Othering refugees: Psychotherapists’ attitudes toward patients with and without a refugee background

ABSTRACT

Objective: A large proportion of refugees present with psychological disorders that require psychotherapy as first-line treatment. However, even in countries with well-established psychotherapy system, refugees continue to face barriers to care. Psychotherapists’ attitudes toward refugees may also impede access to psychotherapy, as it is evident that stereotypes of health professionals contribute to health care disparities. However, little is known about psychotherapists’ attitudes toward refugees. Methods: In a cross-sectional online study of N = 2002 outpatient psychotherapists in Germany (M_age = 54.48 years, 73.1% female), a vignette experiment was applied to examine differences in therapists’ attitudes toward refugee patients from the Middle East and non-refugee patients. Subsequently, associations between attitudes and psychotherapists’ characteristics (e.g., provision of treatment for refugees) were analyzed. Results: Results showed significant differences between therapists’ attitudes toward refugee and non-refugee patients (${\eta }_p^2$ = .23), with more therapy-hindering attitudes toward refugee patients. Higher therapy-hindering attitudes were significantly associated with less frequent provision of psychotherapy for refugees. Conclusion: Our findings provide initial evidence that psychotherapists perceive refugee patients as deviant from the norm and that these divergent attitudes may relate to disparities in mental health care. To avoid such a process of othering, training for psychotherapists should question stereotypes toward refugees.

Keywords:

• refugees
• PTSD
• psychotherapy
• attitudes
• health care disparities

Acknowledgments

The authors would like to thank all psychotherapists for their interest and participation in the study. Special thanks to Philippa Specker for editing this manuscript.

Data Availability Statement

The data and materials have not been made available on a permanent third-party archive to protect the anonymity of participants. The data will only be available upon reasonable request at [email protected].

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10503307.2022.2150097.

Additional information

Funding

This work was supported by the Deutsche Forschungsgemeinschaft [grant number DFG 409654512] and is part of the research group PH-LENS [DFG FOR 2928], subproject TREAT.