Therapeutic practice with refugee clients: A qualitative study of therapist experience

Background: There is limited research on the subjective experience of therapists and their understanding of therapeutic process when working with people from refugee backgrounds. Objective: This study provides a qualitative account of therapists' conceptions of therapeutic practice and experiences of working therapeutically with refugee clients. Method: Participants were 12 mental health workers who had worked therapeutically with people from refugee backgrounds, with an average of 7.6 years (range 1.5-16 years) of experience in this field. Participants completed a semi-structured interview and completed a brief quantitative survey. Findings: Thematic analysis revealed a number of superordinate themes. Four key themes are explored in this study: principles of therapeutic practice; therapy as a relational experience; the role of context in informing therapeutic work with refugee clients; and the impact of therapeutic work on the therapist. Discussion: The results revealed the complexity and demands of working with people from refugee backgrounds. Further, the lack of research evidence for the methods of therapeutic practice described in this study highlights the distinction between naturalistic therapeutic practice and the current state of the evidence regarding therapeutic interventions for refugee clients. The findings have important implications for training and supporting therapists to work with people who have fled their countries of origin and who have often been exposed to highly traumatic events.