Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Psychotherapy | Research article

A qualitative exploration of what works for migrant adolescents in transcultural psychotherapy: perceptions of adolescents, their parents, and their therapists

Authors: Léa Grau, Emilie Carretier, Marie-Rose Moro, Anne Revah-Levy, Jordan Sibeoni, Jonathan Lachal

Published in: BMC Psychiatry | Issue 1/2020

Login to get access

Abstract

Background

Migrant adolescents are at a higher risk than their native-born counterparts of psychiatric disorders, and their care is a public health issue. In France, transcultural psychotherapy is a treatment provided by a group of therapists designed to meet the specific needs of these patients when usual care appears ineffective. The objective of this study was to explore the therapeutic elements at work in transcultural psychotherapy.

Methods

We conducted a qualitative study crossing the perspectives of adolescents receiving transcultural psychotherapy, their parents, their first-line therapist (FLT), and the transcultural therapists. The families were chosen by purposive sampling. Data were collected during semi-structured individual (for FLTs) and group (families and transcultural therapists) interviews that explored the therapeutic elements involved and effective in transcultural psychotherapy. We used interpretative phenomenological analysis (IPA) to examine the data. In all, 44 participants were questioned: three adolescents (2 girls and 1 boy, all aged 18 to 21 years) and their parents (3 mothers and 1 father), three FLTs (2 child psychiatrists and 1 psychologist), and the 34 therapists participating in the three transcultural psychotherapy groups.

Results

The analysis uncovered three themes: (1) the perceived effectiveness of the group’s functioning; (2) the recounting of the individual, family, and cultural history to allow for complexity and nuance; and (3) the personal investment by therapists, made possible by the group.

Conclusions

Our results show some therapeutic elements at work in transcultural psychotherapy that enable it to meet the particular needs of some migrant adolescents that are unmet in standard therapy. Continuing to study transcultural psychotherapy and assess its effectiveness is essential for promoting and optimizing psychiatric care for migrant adolescents.
Literature
1.
Ceri V, Özlü-Erkilic Z, Özer Ü, Kadak T, Winkler D, Dogangün B, et al. Mental health problems of second generation children and adolescents with migration background. Int J Psychiatry Clin Pract. 2017;21(2):142–7.PubMedCrossRef
2.
3.
Belhadj Kouider E, Koglin U, Petermann F. Emotional and behavioral problems in migrant children and adolescents in Europe: a systematic review. Eur Child Adolesc Psychiatry. 2014;23(6):373–91.PubMedCrossRef
4.
de Anstiss H, Ziaian T, Procter N, Warland J, Baghurst P. Help-seeking for mental health problems in young refugees: a review of the literature with implications for policy, practice, and research. Transcult Psychiatry. 2009;46(4):584–607.PubMedCrossRef
5.
Sirin SR, Ryce P, Gupta T, Rogers-Sirin L. The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation. Dev Psychol. 2013;49(4):736–48.PubMedCrossRef
6.
Kirmayer L, Fung K, Rousseau C, Lo H-T, Menzies P, Guzder J, et al. Guidelines for training in cultural psychiatry-position paper. Can J Psychiatry. 2012;57:Insert 1–16.CrossRef
7.
Kleinman AM. Depression, somatization and the “new cross-cultural psychiatry”. Soc Sci Med. 1977;11(1):3–9.PubMedCrossRef
8.
Nadeau L, Jaimes A, Johnson-Lafleur J, Rousseau C. Perspectives of migrant youth, parents and clinicians on community-based mental health services: negotiating safe pathways. J Child Fam Stud. 2017;26(7):1936–48.PubMedPubMedCentralCrossRef
9.
Cummings JR, Druss BG. Racial/ethnic differences in mental health service use among adolescents with major depression. J Am Acad Child Adolesc Psychiatry. 2011;50(2):160–70.PubMedCrossRef
10.
Carballeira Carrera L, Lévesque-Daniel S, Radjack R, Moro M, Lachal J. Clinical approaches to cultural diversity in mental health care and specificities of French transcultural consultationsIn Review; 2019.
11.
12.
Kirmayer LJ, Minas H. The future of cultural psychiatry: an international perspective. Can J Psychiatry. 2000;45(5):438–46.PubMedCrossRef
13.
Santhanam-Martin R, Fraser N, Jenkins A, Tuncer C. Evaluation of cultural responsiveness using a transcultural secondary consultation model. Transcult Psychiatry. 2017;54(4):488–501.PubMedCrossRef
14.
Fernando S. Multicultural mental health services: projects for minority ethnic communities in England. Transcult Psychiatry. 2005;42(3):420–36.PubMedCrossRef
15.
Horlings A, Hein I. Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools. Eur J Pediatr. 2018;177(2):163–9.PubMedCrossRef
16.
Onyut LP, Neuner F, Schauer E, Ertl V, Odenwald M, Schauer M, et al. Narrative exposure therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement. BMC Psychiatry. 2005;5:7.PubMedPubMedCentralCrossRef
17.
Oras R, de Ezpeleta SC, Ahmad A. Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nord J Psychiatry. 2004;58(3):199–203.PubMedCrossRef
18.
Unterhitzenberger J, Eberle-Sejari R, Rassenhofer M, Sukale T, Rosner R, Goldbeck L. Trauma-focused cognitive behavioral therapy with unaccompanied refugee minors: a case series. BMC Psychiatry. 2015;15(1):260.PubMedPubMedCentralCrossRef
19.
Gesine S, Felicia H, Rose MM. Transcultural clinical work with immigrants, asylum seekers and refugees at Avicenne hospital, France. Int J Migr Heal Soc Care. 2009;4(4):33–40.CrossRef
20.
21.
22.
23.
Luborsky L, Rosenthal R, Diguer L, Andrusyna TP, Berman JS, Levitt JT, et al. The dodo bird verdict is alive and well—mostly. Clin Psychol Sci Pract. 2002;9(1):2–12.CrossRef
24.
Lambert MJ, Barley DE. Research summary on the therapeutic relationship and psychotherapy outcome. Psychother Theory Res Pract Train. 2001;38(4):357–61.CrossRef
25.
Cuijpers P, Reijnders M, Huibers MJH. The role of common factors in psychotherapy outcomes. Annu Rev Clin Psychol. 2019;15(1):207–31.PubMedCrossRef
26.
Murphy R, Hutton P. Practitioner review: therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta-analysis. J Child Psychol Psychiatry. 2018;59(1):5–19.PubMedCrossRef
27.
Kazdin AE, Marciano PL, Whitley MK. The therapeutic alliance in cognitive-behavioral treatment of children referred for oppositional, aggressive, and antisocial behavior. J Consult Clin Psychol. 2005;73(4):726–30.PubMedCrossRef
28.
29.
Moro MR. Parenthood in migration: how to face vulnerability. Cult Med Psychiatry. 2014;38(1):13–27.PubMedCrossRef
30.
31.
Truog RD. Patients and doctors — the evolution of a relationship. N Engl J Med. 2012;366(7):581–5.PubMedCrossRef
32.
Hayes D, Edbrooke-Childs J, Town R, Wolpert M, Midgley N. Barriers and facilitators to shared decision making in child and youth mental health: clinician perspectives using the theoretical domains framework. Eur Child Adolesc Psychiatry. 2019;28(5):655–66.PubMedCrossRef
33.
34.
APA Presidential Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am Psychol. 2006;61(4):271–85.CrossRef
35.
Hill CE, Chui H, Baumann E. Revisiting and reenvisioning the outcome problem in psychotherapy: an argument to include individualized and qualitative measurement. Psychotherapy. 2013;50(1):68–76.PubMedCrossRef
36.
Sibeoni J, Verneuil L, Manolios E, Révah-Levy A. A specific method for qualitative medical research: the IPSE (inductive process to analyze the structure of lived experience) approach. BMC Med Res Methodol. 2020;20(1):216.PubMedPubMedCentralCrossRef
37.
Elliott R. Qualitative methods for studying psychotherapy change processes. In: Harper D, Thompson A, éditeurs. Qualitative research methods in mental health & psychotherapy. Chichester: Wiley-Blackwell; 2011 [cité 3 avr 2019]. p. 69-81. Disponible sur: https://​strathprints.​strath.​ac.​uk/​42662/​.
38.
Carretier E, Grau L, Mansouri M, Moro MR, Lachal J. Qualitative assessment of transcultural psychotherapy by adolescents and their migrant families: subjective experience and perceived effectiveness. PLoS One. 2020;15(8):e0237113.PubMedPubMedCentralCrossRef
39.
Patton M. Qualitative research and evaluation methods, 3rd éd. Thousand Oaks: Sage Publications; 2002.
40.
Smith JA, Osborn M. Interpretative phenomenological analysis. In: Qualitative psychology: a practical guide to research methods. 2nde édition (2008) ed. London: Sage; 2003. p. 53–80.
41.
Husserl E. Cartesian meditations : an introduction to phenomenology. Martinus Nijhoff Pub: Leyde; 1977.CrossRef
42.
Lachal J, Simon A, Hassler C, Barry C, Camara H, Massari N, et al. Epidemiological description of 529 families referred for French transcultural psychotherapy: a decade of experience. PLoS One. 2020;15(8):e0236990.PubMedPubMedCentralCrossRef
43.
Barrett MS, Berman JS. Is psychotherapy more effective when therapists disclose information about themselves? J Consult Clin Psychol. 2001;69(4):597–603.PubMedCrossRef
44.
Knox S, Hill CE. Therapist self-disclosure: research-based suggestions for practitioners. J Clin Psychol. 2003;59(5):529–39.PubMedCrossRef
45.
Goldfried MR, Burckell LA, Eubanks-Carter C. Therapist self-disclosure in cognitive-behavior therapy. J Clin Psychol. 2003;59(5):555–68.PubMedCrossRef
46.
Simonds LM, Spokes N. Therapist self-disclosure and the therapeutic alliance in the treatment of eating problems. Eat Disord. 2017;25(2):151–64.PubMedCrossRef
47.
Brown JR, Holloway ED, Akakpo TF, Aalsma MC. « straight up »: enhancing rapport and therapeutic alliance with previously-detained youth in the delivery of mental health services. Community Ment Health J. 2014;50(2):193–203.PubMedCrossRef
48.
Winnicott DW. The child and the family: first relationships. London: Tavistock publications; 1957. p. 147.
49.
Bion W. Experiences in groups. London: Tavistock; 1961.
50.
Kaës R. The question of the unconscious in common and shared psychic spaces. In: The unconscious: further reflections. London: International Psychoanalytical Association; 2007. p. 93–119.
51.
Radjack R, Rizzi AT, Harf A, Moro MR. Actualités en psychiatrie transculturelle en France. Annales Médico-psychologiques, revue psychiatrique. 2017;175(6):561–6.CrossRef
52.
Zempléni A. Le Sens de l’insensé : de l’interprétation « magico-religieuse » des troubles psychiques. Psychiatr Fr. 1983;14(4):29–47.
53.
Lecomte G, Castonguay LG. Rapprochement et intégration en psychothérapie: psychanalyse, behaviorisme et humanisme. Montréal: Gaétan Morin; 1987.
54.
Diorinou M, Tseliou E. Studying circular questioning « in situ »: discourse analysis of a first systemic family therapy session. J Marital Fam Ther. 2014;40(1):106–21.PubMedCrossRef
55.
Altimir C, Capella C, Núñez L, Abarzúa M, Krause M. Meeting in difference: revisiting the therapeutic relationship based on patients′ and therapists′ experiences in several clinical contexts. J Clin Psychol. 2017;73(11):1510–22.PubMedCrossRef
56.
Hawley KM, Weisz JR. Youth versus parent working alliance in usual clinical care: distinctive associations with retention, satisfaction, and treatment outcome. J Clin Child Adolesc Psychol. 2005;34(1):117–28.PubMedCrossRef
57.
Kivlighan DM Jr, Arthur EG. Convergence in client and counselor recall of important session events. J Couns Psychol. 2000;47(1):79–84.CrossRef
Metadata
Title
A qualitative exploration of what works for migrant adolescents in transcultural psychotherapy: perceptions of adolescents, their parents, and their therapists
Authors
Léa Grau
Emilie Carretier
Marie-Rose Moro
Anne Revah-Levy
Jordan Sibeoni
Jonathan Lachal
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Psychotherapy
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02970-w

Other articles of this Issue 1/2020

BMC Psychiatry 1/2020 Go to the issue

Research article

The use of the Hungarian Test Your Memory (TYM-HUN), MMSE, and ADAS-Cog tests for patients with mild cognitive impairment (MCI) in a Hungarian population: a cross-sectional study

Research article

Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

Research article

A systematic review of validated screening tools for anxiety disorders and PTSD in low to middle income countries

Research article

The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: a moderated mediation model

Research article

Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting

Research article

Gender differential impact of bereavement on health outcomes: evidence from the China Health and Retirement Longitudinal Study, 2011–2015