WCP 2025

The increasing number of asylum seekers in the UK underscores the urgent need for research addressing refugees' unique mental health challenges. These challenges often stem from pre-migration trauma, displacement, and post-migration stressors. Despite their elevated risk of psychological distress, refugees in psychotherapy experience high dropout rates, the causes of which remain underexplored.
This qualitative study recruited ten adult refugees and asylum seekers from five countries—Iran, Afghanistan, Somalia, Pakistan, and Saudi Arabia—through purposive sampling via refugee charities and therapy centres. Semi-structured interviews explored therapist cultural competence, language barriers, and differing belief systems between patients and therapists.
Reflexive thematic analysis identified five key themes: (1) Cultural Barriers, including disconnects and communication challenges; (2) Therapeutic Relationship Challenges, such as unmet expectations and fractured alliances; (3) Rigid Therapeutic Approaches; (4) Supportive Therapeutic Relationships, emphasising connection and practical support; and (5) Appreciation for Research Advancing Refugee Well-being.
The findings reveal that refugees' psychotherapy experiences are shaped by significant cultural and relational barriers, rigid approaches, and the value of supportive therapeutic dynamics. These findings emphasise the importance of culturally sensitive and flexible therapeutic practices, alongside tailored linguistic and practical support, to meet refugees' psychological needs. This research informs therapist training, refugee-centered interventions, and the development of equitable mental health services to enhance integration and well-being.
Future research should adopt participatory methods to actively involve refugees in co-designing and implementing mental health interventions. Such approaches could directly inform and transform therapeutic practices and policies, ensuring they effectively address the needs of the communities they serve.