Inmost qualitative studies, the researcher is the main tool of data collection (Yin2013). This is to mean the role one plays as a researcher for a consistent andvalid data generation from participants is higher than other methods of study.However, some level of guidance and direction is also important. Thus, in thisthesis project, the researcher will employ semi-structured in-depth interviewsas the main tool of data collection.
Datacollection instrumentsThestudy samples for this study will be identified by using the snowball technique.The first case will be identified by using key informants in the institute ofpublic health and with external connections of my supervisor. Sampleand sampling procedure 3. Done/doing at least one long term therapywith an immigrant2. Living in Heidelberg1.
English as a working languageThe study population willbe all psychotherapists that are based in Heidelberg. “By its very nature,qualitative research is particularistic” (Yin 2011). Thus, sampling inqualitative research basis more purpose than representativeness; and thepurpose of doing it, most of the time, is not intended for generalization. Thus,in selecting participants for this research, the following inclusion criteriawill be employed StudypopulationThe other decision I hadto make was the distinction between single and multiple case study designs.Since therapists are the main units of analysis I will be asking to generatedata, and because I believe that their experiences are not necessarily the sameand each individual case can provide unique experience, multiple case studywill be used. One another important feature of the use of multiple case studydesigns is that it allows some level of comparison between the cases (Yin 2009).As a main guide in doingthis thesis, exploratory case study design-from the three suggested types, twoof them being explanatory, and descriptive-will be used (Carla 2013). Thereason for this is that the detail provided from cases that will be exploredusing in depth interviews will generate new insights into, and a betterunderstanding of the nature of the cases to be investigated.
In this particular study,since the main purpose is exploring and understanding psychotherapists’experience in working with immigrant clients by deep exploration of their livedexperiences, a qualitative research approach is considered appropriate. Amongthe different guiding approaches for a qualitative study, Case study will beapplied for it allows an in-depth and intensive exploration of a livedexperiences (Yin 2009), which is an interest in this research. The main reasonfor selection in this regard was not anything but purpose of the study.Research design is thelogical sequence that connects the data to be collected with the initialresearch questions (Yin 2009). Depending on the researchers’ orientation andunderstanding of the concept of truth or knowledge, the methods employed followedin connecting these two-research questions and data-varies (Hancock & Algozzine2006). While some consider truth as one, objective and universal (positivists),others consider it as more of subjective and context specific (constructivists)(Carla 2013). ResearchDesign · Whatconditions were changed to improve the working alliance with immigrant clientsin a therapeutic process?· Howdo therapists incorporate the cultural openness to accommodate differences inunderstanding clients perceived cause of problems?· Whatbelief systems (if any) were presented as a barrier in the therapeutic process?· Whatare the different barriers in psychotherapeutic care for immigrants?Research questionsv Understandingthe concept of cultural openness as experienced in therapyv Identifyingcultural differences that have hampered/facilitated the therapeutic processv Exploringchallenges faced by therapist in working with clientsb.
Specificobjectives includeTo explore real life lived experiences and challenges of Psychotherapistsworking with immigrantsa. Themain objective of the study thus is,Objectives of the studyFor example, despite the high burden of mental healthproblems among refugees, there is limited knowledge about how effectivelypeople can deliver mental health care for refugees (Whaley & Davis 2009). Amongthe reported different barriers in a psychotherapy setting by care providers,language, cultural belief systems and patterns of health seeking behavior areworth mentioning. Except the two concepts (language and health care seekingpatterns), cultural beliefs are not so vividly clear. Thus, to betterunderstand these belief systems, it is worth exploring what they reallyarea.
The rationale behind this thesisis the importance of a better understanding a situation to better facilitatechange and improvement.If we take the case of Germany as an example, the number ofrefugees that are living in this country are no longer marginal in number(Henke et al 2017). And this calls for a more culturally, linguistically andmedically adapted care for the existing need (Henke et al 2017). Though someimprovements have been made in this aspect, it is yet with a big room forimprovement.
This belief systems alsohighly influence how the psychotherapist and the client understand each otherin a therapeutic process. The positive working relationship between careprovider and care receiver is one of the most determining factors for thesuccess of the helping process (Elizabeth & Fross 2017). And nowadays, with an ever-increased number ofmigrants in the world, the importance of cultural openness in psychotherapy andhealth response has become indispensable (WHO 2015). Different explanations of mental illness existed since timeimmemorial (Bennet 2006). These explanations also vary acrosssocieties. Even in today’s modern societies, there exists different explanatorymodels for the understanding mental illnesses (Kleinman 2006).
These explanatorymodels show how existing differences basing subjective beliefs about causes ofmental illness across societies may alter patterns of help-seeking and responseto treatment. Refugees help seeking behavior for example is influenced by theiridentified social status and experience before coming to the host countries (Anagnostopouloset al. 2016). These subjective and social natureof beliefs make diagnosis and culturally competent treatment a challenge (Baarnhielmet al.
, 2014). This was shown in a recent studydone about professional’s experiences of delivering care for immigrants in 16European countries that identified belief systems held by refugee patients asone of hindrance factors for accurate diagnosis (Sandu et al 2013).