Title: The well-being of refugees in the UK: Living in peace. An Appreciative Inquiry study.

Short title: The well-being of refugees in the UK.

Authors: Kimberley Embra*, Annie Mitchell and Avril Bellinger

Acknowledgements

I thank my supervisors and co-authors for their guidance and support during the project. I would like to

gratefully acknowledge START and all the people who gave their time to participate and be involved

in this study, without them this would not have been possible.

Keywords: Refugee(s), asylum seeker(s), appreciative inquiry, strengths, resilience, well-being,

coping.

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Abstract:

A participatory approach, using an Appreciative Inquiry (AI) framework was adopted

to explore how refugees cope, and manage their lives in the UK, particularly through

the transition from asylum seeker to refugee, and how services can best support

them. AI is directed towards appreciating what is positive about the social world. In

collaboration with a UK organisation, Students and Refugees Together (START), ten

people (six refugees, two staff and two students) shared their experiences through

interviews, regarding ‘what works well’ and assisted to develop practice. A thematic

analysis identified four main themes: 1) warm relationships and connections: working

together to face challenges; 2) resourcefulness and actively contributing to society;

3) flexible, available and knowledgeable services and 4) managing uncertainty. Also,

eleven provocative propositions were developed collaboratively, identifying key

statements that can be used as ‘best practice’ guidance for services working with

refugees. Findings are presented and discussed in relation to the existing literature.

The use of AI is also discussed, practice implications are highlighted.

Introduction

There are approximately 18 million asylum seekers and refugees worldwide. Most

reside in developing countries (approximately 86%), sometimes in refugee camps.

Less than 2% of these reside in the UK; making up just 0.27% of the UK population

(United Nations High Commissioner for Refugees, 2014).

The terms asylum seeker and refugee are often used interchangeably to denote

different stages of the refugee process. An asylum seeker is a person who has

crossed international borders in search of safety and applies for refugee status under

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the 1951 UN Convention. A refugee is someone who has been successful in such an

application (McColl, McKenzie & Bhui, 2008). Those entering the UK increased

during the 1980s as civil and military conflict, environmental devastation and the

breakdown of state structures in Eastern Europe forced many people from their

homes. Latterly, UK governments have made it more difficult for asylum seekers to

gain entry, reducing rights to social support and welfare provision (Joly, 1996). The

1999 Asylum and Immigration Act removed responsibility for accommodation and

support from the local authorities to central government control within the Home

Office (National Asylum Support Service, NASS). Currently asylum seekers in the

UK have no choice regarding accommodation or area of dispersal, often being sent

many miles from others with the same culture or language.

Decisions regarding whether people are given leave to remain or removed should

take up to six months (UK Border Agency, 2013). In practice, decisions have taken

up to nine years, leaving a person unable to work or relocate to another area of the

country, separating asylum seekers from mainstream society and provisions, making

settlement, integration and development significantly difficult.

Well-being, coping and resilience:

Many asylum seekers and refugees are confronted by similar experiences in their

host country that they were escaping from, including conditions of exploitation,

domination and discrimination, contributing to further psychological distress (Gorst–

Unsworth & Goldenburg, 1998). Reported levels of mental illness are higher in

refugees and asylum-seekers than the general population; one review cited the

prevalence of post-traumatic stress disorder (PTSD) amongst refugees resettled in

Western countries to be ten times higher than an age-matched general population

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(Fazel, Wheeler & Danesh, 2005). It is important professionals do not label normal

reactions to pre- and post-migration stressors as mental illness. Recent debates

argue for a multi-factorial approach contextualising distress and behaviour,

acknowledging the complexity of the interactions involved in all human experience

(DCP, 2013).

Summerfield (1999) critiques quantitative methodologies serving psychiatric

categorisations and risking a distorting pathologisation of refugee distress,

reassigning the social and collective as individual and biological. Additionally, limited

attention has been directed towards understanding positive adaptations, coping and

resilience. Folkman and Lazarus, (1980, p223) define coping as ‘cognitive and

behavioural efforts made to master, tolerate, or reduce external and internal

demands and conflicts among them’. Resilience is used to describe the capacity and

dynamic process of adaptively overcoming or resisting stress and adversity (Rutter,

2012). Asylum seekers and refugees often use their own resources and coping

strategies to manage the considerable difficulties encountered in their country of

origin, during migration, in their host country and throughout the asylum process,

(Williams, 2006). Sherwood and Liebling-Kalifani, (2012) focused on the impact of

violence on mental health for six African refugee women, developing a greater

understanding of resilience and coping. Findings supported the move towards a

holistic model of understanding refugees’ experiences, highlighting the importance of

support to promote resilience in reconstructing identities following traumatic events.

Further, an ethnographic study with 60 asylum seekers and refugees, reported

refugees endeavouring to become proactive social actors in their new communities,

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stressing the importance of social networks in family and communities. (Williams,

2006).

Few studies have addressed well-being and resilience in refugees. Sherwood and

Liebling-Kalifani, (2012) argue that refugees are empowered by focusing on

strengths rather than pathologising their experiences.

Policies and Practice

Health policies and government reports highlight the importance of providing care

adapted to individual needs (Darzi, 2008) and ‘challenging inequalities’ (Department

of Health, 2004). Within Clinical Psychology, there are demands for standardised

‘evidence-based’ interventions. Recommended therapies are based on research

outcomes of normative samples, e.g. Cognitive Behavioural Therapy (CBT). CBT

and other individual therapies have been criticised for ignoring the nature of people’s

reality and the social inequalities acting upon them (Priest, 2006). Clinical

Psychology is challenged to address inequalities and meet the needs of diverse

populations whilst using these standardised, norm-based approaches. Furthermore,

individually-located western constructions of mental health may be culturally

inappropriate for refugees (Watters,2001).

In response, community psychology and social inequalities approaches propose

interventions and prevention strategies extend beyond the therapy room, into the

context in which they occur (Kagan, 2007). Community psychology seeks services

congruent with the community’s own constructions of mental health problems

(Webster & Robertson, 2007), believing that communities generally have expertise to

prevent or reduce such difficulties. A study, involving a process of critical reflection

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by social workers engaged to provide trauma counselling services to 400 displaced

persons from Kosova, described services evolving from counselling to community

work (Whelan, Swallow, Peschar & Dunne, 2002). Culturally, food preparation was

identified as an extremely important role, hence, women spending time together,

preparing food, experienced less disorientation and loss alongside greater self-

esteem and a more relaxed interaction between family members. Emphasis is made

on professionals ‘being there’ for people to talk to, described as ‘professional

loitering’, rather than creating timed, clinical appointments; affirming the community

psychology approach as culturally sensitive.

Webster & Robertson, (2007) argue that community approaches must engage the

wider social and political context, challenging structures that maintain potentially

damaging conditions. Consulting with refugee communities about their own mental

health needs and strengths rather than imposing these externally would be a more

culturally compassionate step towards addressing wider social inequity (Webster and

Robertson, 2007).

Views of asylum seekers and refugees in the UK:

Few studies use qualitative methods to explore peoples’ personal experiences of

being an adult asylum seeker or refugee in the UK (Bhatia & Wallace, 2007; Bogner,

Brewin, & Herlihy, 2010; Burchett & Mathson, 2010; Djuretic, Crawford & Weaver,

2007; Sherwood & Liebling-Kalifani, 2012; Whittaker, Hardy, Lewis, & Buchan, L,

2005; Williams, 2006). Reviewing this literature (Embra, 2013) highlighted several

themes. Social exclusion and stigma, both by society and within the healthcare

system, had important implications for well-being, often mirroring previous

experiences (Burchett & Mathson, 2010). Refugees highlighted social networks as

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significant in coping through adversity, those with limited networks experienced more

difficulties. Differences in perceptions of psychological issues was common,

Whittikar et al, (2005) found that some people felt disabled from sharing their lives

due to fears of being labelled ‘crazy’ and links with spirit possessions.

The studies reviewed did not explicitly explore strengths. However, cognitive

appraisal or ‘positive thinking’ and beliefs, including religious beliefs were highlighted

as helpful strategies in promoting resiliency. For many women, a sense of identity

through education/employment enabling her to provide for her family and feel

empowered was imperative. Preserving cultural identity appears significant in

enhancing well-being.

Studies highlighted that services need to recognise and build upon resilience rather

than focussing on distress. This supports the critique of refugee research for ignoring

resilience and well–being (Watters, 2001). Given the limited literature, further

research is needed to challenge the inequality both within academia and practice,

promoting culturally aware practices responsive to the voices of asylum seekers and

refugees.

Rationale and Objectives:

There is a dearth of qualitative research exploring explicitly resilience of adult asylum

seekers or refugees. Literature instead focuses upon traumatic experiences and

distress, omitting how people can thrive and excluding the voices of asylum seekers

and refugees themselves. Although the reviewed literature considers well-being and

resilience, this is not a focus of the papers. This current research adds a unique

contribution by specifically focussing on the well-being of refugees.

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The broad aims of this study, are to: 1) identify core experiences about how adult

refugees cope and manage throughout adversity, particularly the transition from

asylum seeker to refugee; 2) hear directly from refugees in the UK and those

supporting them, from a strengths based perspective and 3) develop statements of

‘best practice’, for services supporting refugees, based on ‘what works well’.

Methodology

This study is participatory, using Appreciative Inquiry (AI) as a framework. AI is a

growing, innovative, approach, with roots in action research and organisational

development (Cooperrider & Srivastva, 1987). Cooperrider and Srivastva, (1987)

argue that action research is restricted by its implicit positivist assumptions about the

world ‘out there’, that can be described objectively and engineered effectively. AI on

the other hand, is a constructive mode of action research and moves towards a

position of social construction in which all knowledge is co-constructed and

relational. AI is directed towards appreciating and exploring what is positive about

the social world and liberates the creative and constructive potential of organisations

and human communities. AI enables large numbers of people to be involved at

different stages of the process. Results return directly to the people who can make

best use of them.

AI scholars have honed a method that creates an atmosphere for opportunity-

centred change into a practitioner model known as the 4-D cycle: Discover; Dream;

Design and Destiny (Figure 1; Cooperrider, Whitney & Stavros, 2003).

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Figure 1: The 4D model of AI.

Whilst no ‘recipe’ for the novice researcher exists, there is a plethora of literature

reporting experiences of using AI to bring about change and development.

Generally, data are collectively analysed, developing themes, forming the basis of

‘provocative propositions’ (Hammond, 1998).These are challenging statements of

goals, or ‘best practice’ guidance. The literature guiding this current research

included Bellinger and Elliot, (2011); Boyd and Bright, (2007); Carter (2006) and

Reed, Pearson, Douglas, Swinburn and Wilding (2002).

Research context: Students and Refugees Together (START):

This research was carried out collaboratively with the UK organisation, START,

founded in 2001 to support all refugees dispersed to Plymouth (the largest dispersal

point in the South West). START works in partnership with families, individuals and

organisations, facilitating the transition of refugees from ‘people in need’ to self-

reliant contributors to their local communities. START provides one to one support,

addressing issues such as housing, employment; health and community projects that

strengthen community integration and reduce isolation. START offers many

placements to UK and overseas students, such as those studying social work.

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Throughout 2013, START delivered over 7934 1-1 casework hours to 158 refugees

and provided community activities, including ‘Cultural Kitchen’. This fortnightly

project regularly attracts 60-70 refugees, and involves cooking and eating a meal

together and various creative activities.

START is flexible and needs-led, as both the number of refugees dispersed and

country of origin can vary according to the current political stance.

Researcher Position

Research undertaken by a researcher who does not themself identify with the

participant population can be problematic due to interpretation and representation

(Agyeman, 2008). To address this, I made my motivations and assumptions

apparent, engaging in reflective conversations and shaping the study collaboratively

through consultation between the authors and stakeholders and students at START.

Ethical Considerations:

University ethical approval was granted. Initially participants gave verbal agreement

to participate and were given an information sheet. Ethical considerations were

discussed and participants signed a consent form. Whilst participants were offered

the opportunity to use a pseudonym to protect anonymity, six of the ten participants

(four refugees) interviewed chose to keep their real names, possibly suggesting that

protection of identity through pseudonyms is more culturally bound.

Method

The stages of the ‘4D’ cycle overlap. For the purposes of this paper, I will discuss

each stage separately.

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Discovery

Initial consultation involved meetings with stakeholders and informal conversations

with refugees from START. I volunteered at Cultural Kitchen throughout a year and I

was occasionally present in the START office. Being present, similarly to Whelan’s

description of ‘professional loitering’, I built a rapport and trust with people who do

not easily respond to research interest. This consultative element clarified research

focus and methods of data collection. Collaboratively we developed a semi

structured interview, as refugees felt most comfortable with individual interviews. For

staff and students at START, focus groups felt more feasible. Inclusion criterion were

also agreed for those interviewed:

Age 18+

Service user at START

Received refugee status at least one year ago

OR

Staff member or a student at START for at least 6 months

Ten people participated through interviews. However, approximately 25 people

participated throughout the whole process from discovery to destiny. AI is flexible

and does not specify a sample size. Demographic data for interviewed participants

are presented in table 1.

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Table 1: Demographic data.

Service Users Staff / StudentsNames

*PseudonymsAnnie, Boulem, Nawa, Niki, Sena*, Sima*

Janet, Susie (Staff)Poppy*, Lucy* (Social work students)

Age Range (Approximately, age was not required but

offered by some)

24 – 65 Unknown

Number of years as a Refugee in the UK

1 - 7 N/A

Number of years lived in the UK

6 – 12 Unknown

Gender 4 Women, 2 Men. 4 Women.Self-Identified Country of

originDemocratic Republic of Congo (2), Algeria (1), Iran(1), Middle East (1), unidentified (1)

UK (3), Jamaica (1)

Dream

Through ‘professional loitering’ and developing relationships, I gradually ascertained

people’s interest in participating through interviews. Through a snowballing

technique, four individuals self-identified to participate. Additionally a staff member

offered eight other refugees who fit the inclusion criteria, the option to participate via

text message; two agreed. Two staff members and two students also agreed to

participate through the collaborative process.

Six individual appreciative interviews were carried out with refugees and two focus

groups, one with students and one with staff. Refugees were invited to speak about

what has assisted them to manage throughout adverse times as a refugee, sharing

their experiences of the best (and the worst). Staff and students were invited to

identify success stories regarding supporting refugees and appreciating the best of

what START offers. All participants were asked ‘the miracle question’, imagining that

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a miracle had happened that helped support for refugees go well every time,

describing what would be in place and what would happen.

Interviews were recorded and transcribed verbatim. One participant did not consent

to recording, therefore process notes were taken. A timeline was used as a visual

map maintaining focus on the timeframe we were exploring (life as a refugee) and as

a non-verbal means of communication. Interpreters were available but not required,

as all participants had a conversational level of English. Interviews lasted between

26 and 60 minutes. Participants were offered a copy of their interview transcript to

comment or amend. Two participants did not wish to see their transcript, one

participant did not respond. The other seven participants (three refugees, two staff,

and two students) did not wish to make any changes.

Data were analysed initially by myself through thematic analysis (Braun & Clark,

2006), involving multiple readings of the transcripts. The themes developed

summarised the breadth of the stories shared. The other authors also read the

transcripts and commented on the themes, which were modified accordingly.

Design

Two workshops were held, the first at Cultural Kitchen, involving three (interviewed)

participants and second at a START trustee meeting, involving eight individuals

including trustees, staff and a student. Themes from the analysis of interview data,

plus illustrative quotations were presented on flip charts and comments were invited.

Groups developed provocative propositions based on the themes and were

encouraged to think creatively, beyond current practice constraints in order to

articulate ideal practice. I collapsed the statements into eleven propositions, returned

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them to those at the workshops for consideration and collaboratively finalised the

wording.

Destiny

The destiny phase will be continued once this paper has been submitted and

disseminated. A final sharing workshop is planned, inviting participants and

stakeholders of START. Liaison between participants, other service users and

stakeholders will consider practice and service development implications, to ensure

progress towards the envisioned futures. Furthermore, findings will provide a

stimulus, through the provocative statements, to the wider services that support

refugees.

Findings

The discussion of findings will focus on the key themes identified from the interviews,

followed by the suggested provocative propositions.

Four main themes were identified: 1) warm relationships and connections: working

together to face challenges; 2) resourcefulness and actively contributing to society;

3) flexible, available and knowledgeable services and 4) managing uncertainty.

These themes, each with 2 constituent sub-themes, are presented in turn with

supporting quotations. Quotations were chosen to offer a broad range of participant

views and wherever possible a refugee and service provider quotation for each sub-

theme.

1) Warm relationships and connections; working together to face

challenges

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Working collaboratively with professionals was highlighted as helpful in developing

relationships; which in turn assisted with challenges. For most refugees, positive,

respectful relationships were the most significant factor in helping them to cope.

Trust, transparency and reciprocity:

All participants spoke about the benefits of reciprocal relationships between service

users and providers. Trust, transparency and having an emotional investment were

key aspects:

”… she’s very active….when I had my degree I brought the photos …. she cried

you know……she said oh my God you did it because she knows me well you

know, … she was always there for me” Annie

‘The church has been a big support….“It’s like eating; I need it every day, spiritual

eating’. It helps me to keep smiling”. Niki

“if refugees trust their worker it makes the work happen a lot quicker” Janet and

Susie(J&S)

Collaborative working between services was also important:

“….a case worker and social services and these kinds of things and they helped

with us like going with us to schools and if there was any problem in the school we

had to report it to the head teacher” Sena

One participant highlighted a challenging experience in a service which lacked a

relationship:

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“sometimes you go to talk to them, the people in the place they just relate to what

is in the computer and sometimes you even get upset you ask them and it’s not a

human being it’s just information on a computer” Nawa

Belonging in the UK

Some participants spoke about their relationship with the UK; the importance of

feeling accepted in society, stressing aspects that have helped them feel as though

they belong in the UK:

“I decided to change my nationality yeah so I’ll be someone very different, so I

changed my nationality to British” Annie

“I can get my citizenship so I feel I am from this society” Sena

2) Resourcefulness and actively contributing to society

Drawing upon a number of personal strengths and resources to cope, and actively

contributing to society was fundamental for several participants.

Motivation, determination and aspirations to achieve

Personal qualities of motivation, determination and wanting to learn are central in all

narratives; helping people to keep going and promoting resilience:

“….I said ok I can do anything anyway because I don’t want to be on job seekers

long” Annie

“….because England does not recognise her qualifications so she had to go and

do another degree for 3 years and end up getting a job as a designer and moved

to London” (J&S)

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Staff responses mirrored that of the refugees as they also described being motivated

and proactive in the service that they provide:

“…… it’s sizably more difficult now than it was when I started because resources

have shrunk and there’s a lot more obstacles there now than there were, but

actually on the whole with most people we still work alongside them to get to the

place that they want to. So when you can see that actually stuff is successful,

that’s what keeps you going” (J&S)

Two refugees identified wanting to be role models for their children and providing for

them:

“I wanted to study really and to give also a good example for my kids” Annie

“I‘m especially happy for my son because he has a good life and he’s you know,

happy” Sima

Many participants described actively contributing to society, mainly through voluntary

work. Two participants also describe attempting to create a support group, helping

others:

“I’m a chef I cook Fridays, every 2 weeks…….yeah I cooked for 70 people……I

worked for a cancer hospice………for coffee, tea, cake……..I worked in the

shops, the city centre; Save the Children…………I can’t stay home all the time,

just an old man that is finished, no I don’t like that……I’m looking for a volunteer”

Boulem

“……now I can give back to someone, yes it’s good…..I like to help, I like to see

people be free; for me you have to do everything to be free you don’t have to

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depend on people all the time. You know we even organised like a women’s group

and we used to meet every 2 weeks” Nawa

Hope, faith and belief

Several participants described how their beliefs (including religion and belief in God),

faith and hope are very important components to their identity:

“although it is hard, ‘I believe’ and ‘It gives me some hope’ faith helps him to get

where he wants to be, ‘I believe it is possible” Niki

“I’ve got hope, I’ve got belief and I believe in God. God saved me from my life

there, he will save me here……we have beliefs in God and we ask God for

everything” Sena

Nawa highlighted her battle with racism and how ‘being strong’ kept her going:

“it wasn’t easy at all they pushed me a lot, a lot. If I wasn’t strong I would have

done something……… but I always keep myself calm and I said to them that

you can’t do nothing you know….I faced them, I talked to them but I was scared

inside” Nawa

Staff and students highlighted ‘resilience’ as a key factor in the support they offer:

“I haven’t met anyone yet, any service user that has let it get them down. You

can tell that even though they’re frustrated about it….. instead of it letting them

get them down and staying down they really fight to build themselves up…….”

Poppy and Lucy (P&L)

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“I think its people’s personal strength……yeah it is they’re resilient ……

probably the most capable people on the planet they got here, they’ve gone

through huge steps” J&S

3) Flexible, available and knowledgeable services

Participants emphasised the importance of providing and accessing practical

services that are needs-led and readily available.

Supportive organisations offering practical assistance

A knowledgeable service that helps practically, meeting people’s basic needs was

described as imperative, especially when first gaining status. Additionally, friendly,

compassionate and available staff allowed refugees to feel relaxed and engaged:

“I was struggling with the problems with my benefit, and they know how to get it

and how to apply, START helped me. Yeah they filled the form and phoned

them up to see what benefit I can get for because of my son, who’s disabled.”

Sima

“….all the people are happy, all the people are very nice. All the time you find

something, it’s no problem to stay, so very nice” Boulem

“….knowing that START is there and although we might stop working with them

they know that if something goes wrong they can always come back” J&S

Placement students allowed a greater availability and flexibility within the service

provided. The students are learning, creating a parallel process which assists with

power dynamics and collaborative working.

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“we Google it and we say we don’t know so we both don’t know, us and the

service user and then we find out together” P&L

“we’ve got numbers because of the students, that person can walk down the

road with you go to the job centre….. just having that person there the first few

times to kind of work through things I think can be really helpful for people” J&S

Community projects

Several participants described the value of the community projects offered, for

meeting people; developing skills and sharing experiences:

“….you spend time with people you’re not as socially isolated. Finding people

that speak their language or same religion or same culture I think is really

important” P&L

“…..I can go to the allotment and dig the ground and put all stress in the

ground, this helps of course, this life even with everything we’ve got, we still

think about different things and we get tired, we need something to refresh our

brains and we go out there” Sena

4) Managing Uncertainty

Managing uncertainty was a powerful theme especially on-going uncertainty through

the transition from asylum seeker status to a refugee; constant adaptation and

learning processes were described. All refugees felt that being able to communicate

was essential for them to manage.

Learning and adapting

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Several participants talked about the number of unexpected changes during the

transition from asylum seeker to refugee; they felt unprepared:

“…they often come in really frustrated……whilst they’re an asylum seeker they

don’t get prepared for if you get given refugee status then this is what’s going to

happen” P& L

“I didn’t know anything about being a refugee” Nawa

Many described the uncertainties as an asylum seeker as particularly challenging:

“I feel like somebody banned for everything you know?” Sima

“….we can’t do anything, we can’t work, we can’t study and there just was

depression and we were waiting for an answer from the home office……they

break the door and they took families and put them in the detention centre and

they deport them, they force them and it is a very bad experience for some

families. I saw them with children, they suffer deeply, deeply depression” Sena

Despite the on-going uncertainty, there was a sense of safety, freedom and peace

once receiving status. Two participants also highlighted their appreciation:

“I receive money and I have accommodation. I have freedom, I have peace”

Boulem

“…..a good country, a lovely country to live in, I like the system, how they deal

with people without jobs” Sena

One participant highlighted the discrimination that she faced, however the

stabilisation of being a refugee was helpful:

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“He knows that there’s a language barrier and there are rules and regulations

we don’t know, he was just playing the game and treating us like animals”

Nawa

Language and communication

Having some language to be understood, but also to be able to understand others

was vitally important:

“Language barriers and I think that does appear evident on mental health,

anxieties” P&L

“When I don’t understand a word I read this word and I help myself, It is

difficult….. I go to school….. because I live in this country I need to speak

English” Boulem

Participants used the themes and illustrative quotes to collaboratively develop the

‘provocative propositions’ (Table 2). Participants were encouraged to think beyond

current practice constraints in order to articulate statements of ideal practice based

on the themes. These propositions will be adopted by START and embedded into

the service through policies and practice.

Table 2: Provocative Propositions (linked to themes)

Provocative Propositions Key Theme

Every worker will respect, value and celebrate difference and diversity.

Every worker will assist to create new connections and communities for refugees.

Every worker will be compassionate, friendly and always treat others as fellow human beings.

Warm relationships and

connections: working together

to face challenges

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Everyone will be open to faiths and beliefs of individuals; respecting all people’s life experiences.

Everyone will promote and use people’s personal strengths and expertise, as well as available community resources.

Resourcefulness and actively

contributing to society

Every worker will be honest about limitations; signposting to people or services who may know.

There will be someone available to physically go with people to new or difficult situations.

There will be support for other workers e.g. students; developing their knowledge of systems, services and resources.

Flexible, available and

knowledgeable services

All workers will have an understanding of the complexities involved in having an asylum seeker or refugee identity.

Preparation will be offered to all refugees through being honest about the process and uncertainties.

A variety of communication methods to assist with understanding will be used; language skills will be promoted.

Managing uncertainty

Discussion

This study adopted AI to explore how refugees cope, and manage their lives in the

UK, particularly through the transition from asylum seeker to refugee, and how

services can assist this. Participants spoke about the power of having positive

relationships with individuals within services; personal qualities and resiliencies;

uncertainties and how services have assisted them. Interestingly, narratives from

refugees and service providers often mirrored one another. Refugees’ experiences

reflected previous findings on resilience within this population (e.g.Sherwood &

Liebling-Kalifani, 2012).

Findings indicate that simply being friendly, warm and genuinely listening whilst not

pathologising peoples’ experiences, assists development of positive, empowering

relationships, vital in promoting well-being. Additionally, contributing to society, often

through voluntary work, and not relying on benefits, was particularly important and

empowering for refugees. Research suggests that social isolation contributes to

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post-migration distress (e.g. Bogner et al, 2010); a person’s sense of self and self-

worth are determined by interactions with others. This current study highlights how

reciprocal relationships, volunteering and community projects can assist with well-

being.

On-going uncertainties seemed particularly difficult to manage when seeking asylum,

due to feeling unsafe and imprisoned. Transition to refugee involved unexpected

uncertainties and adaptations. Practical and knowledgeable assistance from services

was invaluable and one aspect which assisted refugees to feel safe, despite the

uncertainties. Mason (1993) describes this as a positive shift from unsafe uncertainty

to safe uncertainty. In therapeutic terms, ‘safe uncertainty’ allows for respectful

curiosity and is a mutually beneficial position. Findings show that as a service

START also constantly face uncertainties, however being a small, flexible and open

organisation they can adapt more freely with less bureaucracy.

Despite there being evident traumatic experiences for the participating refugees, no

one spoke of the need to process these, showing extraordinary resilience. Findings

highlighted that personal hope and belief (including religious beliefs) assisted

refugees to manage adversity and cope with experiences such as racism and

discrimination. This research supports the need for innovative community

interventions, empowering refugees, such as the community projects described.

Community psychology is developing increasingly within the wider economic and

political systems (Orford, 2008). In economic challenge and austerity, applied

psychologists can contribute through collectively building on resilience through

networking, creating allies and addressing wider social inequalities that entail social

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action. Additionally, the provocative propositions developed through this research,

can be adopted and developed by wider services supporting refugees.

Methodologically AI, connected with many philosophies of community psychology

e.g. diversity, and emerging findings in the positive psychology movement (Boyd &

Bright, 2007), empowering those who do not typically have a voice in an organisation

or in the community (Rappaport, 1987). This echoes experiences expressed by staff

regarding having a louder voice in the wider system. Seligman (1991) argued that

the process of AI research itself can create a sense of learned optimism, all

participants described feeling heard and empowered throughout the process.

Psychology has, historically, focused on the frailties of the human condition; however

positive psychological approaches are increasingly accepted in the various domains

of psychological practice and scholarship. Community psychology highlights that

asset-based approaches are fundamental in conceptualising the human condition.

This current study supports previous suggestions that AI can aid community

psychologists who are interested in social change interventions (Boyd & Bright,

2002).

Reflective Critique

This study was carried out within one service with a limited sample size and a

gender bias. Consequently, the findings cannot be generalised directly to the wider

population of refugees and services. Although AI is specific to the organisational

setting studied, themes and provocative statements can be used as starting points

for reflection by other organisations supporting refugees. This research offers insight

into refugee well-being from their perspectives, contributing to limited literature. All

25

participants spoke of valuing the opportunity to talk and hoping to assist other

services and refugees.

My own personal values and perspectives will have influenced this research; I

acknowledge the complexity and limitations of conducting cross-cultural research as

a white British woman. To enhance cultural sensitivity, I drew on my own wider

cultural awareness and previous experiences of living and working in other countries.

Also, bracketing interviews (Ahern, 1999) with the third author explored my

motivations for conducting the research and increased my awareness of my own

socio-cultural values. A reflective journal and participant quotations were used to

assist with credibility. START, my supervisors and service users were continuously

consulted regarding addressing cultural barriers; investing time and effort into

developing relationships has been invaluable to this process.

English was not the first language of participating refugees, which possibly

influenced their choices of words to talk about their lives, or they may have omitted

aspects due to being unable to articulate it. Those whom did not feel confident

conversing in the English language, may have felt excluded, despite interpreters

being available.

AI researchers help create new vision in organisations but leave before it is fully

embedded, which may raise false hopes (Liebling, Elliot & Arnold, 2001). Spending

time throughout this research developing relationships, working collaboratively, and

beginning the destiny process hopefully reduced this risk. Personally, my skills in

developing relationships, facilitating, networking and appreciation were enhanced by

this approach and process, which I endeavour to translate into practice, especially

when supporting refugees.

26

Clinical Implications and future research

In the current economic climate, many services find it increasingly challenging to

support people. This research highlights that despite adversities, resilience in

refugees and START is evident. Promoting this well-being, focusing on ‘what works

well’, could be extremely resourceful, appropriate and beneficial.

Boyd-Franklin (1989) suggested that traditional sources of help for ethnic minority

families have been close friends, extended family and the church. This current

research supports claims that empowering families to interact successfully with

external systems are key therapeutic goals (Boyd-Franklin, 1989). Drawing on action

research processes such as AI, community psychologists can offer opportunities for

collective resilience-building and empowerment.

Psychological research often focuses on individually-located problems. Whilst this

research is invaluable, the effects of social inequalities and positive aspects must

also receive attention. AI offers a conceptual, practical framework for improving

practice in a climate of diminishing resources. Whilst AI aims to celebrate group

achievement; igniting intuition by a collaborative vision, it is the process, not the

product alone that creates possibilities (Bellinger & Elliot, 2011). This process will

continue beyond this study; START will integrate the developed ‘best practice’

statements into policy and practice. AI is an under-used research method within

psychology yet has the potential to make significant contributions to research

practice and service delivery.

Future research focusing on other services and refugees in other areas of the UK

would be useful, focusing on a particular ethnicity, age or gender may offer more

27

focused findings. Creative methods of communication could attract a different range

of participants, assisting with potential language barriers.

Conclusion

AI is not easily concluded as the process will continue beyond this paper as START

embeds the propositions into their service though policy and practice. However, this

study has demonstrated how refugees make the best of their position. The themes

identified acknowledge the resilience and qualities that refugees offer, drawing

attention to important clinical/service delivery implications regarding best practice for

supporting refugees, which can be utilised by wider organisations. The process

alone has been a vital component in empowering and promoting well-being for all

those involved. This research is set in an environment of constant policy change,

presenting continual challenges and opportunities for refugees and organisations. It

highlights the need for partnerships between services to promote well-being in

refugees and demonstrates the necessity for psychological services to move towards

societal models of change adopting community approaches. The paucity of literature

demands greater strengths-based research regarding refugees.

28

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