Transcultural aspects in the treatment of posttraumatic and situational distress among middle eastern refugees

Abstract

The increasing size of displaced populations seeking protection in third countries, should be considered in public health and especially in Psychotherapy in that countries. Refugees from the Middle East, usually from collective cultures, require special skills and modifications in the treatment setting. The cultural formulation (CF) of illness and suffering, as described in the recent version of medical standard manuals, is part of this challenge. Besides bridging cultures, the specific nature of trauma, especially highly complex issues such as a genocidal environment, - in our case example - the both transgenerational and the immediate persecution experienced by the Yazidi ethnic and religious minority - the therapist must also consider aspects of distress caused by displacement and exile. The article discusses the needed adaptations in the therapeutic setting, using the case of a Yezidi woman surviving ISIS violence abduction. Within the framework of our treatment, she received cognitive behavioral therapy with individual and group therapies (multimodal interventions) over a period of 10 weeks. Besides establishing stability, safety and orientation and strengthening her self-consciousness, her traumatic experiences were considered from an individual, collective, socio - cultural and political point of view. Both the causes and maintaining conditions of the symptoms as well as the symptoms themselves are being worked on. The sensitive confrontation with the trauma was particularly helpful for the patient. In addition, she learned to participate actively in everyday life and in new social contacts again during therapy. She was able to overcome the passive - avoidant lifestyle since the traumatic event in a somewhat stable manner, although she will still need time to develop a stable perspective in the long term. She was offered the prospect of renewed follow-up treatment if necessary.