
Project background
About 16 of the 82 million people living in Germany have a migration background. This cultural and linguistic diversity becomes a source of social and economic gains.
On the other hand this diversity poses a challenge for the psychosocial health care. In the 1980s the WHO postulated in the Ottawa Charta that healthcare should be based on the cultural needs of the patients and should be created in a respectful and sensitive way.
Numerous studies point out the difficulty in achieving these goals. One example of these findings is that the migratory status is associated with low utilization rate of health care services in comparison with the autochthonous population. This is the case in out- and inpatient mental health care services (Mösko, Pradel & Schulz, 2011, Mösko et al., 2012, Odening et al., 2013). In regard to outcome quality Turkish patients and patients from former Yugoslavia have the lowest treatment effects in mental health care services (Mösko et al., 2011).
Different factors have been discussed as possible barriers to equal access to mental health care service and for worse treatment outcome (Baschin et al., 2012). Divergent cultural beliefs and practices concerning illness and communication difficulties can hinder the psychotherapeutic treatment as well as factors on the side of the healthcare providers like prejudices or uncertainty in dealing with migrants.
The findings of a study by Wohlfahrt and collegues (2006) illustrate that half of the employees in a psychiatric department have negative feelings in the contact with a foreign patient. These feelings handicap the relationship building as well as the success of the treatment.
Also a study on licensed psychotherapists demonstrates that treating patients with a migration background can be challenging. Despite years of working experience, two-thirds of the respondents reported substantial challenges in the psychotherapeutic work with these patients (e.g. divergent values, lack of compliance) (Mösko et al., 2012).
In view of a growing number of patients who are culturally and linguistically diverse, cross-cultural competence is becoming more and more an important basic requirement for psychotherapists. Therefore cross-cultural issues should be considered in basic, further and advanced training for psychotherapists. For this purpose it is necessary to develop well-funded and evaluated cross-cultural trainings. These trainings can be helpful for psychotherapists in becoming more comfortable with cross-cultural issues and in better dealing to the needs of their patients with migration background.
Against this background the current research project develops, conducts and evaluates a cross-cultural competence training for psychotherapists and psychotherapists in further education. The conceptual basis for the intervention is leaned on models from the USA and Canada as well as on the guidelines for cross-cultural competence trainings that were developed under the previous project (Link).
Reference
Baschin, K., Ülsmann, D., Jacobi, F. & Fydrich, T. (2012). Inanspruchnahme psychosozialer Versorgungsstrukturen - Theoretisches Modell für Personen mit Migrationshintergrund. Psychotherapeut, 57, 7-14
Mösko, M., Gil-Martinez, F. & Schulz, H. (2012). Cross-cultural opening in German outpatient mental health care service - Explorative study of strucutral and procedural aspects. Journal of Clinical Psychology & Psychotherapy; DOI: 10.1002/cpp.1785
Mösko, M., Pradel, S. & Schulz, H. (2011). Die Versorgung von Menschen mit Migrationshintergrund in der psychosomatischen Rehabilitation. Bundesgesundheitsblatt, 54, 465-474
Odening, D., Jeschke, K., Hillenbrand, D. & Mösko, M. (2013). Stand der interkulturellen Öffnung in der ambulanten psychotherapeutischen Versorgung in Berlin. Verhaltenstherapie & psychosoziale Praxis, 53-72