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A Rights-Based Approach to Working with Refugees

Empowering clients to speak up for their rights is a complicated business – especially when they have arrived in the UK via refugee camps and war zones. Therapists may find themselves working with guilt and fear, and needing to encourage a sense of justice in the consulting room. Jude Boyles is the Manager and a therapist of a Refugee Council therapy service based in South Yorkshire, offering therapy to Syrian refugees resettled via the Vulnerable Persons Resettlement Programme (VPRS). In her fifth occasional blog about this work, she recalls clients who have been reticent to challenge and complain

 

You don’t pull the hair of the person hugging you…

This expression was shared with me recently by a client when we were talking about her rights. She felt she could not complain about the quality of support she was being offered by another agency because they were “helping” her. When I talked of her right to complain, she reminded me that she was once in a camp surviving on UN vouchers and that thousands of people were living in these camps. Syrian refugees resettled via the Syrian Vulnerable Persons Resettlement Scheme (VPRS) are given refugee status, housing and support on arrival and my client felt guilty that she was complaining.

For some of the refugees I have worked with, it has been challenging for them to work out when they can say they are not happy with a particular service or think a system is unfair. Clients have told me that they are frightened there will be repercussions if they do not agree with or accept the support and/or advice given.

When everything is new, whose advice do you trust and when is it ok to say no?

Creating a sense of justice in the therapy room

I apply a rights-based approach in my therapeutic work with refugees and people seeking asylum. I endeavour to create a sense of justice in the clinical room, in the absence of a just or fair context for most.

At times I have worried that conversations about rights have silenced a client or worse, created a new distance between us as our worlds must seem so different. Finding opportunities to talk about a client’s human rights in any given situation, as well as sharing information about the new culture they find themselves in, is important. Judging how to weave these dialogues into therapy, however, is by no means straightforward. Pacing is crucial.

I have often been impressed at how ready the Syrian refugees I have been working with have been to challenge the system and ask for what they need. Sadly, that’s not the case for everyone. It took my client and I some time to untangle her guilt about leaving people behind from what her rights were, in a context where she was just grateful to be safe. “How do I know if it could be better than this, I cannot judge?” I talked of the UK and its social care framework and the duty that services have to offer good quality care and support to resettled clients.

Contextualising clients’ responses

Another client said the following words to me about a medical procedure his child was due to have: “If I refuse this, will they take my child from me?” I felt a wave of sadness as I realised that he did not yet understand his parental rights in the UK, the NHS and the power of the state. I took time to explain this to him as this was the most therapeutic thing I could do. He saw himself as the protector of his family and he had so many questions. The hospital had been unsympathetic and had judged his response as exaggerated and out of proportion to the surgery that was being proposed. They could not know what he and his family had lived through or understand that his angry and agitated questioning was a reflection of how traumatised he was by what he had seen in the war.

The therapist’s role is not usually to be an advocate, but there are times that contextualising a client’s responses for another professional can be helpful for everyone. 

The Syrian client I began this blog with has chosen not to complain. We have talked about how she had not had a public life in Syria before she fled the war and how hard it felt now to stand up and say she was not happy with how she was being treated. Despite her decision, maybe our discussions about what she can expect from any organisation have been helpful, and she may feel more able to ask for an interpreter in the future.

Sadly, there will be many more times in the coming years that she will not get the service she has a right to.

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Jude Boyles

Jude is the Manager of a therapy service for the Refugee Council, working with Syrian refugees resettled via the Vulnerable Person’s Resettlement Programme (VPRS). Jude edited Psychological Therapies for Survivors of Torture for PCCS Books and published Working with Interpreters in Psychological Therapy with Routledge. She specialises in working with refugee survivors of torture/war and human rights abuses, including gender-based abuse.

In 2003, Jude established the first Freedom from Torture (FFT) rehabilitation centre outside of FFT’s headquarters in London, and managed the service for 14 years. As part of this role, she provided clinical and management supervision to therapists and managers working in the refugee field in the region and carried a caseload of torture survivors. Jude has worked as a national trainer in the field of therapy with refugee survivors of torture for 18 years but has also trained extensively in the field of domestic violence and child sexual abuse for 23 years.

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