Íø±¬ÃÅ

When I hear the word ‘refugee’, it is not a legal category that comes to mind but the faces of those I’ve encountered in the therapy room: a teenager who fled imprisonment and torture after speaking out against their government; a mother torn from her children by conflict; a woman trafficked and sold into slavery. Displacement is never just a single moment; it is the pre-flight trauma, the leaving, the dangers of the journey, and the long uncertainty of asylum, often followed by years of struggle to rebuild a life from the ground up.Ìý

As therapists, where do we begin with such stories? Over time, I learned that we begin by bearing witness: to what is present now, while also holding the weight of past and future. In an asylum process that can take eight to 15 years before granting an answer, demanding repeated retellings of trauma is often met with disbelief. We bear witness to the daily grind of unsafe housing, lack of financial independence, isolation, suicidality and, above all, to the sheer courage it takes to survive.Ìý

I began my psychotherapy career at the Helen Bamber Foundation, a human rights charity working with survivors of trafficking and torture. Later, I joined Room to Heal, where I helped establish a psychosocial programme for asylum-seeking women and survivors of trafficking.Ìý

Working with refugees who have endured severe trauma requires adapting psychotherapy to displacement and insecurity. Judith Herman’s three-phase model of trauma recovery is invaluable here: stabilisation, trauma processing, and reconnection. For refugees, stabilisation may last for years, because homelessness, insecure status, or the threat of deportation keeps them unsafe. Attempting to process trauma under these conditions risks destabilisation. Safety and basic needs are not peripheral to therapy; they are its foundation.Ìý

The organisations I worked with embodied these principles. At the Helen Bamber Foundation, legal, medical, and psychosocial support were offered side by side. Most clients arrived destitute – at best sofa-surfing, at worst homeless and vulnerable to re-trafficking. My first task was stabilisation: checking access to medication, ensuring safety from further exploitation and slowly helping clients secure food, housing, and legal protection. Often, my role resembled casework more than therapy, but until these needs were met, there was no ground for deeper work. Trust was built through practical interventions; only then could trauma be addressed.Ìý

At Room to Heal, therapy was rooted in community. Alongside individual and group therapy, members cooked and gardened together. One client described it best: ‘On Wednesdays in therapy we cry. On Fridays in the garden we laugh’. In such moments, dignity and belonging could be restored.Ìý

Even when leave to remain is granted, another difficult journey begins: finding work, housing, and a place in the community. Legal safety does not erase years of trauma, but it opens the possibility of rebuilding, slowly, and with support.Ìý

I write this blog ahead of World Mental Health Day – focused this year on access to care in humanitarian crises and against the backdrop of UK headlines about small boats and asylum hotels.Ìý

Seen through the lens of trauma work, one pattern is clear: access to basic services underpins psychological safety. As these services are eroded for host communities in the UK, they too feel unsafe, and it is easy to see how such insecurity can translate into calls to close borders. But if exclusion and division become our only response, we risk sleepwalking into creating the very environments that asylum seekers are fleeing from.Ìý