Relationship and Family Therapy for Newly Resettled Refugees: An Interpretive Description of Staff Experiences

Abstract

The needs of refugees are of crucial concern internationally. Relational trauma is an area that is particularly under-emphasised and under-researched. The Strength to Strength program (STS) was a relationship and family counselling service for recently arrived refugees in Sydney, Australia. The service model built on post-Milan systemic family therapy principles to include cultural and trauma-informed aspects of care. This study explored the design and impact of the program, through qualitative accounts provided by service users. This paper focuses on the experiences of staff of the program, and the ways in which more traditional, Western-informed modes of family therapy were transformed by refugee client needs. The specific study aim was to identify and describe transformations to the delivery of relationship and family counselling with refugees that enabled care, from the perspective of STS staff. A thematic analysis of interviews with STS service staff (bicultural workers, family therapists, managers; n = 10) was undertaken, guided by an interpretive description framework. Findings revealed that acceptable and useful clinical innovations to standard care included the use of community groups, the unique role of the bicultural worker, and increased reliance on more directive and practical modes of family therapy rather than insight-oriented post-Milan techniques. The role of community-based intervention to enrich existing Western-informed models of care for use with refugees was vital. STS was an example of staff-driven innovation to the therapeutic care of refugee families resettling in a Western country and took into account their unique and complex set of cultural, practical, and psychological client needs. Future service delivery is best guided by the incorporation of multi-faceted approaches to care that allow for phasing of treatment in line with client culture, needs, and readiness.