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Effective Clinical Interventions with Asylum Seekers

Effective Clinical Interventions with Asylum Seekers

The experience of asylum seekers and refugees who face the risk of forced repatriation differs in critical ways from the general pattern of refugees who have secure residency. Clinical research conducted by STARTTS and by the UNSW Psychiatry and Teaching Unit has documented the presence of an anticipatory traumatic stress condition amongst refugees with insecure residency, associated with vivid distressing intrusive thoughts about the future that is distinct but associated with post traumatic stress disorder. The research has found that both PTSD and anticipatory stress symptoms were highly responsive to changes in residency status across a two year period, but with anticipatory traumatic fear showing heightened sensitivity to continuing uncertainty.

The identification of anticipatory traumatic stress associated with intrusive future oriented fears may help to explain the exceptionally high rates of apparent posttraumatic stress symptoms in post-conflict settings characterised by ongoing security and safety concerns. Another key question that arises from the identification of an anticipatory traumatic response is the extent to which clinical interventions are able to assist asylum seekers and refugees while they still face ongoing uncertainty. There is a growing body of evidence however that suggests that even in situations of threat there may be important clinical outcomes that can be achieved by targeted clinical interventions and support. Clinical models to guide such interventions will be discussed and reviewed.