Therapists’ Experiences of Delivering Therapy to Children Seeking Refuge and Asylum: A Qualitative Study

Abstract

Objective

Few studies examine how therapists adapt their approaches when providing psychological therapy to children seeking refuge and asylum and how therapists experience the unique challenges of this work. This study aims to explore therapists’ experiences in delivering therapy to children seeking refuge and asylum, specifically focusing on how they conceptualise their work and provide care to this population.

Method

Nine mental health therapists working in the United Kingdom took part in semi-structured interviews and data was analysed qualitatively using thematic analysis.

Results

Data from the interviews were organised into three superordinate themes: the importance of remaining flexible in therapy; stepping into different roles; navigating therapeutic instability. These themes covered the kinds of adaptations that therapists make in their work with this population – both in technique and therapeutic stance – as well as the struggles therapists face.

Conclusions

This study explored therapists’ experiences of delivering therapy to CSRA. Findings highlight the centrality of cultural adaptations in this work, alongside therapists’ roles in supporting patients with non-clinical needs. Therapists also reported emotional distress related to the significant challenges and instability CSRA face during the asylum process in the UK. Further research could examine these areas in greater depth to strengthen the understanding of clinical work with CSRA and inform practice and policy.

Plain Language Summary

There is limited research on how therapists support children who are seeking refuge or asylum, and the unique challenges involved in this work. This study explored the experiences of nine therapists in the United Kingdom who provide psychological support to these children. Through interviews, therapists described needing to be flexible in how they deliver therapy, often adapting their usual approaches to meet each child’s cultural background and changing life circumstances. They also reported taking on roles beyond traditional therapy, such as advocating for their clients within complex asylum and social care systems. A key challenge was managing ongoing instability in the children’s lives, which could disrupt the therapeutic process. Therapists also described experiencing emotional strain due to the difficult situations their clients face. Support from colleagues was an important way to cope with these challenges. Overall, the findings highlight the need for culturally responsive care, greater systemic support, and resources to help therapists effectively support children seeking refuge or asylum.