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Guessoum SB, Minassian S, de Staël P, Touhami F, DiGiovanni M, Radjack R, Moro MR, Benoit L. Multimodal co-therapy for unaccompanied minors: a qualitative study. Child Adolesc Psychiatry Ment Health 2022; 16:81. [PMID: 36344979 PMCID: PMC9641960 DOI: 10.1186/s13034-022-00518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Unaccompanied refugee minors-or unaccompanied minors-are children and adolescents who have been separated from parents and other relatives and are not being cared for by an adult. Unaccompanied minors are a vulnerable population, with numerous stressors and complex psychiatric symptoms necessitating specialized mental health care. This study explores patients' experiences of a Multimodal Co-Therapy for Unaccompanied Minors (MUCTUM), which encompasses cultural, biological, narrative & institutional approaches to care. METHODS MUCTUM is a co-therapy program for unaccompanied minors, with a psychiatrist, psychologist, native-language interpreter, and caseworker for each patient. In this qualitative study, we interviewed adolescents about their experiences with MUCTUM and analyzed these semi-structured interviews using a phenomenological framework (Interpretative Phenomenological Analysis). RESULTS Qualitative analysis of 16 interviews discovered that unaccompanied minors felt misunderstood before participating in MUCTUM, describing a sense of strangeness and loneliness in relation to psychiatric symptoms. Several youths experienced triple stigmatization: of being unaccompanied minors, of suffering from psychotrauma, and of being mental health patients. We further describe three overarching domains that inform on MUCTUM support to unaccompanied minors: (1) A safe space for unaccompanied minors; (2) Helpful interventions during therapy; and (3) Narrating one's story can "set us free" if guided carefully by care providers. CONCLUSION This study suggests that MUCTUM therapy may efficiently support unaccompanied minors' mental health by acknowledging their hierarchy of needs. Psychotherapeutic strategies include creating a safe place, providing culturally appropriate care and patient-centered therapy, addressing concrete problems, supporting relationships, and making use of limited reparenting in therapy. Delayed and progressive inquiry about traumatic events may be beneficial. Replication of these findings and their field application is warranted.
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Affiliation(s)
- Sélim Benjamin Guessoum
- Department of Child and Adolescent Psychiatry, Assistance Publique - Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014, Paris, France. .,Université Paris Cité, PCPP, Paris, France. .,Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France.
| | - Sevan Minassian
- grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France
| | - Pauline de Staël
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France
| | - Fatima Touhami
- grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France
| | - Madeline DiGiovanni
- grid.47100.320000000419368710Child Study Center, Yale School of Medicine, New Haven, USA
| | - Rahmeth Radjack
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - Marie Rose Moro
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - Laelia Benoit
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France ,grid.47100.320000000419368710Child Study Center, Yale School of Medicine, New Haven, USA
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