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Softas-Nall, Basilia

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This study examined the perceptions of mental health professionals through their experiences of adapting counseling treatments to meet the cultural needs of their refugee clients. For this interpretative phenomenological study, 11 licensed clinicians participated in in-depth, semi-structured interviews that utilized multicultural counseling and vicarious trauma theories. Results were presented in superordinate and subordinate themes. This study added to the literature and exploration of the unique experiences of mental health providers culturally adapting their counseling approaches in order to provide more effective services to refugee communities. Participants discussed the influences of their cultural backgrounds, the challenges, supports, and areas of growth they experienced in their academic training and their experiences of working with interpreters, colleagues, and supervisors in their professional careers of providing mental health services to refugee clients. The participants discussed ways in which they had experiences of low professional self-efficacy, difficulties with cultural boundary negotiations, vicarious trauma, stress, exhaustion, or professional overwhelm in the early stages of their adaptation process. Areas of support for participants included culturally sensitive supervision and consultation from peers and utilization of cultural expertise from interpreters. Themes identified using interpretative analysis included the early stages of (a) clinicians’ cultural backgrounds, (b) influences of academic training followed by the initial professional challenges of (c) trial-and-error learning, and (d) vicarious trauma, as well as supportive experiences with (e) interpreters/cultural navigators, (f) identifying clients’ strengths and areas of resilience, and (g) supervision/consultation with other professionals who had experience working with refugee communities. Participant clinicians reflected on ways in which the collective influence of each aspect of these developmental stages resulted in shifts in their therapeutic conceptualizations, resulting in (h) effective cultural adaptations, (i) increased counseling self-efficacy and more secure professional identities. These results provided a more comprehensive perspective on experiences of the adaptation process of mental health providers when working with clients from refugee backgrounds. The results gave context to the developmental process participants experienced and insight into the changes in clinical conceptualization and transformative professional identity that emerged from the challenges and areas of support they experienced during each stage of their professional progression. Suggestions for counseling psychologists, supervisors, mental health professionals, and academic trainers to use in their work included reflective examination of the influences and impact of clinicians’ cultural identities on clients as well the cultural influences on the mental health paradigms in academic training. Supervisors could assist in the validation and normalization of the stress involved with early stages of the adaptation process and in providing concrete cultural knowledge and feedback to align with developmental stages of their trainees. Research on cultural adaptations for refugee clients should continue to explore the clinical frameworks to guide adaptation processes with additional emphasis on developmental models for adaptation including clinician examination of the influences of their own cultural backgrounds and the cultural foundations of the academic training from which their treatments were adapted. Sharing narratives of clinical experience regarding the unique aspects of providing mental health services to refugee communities could serve to support fledgling professionals in navigating the early challenges of the developmental process and lead to an increase in the efficacy of care for clients and communities in need of services.


184 pages

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