Mental Health & Displacement
Why we are needed
Supply situation
Is psychotherapy for traumatized refugees not paid for by the state?
Reality is complex. First of all, there are very few psychotherapists anyway who offer therapy with language intermediaries or in English. Furthermore, asylum seekers are not health-insured for the first 36 months of their stay and must apply for medical treatment through the social welfare office in accordance with the Asylum Seekers' Benefits Act. Consequently, they generally receive medical help only in cases of acute illness or pain. In the case of psychotherapy, this means extensive and difficult-to-prepare applications, months of processing times, and uncertain approvals—including for language mediation. Many affected individuals remain without adequate help during this time.
Even though refugees are entitled to benefits under the statutory health insurance system, they encounter numerous hurdles in the German healthcare system. For example, there is a lack of region-wide provision for language mediation, which severely impedes access to medical care. In addition, refugees face diverse challenges when accessing regular healthcare, such as limited regional services, discrimination within the healthcare system, or generally restricted capacities in medical practices. We are trying to close this gap.
Psychotherapy
Psychotherapy refers to the targeted and professional treatment of psychological disorders using psychological means. The specific methods and concepts are shaped by schools of psychotherapy and are scientifically grounded. The goal is the reduction of symptoms, the improvement of psychosocial functioning and quality of life, as well as a change in unfavorable patterns of experience, behavior, and relationships.
Our psychotherapists work primarily on the basis of cognitive behavioral therapy. At the beginning of treatment, a diagnostic assessment is conducted. Building on this, the therapist and client jointly develop an individual understanding of the existing difficulties, as well as concrete therapy goals and a suitable treatment plan. During the therapeutic process, elements from systemic therapy, body-oriented therapy, and play therapy are integrated as needed. This allows the treatment to be flexibly adapted to the needs and life situations of the clients. When deemed beneficial, important attachment figures or the social environment are also involved in the therapeutic process. The aim is to strengthen existing resources and support systems, facilitate coping with stressful situations, and promote lasting stability.
Psychotherapy can help when psychological distress limits daily life, the individual or those around them suffer as a result, and personal coping strategies no longer work. A stable therapeutic relationship and the motivation to participate are crucial prerequisites for psychotherapy to be effective.
Trauma and trauma-related disorders
Trauma
A trauma is an experience of exceptional threat or catastrophic magnitude that would cause deep despair in almost anyone. In such situations, the usual strategies and coping mechanisms no longer work. Those affected feel extremely helpless, powerless, and at the mercy of the situation.
Examples of traumatic events include accidents, experiences of violence, war experiences, natural disasters, or the sudden loss of a close person.
Trauma and PTSD – what is the difference?
A trauma is the stressful event itself. Post-traumatic stress disorder (PTSD) can develop if this event is not processed. Typical symptoms include flashbacks, avoidance behavior, emotional numbness, or constant hyperarousal.
However, not every traumatic experience automatically leads to PTSD – it is only one possible consequence.
PTSD
People with PTSD frequently experience:
- Persistent memories or re-experiencing of the trauma through intrusions or nightmares
- avoidance behavior to bypass triggers
- Persistent hyperarousal, e. B. Sleep disordersörashes, irritability, concentration problems, or jumpiness
Flashbacks can suddenly transport sufferers back into the traumatic situation. The triggers for this are so-called triggers – for example, sounds, smells, or other stimuli associated with the trauma. The reactions range from anxiety and panic to freezing, with sufferers often feeling helplessly at the mercy of the memories.
Trauma-related disorders
In addition to PTSD, traumatic experiences can also trigger other mental illnesses. People react differently to trauma, and possible consequences include:
- Anxiety disorders
- Depression
- Addictive disorders
- Dissociative disorders
- Obsessive-compulsive disorders
- Physical symptoms without a medical cause (somatization disorders)
Several of these disorders can occur simultaneously and reinforce each other.
Depression – more than just sadness
Depression is a serious mental illness that can manifest, among other things, through a persistently depressed mood, loss of interest, and reduced energy. For a diagnosis, the symptoms generally must persist for a period of at least two weeks. Depression is also frequently accompanied by other symptoms, such as sleep disturbances, reduced appetite, feelings of guilt, lower self-esteem, as well as concentration and memory difficulties, or even thoughts of suicide.
Treatment generally involves psychotherapy and, depending on needs, supplementary medication such as antidepressants. Which form of therapy is used depends on the severity of the illness and can take place on an outpatient basis or, in more severe cases, also inpatient.