Adolescent attendance at transcultural psychotherapy: a retrospective cohort study.

Migrant adolescents in therapy for psychological problems are at risk of poor attendance or even of dropping out. Transcultural psychotherapy has been developed in France to take cultural diversity into account in psychological treatment and to deal with the specific difficulties encountered in the psychotherapeutic treatment of this population. This study aims to assess adolescents' attendance rates to this form of psychotherapy and to explore the association of these rates with demographic, cultural, and clinical variables. We conducted a retrospective clinical cohort study of 148 adolescents aged from 11 to 20 years treated between 2008 and 2018 at two transcultural psychotherapy centers in Paris. Statistical analyses tested demographic, cultural, and clinical hypotheses. The main result was the high attendance rate at transcultural psychotherapy sessions among adolescents (77.8%). Attendance rates were not associated with age, gender, family size, generation of migration, or cultural area of origin, but were significantly linked to support in therapy, specifically, the presence at the first transcultural psychotherapy session of the first-line therapist, an interpreter, or both. Transcultural psychotherapy appears to be an effective method for addressing the complex symptoms experienced by migrant adolescents. Better attendance at sessions is statistically significantly associated with factors favoring a therapeutic alliance, specifically, the presence of the first-line therapist or an interpreter in TPT sessions and the existence of support from a social worker. The holistic approach of transcultural psychotherapy to adolescent care may explain the high attendance rates observed.

[The difficulty of growing old far from home]. / De la difficulté de vieillir loin de chez soi.

Somatic difficulties, solitude and the loss of independence are challenges facing ageing people, whatever their culture. However, when one is far from one's home, one's country, one's family, in a complex political and social context, this stage of life can be even more of an ordeal.

[The discussion group "Maternity wards and cultures, exchanges around cradles"]. / Le groupe de parole "Maternités et cultures, échanges autour des berceaux".

At the Port-Royal maternity ward in Paris (14th arrondissement), a system has been set up as part of the liaison work. The discussion group "Maternities and cultures, exchanges around cradles" offers a sharing and carrying place in this so singular period of "becoming a mother" . Cultural and professional mixing is at the heart of this system. Presentation of observations of the group's movements over two years.

[Coconstructing care with teenagers and their families from elsewhere]. / Coconstruire le soin avec les adolescents et leurs familles venus d'ailleurs.

At the "Maison de Solenn", the role of the nurse is complex and plural. One of our main missions is to receive healthcare demands, to evaluate their pertinence and to direct them, if necessary, towards more adapted structures or professionals. This reception can be done by telephone or directly on site. The nurse must also point out the institutional framework for any follow-up undertaken in the structure. She is also responsible for accompanying the patient and the family to the various care providers. This welcome and support nursing role exists in more specifically transcultural situations.

Assessment of transcultural psychotherapy to treat resistant major depressive disorder in children and adolescents from migrant families: Protocol for a randomized controlled trial using mixed method and Bayesian approaches.

OBJECTIVES: Cultural variations complicate psychiatric care, especially for migrant children. Transcultural psychotherapy (TCP) is an original psychotherapeutic technique developed to address complex situations of resistant mental disorders in the context of migration. This research will aim to assess the efficacy, the acceptability, and describe the therapeutic processes of TCP for the treatment of depression in first or second generation of migration children and adolescents. METHOD: Mixed method study using a multicenter, Bayesian randomized clinical trial with blinded evaluation of the primary outcome. Two parallel groups of 40 children or adolescents from 6 to 20 years old and their family will be included. In the experimental group, patients will attend six sessions of transcultural therapy in addition to usual care. RESULTS: The improved Clinical Global Impression scale scores at 6 months will be compared across groups. Qualitative analysis of families and therapists' interviews will allow to specify the therapeutic processes and acceptability of the therapy. CONCLUSION: The findings will encourage the development and routinization of TCP for second-line use and its adaption as a first-line technique in this population.

[Puberty ritual of a Tamil girl in France and psychopathology]. / Rituel de puberté chez une jeune fille tamoule en France et psychopathologie.

What place should be given to puberty? In France, it is an intimate act that belongs only to the young girl. In Sri Lanka, it is a family and collective act that is ritualized and celebrated. Young girls born into Tamil families living in France have to make these very different logics cohabit. Analyse of a young girl's great suffering at puberty and its methods of reconstruction, which take into account the ways of doing and thinking about puberty here and there.

[Do you like me French or Tamil?] / Tu m'aimes à la française ou à la tamoule ?

In a cross-cultural consultation, a young girl of Tamil origin born in France seeks the love of her parents by oscillating between two cultures. Through group development and translation, the daughter and the mother are brought to understand each other's suffering and discover that they share the same deep love, even though it is expressed differently.

Epidemiological description of 529 families referred for French transcultural psychotherapy: A decade of experience.

BACKGROUND: Transcultural psychotherapy (TPT) is an original therapeutic method developed in various forms in France and several other countries in Europe as well as North America to address issues of migrant mental health care when psychosocial, economic, or cultural barriers hinder its accessibility and effectiveness. This study aims to describe the patients referred for TPT in Paris and its suburbs over the past decade, to examine intercultural differences and associations with social, demographic, and clinical variables, and to assess TPT in terms of patient adherence, attendance, and duration of care. METHOD: Retrospective study of 529 patients referred for TPT care, classified in three categories-no treatment, initiated treatment, engaged and continuing treatment. Collection and analysis of social, demographic, cultural, and clinical data, as well as of country of origin, duration of treatment, number of sessions attended (adherence), and number of sessions scheduled. RESULTS: In all, 301 patients from 45 countries participated in an 11-month course of care lasting an average of 8 sessions. Most were children, accompanied by their families. The main psychiatric symptoms at the beginning of treatment were depressive, and the main cultural problem identified was the existence of a traditional theory explaining the illness in the family's culture. Patients kept 80% of their appointments for sessions, and attendance was not associated with socio-cultural or clinical variables. CONCLUSION: The high level of treatment adherence and attendance over time suggest that TPT is an effective method for addressing complex symptoms experienced by migrant families. Results highlighted the potential richness and originality of studies based on retrospective medical data.

[Study on parent-to-child transmission related to Sri Lanka's civil war]. / La transmission parents-enfants liée à la guerre civile du Sri Lanka.

The dynamics of transmission between Tamil parents who fled the civil war in Sri Lanka and their children born in France were studied. The possible trauma that results from the transmission can affect the following generations in a more or less conscious way. The qualitative methodology was based on T-MADE, a method of transcultural analysis of the children's drawings, linked to the analysis of the parents' narrative.

[Social Cultural and Psychological Effects of Marriage among Second Generation Tamil Adults in France. Case Study-Renuka: A Western-Style Arranged Marriage]. / Effets sociaux, culturels et psychologiques du mariage chez les adultes tamouls de seconde génération en France. Étude de cas ­ Renuka : un mariage arrangé à l'occidentale.

Objective This study is a comprehensive approach to psychic conflicts encountered by young women confronted with divergent cultural models. It relates the tensions experienced by Renuka, Tamil born in France, in her marital choices between cultural verticality and interbreeding. Method Renuka's matrimonial journey is explored through in-depth semi-structured interviews analyzed using Devereux's complementarist method. Results In a multicultural space, there is a difficulty of positioning. Marital choices reveal intrapsychic tensions that can be overcome by mobilizing strategies, processes and mechanisms articulating identificatory models. Conclusion This study explores the issues of marriage in a migratory context and its effects on the psychic life of individuals and relates the major issues of our mixed societies.

[Language countertransference]. / Le contre-transfert langagier.

In the transcultural approach, emphasis is placed on cultural countertransference in order to account for caregivers' implicit and explicit reactions with regard to patients and their history. As language is a constitutive element of culture, linguistic countertransference must be granted a place, in care, research and teaching.

[A tool for the language evaluation of bilingual children]. / Un outil pour l'évaluation langagière des enfants bilingues.

The native language is a vehicle for transmission and inscription into a culture. In children of migrants who grow up between two languages and two cultures, language develops in a context of bilingualism. This specific context requires bilingual assessments to ensure that a child's complete skills are assessed. The language assessment of non-French-speaking children and first-time immigrants, has been set up at Avicenne hospital in Bobigny. It is the first transcultural tool for the assessment of native languages.

[Teenagers' drawings in transcultural consultations]. / Les dessins des adolescents en consultation transculturelle.

The place of teenagers' drawings has been studied as part of a transcultural consultation, based on the creativity of the children of migrants. When speaking is difficult, drawings enable teenagers to show another dimension of their internal world. Aravin, a young Tamil boy, who lacked the necessary words, was able to express all the complexity of his thoughts through his drawings, finally being able to formulate in the group the difficult situations which he was drawing.

[The drawing, an indicator of language divides]. / Le dessin, un révélateur des clivages langagiers.

The drawing is used as a mediation tool in the framework of a cross-cultural consultation "bilingual group". Clinical reference materials show that this mediation is suitable for children having difficulties switching between the language spoken at home and that spoken at school.

Evaluar y diagnosticar las patologías del lenguaje en un contexto bilingüe / Evaluate and diagnose language pathologies in a bilingual context / Avaluar I diagnosticar les pathologies del llenguatge en un context bilingüe

La transmisión psíquica de la lengua materna de padres a hijos es una necesidad con el fin de que los afectos, las representaciones y las experiencias culturales circulen en el seno del ambiente familiar. El análisis de datos epidemiológicos y el examen de otros datos provenientes de la práctica clínica añadida a la investigación en el campo transcultural nos indican que los trastornos del lenguaje que se estructuran en un contexto bilingüe no son forzosamente consecuencia de la "bilingualidad", pero tienen, sin embargo, una naturaleza específica dada por factores psicológicos y culturales. La Prueba de Evaluación del Lenguaje para Alófonos y Recién llegados (Elal Avicenne) es una metodología basada en el conocimiento de las prácticas de historia del lenguaje familiar y en el reconocimiento de los conocimientos lingüísticos exógenos que puede detectar dichos trastornos

The psychic transmission of the mother tongue from parents to children is a necessity which makes it possible for affect, representations and cultural experiences to circulate within the family environment. The analysis of epidemiological data and the consideration of other data from clinical practice added to the cross-cultural field research indicate that language disorders that are structured in a bilingual context are not necessarily a result of "bilinguality", but rather they have a specific caused by psychological and cultural factors. The Language Assessment Test for Allophones and Newcomers (Elal Avicenna) is a methodology based on knowledge of the practices family history of language and recognition of exogenous linguistic knowledge of the that can detect such disorders

La transmissió psíquica de la llengua materna de pares a fills és una necessitat que té la finalitat que els afectes, les representacions i les experiències culturals circulin en el si de l’ambient familiar. L’anàlisi de dades epidemiològiques i l’examen d’altres dades que provenen de la pràctica clínica afegida la investigació en el camp transcultural ens indiquen que els trastorns del llenguatge que s’estructuren en un context bilingüe no han de ser necessàriament conseqüència de la “bilingualitat”, però tenen una naturalesa específica que ve donada per factors psicològics i culturals. La Prova d’Avaluació del Llenguatge per Al·lòfons i Nouvinguts (Elal Avicenne) és una metodologia basada en el coneixement de les pràctiques de la història del llenguatge familiar i en el reconeixement dels coneixements lingüístics exògens que pot detectar aquests trastorns