The centrality of the collective to Syrian identity and the ability of war to disrupt community ties have led to significant violations of Syrians’ pre-war assumptions about themselves, the world, and their place in the world. Guided by the integrated meaning-making model, this qualitative cross-sectional study assessed Syrian refugees’ meaning trajectories through their reappraisals of the war, attempts to repair community-informed shattered meanings, and those processes’ outputs (i.e., meanings-made) and outcomes (i.e., perceived psychological adjustment). We conducted semi-structured cognitive interviews with 39 Syrian war-exposed adults living in urban communities across Portugal, most of whom were beneficiaries of higher education programs for refugees. Interviews were analyzed through thematic analysis. Results suggest that the war severely disrupted Syrians’ sense of collective self, and that they repeatedly engaged in search for meaning, appraisals of the war, and reappraisals of shattered beliefs, life goals, and sense of purpose, both during wartime and in resettlement. In Portugal, despite persistent negative beliefs about the collective and ongoing and distressing searches for meaning, participants’ lived experiences concomitantly informed positive meaning reappraisals, including progressive restoration of worldviews, new opportunities for self-realization, and newly-found purpose, leading to perceived psychological benefits and growth. These findings suggest that meaning-making is both a trajectory and a dynamic process, informed by place and sociopolitical context. Clinical work to facilitate adaptive meaning-making and meaning-informed psychosocial interventions that help restore refugees’ shattered beliefs about safety, predictability, trust, and belonging, may be helpful directions to promote positive psychological adjustment and improve long-term integration prospects in refugees.
Objective: This mixed-methods study assessed the prevalence of pre-and postmigration trauma and stressors as determinants of refugee mental health in resettlement. Method: Forty-four war-affected Syrian civilians arriving in Portugal through four streams—UNHCR resettlement, EU relocation, spontaneous asylum, and higher education programs for refugees—participated in focus groups and individual interviews. Participants completed self-report measures of trauma and torture and PTSD symptoms, and narrated pre- and postmigration experiences and distress through semistructured interviews. We used descriptive statistics to characterize incidence of trauma and distress, and thematic analysis to identify themes of pre- and postflight stressors. Results: Participants reported a mean 12.9 (SD = 7.2) war trauma events, with six men also disclosing having been tortured. Twenty-five percent met diagnostic criteria for PTSD. Key results identified preflight contextual, personal, family, and community daily stressors capable of shattering prewar meaning systems, and postflight common stressors aggravated by state-sponsored host conditions, the ongoing conflict, and, for the student group, subsequent to temporary returns to Syria. Conclusion: Regardless of legal status on arrival, civilians from war-torn countries may be exposed to pre- and postmigration trauma and stressors that severely impact their mental health, reinforce feelings of uprootedness, and dim integration prospects. Findings highlight the need for host countries to create opportunities for agency and autonomy to improve refugees’ own integration prospects and ability to initiate their path to recovery.
As research subjects, refugees have numerous potential vulnerabilities. This study aimed to examine the ethics- and trauma-informed challenges of implementing a mental health research protocol with Syrian refugees living in Portugal. Guided by the integrated meaning-making model, the research project “Journeys in Meaning” employed a mixed-methods cross-sectional design to explore posttraumatic cognitive processing in refugees using two phases of data collection: two focus groups (Phase 1) to test the protocol and 39 in-depth individual interviews (Phase 2) to implement the protocol. Results examine the strategies used to address the following: methodological challenges related to protocol design, participant recruitment, and language; ethics- and trauma-informed challenges aimed at minimizing harm and maximizing benefit to participants that followed social justice principles; and perceived compassion fatigue on the part of the researcher following repeated empathetic exposure to traumatic content. Findings suggest the need for adaptive approaches to research with refugee populations that challenge strict compliance with the traditional principles of “do no harm” and researcher neutrality, and that accommodate individual and community complexities.
Religious meaning-making may facilitate psychological adjustment to even the most extreme traumatic stressors, including war and forced displacement. Yet, few studies have examined the religious meaningmaking trajectories of refugees and none from an Islamic perspective. This qualitative cross-sectional study investigated Syrian Muslims' postwar meaning-making experiences, guided by Park's (2010) meaningmaking model. Thirty-three Syrian Muslim refugees living in Portugal were interviewed 8 years after the onset of the war. Thematic analysis was used to explore cognitive reappraisal processes informed by Islam. The recurrent nature of meaning-making throughout refugees' displacement trajectories; religious struggles as a key determinant of religious meaning-making; meaning-making as dynamic trajectories with no clear end; place of settlement as a source of meaning; and the ability of Islam to withstand extreme challenges and provide a last-resort narrative, even for those individuals with severely eroded beliefs. Findings highlight the need for practitioners in host countries to incorporate faith and religious traditions in the provision of care.
Objectives This research seeks to determine what impact HealthRight International's Access to Support and Services for Survivors of Torture (ASSIST) remote case management program has on the physical, psychological, and social wellbeing of survivors of torture. Method A retrospective case record review was conducted of 54 adult foreign-born survivors of torture who received remote case management services through ASSIST. Survivors were interviewed at intake, and 6 months after the initial assessment, the Survivor of Torture Outcomes Matrix (SOT Matrix) was utilized to determine changes in well-being. Results Survivors report improved well-being along with 12 of the 14 indicators in the SOT Matrix between the initial assessment and the 6-month assessment. Conclusions Findings indicate that survivors report overall improved well-being after 6 months of receiving remote case management, pointing to remote case management as a promising practice which would allow increasing numbers of survivors who live far from traditional torture treatment centers to access specialized care.
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