Aikuisten turvapaikanhakija- ja pakolaisasiakkaiden kokemat ja terapeuttisissa keskusteluissa kuvaamat ongelmat, auttavat tekijät ja hyödylliset muutokset

Abstract

This research aimed to examine the special features of mental health and the psychological problems of adult asylum seekers and refugees. One study was developed to meet this research aim. This research also aimed to empirically examine adult asylum seeker and refugee clients’ change processes through therapeutic conversations. Three studies were developed to meet this research aim. The methodology for Study I was a review article, while Studies II, III and IV, which included the foremost empirical part of this research, employed client-focused qualitative change process research methodology. The data for these three studies consisted of the videotaped natural therapeutic sessions of six adult asylum seekers and refugee clients. The formulations that were given by the clients (as expressed by an interpreter) were extracted as units of analysis. The second study focused on clients´ problems; the third examined the factors that were helpful with problems and contributed to positive change; and the fourth explored positive changes. Based on first study, it was found that the mental health should not be perceived and conceptualised only through psychological problems and psychological problems should consider more than symptoms. The first study indicated that the fulfilment of basic human needs, active and positive coping methods and gaining a sense of agency in one’s life were important factors for better mental health. In the second study, it was found that clients’ problems included formulations of mental ill-being and various practical life problems. They were part of the same problem experience. In the third study, it was found that helpful factors included therapeutic conversational practice, the clients themselves, crisis workers, the therapeutic relationship and extra-therapeutic factors. The fourth study indicated that clients’ positive changes concerned a diverse field of changes that the clients had noticed in themselves and in their thinking, feelings and behaviour. This research emphasises that also other factors beside therapeutic conversational practice shape clients’ change processes and influence their therapeutic outcomes. Thus, the main task of workers who conduct therapeutic conversations include the recognition, activation and management of various factors that shape the change process, influence outcomes, help clients with their problems and contribute to positive changes, and also the steering the cooperative effects of these factors in the most beneficial direction.