نوع مقاله : مقاله پژوهشی
عنوان مقاله English
نویسندگان English
Abstract
The present study aimed to explain the role of cultural factors in the effectiveness of psychosocial interventions for non-native migrants in Tabriz, a city that has faced emerging challenges in cultural adaptation, mental health, and social cohesion due to an increase in both internal and external migrant populations in recent years. The research population consisted of 15 participants from three main groups: Group P (specialists in psychology, counseling, art therapy, and mental health), Group S (cultural-social experts such as sociologists, anthropologists, university lecturers, and cultural activists), and Group K (field workers including social workers, trainers, urban planners, and NGO members). These individuals were selected due to their practical experience and deep insight into psychosocial interventions in multicultural contexts. Data were collected using semi-structured interviews and analyzed using Brown and Clarke's six-step thematic analysis method. The results showed that four main themes were common in the perceptions of specialists: "understanding and respecting the cultural-religious context," "communication challenges and strategies," "empowerment and community-based participation," and "systemic and professional requirements." Evidence suggests that barriers such as linguistic differences, cultural taboos, lack of cultural mediators, weak cultural competency training for specialists, and lack of institutional coordination reduce the effectiveness of interventions. Conversely, the use of local languages and symbols, the participation of local leaders, the utilization of non-verbal tools (art, storytelling, music), the activation of internal capacities within the migrant community, and the design of macro-cultural policies can improve migrants' trust, participation, and social adaptation.
Introduction
In recent decades, Iran has experienced significant demographic and social transformations that have altered settlement patterns and increased internal migration. These population movements, rooted in economic, social, political, and environmental factors, have led to the transformation of major cities. Tabriz, as one of Iran's metropolises, has received a considerable population of migrants from various provinces with diverse languages, customs, and beliefs (Karimi & Moudhen, 2019). The coexistence of these diverse groups in an unfamiliar environment presents numerous psychosocial challenges. Entering a new lifeworld requires adaptation to new spaces, languages, norms, and social relationships—a process that can be accompanied by feelings of homesickness, loneliness, rejection, and difficulties in effective communication (Berry, 2015). From a psychological perspective, these acculturative pressures can lead to anxiety, depression, low self-esteem, and impaired social functioning (Samovar et al., 2017).
The role of mental health professionals and social services in facilitating adaptation and supporting the psychological well-being of these populations is essential. However, many psychosocial interventions are designed and implemented without adequate attention to cultural, linguistic, and identity differences. Neglecting cultural diversity creates a gap between service providers and non-native clients, where "cultural distance" becomes a barrier to effective helping (Sue et al., 2012). Most psychotherapy frameworks and common interventions are built on assumptions of the dominant culture, which may not align with the lived experiences and psychological realities of migrant individuals or those belonging to different subcultures. Fundamental differences in emotional expression, coping methods, family concepts, gender roles, and even the understanding of mental illness among Iranian ethnic groups require culturally sensitive approaches (Samovar et al., 2017). The lack of systematic and specialized training in cultural competence for psychologists, counselors, and social workers—despite the expansion of humanistic and intercultural approaches in contemporary psychology—remains a serious challenge in the mental health system.
In many countries, specific protocols and guidelines for providing mental health services in multicultural or migrant-receiving communities have been developed. However, in Iran, particularly in cities like Tabriz with significant ethnic diversity, such culturally adapted frameworks are largely absent. This gap not only reduces intervention effectiveness but also creates a form of cultural inequality in access to mental health services, placing minority, migrant, or ethnically diverse groups at risk of "therapeutic marginalization" (Griner et al., 2021; Mousil et al., 2021). Given these gaps, the present study seeks to address the question: To what extent are cultural strategies incorporated in psychosocial interventions provided to non-native individuals in the metropolis of Tabriz? What strategies do professionals and activists in this field employ to bridge this cultural gap? Ultimately, how can these strategies be organized into a coordinated operational framework to promote psychological adaptation and equity in access to mental health services for the migrant community?
Research Methodology
This qualitative study employed a descriptive-exploratory thematic analysis approach to understand the lived experiences and perspectives of professionals regarding cultural strategies in psychosocial interventions for non-native individuals in Tabriz. The research population comprised psychologists, counselors, social workers, sociologists, and field activists with practical experience working with migrant and non-native populations in Tabriz. Purposive snowball sampling was used, beginning with several well-known experts and continuing until theoretical saturation was achieved. A total of 15 participants were recruited, categorized into three groups: Group A (psychologists, psychotherapists, family counselors—focusing on psychological aspects and therapeutic processes), Group B (sociologists, social workers, policy experts—focusing on macro policies and socio-cultural analysis), and Group C (NGO activists, educators, urban planners, facilitators—focusing on field implementation and social facilitation).
Data were collected through in-depth semi-structured interviews lasting 45-90 minutes. The interview guide included open-ended questions based on the research literature and main study themes, such as "What is your perspective on cultural considerations in psychosocial interventions for non-native individuals?" "What cultural-communication challenges have you experienced in field work?" and "What strategies do you propose for adapting treatment processes?" All interviews were audio-recorded with participants' written consent and transcribed verbatim. Data analysis followed Braun and Clarke's (2006) six-step thematic analysis: familiarization with data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. Ethical considerations including informed consent, confidentiality, anonymity, the right to withdraw, and data security were strictly observed, with ethical approval obtained from the university ethics committee.
Discussion
Theme 1: Understanding and Respecting the Cultural-Religious Context
This overarching theme emerged as the foundation of culturally responsive interventions, emphasizing that acknowledging cultural and religious differences is the starting point for establishing effective therapeutic relationships with non-native clients. The sub-themes included: the importance of recognizing cultural and religious differences, adapting interventions to values and beliefs, and broadening the therapist's perspective. Participants consistently emphasized that a "one-size-fits-all" approach cannot address the diverse needs of native and non-native individuals. As one participant (A-1) stated: "A psychotherapist should not treat someone from another culture with mental assumptions influenced by their own dominant culture; this can create challenges for both sides." Another participant (B-2) noted: "Many psychosocial interventions are designed and implemented without adequate attention to cultural, linguistic, and identity differences, turning cultural distance into a barrier to effectiveness."
This theme highlights the necessity of moving beyond superficial cultural awareness to deep cultural understanding. Participants emphasized that therapists must recognize their own cultural biases and assumptions before they can effectively engage with clients from different backgrounds. The importance of understanding non-verbal communication, unwritten norms, and cultural nuances was repeatedly emphasized, as these subtle cultural elements often determine the success or failure of therapeutic engagement. The theme suggests that cultural competence is not merely a technical skill but a fundamental orientation that shapes the entire therapeutic process.
Theme 2: Challenges and Inclusive Communication Strategies
The second theme addressed the practical challenges encountered in cross-cultural therapeutic encounters and the strategies developed to overcome them. Sub-themes included: the role of interpreters or cultural mediators, use of non-verbal tools and artistic expression, and community engagement. A central finding was the critical role of the cultural mediator—a bridge between non-native individuals and intervention providers that facilitates the adaptation of therapeutic protocols to the cultural contexts of non-native clients. As one participant (C-7) explained: "The cultural mediator is not just a translator of words but a translator of meanings, values, and expectations." Another participant (C-9) added: "When the mediator is present, families become less defensive and more willing to engage."
The use of non-verbal tools—including art therapy, music, storytelling, and body language—emerged as a particularly effective strategy for clients facing language barriers. Participants reported that artistic and expressive methods bypass linguistic limitations and tap into universal human experiences, making them especially valuable in multicultural settings. Community engagement through building trust with community leaders and leveraging existing social networks was also identified as crucial. This theme suggests that effective communication in cross-cultural psychosocial interventions requires a multi-modal approach that extends beyond verbal dialogue.
Theme 3: Empowerment and Community-Based Participation
This theme emphasized moving beyond a passive recipient model toward active community engagement in the intervention process. Sub-themes included: creating shared social-cultural spaces, utilizing NGO capacities, developing civil society organizations, and citizenship education. Participants stressed that interventions should not be imposed on communities but co-created with them. As one participant (C-15) stated: "Shared projects and intermediary social institutions like NGOs demonstrate that intervention strategies should be extended from the individual level to the institutional and social level." Another participant (B-4) noted: "Life skills training and awareness of citizenship rights can serve as key intervention axes for reducing psychological problems among migrants."
Creating shared physical and social spaces—such as parks with cultural programs, culture houses, and sports events—was identified as a powerful mechanism for facilitating direct interaction between migrants and host communities. These spaces, when designed with cultural sensitivity and facilitated by trained social facilitators, provide opportunities for natural, unforced interaction that builds trust and mutual understanding. Citizenship education and life skills training emerged as empowerment strategies that help migrants navigate their new environment with greater confidence and competence. This theme reflects a paradigm shift from deficit-based approaches to strengths-based, participatory models of intervention.
Theme 4: Systemic and Professional Requirements for Service Providers
The fourth theme focused on the macro-level structures and policies necessary to support culturally responsive psychosocial interventions. Sub-themes included: addressing resource challenges, policymaking and coordination, systemic investment in training and infrastructure, and continuous research and evaluation. Participants emphasized that cultural challenges cannot be resolved through individual therapist efforts alone; they require systemic reform. As one participant (B-12) stated: "Cultural challenges in interventions are not resolved solely through individual therapist efforts; macro structures and policymakers also need reform and revision." Another participant (A-11) noted: "The lack of such guidelines forces professionals to rely on intuition, personal experience, or informal translation of Western models, which reduces effectiveness."
Systemic requirements identified included: mandatory cultural competence training for all mental health professionals, revision of university curricula to include cross-cultural competencies, development of culturally adapted assessment tools (avoiding Western bias), establishment of coordination mechanisms among relevant institutions (municipality, welfare, universities), sustainable funding for culturally responsive programs, and continuous evaluation and adaptation of interventions. This theme underscores that sustainable change in the quality of psychosocial services for non-native populations depends on institutional commitment and policy reform, not just individual professional development.
Synthesis and Model Development
The integration of these four themes reveals a multi-level model for culturally responsive psychosocial interventions for non-native populations. At the individual clinical level, cultural competence and use of cultural mediators reduce the cultural distance between therapist and client. At the community level, shared spaces, empowerment programs, and NGO partnerships foster social cohesion and sustainable participation. At the systemic level, supportive policies, resource allocation, and institutional coordination create an enabling environment. These three levels are interconnected and mutually reinforcing.
The findings also demonstrate that cultural adaptation of interventions operates through several interconnected mechanisms: (1) linguistic and symbolic adaptation that makes therapeutic communication meaningful; (2) socio-structural adaptation that addresses practical barriers to participation; (3) economic-empowerment adaptation that addresses material concerns affecting mental health; and (4) policy adaptation that creates sustainable institutional support. Each of these mechanisms contributes to the overall effectiveness of psychosocial interventions in promoting the psychological well-being and social integration of non-native populations.
Conclusion
This study examined cultural strategies in psychosocial interventions for non-native individuals in Tabriz. The findings revealed four overarching themes: understanding and respecting the cultural-religious context; challenges and inclusive communication strategies; empowerment and community-based participation; and systemic and professional requirements for service providers. The thematic analysis demonstrated that culturally responsive interventions require attention to multiple levels: individual clinical practice, community engagement, and systemic policy reform.
The research confirmed that cultural adaptation of interventions significantly increases trust, participation, and effectiveness. Using local language and cultural symbols, incorporating cultural mediators, creating shared social spaces, providing intercultural education, and combining economic empowerment with social support were all identified as effective strategies. The presence of local community leaders was found to enhance program legitimacy, reduce resistance, and ensure sustainability. Economic-empowerment initiatives such as micro-loans, skills training, and local market integration were identified as crucial for sustaining participation by addressing material concerns that affect mental health.
The study's contributions include: providing empirical evidence from the Iranian context on the effectiveness of culturally adapted psychosocial interventions; identifying specific strategies applicable in multi-ethnic urban settings; and developing an integrated model linking clinical, community, and systemic levels. The findings have practical implications for mental health professionals, urban planners, policymakers, and NGO activists working with migrant and non-native populations.
Limitations include the qualitative nature of the study, which limits generalizability; the focus on Tabriz as a single site; and the reliance on self-reported perspectives. Future research should conduct quantitative studies to measure the effectiveness of specific cultural adaptation strategies; examine interventions across different Iranian cities with varying ethnic compositions; explore the perspectives of non-native clients themselves; and evaluate the long-term outcomes of culturally adapted interventions. The study highlights the importance of moving beyond one-size-fits-all approaches to mental health service delivery and developing culturally responsive models that respect diversity, promote equity, and enhance the psychological well-being of all community members.
کلیدواژهها English