Asylum-seekers' experiences of trauma-focused cognitive behaviour therapy for post-traumatic stress disorder: a qualitative study.
BACKGROUND
Trauma-focused CBT (TFCBT) is an evidence-based treatment for posttraumatic stress disorder (PTSD), but little is known about whether it is an acceptable and effective treatment for asylum-seekers presenting with PTSD.


OBJECTIVE
This study considers the acceptability of TFCBT for asylum-seekers with PTSD by exploring their experiences of this treatment.


METHODS
Seven asylum-seekers who had received CBT involving a TFCBT component were interviewed using a semi-structured schedule. The transcribed interviews were analysed using interpretative phenomenological analysis (IPA). Interpretative themes were developed iteratively to closely reflect participants’ common and distinct experiences.


RESULTS
Six super-ordinate interlinking themes are discussed: Staying where you are versus engaging in therapy; Experiences encouraging engagement in therapy; Experiences impeding engagement in therapy; Importance of the therapeutic relationship; “Losing oneself” and “Regaining life”.


CONCLUSIONS
Participants described their ambivalence about engaging in TFCBT. Such treatment was experienced as very challenging, but most participants also reported finding it helpful. Various experiences that appeared to encourage or impede engagement are outlined. These preliminary findings suggest that fear of repatriation can impede engagement in TFCBT, but that some asylum-seekers with PTSD still report finding TFCBT beneficial. The clinical implications are discussed, including the special importance of the therapeutic relationship.
Child and Adolescent Mental Health Service, Birmingham, UK.
Felicity
F
Vincent
Helen
H
Jenkins
Michael
M
Larkin
Sue
S
Clohessy
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003906:Developing Countries; D004739:England; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D017060:Patient Satisfaction; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D014852:Wales; D055815:Young Adult