Transcultural Clinical Work with Immigrants, Asylum Seekers and Refugees at Avicenne Hospital, France

Abstract

This article presents and critically analyses an approach that is part of a specific context of health care ideologies and services in France: the ethnopsychoanalytic consultations that are practised at the Avicenne Hospital. It is one of the few places where a specific approach for immigrant clients is offered in a university hospital. We give some background information both on the history of the hospital and on the ethnopsychiatric consultation. We then discuss some of the basic principles of the French ethnopsychoanalytic approach, and describe the work in a multicultural group setting.We also give some information about the indications for this kind of therapy, on the population served and on the way the transcultural consultation co-operates with other services. A short case presentation will illustrate the description of the French ethnopsychoanalytical approach and lead to a critical conclusion analysing the strengths and weaknesses of this model.

Clinical approaches to cultural diversity in mental health care and specificities of French transcultural consultations: A narrative review.

“…The adaptation of mental health care to a context of cultural diversity began in English-speaking countries in the 1970s and in France in the 1980s (12,14).…”

“…According to Devereux, the basic mechanisms of mental functioning are universal, but the processes of an individual's socialization in their culture of origin must be understood to be able to access this universal dimension, since these cultural processes generate diverse and varied clinical events (10,14). From this paradigm, Tobie Nathan at the Avicenne Public Hospital created an innovative psychotherapeutic framework intended for migrant families: the ethnopsychiatry group.…”

“…Accordingly, anthropological and clinical psychoanalytic approaches are used. The clinical approaches rest on elements from psychoanalytic parent-children therapy, narrative therapy, and systemic and psychoanalytic family therapy, combined with techniques of cultural mediation (14).…”

“…Healthcare systems can adapt in several ways: using interpreters and cultural mediators, training professionals in cultural competence ( Table 1) and supervision, making innovations in the therapeutic framework of general mental health services, and developing specialized clinics for ethnic minorities (8,10,(12)(13)(14)(15)(16)(17)(18)(19). In France, a complete psychotherapeutic method was conceived in the 1980s by T. Nathan and then expanded by MR Moro (one of the authors) for the management of migrant families facing issues that cannot be solved in standard psychotherapy: Transcultural Psychotherapy (TPT).…”

Une clinique de l’accueil et de l’accompagnement. La prise en charge d’une famille demandeur d’asile politique réfugiée en France

“…Nous travaillons selon des modalités de consultation particulières [22] : la famille est reçue par un petit groupe de thérapeutes et un traducteur 2 . L'organisation de la parole passe par un thérapeute principal avec des modalités d'intervention qui cherchent davantage à produire du récit qu'à interpréter avec une prise en compte clinique des aspects culturels [3] et du vécu traumatique du groupe familial.…”