TY - JOUR
T1 - Refugees and asylum seekers who have experienced trauma
T2 - Thematic synthesis of therapeutic boundary considerations
AU - Davoren, Niamh
AU - McEleney, Alice
AU - Corcoran, Santhi
AU - Tierney, Phelim
AU - Fortune, Dónal G.
N1 - Publisher Copyright:
© 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Objective: Therapeutic boundaries are limits to appropriate behaviours within a therapist–client relationship (e.g. related to accepting gifts, self-disclosures, therapist neutrality and advocacy). Therapeutic boundary considerations are fundamental in the care of refugees and asylum seekers. Research on the experiences of therapists navigating such boundaries is sparse and warrants further exploration. The aim of this qualitative systematic review was to thematically synthesise literature regarding therapists' (psychologists, psychotherapists, counsellors) experiences of implementing flexible therapeutic boundaries with refugee and asylum seeker clients and determine how such applications have been helpful for therapeutic interventions. Method: Six databases were searched. Following full-text screening, 21 papers were included in the analysis. Boundary theory underpinned the analysis. Results: Three major themes were developed: (i) Changes to Therapeutic Practice & Therapeutic Intervention, (ii) Re-Conceptualisation of Therapy as ‘Clinical Political’ and Re-Conceptualisation of Therapist Identity and (iii) Careful Monitoring of Personal Boundaries—Not becoming ‘Hardened’ or ‘Haunted’. Papers described how, when used in a reflective, considerate way, flexible therapeutic boundaries can strengthen the therapist–client alliance and positively impact therapeutic interventions. Many therapists acknowledged making conscious efforts to re-conceptualise therapeutic work with refugee and asylum seeker clients from advocacy standpoints. However, systemic constraints, and lack of guidance, made this difficult to navigate and contributed to therapist burn-out. Conclusions: Boundary considerations manifested as interpersonal, structural and cultural changes to practice. These have implications for clinical practice and developing guidelines on boundary practices with refugees and asylum seekers. Future research should explore promoting therapist well-being and training needs for therapists supporting this population.
AB - Objective: Therapeutic boundaries are limits to appropriate behaviours within a therapist–client relationship (e.g. related to accepting gifts, self-disclosures, therapist neutrality and advocacy). Therapeutic boundary considerations are fundamental in the care of refugees and asylum seekers. Research on the experiences of therapists navigating such boundaries is sparse and warrants further exploration. The aim of this qualitative systematic review was to thematically synthesise literature regarding therapists' (psychologists, psychotherapists, counsellors) experiences of implementing flexible therapeutic boundaries with refugee and asylum seeker clients and determine how such applications have been helpful for therapeutic interventions. Method: Six databases were searched. Following full-text screening, 21 papers were included in the analysis. Boundary theory underpinned the analysis. Results: Three major themes were developed: (i) Changes to Therapeutic Practice & Therapeutic Intervention, (ii) Re-Conceptualisation of Therapy as ‘Clinical Political’ and Re-Conceptualisation of Therapist Identity and (iii) Careful Monitoring of Personal Boundaries—Not becoming ‘Hardened’ or ‘Haunted’. Papers described how, when used in a reflective, considerate way, flexible therapeutic boundaries can strengthen the therapist–client alliance and positively impact therapeutic interventions. Many therapists acknowledged making conscious efforts to re-conceptualise therapeutic work with refugee and asylum seeker clients from advocacy standpoints. However, systemic constraints, and lack of guidance, made this difficult to navigate and contributed to therapist burn-out. Conclusions: Boundary considerations manifested as interpersonal, structural and cultural changes to practice. These have implications for clinical practice and developing guidelines on boundary practices with refugees and asylum seekers. Future research should explore promoting therapist well-being and training needs for therapists supporting this population.
KW - boundaries
KW - cross-cultural
KW - psychologists and psychotherapists
KW - refugees and asylum seekers
KW - therapeutic intervention
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85169707165&partnerID=8YFLogxK
U2 - 10.1002/cpp.2894
DO - 10.1002/cpp.2894
M3 - Review article
AN - SCOPUS:85169707165
SN - 1063-3995
VL - 31
JO - Clinical Psychology and Psychotherapy
JF - Clinical Psychology and Psychotherapy
IS - 1
M1 - e2894
ER -