ABSTRACT
This chapter outlines some important factors to consider in the initial assessment of the therapeutic setting with specific attention given to refugee-related issues. Particular emphasis is placed on the importance of gender, and consideration is given to the possible intercultural nature of the therapist–patient dyad in transference–counter transference, free association, and interpretation. The nature of the refugee patients is outlined, highlighting the difficulty and importance of differentiating between needs associated directly with external trauma, and needs resulting from being treated as a transitional object by mothers or other primary caregivers. The clinical characteristics presented in literature and the medical model of diagnosis which is complex, with a wide range of diagnoses and high rates of co-morbidity is not best way of dealing with people with existential traumatic endurance. Epidemiological research by the World Health Organization shows that one out of two people have been or will be seriously traumatised at some point during their life.
