Traumatized Refugees in Psychotherapy: Long-Term Changes in Personality, Mental Health, Well-Being, and Exile Life Functioning

Convergence in a multi-method study between Rorschach and self-report data of traumatized refugees assessed before and after psychotherapy

Rorschach and self-report instruments represent methodologically different types of assessment, which together may yield incremental information about the test-taker. There is little evidence on whether and when results from these methods converge.

OBJECTIVE

To examine possible convergences between Rorschach trauma-related personality variables and self-reported variables.

METHOD

Before and after psychotherapy 22 traumatized adult refugee patients were assessed with the Rorschach Performance Assessment System (R-PAS), symptom checklists of posttraumatic stress, anxiety and depression, and a quality of life questionnaire. Correlational analyses between eight R-PAS variables and 10 self-reported variables were performed.

RESULTS

The findings showed inconsistent and nonsignificant correlations pretherapy. Posttherapy, however, all R-PAS variables except Complexity correlated positively with symptoms of mental disorder, and negatively with the quality of life variables, as predicted. The R-PAS variables Mutuality of Autonomy-Pathology, Poor Human Representation, Critical Content, and Form Quality-minus%, converged significantly with most of the self-reported variables, with medium to large correlations.

CONCLUSION

The finding of convergence only after psychotherapy, may tentatively suggest greater self-knowledge and internal consistency through the therapy experience, and increased trust and self-disclosure through the repeated meetings with the researchers. The findings represent a promising contribution to a cumulative validation process of convergence between Rorschach and self-report data.

Life and mental health in limbo of the Ukraine war: How can helpers assist civilians, asylum seekers and refugees affected by the war?

The terror spread by the war disrupts lives and severs families, leaving individuals and communities devastated. People are left to fend for themselves on multiple levels, especially psychologically. It is well documented that war adversely affects non-combatant civilians, both physically and psychologically. However, how the war puts civilians' lives in a limbo is an under-researched area. This paper focuses on three aspects: (1) how the mental health and well-being of Ukrainian civilians, asylum seekers, and refugees are affected by the war caused limbo; (2) what factors affect this process of being stuck in the limbo of war; and (3) how psychologists and helpers in the war-ridden and host countries can provide meaningful support. Based on the authors' own practical work with Ukrainian civilians, refugees, and professional helpers during the war, this paper provides an overview of multi-level factors that impact human psyches in a war, and possible ways to help those who are living in the war limbo. In this research and experiential learning-based review, we offer some helpful strategies, action plans, and resources for the helpers including psychologists, counselors, volunteers, and relief workers. We emphasize that the effects of war are neither linear nor equal for all civilians and refugees. Some will recover and return to a routine life while others will experience panic attacks, trauma, depression, and even PTSD, which can also surface much later and can prolong over the years. Hence, we provide experience-based ways of dealing with short-term and prolonged trauma of living with war and post-traumatic stress disorder (PTSD). Mental health professionals and other helpers in Ukraine and in host countries can use these helping strategies and resources to provide effective support for Ukrainians and for war refugees in general.

Predictors of the 10 year course of mental health and quality of life for trauma-affected refugees after psychological treatment

Background: Trauma-affected refugee patients benefit from psychological treatment to different degrees. Only a handful of studies has investigated potential predictors of treatment outcome that could throw light on the great variability in outcomes reported for this group. Such knowledge may be vital to better tailor prevention and treatment efforts to the needs of different individuals and subgroups among these patients. Objective: In a naturalistic and longitudinal study, the aim was to analyse demographics and traumatic exposure as potential predictors of the participants' long-term trajectories of mental health symptoms and quality of life. Method: A group of 54 multi-origin adult refugee patients with complex traumatic exposure, such as armed conflicts, persecution, torture, and childhood adversities, were interviewed face to face over up to 10 years; at therapy admittance, and at varying points in time during and after psychotherapy. Checklists of war-related and childhood trauma, mental health symptoms, and quality of life were included in the interviews. In linear mixed effects analyses, interaction was analysed with potential predictors included separately because of the sample size. Time was modelled as continuous from inclusion into the study. Results: Gender predicted the course of symptoms of post-traumatic stress, anxiety, and depression, and of quality of life in physical health and social relationships. Childhood family violence and experiences of torture predicted the course of depression, whereas the extent of exposure to war-related trauma events and having experienced torture predicted the course of anxiety. Conclusions: The results indicated greater chronicity in male refugees, in refugees who had experienced domestic violence during childhood, in refugees who had experienced torture, and in refugees with more numerous types of potentially traumatic war-related experiences. The findings highlight the need for gender-sensitive research, rehabilitative efforts, and treatment. HIGHLIGHTS In a 10 year longitudinal and naturalistic therapy follow-up study of traumatized refugees, female gender, childhood trauma, war trauma, and torture predicted mental health and quality of life outcomes.Male participants responded less than females to therapy.