Movement-Based Therapies for Resettled Refugee Populations in the United States

ABSTRACT Persons who are refugees may experience mental health concerns, such as posttraumatic stress disorder and depression, due to multiple layers of trauma experienced before, during, and after fleeing their country of origin. Although several health system– and community-based mental health interventions have been found to be effective in improving mental health outcomes among persons who are refugees in the United States, these services are underutilized among refugees. Movement-based and mind body–focused practices, such as yoga, may play an important role as complementary mental health supports for refugees. Data on the effectiveness of these practices in these populations are limited, and further research is needed. However, these practices can still be introduced in a safe way by trained professionals and offered as adjunctive therapeutic approaches to traditional Western psychotherapy options. We offer recommendations for clinical providers working with persons who are refugees and for movement-based facilitators and therapists on how to introduce these practices to resettled refugee populations in the United States.

“Other psychotherapies”: Healing interactions across time, geography, and culture

This article introduces the special issue of Transcultural Psychiatry entitled “Other Psychotherapies”: Healing Interactions across Time, Geographies, and Cultures. This special issue is intended to highlight that, rather than being exclusively a modern phenomenon, variants of psychotherapeutic practice have existed for millennia in diverse sociocultural contexts. This article explores the historical development of Western psychotherapy and points to the important contribution that Greco-Roman scholars from antiquity made to contemporary understandings of mental states and emotional wellbeing. The ways in which healing interactions have been localized to reflect the local cultural and geographic contexts are also highlighted through a discussion of recent work in psychotherapeutic geographies. This allows us to identify commonalities and differences between various forms of psychotherapy. We also consider how particular subcultures may influence the future development of psychotherapy. This article serves to foreshadow the themes that are explored in more detail in the collection of articles that make up the “Other Psychotherapies” special issue. The various articles that contribute to the special issue are introduced, and the key issues explored by these articles briefly highlighted. The intention of the special issue is to facilitate an opportunity to appreciate the ways in which psychotherapies are a product of the epoch, setting, and institutions that shape people’s lives.

Western Psychotherapy in an Eastern Context

This chapter reviews the history of psychotherapy in China and the gradual opening to Western ideas about psychotherapy. It details the difficulty of getting a Western mind around what Chinese therapists thought was psychotherapy and the ways in which their understandings only became accessible through working together. Translating the concepts into action, not just language, revealed the points of cultural collision. A workshop and a process group illuminated our shared humanity. A decision about how the recording of the process group was to be used, however, unearthed differing fundamental assumptions about privacy and piracy.

Association between Anterior Cingulate Neurochemical Concentration and Individual Differences in Hypnotizability

Hypnosis is the oldest form of Western psychotherapy and a powerful evidence-based treatment for numerous disorders. Hypnotizability is variable between individuals; however, it is a stable trait throughout adulthood, suggesting that neurophysiological factors may underlie hypnotic responsiveness. One brain region of particular interest in functional neuroimaging studies of hypnotizability is the anterior cingulate cortex (ACC). Here, we examined the relationships between the neurochemicals, GABA, and glutamate, in the ACC and hypnotizability in healthy individuals. Participants underwent a magnetic resonance imaging (MRI) session, whereby T1-weighted anatomical and MEGA-PRESS spectroscopy scans were acquired. Voxel placement over the ACC was guided by a quantitative meta-analysis of functional neuroimaging studies of hypnosis. Hypnotizability was assessed using the Hypnotic Induction Profile (HIP), and self-report questionnaires to assess absorption (TAS), dissociation (DES), and negative affect were completed. ACC GABA concentration was positively associated with HIP scores such that the higher the GABA concentration, the more hypnotizable an individual. An exploratory analysis of questionnaire subscales revealed a negative relationship between glutamate and the absorption and imaginative involvement subscale of the DES. These results provide a putative neurobiological basis for individual differences in hypnotizability and can inform our understanding of treatment response to this growing psychotherapeutic tool.

Dang-Ki healing: An embodied relational healing practice in Singapore

This article explores the processes of transformation of the self in dang-ki healing, a form of Chinese spirit mediumship in Singapore, drawing on more than a decade of ethnographic research. In dang-ki healing, it is believed that a deity possesses a human, who is called a dang-ki, to help clients (i.e., devotees). Through the dang-ki, clients can interact with powerful deities in ways that help them feel hopeful and supported. The dang-kis themselves may also benefit therapeutically from their participation as mediums. Many dang-kis suffer from personal conflicts and distress before becoming a medium and they express and transform their distress through the idiom of spirit possession. Since deities represent traits and moral values promoted in Chinese culture, possession by a deity allows the dang-ki to embody an ideal self and to acquire spiritual knowledge by engaging in ritual practices involving cleansing, self-mortification, stereotyped movements, and altered consciousness. At the same time, junior possessing deities must undergo training under the guidance of senior deities to achieve a higher level of spiritual existence by helping clients through the dang-ki's body. Thus, in dang-ki healing, practitioners, clients and possessing deities are transformed in parallel ways. The dynamics of this reciprocal and interdependent healing process differ from the individualistic approaches in Western psychotherapy and shed light on the links between healing processes, cultural ontologies, and concepts of personhood.

Satisfaction of trauma-affected refugees treated with antidepressants and Cognitive Behavioural Therapy

Purpose: This study seeks to evaluate the satisfaction of trauma-affected refugees after treatment with antidepressants, psycho-education and flexible Cognitive Behavioral Therapy (CBT) including trauma exposure. Material and methods: A treatment satisfaction questionnaire was completed by patients at the end of a randomised controlled trial (RCT) comparing treatment with CBT and antidepressants. A patient satisfaction score was developed based on the questionnaire, and predictors of satisfaction were analysed in regression models. Telephone interviews were conducted with patients dropping out of treatment before the end of the trial. Results: In total, 193 trauma-affected refugees with PTSD were included in the study. Patients were overall satisfied with flexible CBT including exposure treatment in cases where this was part of the treatment. There was no statistically significant association between treatment outcome and satisfaction and satisfaction and treatment efficacy were independent of each other. The results showed that bi-cultural patients who had lived in Denmark for more than a decade were satisfied with the treatment based on a western psychotherapy model. Discussion: Treatment with selective serotonin reuptake inhibitor and flexible CBT, including trauma exposure, is acceptable for trauma-affected refugees. More studies are needed to evaluate patient satisfaction with western psychotherapy models in refugee patients who have recently arrived and to compare satisfaction with alternative treatment models.