Examining the Therapeutic Process with Refugee Youth

In an effort to make mental health services more accessible to and appropriate for refugee and immigrant youth, mental health practitioners are increasingly adopting community-based, comprehensive models of clinical practice that bridge therapy, case management, and advocacy. Though existing empirical evidence, however limited, suggests these programs are successful in improving outcomes and reducing symptoms for refugee children and adolescents, little is known about the specific tactics individual clinicians employ to guide the therapeutic process within these settings. To answer the question, “How do mental health clinicians supporting refugee clients approach clinical practice?” this study used grounded theory coding to thematically analyze semi-structured interviews previously conducted with five mental health clinicians working in community-based clinical practice with refugee youth. Results suggest that clinicians cultivate expansive, non-traditional therapeutic relationships with their clients and other actors as a means of bridging cultural difference and responding to clients’ complex needs. Particular strategies clinicians used to build these relationships were examined, and ethical dilemmas regarding establishing boundaries emerged. These findings provide a nuanced understanding of the mechanics of community practice and its personal impact on practitioners while at the same time underscoring the need for clinical training that better prepares professionals to work with diverse clients