Clinicians’ perspectives on professional dilemmas and boundaries in mental health care for undocumented migrants with PTSD

Abstract

Background: In the treatment of asylum seekers with PTSD who illegally reside in the Netherlands, several problems can occur, due to their specific psychosocial difficulties.A tailored treatment programme is currently implemented in the Netherlands and appears feasible under certain conditions. Factors complicating evidence-based care provision need specific attention. Not much is known about the issues that complicate treatment for therapists, within this setting. Objective: The aim is to explore the management of professional boundaries by therapists within an outpatient treatment trajectory for undocumented asylum seekers with PTSD. Secondary aims comprise the perspective of the clinicians regarding the impact of the setting, the therapeutic relationship, processes of transference and countertransference, and personal factors of both the patient and the therapist that influence the management of boundaries. Method: As part of a larger PhD project and based on literature review and extensive clinical experience, a focused ethnography is conducted. Methods used are observations, semi-structured interviews with therapists, member checks and, if necessary, focus groups. Participants are selected by purposeful sampling from past and current treatment providers at an outpatient department for undocumented asylum seekers in the Netherlands. Results: Results to be obtained. A systematic literature search and preliminary results of conducted semistructured interviews with therapists will be presented. Conclusions: Issues and difficulties that complicate treatment for therapists treating undocumented asylum seekers with PTSD will be analysed and discussed.