge (i.e., lived experience, expertise) become resources that heighten a team's perspicacity. The enactment of the proposed procedures shifts the meanings and application of confirmation processes so they become appropriate for critical, constructivist, and participatory research. They change the theoretical formulation from a democratic process of confirming objective perceptions to a collaborative process of intersubjective recognition that values diverse knowledge sources. We focus on the example of researcher consensus, providing a brief history of past rationales and practices for this procedure, and describing our approach as strengthening findings as well as improving research team dynamics. This form of collaboration ameliorates prior concerns expressed about consensus, such as intergroup power differentials, and the fear that attuned investigators may weaken their interpretations to obtain consensus with others. In this process, we identify sources of epistemic privilege, detail methodological procedures, and offer suggestions for research reporting.
Abstract. More people than ever in history are being displaced and becoming refugees due to political conflict, climate change, and persecution, among others. Meeting the mental health care needs of refugees has become a global priority. This population’s needs are unique due to the multiple traumatic experiences of refugees, their difficulties in navigating various systemic barriers, and the minimal specialized cultural training in refugee care. In order to improve the health of refugees, it is important to examine how care is delivered and the provider and systemic factors that perpetuate inequities and cultural misunderstandings in providing care. Most of the refugee literature focuses on refugee factors that limit access to care but falls short on discussing providers’ lack of training in refugee care. In the following paper, we present refugee mental health training considerations for providers. These considerations are based on the lessons learned from direct clinical work in a refugee clinic located in a major public academic hospital in the New England area (United States of America). The authors discuss the particular context of caring for refugee populations, the skills needed to work with this population, and considerations for navigating provider and systemic barriers that arise in refugee care. We believe that training mental health providers can have significant implications for refugee mental health care utilization, patient improved treatment outcomes, and on refugees’ increased sense of self-determination.
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