Using Ethnomethodology to Analyse Co-Narrated Atrocity Stories Told in Qualitative Interviews With Social Work Approved Mental Health Professionals

Abstract Background Jordan has received more than three million refugees from bordering countries during times of conflict, including over 600 000 Syrian refugees between 2011 and 2021. Amidst this humanitarian crisis, a new mental health system for Syrian refugees has developed in Jordan, with most clinical services administered through non-governmental organizations. Prior studies have identified increased risk of psychiatric disorders in refugee populations and significant barriers for Syrian refugees seeking mental health treatment, but few have reviewed the organization or ability of local systems to meet the needs of this refugee population. Methods Qualitative interviews of mental health professionals working with refugees in Jordan were conducted and thematically analyzed to assess efficacy and organizational dynamics. Results Interviewees described barriers to care inherent in many refugee settings, including financial limitations, shortages of mental health professionals, disparate geographic accessibility, stigma, and limited or absent screening protocols. Additional barriers not previously described in Jordan were identified, including clinician burnout, organizational metrics restricting services, insufficient visibility of services, and security restrictions. Advantages of the Jordanian system were also identified, including a receptive sociopolitical response fostering coordination and collaboration, open-door policies for accessing care, the presence of community and grassroots approaches, and improvements to health care infrastructure benefiting the local populace. Conclusions These findings highlight opportunities and pitfalls for program development in Jordan and other middle- and low-income countries. Leveraging clinician input can promote health system efficacy and improve mental health outcomes for refugee patients.

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Tilpasningsstrategier på Sexologisk Klinik – En undersøgelse af transkønnede klienters forhandling af identitet

Dansk Sociologi ◽

10.22439/dansoc.v28i3.5642 ◽

2017 ◽

Vol 28 (3) ◽

pp. 41-59

Author(s):

Ida Friis Thing ◽

Viola Marie Skovgaard

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

Health Professionals ◽

Qualitative Interviews ◽

Public Healthcare ◽

Institutional Identity ◽

Theoretical Concepts ◽

Negotiation Of Identity ◽

The Social ◽

To Receive

Denne artikel præsenterer resultaterne fra 9 kvalitative interviews med transpersoner, der enten er eller har været i behandling på den offentlige institution Sexologisk Klinik på Rigshospitalet i København. I Danmark har de to offentlige institutioner Sexologisk Klinik og Sexologisk Center Aalborg monopol på behandling af transpersoner. Klienter der ønsker hormonel eller kropsmodificerende behandling må således gennemgå et udredningsforløb på en af disse institutioner. Artiklen viser, hvordan identiteten transseksuel kan siges at udgøre en institutionel identitet på Sexologisk Klinik, som klienterne aktivt udfordrer, følger eller indretter sig strategisk efter. I artiklen analyserer vi, ved hjælp af Goffmans teoriapparat fra hans analyse om den totale institution, hvordan klienterne gør brug af tilpasningsstrategier i et forsøg på at håndtere de institutionelle identiteter, de tilbydes. Vi viser, at klienterne i udpræget grad anvender, hvad Goffman betegner som en koloniserende tilpasningsstrategi på klinikken og således bestræber sig på at få mest ud af institutionens muligheder ved at omstrukturere deres livshistorier, så de passer til institutionens kriterier for godkendelse til behandling. I analysen benyttes en kombination af symbolsk interaktionisme og socialkonstruktivisme til at undersøge den relationelle karakter af reproduktionen af den institutionelle identitet transseksuel. ENGELSK ABSTRACT: Ida Friis Thing and Viola Marie Skovgaard: Strategies ofadaptation at a sexology clinic: a study of transgenderclients’ negotiation of identity This article presents the results from nine qualitative interviews with transgender clients concerning their experiences with a public healthcare sexology clinic. At this institution transgender clients apply for approval to receive hormonal treatment and body modifying surgery. The article analyses the social process of clientisation in encounters between clients and mental health professionals, which involve the construction of the institutional identity transsexual, that is, some conditions for how the clients might perceive and present themselves. We employ Goffman’s theoretical concepts from his analysis of the total institution to describe how clients adapt to this process of clientisation by making use of a variety of strategies. Some clients are continuingly resisting the institution and the mental health professionals, while other clients adapt fully to the institutional ideology of therapy. However most clients take advantage of possibilities within the institution by creating narratives that correspond with the institutional criteria for the diagnosis transsexual. We employ a combination of the symbolic interactionist and the social constructivist approaches to emphasize the relational character of the reproduction of the institutional identity transsexual. Keywords: Clientisation, Adaptation Strategies, Goffman, Institutional Identities, transgender

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Local clinician perspectives on cause, impact, and treatment of key expressions of distress in Cambodian children

Transcultural Psychiatry ◽

10.1177/1363461520905995 ◽

2020 ◽

pp. 136346152090599 ◽

Cited By ~ 1

Author(s):

Caleb J Figge ◽

Cecilia Martinez-Torteya ◽

Sopheap Taing ◽

Sotheara Chhim ◽

Devon E Hinton

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

Health Professionals ◽

Qualitative Interviews ◽

Intervention Development ◽

Current Treatment ◽

Child Trauma ◽

Sociocultural Context ◽

Health Service Provision ◽

The Impact

Child trauma and posttraumatic stress in Cambodia is highly prevalent, perpetuated within a postwar sociocultural context. The examination of locally meaningful expressions of distress is needed to provide culturally sensitive assessment and treatment of trauma-affected Cambodian children. The acceptable, feasible, and sustainable incorporation of expressions of distress into assessment and intervention development relies on key mental health professionals operating in Cambodia, who can provide invaluable perspectives on child trauma experiences in this particular sociocultural context. In this study, qualitative interviews were conducted with 15 Cambodian mental health professionals (MHPs) who work directly with trauma-affected Cambodian children. MHPs were presented with seven key posttraumatic problems derived from previous qualitative interviews with Cambodian children and caregivers, and discussed 1) the causes of these problems, 2) the impact of the problem on the child or those around them, 3) the current treatment for the problem in Cambodia, and 4) recommended treatment. MHPs provided unique insights and perspectives of trauma-affected children in the Cambodian context regarding key target problems, including palpitations, difficulties in school, headache, and thinking too much, and highlighted future directions for assessment and intervention. Recommendations are discussed in regard to programming design and organizational training development to promote culturally salient, feasible, and sustainable mental health service provision in Cambodia.

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