Clinical Considerations in the Psychological Treatment of Refugees

The refugee experience is a complex phenomenon and subject to a multitude of influencing factors including reminiscences of the traumatic past, and distress related to post-migration and ecological factors. While posttraumatic stress disorder (PTSD) is highly prevalent among refugees, psychiatric comorbidity is rather the rule than the exception. Though the literature provides evidence for the effectiveness of trauma-focused treatment in reducing symptoms of PTSD among refugees, PTSD may neither be the only nor the most important aspect, and the exclusive therapeutic focus on PTSD often does not result in satisfactory treatment responses. This chapter seeks to put the refugee experience into a broader context integrating clinically relevant aspects of pre- and post-migration. Practical recommendations are given in order to overcome obstacles and pitfalls and to achieve more favorable outcomes in the treatment of this vulnerable population. Clinical considerations are illustrated by two case reports