Integrating Cultural Beliefs About Illness in Counseling With Refugees: A Phenomenological Study

Researchers have suggested that people with refugee status have heightened rates of western-defined psychiatric symptoms. Following this evidence, treatments have been adapted with the intent to foster culturally competent service provision for members of refugee communities. Absent in this research is attention to how clinicians address diverse beliefs about illness constructed within the cultures of refugee individuals. As such, even adapted treatments may not readily integrate beliefs about illness espoused in these communities into counseling. The purpose of this descriptive phenomenological study was to explore the meaning mental health care providers ascribe to integrating refugee individuals’ cultural beliefs about illness and treatment into counseling. Interviews (N = 8) were analyzed accordant with descriptive phenomenology. Four themes were identified: (a) Presenting Concerns, Stigma, and Expectations, (b) Centering Diverse Explanations of Distress, (c) Shifting the Work to Connect, and (d) Language as Barrier and Opportunity. The themes represent the meaning that participants ascribed to focusing on what their clients from refugee communities bring to treatment and the value of centering their explanations of distress. Further, they expressed the clinical value of changing how they work and the difficulty as well as benefit of language in treatment. The value of integrating diverse illness beliefs into counseling from a multiculturally oriented perspective is discussed.