By Tanya Elez, Ph.D.
When supporting refugee clients, it’s easy to focus on symptoms and diagnoses. But research-and lived experience-show that relationships are at the heart of both trauma and healing. As clinicians, how can we assess and strengthen the relational networks that help refugees recover and thrive? Here’s a practical guide, inspired by recent best practices and real-world clinical wisdom.
1. Look Beyond the Individual: Map the Relational Landscape
- Ask about family, friends, and community:
“Tell me about your family and the role they play in your life here.”
“How have your relationships changed since migrating?” - Explore changes in family roles and responsibilities:
Displacement often means shifting roles, new stressors, and sometimes conflict or distance. - Assess for both loss and resilience:
Notice not just what’s missing, but also the creative ways clients maintain connection (phone calls, rituals, shared meals, or even WhatsApp groups).
2. Use Culturally Responsive Questions
- Adapt your language:
Use open-ended, non-assumptive questions that respect cultural differences in family structure, caregiving, and emotional expression. - Sample prompts:
“What cultural traditions are important for you and your family?”
“How do you stay connected with people from your community or country of origin?”
3. Integrate Relational Assessment with Standard Screening
- Combine relational questions with validated tools like the Harvard Trauma Questionnaire or Refugee Health Screener-15 (RHS-15) for a comprehensive picture.
- Remember: Relational distress may show up as physical symptoms, withdrawal, or changes in family dynamics.
4. Identify Barriers and Bridge Gaps
- Common barriers:
Language differences, technology access, stigma, or fear of community gossip. - Clinician tip:
Help clients problem-solve around these barriers, and connect them with resources (interpreters, community groups, tech support).
5. Support Relational Healing and Growth
- Honor grief and loss:
Make space for mourning lost relationships and disrupted family ties. - Foster new connections:
Encourage participation in community organizations, peer support, or cultural groups. - Empower strengths:
Highlight how clients have already adapted and supported others, and invite them to share their wisdom.
Quick-Reference Table: Relational Assessment Domains
| Domain | What to Ask/Look For | Example Questions |
|---|---|---|
| Family & Close Relationships | Changes in roles, loss, support, or conflict | “Who do you turn to for support?” |
| Social Connections | Friendships, community involvement, isolation | “How do you feel about making new friends here?” |
| Cultural Identity | Traditions, language, values, sense of belonging | “What helps you feel at home in this country?” |
| Coping & Advice | Strategies for connection, advice for others | “What advice would you give others in your situation?” |
Final Thoughts
Relational assessment isn’t just a checklist-it’s a way of seeing the whole person in context. By mapping relationships, honoring cultural identity, and supporting connection, clinicians can help refugee clients move from surviving to thriving.
Interested in more practical tools for working with refugees? Check out our next post on relational interventions and family-based strategies for healing after trauma.
Beyond Refugee Trauma 
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