Adolescences Disrupted in Displacement: The Protective Effect of Friends as Proxy Family for Unaccompanied Adolescent Refugees Resettling in Ireland

Abstract

It has become very clear throughout my psychotherapy work with unaccompanied and separated adolescents (UASA) in Ireland, that friendships often provide a critical source of protective psychosocial support within adolescences frequently interrupted by conflict, violence and perilous journeys. Although the increasing importance of friendships in adolescence and more specifically during times of adolescent stress, is well-documented, friendships are likely to be brought into even sharper focus during unaccompanied adolescent displacement, as they typically take on functions more traditionally associated with the absent family. This qualitative exploration of the protective effect of friendships for UASA uses reflexive thematic analysis to analyse composite clinical case material and composite eco-maps to capture the lived friendship experiences of UASA. The data clearly illustrates that UASA friendships provide a safe, accepting, protective space and enabling context in which they can gain psychological and practical peer support and approval.

1. Introduction

Central to this chapter is an understanding of adolescence as a life stage that whilst variable in its boundaries, expectations and lived experience, is perceived cross-culturally as an important period of transition from childhood to adulthood [1]. The adolescences experienced by those who are forcibly displaced are frequently disrupted by conflict, violence and perilous journeys, which together with the associated experiences of profound loss (of home, identity, relationships, trust, and life as it was), all have a critical impact on adolescent development [2, 3]. During the course of the author’s work as a humanistic and integrative expressive arts psychotherapist working with unaccompanied adolescents seeking asylum (UASA) in Ireland, it has become very clear that one of the ways in which the impact of these disruptions is alleviated is through friendships, which can provide a crucial source of psychosocial support. This support can help to compensate for the abrupt loss of family life experienced by these young people.

Friendships are likely to be brought into sharper focus for UASA than for adolescents who flee with family members, and tend to take on functions more traditionally associated with families given the absence of their physical presence and support [4, 5]. Taking into account both physical and virtual family presence, the latter being facilitated by digital media as illustrated by [6], there is a clear blurring of boundaries between conventional friendships and family roles for these young people. This can be conceptualised using Spencer and Pahl’s ‘patterns of suffusion’ model [7, 8], which inspires a culturally sensitive re-imagining of personal relationships through the grounding of people in flexible and supportive personal communities. A systematic search of all relevant journal databases for research on disruptions to adolescence for these young people suggests that conceptualising UASA friends as proxy family and exploring their protective effects during this critical developmental stage, remains largely unexplored, although notable exceptions include a study on the nature and importance of UASA friendships within residential group settings in Ireland [4], and research into social networks among unaccompanied minors in Sweden [9] , which both provide important contributions to the field. Instead, the focus has typically been on the impact of lost educational opportunities [10, 11, 12], and changes in family relationships and gender roles [2].

This chapter therefore attempts to redress this imbalance by contributing to the literature on UASA friendships in two distinctive ways: firstly through its specific focus on the protective effects of friends as proxy family for UASA and secondly through its innovative use of the author’s complementary reflective clinical journal (RCJ) and eco-maps with accompanying narratives (EMN) to develop composite first person narrative case material, in order to capture the lived friendship experiences of UASA. The conceptual framework for the narrative case material was provided by the reflective lifeworld approach (RLA) [13], which has principally been used in health-care settings to explore the complexities of lived experiences [14]. Reflexive thematic analysis (Reflexive TA; [15, 16]) and Polytextual thematic analysis (Polytextual TA; [17]), were used to analyse the RCJ and EMN composite data respectively.

2. Unaccompanied refugee minors in Ireland

In 2020, approximately 10,300 of the 16,700 children arriving in member states of the European Union, were considered to be unaccompanied minors (UM); young people below the age of 18 who were not in the care of, or accompanied by, a responsible adult [18]. The vast majority (83%) of these young people were aged between 15 and 17 years and fleeing from regions of the Middle East, South Asia and Africa [19]. UM began arriving in Ireland in the mid 1990’s and although the number of UM recorded in Ireland is low compared to other EU Member States, this number steadily increased from 97 referrals to the Social Work Team for Separated Children Seeking Asylum in 2014 to 184 referrals in 2020, an increase consistent with international trends. In Ireland, newly arrived UM under 12 years of age are found a foster care placement and those who are 12 years or over are usually placed in a residential intake unit (RIU) which is registered as a children’s home. A multidisciplinary social work risk and needs assessment is carried out, which includes child protection, medical, psychological, educational and language assessments [20]. Following the latter, the young person will typically be placed in a transition programme to prepare them for mainstream secondary educational or other training options [21].

3. The impact of trauma and loss on unaccompanied adolescents and the importance of friendships

The diverse lived experiences of UM have typically been conceptualised in terms of the three stages of pre-migration, the migration journey and post-migration [22]. The witnessing or experiencing by UM of terrifying events during the first two stages together with experiences of deep loss, have been shown to increase the risk of psychological trauma [23], especially as the loss of home includes a myriad of emotional associations and experiences in addition to the physical space [22]. Research also indicates that dislocation from family places UM at a significantly higher risk for the development of psychopathology than refugee children living with a family member [24, 25], thereby highlighting the context of extreme disadvantage in which they are operating [9]. Furthermore, the asylum-seeking process in the host country often results in increased stress and further disempowerment [26].

It is, however, important to remember that although the shared refugee experience is frequently associated with trauma, such experiences can have varying impacts on mental health, depending on the temperament, resilience, attachment to the primary caregiver (s), and adaptive coping skills of the individual as well as the social supports available [27], with some refugees developing psychological difficulties, and others being able to cope, adapt and thrive [28]. Given the variability of trauma responses, it may be more helpful to consider the refugee experience in terms of the universal experience of loss, and to recognise that the loss of friends as well as family in the home country during adolescence, the developmental stage when friendships are typically assuming a greater importance in the developing identity of the young person, can also have a negative impact on UASA.

Establishing new friendships during and after the migration journey is therefore of critical importance for positive identity development experienced in adolescence as a sense of mattering and belonging and the ability to adjust to change [1]. The importance of friendships for adolescent well-being has been demonstrated by the role they play in protecting against the harmful effects of experiencing low self-esteem and depression during this life-stage [29, 30], in developing coping and resilience [31, 32] and in identifying the role of positive peer support-seeking experiences in buffering the impact of daily worries and anxiety [33].

4. UASA adolescent friendships as a potentially reparative coping resource

The rupture and repair cycle is at the heart of the attachment relationship between parent and child. It forms the core of emotional security and self-confidence and is established during a child’s early life [34, 35]. This fundamental dimension of psychological development is mirrored in the rupture caused by the abrupt loss of family life through forced displacement for UASA and the potential reparative effect of friendships. Although the enforced absence of family support means that friendships during the migration journey are likely to take on a greater significance for UASA than for young people accompanied by their families, the description of UASA as ‘unaccompanied’ may be somewhat misleading, as although UASA may arrive in the host country without an accompanying adult, they usually arrive in the company of other young people, with whom close friendships often develop based on shared experiences [4].

Ethnic, national and religious connections have been shown to provide potential channels through which social bonds can be formed between refugee young people [36]. Evidence has also been found of the enduring nature of friendships developed during the migration journey due to the profundity of the shared experiences, with UASA seeking to maintain or re-establish contact upon arrival in the host country [37]. The importance of the assistance and support provided by UASA friends during the migration journey to Australia as well as the comfort experienced when travelling with young people who speak the same language has also been highlighted [38]. In addition, UASA experiences of camaraderie on the journey, which include collaborative tent building using abandoned materials have been documented [39]. However, barriers to developing deep friendships have also been reported. The often-fleeting nature of friendships made by UASA during the flight stage due to its unpredictable and transitory nature have been highlighted [38], and a protective position of mistrust amongst UASA has been identified [25]. Furthermore, the strategy by people smugglers of repeatedly splitting up UASA friendship groups to prevent them from building trust and developing inter-personal ways of coping, which implicitly recognises the potential power of these aspects of adolescent friendships, has also been documented [40].

The importance of developing adolescent friendships for coping is reflected in theoretical models, clinical assessment tools and therapeutic interventions [41]. Within its interacting layers, Bronfenbrenner’s [42] ecological systems model recognises the potential inter- and intra-personal support and enrichment derived from developmentally appropriate levels of friendship [41]. Social connections are also conceptualised as a key coping resource in Lahad et al.’s Basic Ph model [42], which has been used as an effective resiliency assessment, intervention and recovery model in many different disaster contexts where forced displacement is a direct consequence, including the second Lebanon War [43], the Yugoslav war [44] and post-hurricane Katrina [45].

5. Mitigating challenges of post-migration through the creation of community and proxy families

The specific challenges of the ‘post-migration’ or resettlement phase for UASA have also been widely documented [9, 46]. Instead of the safety and security which they were seeking, UASA everyday lives are often over-shadowed by the horror of the past, challenges of the present and uncertainty about the future [22, 23]. Coping with bureaucratic and insensitive support systems alone can be overwhelming [25, 47] and language barriers and navigating complex social services and legal institutions, frequently without adequate support, often increase the experiences of vulnerability and despondency [3]. In these circumstances, it is natural for UASA to turn to other UASA to whom they can relate through shared experiences of the past and the present. Furthermore, as UASA have lost the community of their homeland and often come from societies where life is experienced and decisions are made collectively, friendship networks can recreate supportive communities in which traditions, cultures and belief systems can be shared and expressed [47].

Participants in research which explores UASA social networks, have been found to attribute ‘family-like’ properties to their friendships by referring to friends, and particularly ‘like-ethnic’ friends, as their ‘new family’ [9]. Social networks in this context have also been described as ‘proxy families’ [48], a phenomenon which is reinforced by the particular form of ‘collective’ living experienced in group homes for UASA and refugee reception centres for accompanied young people [4]. For example, an exploration in the German host context found that child and adolescent friendships were forged across linguistic and cultural boundaries in the corridors and play areas of reception centres where German was often used as a lingua franca, thereby improving linguistic skills and often encouraging parental friendships [49]. However, it is important to note that the transitory nature of displaced lives in these spaces can also compromise any meaningful investment in friendships. Eritrean females living in Norweigan reception centres reported experiencing significant emotional distress when friends were moved to different centres [5].

6. Methodology

6.1 Capturing the lifeworld through reflexive clinical journaling and eco-maps

Developing a deep understanding of UASA perceptions of friendships and their contribution to managing life challenges requires access to their lifeworlds. The phenomenological philosophical concept of lifeworld, developed by philosopher Edmund Husserl [50], has been transformed into an empirical research approach, the overall aim of which is to describe and elucidate the lived world in order to increase our understanding of human experience [13]. This forms the guiding principle for the current research which identified the importance of UASA friendships through the author’s documentation and interpretation of clinical psychotherapy sessions with UASA, as captured in the RCJ and EMN. Although the RCJ was originally engaged in by the author as a self-supervisory process to increase practice awareness, and the ecomaps were introduced to map out UASA pictures of social supports and identify connections (both present and absent), to explore with them, it soon became apparent that the reflections contained therein offered rich accounts of lived experiences, which would be of interest to researchers and clinicians. There followed a process of considerable reflection by the author on the most ethical ways to document insights from the data whilst protecting UASA identities.

6.2 Ethical and professional considerations in writing about psychotherapy clients

Psychotherapy codes of ethics obligate clinicians who write about their casework to protect client confidentiality and privacy by requiring either the consent of the client or adequate disguise of the case material [51]. Although obtaining consent may seem like the safest option for meeting these requirements, scholars have questioned the possibility of obtaining truly informed consent in this context [52]. This has been described as ‘a highly charged interpersonal act’ [53], and the power differential between psychotherapist and UASA has been identified, highlighting the negative impact which this intrusion into the therapeutic space could have on the therapeutic relationship and outcomes [54].

Nevertheless, it is also important to draw attention to examples of case studies of therapeutic work with refugees in which clinical case material has been used collaboratively by client and therapist in an insightful and intuitive way. Notably, a sensitive exploration carried out with a former young refugee client of the potential impact of using their chosen clinical material, before a collaboration with him to explore his own experiences of the therapy process [55]. This young person was keen for this piece of work to inform future therapeutic work.

As the requirement to take adequate steps to disguise client identity is rarely elucidated by psychotherapy professional bodies, the nature of this disguise is generally left to the judgement of the clinician-researcher [56]. The construction of composite cases where clinical material from two or more client case sources is blended and presented as a single case, removes the consent requirement and avoids the risk of developing single case disguise with too little or too much disguising detail [53]. Three composites were therefore developed for the current study and ethical approval was granted by the Faculty of Arts, Humanities and Social Sciences Research Ethics Board in Trinity College, Dublin, Ireland.

6.3 Clinical reflections and eco-maps in the therapeutic process

Textual records of psychotherapy sessions can range from brief factual accounts to more subjective descriptions which document the emotional aspects of therapeutic engagement [57]. This more subjective writing can be characterised as ‘associative jottings’, which can provide an important source of information for post-session self-reflection by capturing the intersubjectivity of the therapist-client encounter. The combination of subjective writings with brief essential factual information, an approach which situates UASA at the very heart of the process, emerged naturally for the author, being consistent with her humanistic way of working. Eco-maps were frequently created by the UASA during different stages of therapy. Originally conceptualised by Ann Hartman, their creation allows professionals to engage clients in conversations about family, relationships, sources of social support and inclusion in wider social networks, which are then illustrated in a one-page graphic representation [58, 59]. Eco-maps typically use coding conventions of circles to represent people, which are linked by different types of line to depict the nature of their interactions. These include relationship strength, interaction frequency, and support type and are often used by social workers as a way of learning about individual and family support systems [60]. The author adapted the eco-map in the therapy setting with UASA, by using miniature physical objects as symbols to represent people and other important relationships and belief systems [61]. Psychotherapy work with symbols was originally conceptualised by Carl Jung, [62, 63], who used symbols with clients to allow unconscious material to be brought into conscious thinking. This approach is particularly useful when working with adolescents, as the process of adolescent individuation and self-awareness development involves an interaction between the unconscious and conscious self [64].

During therapy sessions, UASA were invited to select symbols to represent all important sources of support in their lives and to arrange all of the symbols on a large wooden tray to form a 3D multi-dimensional eco-map. This visual tool allowed the UASA to project ideas from their family, peer group, belief systems and other social and cultural systems onto the symbols. The author explored the various configurations of closeness and distance between the symbols with the UASA to help them to reflect on alliances, alignments, absences and hierarchical structures. This provided an empathetic setting for UASA to access conscious and unconscious material on friendships and social connections within the therapeutic process.

6.4 Developing composite first-person narrative case material for reflexive and polytextual TA

The composite first person narrative provides a reflective story with which readers can personally connect and use of the personal pronoun ‘I’ ensures that the composite UASA is characterised as someone who typifies the general experience within a living and situated context. Drawing on an existing methodological approach and reflections on research rigour [65], the author developed and implemented a five-stage process to build the composites and identify relevant themes. The clinical reflections in the RCJ and EMN took the form of brief notes (one to two paragraphs) and eco-map photographs, taken after every UASA psychotherapy session during the period 2016–2020. The author worked with a total of thirty-three UASA during this period and each young person attended between six and forty-five psychotherapy sessions, with an average of sixteen sessions.

Table 1 documents this process for transparency and demonstrate that narratives are derived directly from the original data:

Stage	Task	Outcome
1	Preliminary screening and coding of the RCJ and EMN material for overall composite formulation.	Identification of the connection between experiencing different UASA living arrangements and being exposed to different friendship opportunities and experiences
2	Organisation of material for composites, including eco-map images, based on the current UASA living arrangements.	Three UASA living arrangements identified and data organised accordingly: foster family residential intake units (RIU) recently transferred to a Direct Provision Centre (DPC).a
3	Removal of all names and other potentially identifying information from the composite narrative material (only possible after identifying living circumstances).	Respecting of confidentiality and anonymity during the subsequent stages of the research process
4	Construction of composite narratives from the data.	Three composite narratives constructed from the data (each includes 1-2 composite eco-map images): Mamoud (M, 16 years old): a composite of 16 RCJ and 6 EMN entries of UASA living in foster care.; Amina (F, 17 years old): a composite of 20 RCJ and 7 EMN entries of UASA living in RIU’s.; Raheem (M, 17 years old): a composite of 14 RCJ and 4 EMN of UASA recently transferred to a DPC
5	Reflexive and polytextual TA	Friendship themes identified within composite narratives and eco-map composites using reflexive and polytextual TA respectively.

Table 1.

Building the composites and analysing the data: a staged approach.

^a

Ireland’s reception system for asylum seekers

The same compilation process was adopted for both data sets to ensure consistency of approach. Each composite narrative was formed from 14–20 RCJ entries and 4–7 EMN, with the latter providing the content for the eco-map composites which were (re)-constructed from 22 individual eco-map photographs integrated by the author into the RCJ. The author constructed five, living-arrangement-aligned, eco-map composites from the individual eco-maps which were photographed and incorporated into the composite narratives (see Figures 1–4). The author’s first-person narrative descriptions of UASA clinical process and experiences within the RCJ and EMN, were then reflected in the re-presenting of their experiences and opinions in the composite narratives. Although relatively uncommon, the composite narrative approach has been used when researching complex issues where anonymity is critical, such as teacher-pupil relationships [66]; British politician’s views [67] and military mother’s experiences [68].

Figure 1.

Mamoud’s proxy family eco-map.

Figure 2.

Amina’s friendship eco-map.

Figure 3.

Raheem’s eco-map for coping with the stressors of resettlement.

Figure 4.

Raheem’s eco-map for the ways in which he experienced his childhood.

As the nature of the relationship between the author and the UASA prevented the co-creation of composite pseudonyms, the author endeavoured to balance the tension between protecting UASA identity whilst preserving the richness of the data and reflecting their countries of origin [69], by selecting the pseudonyms of Mamoud, Amina and Raheem names which are widely used in countries of the Middle East, South Asia and Africa. Although the composites combine clinical case material from both genders, a gender was assigned to each composite to ensure theme coherence; one female and two males, which reflected the gender split amongst UASA engaging in psychotherapy with the author at the time. As well as capturing common UASA experiences in the therapy room, each composite incorporates ‘one off’ individual experiences thereby ensuring multidimensionality.

6.5 Reflexive and polytextual thematic analysis: an inductive approach

A data-driven inductive approach to Reflexive and Polytextual TA conducted within the Reflective Lifeworld Approach framework [13], was adopted for the composite data. There was no pre-determined coding frame and as advocated for psychotherapy research [70], the author considered themes to be active creations uniting data and capturing implicit meaning beneath the data surface. Each composite text was read repeatedly for familiarisation with the complexity and scope of the data and analysed using Reflexive TA. Polytextual TA was used to analyse the eco-map composites [17]. Interesting features focused on the protective effects of friendships were assigned initial codes which were combined into potential themes according to similarity and prevalence and then re-checked against the data. 32 categories relating to the protective effects of friendships across both data sets were identified and grouped into the following four themes.

1. Friends as proxy family

2. Deep emotional and experiential bonds

3. Coping with the stressors of resettlement by connecting with friends

4. Friends helping to heal the ruptures of lost childhoods

7. Results

7.1 Friends as proxy family (Theme 1)

The ‘patterns of suffusion’ concept is particularly relevant for the UASA in this study with its underlying premise that friends can become family-like when they have a strong sense of responsibility towards one another and where an enduring relationship assumes a high degree of significance in their lives [7]. Patterns of suffusion identified amongst Eritrean women living in Norweigan asylum reception centres, which meet the normative expectations of family relationships by providing unconditional emotional and practical support and loyalty, have been conceptualised as ‘proxy families’ [48]. This process of suffusion is captured in Mamoud’s description of his friends as ‘brothers’, which conveys the importance of their family-like roles:

I miss my family so much but it’s like my friends are now my family. I have five brothers at home but also four brothers here. We met in Greece and are from the same country with the same language and we came here together. They’re not friends, they’re brothers - it’s different. (Mamoud, RCJ)

Experiencing friends as proxy family during flight from his home country, manifests strongly in the narrative which accompanied Mamoud’s eco-map image (see Figure 1). The narrative consists of his responses to the author’s warm invitation to describe the objects chosen and her gentle observations, reflections and feedback on symbol choice, arrangement and distancing.

I met Aboud when I was running away after the explosion. He’s the soldier with the flag in the picture beside me – I have the sword. I was only 12 years old and he took me into his home as his brother. His whole family accepted me and even his sisters and wife did not wear the hijab around me¹. His mum is the angel horse and his wife and sisters are the princesses – they are still protecting me (Mamoud, EMN)

Amina also refers to friends made in the RIU since fleeing her country, as her new family, and emphasises the importance of having friends to take on roles which she perceives as usually fulfilled by her family, such as providing company, intimacy and support. It is evident that her situation has made her reflect on the blurring of boundaries between friends and family:

We’re all living in the same place, cooking together, speaking our language (apart from when staff tell us to speak English) and talking about weird Irish stuff! It’s comforting and you don’t feel alone. So it feels like family and sometimes I make myself think that this is my new family and try to forget about my ‘real’ family but I never ever can. (Amina, RCJ)

For Raheem, attributing family-like descriptors to the two closest friends he had to leave behind when he moved from the RIU to a DPC after turning eighteen, demonstrated that their relationship had taken on additional qualities, which would ultimately strengthen the friendship tie:

They’re my brothers – sometimes I forget that I haven’t known them all my life (Raheem, RCJ).

These patterns of UASA suffusion and proxy family relationships were in clear evidence in all three composites across both RCJ and EMN data sets.

7.2 Deep emotional and experiential bonds (Theme 2)

Mamoud, Amina and Raheem all talk about the strength of the friendship bonds between themselves and their closest friends which grew from the intense emotional and harsh physical experiences which they had shared both during flight and since arriving in Ireland. Raheem talks about a deep bond between himself and his two closest friends which was not threatened by his recent move to a DPC:

We went through so much together that it doesn’t matter where we live – even if we end up in different countries - we will always be so so close - no one else can understand. It’s so hard being moved here and leaving them behind it’s like I left part of me behind. We will do anything for each other … now and always (Raheem, RCJ).

Parallels can be drawn between the intensity of these bonds and those documented between war veterans deployed together during periods of armed conflict [71]. Although UASA evidently do not undergo military training which develops intense reliance between soldiers, it could be argued that the profound shared UASA experiences of war and terror, albeit as witnesses or victims rather than in combat roles, also result in the development of deeply personal emotionally sustaining relationships. Of critical importance in this context is the evidence base evaluated by Bessel Van Der Kolk, which demonstrates that the presence of a good support network constitutes the single most powerful protection against becoming traumatised in response to a terrifying event and that when human beings are traumatised, they recover in the context of relationships which can provide physical and emotional safety [27].

Like UASA, soldiers suffer the loss, albeit as a more managed, predictable and often temporary process, of their family relationships and the growth of their new (military) family—described as ‘surrogate family members’ [71] and ‘brothers and sisters in arms’ [72]. For soldiers during the transition to the war phase of deployment, and UASA during the flight phase of forced displacement, physical and social isolation, experiencing shared risks and the deprivations associated with these respective phases, encouraged them to rely heavily on their close friendship networks for social and emotional support, leading to the forging of strongly bonded relationships (see the seminal work of John Bowlby on the ways in which early bonding patterns with primary caregivers develop and guide future relationships [34]). Furthermore, bonding capital has been identified as the strongest form of social capital available to displaced young people in their host countries [9].

Amina’s experiences also demonstrate the strength of this bond as she describes how the only person who could understand how she was feeling was the friend from her home country with whom she had shared ‘shocking and terrifying’ experiences:

She went through all that bad stuff with me – and knowing that she understands makes me feel calmer and safe. It’s like unspoken and cos we went through it together we have a bond forever. (Amina, RCJ)

Amina’s remarks on feeling safe within this deeply bonded friendship are reminiscent of comments made by the combat soldiers in an ethnographic study by Jamie Ward [72]. The depth of UASA bonded friendships is also illustrated in her use of an angel figure in her eco-map image to depict her friend Khadija with whom she journeyed through four countries (see Figure 2). In response to the author verbally noticing her hesitation when choosing the figure, she responded:

Yeah I was drawn to the angel cos she (Khadija) protects me but I hesitated cos it has a wing missing but then I thought well Khadija lost her dad so it’s like a part of her has gone and losing the wing meant she couldn’t function properly cos of her dad so it kind of fit (Khadija, EMN).

For Amina, the use of the damaged symbol led her to acknowledge and interpret the impact of Khadija’s loss and identify qualities in her friend which she may not have previously considered:

It’s less than a year since she lost her dad and she’s still been taking care of me – she’s so strong. (Raheem, EMN)

Amina’s choice of an angel for Khadija and a baby gorilla to represent herself, created important therapeutic distance which facilitated the development of role-play dialogue between the two symbols. This allowed Amina to speak through the gorilla rather than directly verbalising her pain and also to focus on the symbols when she needed grounding and wished to avoid eye contact. This created a space where Amina could safely explore her loss, whilst allowing the author to bring unconscious material into Amina’s conscious awareness, thereby enabling her to explore the associated feelings, beliefs and thoughts [73].

7.3 Coping with the stressors of resettlement by connecting with friends (Theme 3)

The importance of connecting with friends for refugee coping and overall well-being during the resettlement phase and indeed during all stages of forced migration is well-documented [74, 75] and the social channel of coping is one of the dominant coping modes in Lahad et al’s [43] BASIC-Ph integrative model of coping and resiliency [42]. Friendships are consistently evoked by Mamoud, Amina and Raheem as providing important sources of coping, as evidenced by Amina:

Whenever I think that I can’t cope with any more terrible news from home, I call over to Mariyam – she knows that when I go it means that something bad has happened and that I need company, not even to talk (Amina, RCJ)

Mamoud talked about connecting with friends from the RIU to help him cope with the isolation which he felt after moving to foster care:

I spend a lot of time in my room cos downstairs I’m in the way – I don’t feel part of the family and I really miss my friends from the RIU – they were always there when I felt bad, when I was missing my family, they just got it. We would listen to music from our country or prepare food together. Now I have to text or call and although our friendship will always be so strong, it makes it harder (Mamoud, RCJ)

However, he also acknowledged that sometimes he didn’t want to over-burden his friends with his problems:

Sometimes I just try to cope with things on my own – I know that my friends have their own problems to deal with. Although therapy can support me you haven’t been through it so can’t fully understand (Mamoud, RCJ)

This assertion that full understanding can only come from others who have experienced similar situations is consistent with findings from research into adolescent help-seeking experiences more generally, including adolescents in foster care [76, 77]. A reluctance to over-burden friends has also been documented amongst UM’s [4]. Moreover, as well as offering informal help and support, UASA described helping friends to access mental health services:

Lila was really struggling to cope and when she got really bad I told my social worker and we persuaded her to get some professional help (Amina, RCJ)

Raheem’s social channel of coping was strongly represented in the eco-map he produced when invited to choose symbols to represent ‘different things which help you to cope when you’re not feeling great’ (see Figure 3). The talking figures were placed centre stage (representing Raheem and a friend) and other activities with friends such as enjoying nature and animals, playing sport and engaging in faith-based practices were represented. The author explored with him the emotions he was feeling as he described each symbol and its qualities.

This helped Raheem to get in touch with important conscious and unconscious feelings and thoughts. The symbols placed most closely to Raheem represented God and discussion of their position in relation to the arrangement of other symbols was useful in raising Raheem’s awareness of the nature of this relationship.

7.4 Friends helping to heal the ruptures of lost childhoods (Theme 4)

Mamoud, Amina and Raheem all talked about their different experiences of missing out on their childhoods because of the circumstances which led to forced displacement. Mamoud expressed his sadness at not having been able to play as a child and talked about making up for this with his friends:

I should feel happy seeing the kids around here play but I feel sadness that I had to work to survive when I was twelve years old when the war started. I think that’s why I love having a kick around and messing around with my friends – it’s like we are making up for it (Mamoud, RCJ)

On Raheem’s first visit to the therapy room the author noted that his eyes were immediately drawn to a big jar of marbles in the corner. She offered to play with him and after some hesitation which lasted for several sessions, which he later divulged was due to his perception of playing with marbles as being for younger children, he shared games from his home country. In addition to facilitating therapeutic relationship building, this enabled Raheem to re-visit a time in his life when he was able to play freely and to share different aspects of his culture with the author. This was the start of the process of supporting him to put together the narrative of his life. It also led him to buy a small net of marbles:

Yes, I bought just a small net of marbles and they felt kind of comforting so I just had them in my pocket, but last week they fell out and my house-mate saw them and at first he teased me but then he wanted to hold them and we ended up playing them in the room and laughed and laughed and it was so fun (Raheem, RCJ)

Raheem returned to this incident several times and when invited to choose symbols to build a picture of how he experienced his childhood (see Figure 4), the marbles were the first things he chose:

When the author commented on the very gentle way in which he handled the kite-flying figure, he became visibly upset and talked about the feeling of freedom he experienced when flying kites in his home country, where they formed an important part of the culture and tradition [78]. This led to a resiliency-enhancing kite-making activity in later sessions which drew on many of Lahad et al’s dimensions of coping [42]. For example, the ancient tradition of kite-making (which drew on beliefs, values and cultural heritage) also engaged Raheem in the use of his imagination and creative problem solving skills. When reflecting on his eco-map Raheem saw himself as the small animal looking up at the kite flyer and said that the stones were his current friends:

The stones are the friends I have now - I picked the stones as they are all different and have seen a bit of life with their rough edges and one of them, my friend I play marbles with, is over with the play stuff (Raheem, EMN)

The link between Raheem’s present and past selves provided by play was clear from his EMN narrative and RCJ entries and it was evident that his friends played an important role in helping him to re-imagine those parts of his childhood which he perceived the war in his home country to have taken from him.

8. Conclusions

The aim of this study was twofold: firstly to gain insights into the ways in which friendships help UASA to cope during their migration journeys, upon arrival in Ireland and during the early years of resettlement and secondly to explicate the process of composite narrative character development from the RCJ and EMN clinical case material. This approach, which removed the requirement to obtain informed consent, was developed after carefully considering the critical debate which questions whether bona fide informed consent can ever be obtained in the therapy context [52, 79].

In addition to addressing the issues of confidentiality and the impact on the therapeutic relationship of seeking consent, the decision to present the current data as a series of composite narratives based on a combination of the notes from the RCJ and EMN data, was prompted by the desire to convey the richness and social and emotional complexity of individual motivations and values over time. Interview studies frequently include only one interview with each participant, often without forming a relationship beforehand and sometimes requiring an interpreter who may filter the conversation. Use of the RCJ and EMN provides the opportunity to explore experiences which have been processed within the context of a meaningful and trusting relationship which has been developed over time. The themes identified from these data sources captured the protective effects of friendships in the lives of the three composite characters of Raheem, Amina and Mamoud.

Amina’s observation that friends take on roles traditionally associated with family, together with the rupture described by Raheem when he had to leave his ‘brothers’ behind after moving from an RIU to a DPC, provide clear evidence of the blurring of traditional familial and friendship boundaries captured by Spencer & Pahl’s, patterns of suffusion conceptualisation [7]. Mamoud’s description of his friend Aboud as a ‘brother’, choosing a soldier symbol to represent him in a protector role in his eco map, also evokes this blurring of boundaries. Furthermore, the strength of the emotional and experiential bonds which grew from intense shared experiences permeates the data and parallels are drawn between the intensity of these bonds and those documented between war veterans upon deployment. Mamoud experienced these bonds as unbreakable, irrespective of his changed living circumstances and the increased physical distance from his friends. Gentle observations made by the author on Amina’s use in her eco-map of a damaged angel to represent her close friend led to increased insight for her into the nature and strength of the emotional bond between them.

There were also many examples of the perceived importance of connecting with friends to help cope with the stressors encountered during resettlement. For Amina, sharing her difficulties with her friends was particularly important at times when circumstances in her home country were unbearable. Although Mamoud also connected with his friends when he needed support, at times he felt that sharing the full extent of his pain was too great a burden to place on his friends who were dealing with their own difficulties. Moreover, Raheem’s eco-map illustrated the importance of sharing more somatic experiences when connecting with friends. Finally, the impact of ruptures of lost childhoods were described in all three composites, with Mamoud exploring the ways in which he compensated for missed play opportunities in his home country through engaging in playful activities with his friends in Ireland and Raheem finding both comfort and enjoyment in playing marbles. Making a kite with the author was found to be a highly therapeutic experience for Raheem which as well as tapping into his sociocultural traditions and skills, developed into conversations about freedom, and of creating and imagining a future.

Although the nature of the protective effects of all UASA friendship experiences cannot be generalised from the data, the three composite narratives provide a unique multi-modal re-presentation of the friendship experiences of thirty-three UASA in Ireland, highlighting the different ways in which friendships can be protective and how they can take on roles traditionally associated with family. This ultimately develops a deeper understanding of these experiences. The use of composite narratives provided an effective way of presenting anonymised clinical data where relationships had already been developed, which retained the richness and complexity of personal experiences. The findings have important implications for all professionals who are interested in understanding and supporting the needs of UASA.

Conflict of interest

The author declares no conflict of interest.

Notes/thanks/other declarations

None.