Cultural Competence of Professionals Working With Unaccompanied Minors: Addressing Empathy by a Shared Narrative

Radjack, Rahmeth; Touhami, Fatima; Woestelandt, Laure; Minassian, Sevan; Mouchenik, Yoram; Lachal, Jonathan; Moro, Marie Rose

doi:10.3389/fpsyt.2020.00528

Cited by 17 publications

(22 citation statements)

References 54 publications

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“…The interpreter is a professional translator who is also trained in cultural mediation and attends every session [ 19 ]. MUCTUM aims to provide a pluralist approach in which mental health providers efficiently integrate the psychiatric and psychological assessments and interventions including biological, institutional, transcultural and narrative approaches [ 3 , 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

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Multimodal co-therapy for unaccompanied minors: a qualitative study

Guessoum

Minassian

Staël

et al. 2022

Child Adolesc Psychiatry Ment Health

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Background Unaccompanied refugee minors—or unaccompanied minors—are children and adolescents who have been separated from parents and other relatives and are not being cared for by an adult. Unaccompanied minors are a vulnerable population, with numerous stressors and complex psychiatric symptoms necessitating specialized mental health care. This study explores patients’ experiences of a Multimodal Co-Therapy for Unaccompanied Minors (MUCTUM), which encompasses cultural, biological, narrative & institutional approaches to care. Methods MUCTUM is a co-therapy program for unaccompanied minors, with a psychiatrist, psychologist, native-language interpreter, and caseworker for each patient. In this qualitative study, we interviewed adolescents about their experiences with MUCTUM and analyzed these semi-structured interviews using a phenomenological framework (Interpretative Phenomenological Analysis). Results Qualitative analysis of 16 interviews discovered that unaccompanied minors felt misunderstood before participating in MUCTUM, describing a sense of strangeness and loneliness in relation to psychiatric symptoms. Several youths experienced triple stigmatization: of being unaccompanied minors, of suffering from psychotrauma, and of being mental health patients. We further describe three overarching domains that inform on MUCTUM support to unaccompanied minors: (1) A safe space for unaccompanied minors; (2) Helpful interventions during therapy; and (3) Narrating one’s story can “set us free” if guided carefully by care providers. Conclusion This study suggests that MUCTUM therapy may efficiently support unaccompanied minors’ mental health by acknowledging their hierarchy of needs. Psychotherapeutic strategies include creating a safe place, providing culturally appropriate care and patient-centered therapy, addressing concrete problems, supporting relationships, and making use of limited reparenting in therapy. Delayed and progressive inquiry about traumatic events may be beneficial. Replication of these findings and their field application is warranted.

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Section: Methodsmentioning

confidence: 99%

“…The UM then explains why they drew, shaped, and colored the circles in such a way, as a support of narration of their path. Second, in the “three objects,” the patient is invited to bring (or think about) three objects that symbolize past, present, and future, to support the narrative process [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Multimodal co-therapy for unaccompanied minors: a qualitative study

Guessoum

Minassian

Staël

et al. 2022

Child Adolesc Psychiatry Ment Health

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“…Training in transcultural psychiatry in Université Paris Cité in France is embedded in the early curriculum and provided in later programs for care providers and cultural mediation (73,78). Training also occurs through mentoring during consultations, lecture courses, role-playing, or use of senior resident-assisted consultations.…”

Section: Training: Pluralistic Competencymentioning

confidence: 99%

Articulating biological and social approaches in child and adolescent psychiatry

Guessoum

Benoit

Thomas

et al. 2022

Front. Child Adolesc. Psychiatry

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Child and adolescent psychiatry has been based on numerous fields of research and theories, including neuroscience, physiology, psychology (developmental, psychodynamic, systemic, cognitive-behavioral, etc.), anthropology, sociology, and education sciences. Integrating transdisciplinary knowledge in multi-level models is an ongoing challenge for the future that is not immediately applicable in clinical practice and research. Articulating, i.e., to connect, to be jointed, (psycho)biological and (psycho)social approaches in child and adolescent psychiatry is a daily challenge for clinicians and researchers. Research is often limited to specific fields whereas real-life clinical practice needs a pluralistic approach. Research designs, tools, and clinical training need to provide knowledge applicable to the necessarily pluralistic daily clinical practice. This article provides some perspectives on how to articulate biological and social approaches, from research to clinical practice, and discusses the concept of pluralistic approaches, multimodal interventions, and how to provide articulated mental health care and training. Suggestions to better articulate biological and social approaches are provided: (I) State that the research object can be approached from different theoretical, research and clinical angles and explain the one chosen; (II) Propose synthesis articles that articulate biological and social knowledge; (III) Design biological studies that take into account social factors, and design social studies that take into account biological factors; (IV) Design transcultural tools; (V) Build pluralistic interventions, i.e., therapeutic modalities and mental health care settings that articulate biological and social approaches; (VII) Develop training in pluralistic articulated care.

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“…Ums thus need specific mental health care, with cross-cultural competencies and a focus on the migration experience and complex trauma [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Our department specializes in transcultural care and regularly receives patients referred either when their symptoms appear to be culturally coded, when the transcultural approach is necessary to create a bond difficult to establish otherwise [ 5 ], or at the request of other teams, when the first-line medical-psychological center ( Centres Medico-Psychologiques (CMP): First-line community public service dedicated to primary psychological and psychiatric care) seems unable—for whatever reason—to disentangle the multidimensional complexity of the situation…”

Section: Introductionmentioning

confidence: 99%

How Do We Address and Treat the Trauma of a 16-Year-Old Girl, Unaccompanied Minor, and Her Rape-Born Son? A Case Report

Radjack

Molino²,

Ogrizek

et al. 2022

Healthcare

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Background: The child psychiatry unit of the Cochin Hospital in Paris is specialized in a transcultural clinical approach and treatment of psychotraumatism. The clinical demands addressed to the service often combine several levels of vulnerability: recent migration, repeated and intentional traumas, isolation and breach in family bonds sometimes precarious living conditions. Mastering how to approach trauma content adapting to the person’s temporality while taking into account the individual, family and collective dimensions, is a key driver to the clinical intervention (of our approach). Objective and method: We describe a paradigmatic clinical situation articulating its multidimensional complexity: the case of Céline, a 16-year-old Mozambique teenager, unaccompanied minor (UM), who arrived in France three years ago with her 4-year-old child born out of rape. They are both cared for by Paris Child Welfare Bureau. The authors used the CARE guidelines for a rigorous approach to clinical case writing. Results and discussion: In the clinical discussion, we highlight the pertinence of transcultural abilities for the treatment of a complex PTSD (post-traumatic stress disorder). We describe the measures taken to adapt the clinical interview framework to the mother’s psychic temporality, while negotiating what can be said in attendance of the child. The idea of tranquility is primordial—whether she decides to tell or not tell the child. Removing the pressure to have to tell is an element of treatment. Conclusion: Working through a progressive narrative construction, the therapeutical process allowed for the restoration of multiple levels of continuity between times prior to the trauma and following it, as well as prior to migration and following it, to create a continuum from adolescence to adulthood. Restoring narrativity favors the process of becoming a mother and the one of negotiating this new identity. The therapeutic axes also focused on improving the well-being of the UM-mother and preventing the impacts of transgenerational trauma transmission to the child. For women with similar experiences, , sharing their emotions and their stories with us makes their choice about telling their child legitimate and comfortable, regardless of the decision they make.

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Cultural Competence of Professionals Working With Unaccompanied Minors: Addressing Empathy by a Shared Narrative

Cited by 17 publications

References 54 publications

Multimodal co-therapy for unaccompanied minors: a qualitative study

Multimodal co-therapy for unaccompanied minors: a qualitative study

Articulating biological and social approaches in child and adolescent psychiatry

How Do We Address and Treat the Trauma of a 16-Year-Old Girl, Unaccompanied Minor, and Her Rape-Born Son? A Case Report

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