Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants ( N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile.
This article outlines the cultural and psychological effects of globalization. It looks at the impact of globalization on identity; ideas of privacy and intimacy; the way we understand and perceive psychological distress; and the development of the profession of psychology around the world. The article takes a critical perspective on globalization, seeing it as aligned with the spread of neoliberal capitalism, a tendency towards cultural homogenization, the imposition of dominant 'global north' ideas and the resultant growing inequalities in health and well-being. However, it also argues that the increased interconnectedness created by globalization allows for greater acknowledgement of our common humanity and for collective efforts to be developed to tackle what are increasingly global problems. This requires the development of more nuanced understandings of cultural differences and of indigenous psychologies.
Simulated patient role-plays (SPRs) with trained actors are a recent development in the training of clinical psychologists. This paper reports on the introduction and evaluation of SPRs as both a method used to teach clinical consultation skills and as a method to formatively assess trainee clinical psychologists' acquisition of these skills. The evaluation used a number of focus groups with clinical psychology trainees, programme staff and clinical supervisors to explore the acceptability of these methods in teaching and assessment, the experience of using them and the impact on trainees' learning. Focus group interviews were transcribed verbatim and analysed using template analysis. The core theme from the analysis concerned the capacity of SPRs to authentically recreate a clinical environment and capture the trainee's clinical practice. The concept of authenticity is discussed in relation to clinical skills teaching and the wider profession of clinical psychology.
Background: Guidance on the provision of mental health services in the UK acknowledges the need for psychological therapists to be able to deliver culturally sensitive psychological interventions. Aim: The current study explored the experiences of recently trained therapists within the UK Improving Access to Psychological Therapies training programme. It sought to understand whether their practice of cognitive-behavioural therapy is culturally sensitive and consistent with current cultural competence guidance, and how training contributes to their development. Method: Focus groups using a semi-structured interview were conducted with participants from three psychological therapy services. The interviews were recorded and transcribed, and the data analysed using template analysis. Results: Participants demonstrated a range of perspectives and practices that were consistent with cultural competence guidance. Abilities were attributed to personal and professional experience, and to personal motivation to develop cultural competence. Training was not considered to have significantly contributed to cultural competence. Conclusions: Therapists can work in a culturally sensitive way without a comprehensive training based on cultural competence guidance. To be able to draw on personal and professional cultural experience may be a primary contributor to cultural competence. Training can augment experience and suggestions are made for how it may be improved.
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