# Therapy-facilitated integration responsibility: qualitative interviews with refugee psychotherapy clients in Germany

## TL;DR

This study explores how psychotherapy helps refugees in Germany integrate into society by improving their mental health and reducing loneliness.

## Contribution

It introduces the Therapy-Facilitated Integration Responsibility framework, linking psychotherapy to successful integration.

## Key findings

- Psychotherapy experiences like therapeutic relationships and guidance are crucial for integration measures like language learning and employment.
- Emotional distress and loneliness significantly hinder integration, but therapy can help overcome these barriers.
- Addressing mental health early supports refugees in tackling integration tasks sooner.

## Abstract

Many refugees experience substantial pre-, peri- and post-migration stress resulting in high prevalence rates of mental disorders. Additionally, refugees face significant challenges integrating into their host society. Even though access to psychotherapy for refugees might impact the integration process beneficially, research on refugees’ perspectives on psychotherapy, integration and the interaction with emotional distress is limited. This study explores refugees’ perspectives on how psychotherapy may influence their integration process and enhance their psychological well-being.

Six in-depth, problem-centered interviews were conducted with refugees after they had completed psychotherapy in Germany one to two years earlier. The male interviewees, aged between 23 and 44 years, were from Afghanistan (n = 1), Gambia (n = 3), Senegal (n = 1) and Turkey (n = 1). The interviews were conducted in English or German and lasted between 35 and 90 min. The data was analyzed with Constructivist Grounded Theory.

The qualitative analysis led to the development of the framework Therapy-Facilitated Integration Responsibility. This framework identified therapy experiences, especially the Therapeutic Relationship, Opening Up and Being Guided, as crucial for taking on integration measures such as language acquisition, employment, and combating loneliness, ultimately fostering well-being in the host country. Therapy helped the interviewees to overcome a Burdened Integration Responsibility, which was strongly influenced by Stressors Before Arrival, Post-Migration Stressors and Everyday Loneliness.

This study gives insight into the interplay of refugees’ emotional distress and integration. It underlines the need to promptly address refugees’ emotional distress and loneliness to support them tackling integration measures soon after their entry into the host country.

Not applicable.

The online version contains supplementary material available at 10.1186/s12888-025-07716-0.