A Qualitative Examination of How Spirituality Assists Cambodian Refugee Older Adults in Coping with Trauma

Background and Purpose

After decades of resettlement in the United States, refugees from Cambodia have been found to continue to experience high rates of post-traumatic stress disorder (PTSD) at 62% and past-year depression of 51%, compared to 3% and 7% in the general population (Marshall et al, 2005). Despite the mental health challenges, Cambodian Americans have low rates of mental health service utilization (Thikeo et al, 2015). According to Ostrander et. al (2017), social services providers are unprepared to assist Cambodian Americans with their mental health needs. Additionally, providers are unequipped with an understanding of Eastern cultural values and lack attunement to the influence of spirituality/religion in promoting well-being (Lee, 2007).

Methods

This study used a phenomenological qualitative approach to answer: how does practicing spirituality assist Cambodian American refugee older adults in coping with trauma experienced during the genocide, the subsequent migration to the United States, and during resettlement? Purposive and snowball sampling were used to recruit participants who: 1) worked at a Cambodian-specific ethnic agency or program, and 2) provided services to Cambodian Americans. Semi-structured interviews were conducted with 29 participants. Two members of the research team conducted data analysis guided Glaser and Strauss' (1999) constant comparative method. Methodological rigor was attained through the application of strategies that included journal reflections, methodological journal, and prolong engagement.

Results

The analysis of data among participants (n=29) revealed: 1) spirituality provides opportunities for socialization/belonging among older refugee Cambodian Americans; 2) spirituality promotes family engagement and intergenerational relationships among Cambodian American families; and 3) spirituality promotes and preserves cultural ties to heritage.

Conclusion and Implications

Findings from this study contribute to a larger base of literature that examines the significance of spirituality as a protective factor among refugees and as a tool for coping with life’s challenges; particularly for Cambodian immigrants who may be at risk of depression and social isolation (e.g. Lee and Chan, 2008). The findings also inform practice by highlighting the spiritual practices of Cambodian Americans who experienced trauma due to genocide in their home country, migratory challenges on the way to the United States, and subsequent life stressors living in the United States.

References

Glaser, B., & Strauss, A. (1999). The discovery of grounded theory: Strategies for qualitative research. Aldine Transaction.

Lee, E. (2007). Religion and spirituality as predictors of well-being among Chinese American and Korean American older adults. Journal of Religion Spirituality & Aging, 19(3), 77-100.

Lee, E. & Chan, K. (2008). Religious/spiritual and other adaptive coping strategies among Chinese American older immigrants. Journal of Gerontological Social Work, 52, 517-533.

Marshall, G.N. et al. (2005). Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA, 294(5), 571-579.

Ostrander, J., Melville, A., Berthold, S.M. (2017). Working with refugees in the U.S. Advances in Social Work, 18(1)66-79.

Thikeo, M., Florin, P., & Ng, C. (2015). Help seeking attitudes among Cambodian and Laotian refugees. Journal of Immigrant and Minority Health, 17(6), 1679–1686.