A Point in the Heart: Concepts of Emotional Distress Among Albanian-Speaking Immigrants in Switzerland

Shala, Mirëlinda; Morina, Naser; Gross, Corina Salis; Maercker, Andreas; Heim, Eva

doi:10.1007/s11013-019-09638-5

Cited by 23 publications

(20 citation statements)

References 89 publications

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“…They found that more rigorous studies revealed CCD that clearly dif-fered from Western diagnoses of common mental disorders. Such studies examine people's ways of expressing suffering, their assumptions about causes of distress and possible ways to overcome it, physiological and spiritual meanings attributed to suffering, and the distinction between universal human suffering and mental illness (e.g., Keys, Kaiser, Kohrt, Khoury, & Brewster, 2012;Kohrt & Hruschka, 2010;Shala, Morina, Salis Gross, Maercker, & Heim, 2019).…”

Section: Theoretical and Empirical Foundations For Cultural Adaptationmentioning

confidence: 99%

“…Another example are findings related to fatalism. An ethnopsychological study showed that Albanian-speaking immigrants in Switzerland understood their suffering as part of normal life, given by god or fate (fati), and something that cannot be cured but has to be borne with endurance (durim) (Shala et al, 2019). Fatalism was also found among Turkish immigrants in Germany (Franz et al, 2007;Reich, Bockel, & Mewes, 2015).…”

Section: Cultural Concepts Of Distressmentioning

confidence: 99%

See 1 more Smart Citation

Cultural Adaptation of Scalable Psychological Interventions: A New Conceptual Framework

Heim

Kohrt

2019

CPE

Self Cite

117

110

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The worldwide mental health treatment gap calls for scaling-up psychological interventions, which requires effective implementation in diverse cultural settings. Evidence from the field of global mental health and cultural clinical psychology indicates cultural variation in how symptoms of common mental disorders are expressed, and how culturally diverse groups explain the emergence of such symptoms. An increasing number of studies have examined to what extent cultural adaptation enhances the acceptability and effectiveness of psychological interventions among culturally diverse groups. To date, this evidence is inconclusive, and there is a lack of studies that dismantle the multiple types of modifications involved in cultural adaptation. Based on empirical evidence from ethnopsychological studies, cultural adaptation research, and psychotherapy research, the present paper offers a new conceptual framework for cultural adaptation that lays the groundwork for future empirical research. The cultural adaptation framework encompasses three elements: i) cultural concepts of distress; ii) treatment components; and iii) treatment delivery. These three elements have been discussed in literature but rarely tested in methodologically rigorous studies. Innovative research designs are needed to empirically test the relevance of these adaptation elements, to better understand the substantial modifications that enhance acceptability and effectiveness of psychological interventions. Using a theory-driven approach and innovative experimental designs, research on cultural adaptation has the potential not only to make psychological treatments more accessible for culturally adverse groups, but also to further advance empirical research on the basic question about the “key ingredients” of psychotherapy. The phenomenology of common mental disorders, as well as mind-body concepts, vary across cultures. Cultural adaptation may enhance the acceptability and effectiveness of psychological interventions. There is a lack of empirical evidence on the substantial modifications in cultural adaptation. Theory-driven, experimental approaches are needed in cultural adaptation research. The phenomenology of common mental disorders, as well as mind-body concepts, vary across cultures. Cultural adaptation may enhance the acceptability and effectiveness of psychological interventions. There is a lack of empirical evidence on the substantial modifications in cultural adaptation. Theory-driven, experimental approaches are needed in cultural adaptation research.

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Section: Theoretical and Empirical Foundations For Cultural Adaptationmentioning

confidence: 99%

Section: Cultural Concepts Of Distressmentioning

confidence: 99%

Cultural Adaptation of Scalable Psychological Interventions: A New Conceptual Framework

Heim

Kohrt

2019

CPE

Self Cite

117

110

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“…Several studies showed that the cross-cultural setting might be a challenge to provide appropriate mental health care to refugees and asylum seekers for a variety of reasons such as stigma, taboo, trust issues, and a mismatch between Western concepts of diagnosis and treatment and the problems and needs perceived by refugees and asylum seekers [4,40,[65][66][67][68][69][70][71][72]. Moreover, the expression of the perceived problems, idioms of distress, or symptom expression of common mental disorders can vary substantially within and between cultural backgrounds and may decrease the accuracy of diagnostic appraisals and treatment outcome [73][74][75][76]. Therefore, a culturally sensitive treatment approach considering i.a.…”

Section: Barriers To More Frequent Treatment Of Refugees and Asylum Smentioning

confidence: 99%

Barriers to access to outpatient mental health care for refugees and asylum seekers in Switzerland: the therapist’s view

et al. 2020

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Background: More than 120,000 refugees and asylum seekers are currently living in Switzerland. The prevalence of mental disorders among this population is significantly higher than that in the general population. While effective treatment options and cross-cultural, specialized treatment centers exist, they tend to be overloaded by their target populations. General outpatient primary health care providers might be able to compensate for the lack of specialized treatment slots. To date, however, it is unknown how often and under what conditions (e.g., length of waiting lists) refugees and asylum seekers are treated outside of specialized centers and whether there are barriers that prevent providers in outpatient settings from treating more patients in this subgroup. The present study aimed to assess the challenges and barriers faced by psychiatrists and psychotherapists working in outpatient settings in Switzerland in treating refugees and asylum seekers to determine the potential capacity of this group to provide mental health care. Methods: An online survey was conducted during the winter of 2017/2018. The survey was constructed in three official languages and took 10-15 min to complete. Spearman's correlations, Mann-Whitney U-Tests, and Chisquared tests were conducted to analyze the data. Results: Eight hundred and sixty-seven (N = 867) psychotherapists and psychiatrists working in outpatient settings completed the survey: 43% of them reported having treated between 1 and 9 refugees or asylum seekers in the past 12 months, and a further 13% reported treating 10 or more. Interpreters were used for almost every other patient with a refugee or asylum-seeker background. At the same time, the funding of interpreters, as well as the funding of treatment in general, were reported to be the biggest hurdles to treating more refugees and asylum seekers. Conclusions: Given the low number of patients rejected for capacity reasons (between 2 and 5%) and the median waiting times for the admission of new patients ranging between 2 and 3 weeks, outpatient primary mental health care providers might treat more refugees and asylum seekers and relieve specialized treatment centers. However, barriers such as lack of funding of interpreters seem to hinder them. Appropriate steps by the authorities are needed to improve the current situation.

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“…Hassan et al (2005) note that many Syrian refugees attribute obsessive rumination to satanic temptations, using the Arabic word wisswas meaning both the devil and unpleasant recurrent thoughts. Among Albanian migrants in Switzerland, this has been referred to as a "point in the heart" or "Brenge": the beginning of rumination triggered by different causes (Shala et al, 2020). Droždek and Wilson (2007) highlight some more examples from the literature: In the experience of many Salvadoran refugees who report "attaques nervios," a somatic response involving feelings of anxiety, fear, and anger, and calor, an experience of intense heat that extends through one's body.…”

Section: Culturally-informed Responses To Trauma: Attributing Meaningmentioning

confidence: 99%

Culturally Informed Manifestations of Trauma

Theisen-Womersley

2021

Trauma and Resilience Among Displaced Populations

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A Point in the Heart: Concepts of Emotional Distress Among Albanian-Speaking Immigrants in Switzerland

Cited by 23 publications

References 89 publications

Cultural Adaptation of Scalable Psychological Interventions: A New Conceptual Framework

Cultural Adaptation of Scalable Psychological Interventions: A New Conceptual Framework

Barriers to access to outpatient mental health care for refugees and asylum seekers in Switzerland: the therapist’s view

Culturally Informed Manifestations of Trauma

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