Working with unaccompanied asylum-seeking young people: cultural considerations and acceptability of a cognitive behavioural group approach

Abstract

This paper outlines a psychological skills group for unaccompanied asylum-seeking young people with a focus on cultural adaptations in the context of a UK mental health service. Unaccompanied asylum-seeking young people have typically experienced multiple losses, traumatic experiences, significant disruption and psychosocial stressors. These experiences occur during a key developmental period and outside of the context of a supportive family environment. Mental health difficulties are estimated to be present in 41–69% of this population. Prevalence rates are higher than among children seeking asylum with their families or children who are not from refugee or asylum-seeking backgrounds. Cognitive behavioural approaches were considered to be applicable and useful when working with this client group. Group approaches may offer unique benefits for this population through peer support and normalization. The group described was planned around three key themes: physical health needs, emotional wellbeing and resilience-building. A number of adaptations were made to meet the needs of this population which included engagement, considering physical health needs, sleep, language needs, issues related to power, race and status, and thinking about the needs of the group as young people. Attendance ratings, session rating scale outcomes, preliminary effectiveness data and qualitative feedback from young people identified that this is an acceptable approach for these young people. Unaccompanied asylum-seeking young people require a broad package of care; however, making adaptations to routine practice allowed access to evidence-based interventions to support mental health and wellbeing.

Implementing Narrative Exposure Therapy for unaccompanied asylum-seeking minors with post-traumatic stress disorder: A pilot feasibility report

“…Other interventions and support were implemented alongside NET; therefore, the outcomes shown may not be only attributable to NET. However, evaluation of other psychosocial interventions within this client group did not demonstrate the same improvement in PTSD symptoms (King & Said, 2019).…”

“…It has been demonstrated that UAM may be better able to communicate mental health needs once they are already in contact with mental health services (Sanchez-Cao, Kramer, & Hodes, 2013). King and Said (2019) found that offering a psychological skills group enabled young people to develop their relationship to help and supported young people to engage in trauma-focused therapy.…”

“…The client was prescribed quetiapine and an SSRI (selective serotonin reuptake inhibitor) and received continued psychiatry reviews to monitor this, attending approximately once every 6 weeks over his episode of care in the team. All the clients were invited to attend an open psychological skills group, as outlined in King and Said (2019); two clients attended this regularly. When agreeing therapy goals with all clients, they reported that their PTSD re-experiencing symptoms were the most distressing and what they wanted help with from therapy.…”

Fast Feet Forward: Sports training and running practice to reduce stress and increase positive cognitions in unaccompanied asylum‐seeking minors

“…Furthermore, immigrants and refugees are less inclined than their native‐born counterparts to seek or be referred to mental health agencies (Le Meyer, Zane, Cho, & Takeuchi, 2009). In line with this, research has begun to highlight that group approaches with unaccompanied young people allow for the experience of peer support and the normalisation of therapeutic input (King & Said, 2019).…”

Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

“…Working with unaccompanied asylum-seeking young people: cultural considerations and acceptability of a cognitive behavioural group approach (King and Said, 2019) This paper describes the development of a culturally adapted intervention and outlines a psychological skills group for unaccompanied asylum-seeking children (UASC). The authors also report feasibility, acceptability and preliminary effectiveness of the intervention.…”