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Culturally Sensitive Treatment for Substance Use Disorder

Forced migration involves many stressors for people who cannot return to their country of origin due to personal risk for reasons of race, religion, political opinion, or other reasons for persecution. These stresses increase risk for substance use disorder (SUD), including complex trauma, family separation, stress of acculturation, and ongoing difficulties and discrimination in host countries. However, negative attitudes within and outside these individuals’ new communities create barriers to identifying and treating SUD. In addition, lack of culturally sensitive treatments present an additional challenge.

With increasing prevalence of SUD and awareness of barriers to treatment, one group of researchers in Germany reached out to a local community of Syrian refugees. Using a participatory research approach, these researchers used focus groups with adult males in the community to explore culture-specific beliefs and concepts related to SUD. The researchers used the resulting information to adapt an existing program entitled Skills-Training of Affect Regulation (STAR) to be more relevant to the local Syrian community. The STARC-SUD prototype was then piloted in German with simultaneous translation to groups of adult male Syrian refugees.

Some cultural differences noted were the Syrians’ lack of familiarity with the concept of psychotherapy, different understanding and acceptance of substance use and addiction, gender roles, and the importance of religious beliefs in understanding the world. As one example of a culture-sensitive adaptation, the revised STARC program incorporated religious content in the program, but found that participants varied in their responses: “some refugees perceived religion as a source of strength, others experienced it as a source of threat.” The authors conclude that qualitative research with the target population is essential for informing cultural adaptations of existing interventions and to meet the specific needs of the target group.

Source: Lotzin, A., Lindert, J., Koch, T., Liedl, A., & Shafer, I. (2021). STARC-SUD – Adaptation of a transdiagnostic intervention for refugees with substance use disorders. Clinical Psychology in Europe, 3, e5329. Doi: 10.32872/cpe.5329

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the Center of Alcohol & Substance Use Studies.