Muslim Middle Eastern clients' reflections on their relationship with their occupational therapists in mental health care

Abstract

Persons with a Middle Eastern background represent a minority in Sweden which has significantly increased in size over recent years. The purpose of the present study was to explore the elements that shape the experiences and perceptions of clients with a Middle Eastern background living by Muslim norms who received occupational therapy in mental health care at the time of participating in the study. The study included interviews with 11 clients who received occupational therapy in mental health care. Data collection and analysis were carried out in accordance with the grounded theory approach. One core category, desiring a union, described the clients' desire for an alliance with the therapists that encompassed the realities and truths embedded in their values, preferences, world-views, and belief systems, as well as a wish to reconstruct their abilities to function and perform daily life tasks within their cultural contexts. The core category included sub-categories: desiring relationship, desiring affiliation, and desiring affirmation as well as some related components. The overall findings showed a tentative model in which the notion of mahram affinity was embedded. The results demonstrated that the clients' views regarding desiring a union had their support in collectivistic world-views that often clash with those of the therapists.

Immigration, Participation in Health Services and Social Occupations: A Literature Review

“…The second relates to the current environment of the country of immigration. This is similar to Pooremamali et al 18 who highlight the confusion experienced by young immigrants with mental health problems between the culture of family and health care professionals within the host country. Understanding the interaction between the person, occupation and environment is fundamental to understanding clients' occupational life.…”

“…Evidence supports that culturally adapted occupational therapy interventions have been successful in helping immigrant clients with mental health to managing their new situation. 18 There has been great emphasis on cultural sensitivity 51 and culturally responsive care 52 during the past decades, but none of the studies seemed to have paid attention to the details of the quality of culturally adopted health care services. Several studies considered diversity in nationalities, ethnicity and religion, and culture in the sense of beliefs and life patterns, as obstacles to the provision of health services.…”

“…30,32,35,42,53 However, none has studied cultural differences as an empowering or enabling factor in the social and community participation of immigrants. 18,19,34,54 The concept of culture also appears to have been simplified. The depth of the concept of culture with "… shared experience and meaning, as well as process involved in creating, ascribing and maintaining meaning to objects and phenomena in the world. "…”

“…Successful occupational therapy intervention for immigrant clients has proven to be where special attention to the clients' narratives has enabled them to find themselves within their past, present and future as an occupational being. 18 There are studies that support that immigration could be turned into a positive experience for clients and be employed as an enabling factor, instilling hope for the future. 57,58 Conversely, viewing immigration as a negative characteristic of a client could create an obstacle in establishing trust and building a therapeutic relationship, which is one of the central aspects of occupational therapy intervention.…”

“…17 Up until now previous studies within the field of occupational therapy, in particular mental health, have shown several shortcomings in providing optimum intervention to immigrant clients, due to differences in world views between clients and staff about the concept of occupation, participation and their potential values. 18,19 The problem is that when looking at variety of disciplines, it appears that immigrants' participation has been identified differently across publications. A wide range of factors is linked to immigrants' participation in community, social and health services.…”