Effective Clinical Interventions with Asylum Seekers
Clinical Master Class Evening held on 26 November 2014
These recorded lectures are available to be viewed for a small fee at Psychevisual.
Clinical Models for Working with Asylum Seekers and Refugees Facing Insecure Residency
Professor Zachary Steel
The experience of asylum seekers and refugees who face the risk of forced repatriation differs in critical ways from the general pattern of refugees who have secure residency. Clinical research conducted by STARTTS and by UNSW Psychiatry Research and Teaching Unit has documented the presence of an anticipatory traumatic stress condition amongst refugees with insecure residency associated with vivid distressing intrusive thoughts about the future that is distinct but associated with posttraumatic stress disorder. This research has found that both PTSD and anticipatory stress symptoms were highly responsive to changes in residency status across a two year period, but with anticipatory traumatic fear showing heightened sensitivity to continuing uncertainty. The identification of anticipatory traumatic stress associated with intrusive future oriented fears may help to explain the exceptionally high rates of apparent posttraumatic stress symptoms in post-conflict settings characterised by ongoing security and safety concerns. Another key question that arises from the identification of an anticipatory traumatic response is the extent to which clinical interventions are able to assist asylum seeker and refugees while they still face ongoing uncertainty. There is a growing body of evidence however that suggests that even in situations of threat there may be important clinical outcomes that can be achieved by targeted clinical interventions and support. Clinical models to guide such interventions were discussed and reviewed.
Aren’t they Ordinary People? They are just like you and me….but, have survived extraordinary challenges
Australia’s introduction of offshore processing and detention centres is seen by some refugee advocates as a strategy to dehumanise and distort genuine claims of asylum seekers. The shroud of humiliation and culture of disbelief it generates has the potential to exacerbate symptoms of asylum seekers and further impair their healing and recovery. Looking at the issue pragmatically, people like my client “Vijay”, sacrifice everything and risk their lives in attempts to find a safe haven. However, overwhelmed by helplessness, grief, guilt and shame upon their realisation that there is no real end to their miseries in the foreseeable future, their past returns to haunt them with renewed vigour. Many of the recently introduced draconian measures remind them of the regimes they have escaped from. As clinicians we run the risk of “hardening our hearts” and succumbing in this political conundrum or feel equally helpless and get swept away by the tide of compassion. In this case presentation Pearl Fernandes illustrated how as clinicians we may tap into and unleash the wellsprings of courage and resilience in our refugee clients.