**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 [10–12], 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].

*Adolescences Disrupted in Displacement: The Protective Effect of Friends as Proxy Family… DOI: http://dx.doi.org/10.5772/intechopen.103151*

### **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 asylumseeking 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 selfconfidence 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

*Adolescences Disrupted in Displacement: The Protective Effect of Friends as Proxy Family… DOI: http://dx.doi.org/10.5772/intechopen.103151*

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 ecomap 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

#### *Adolescences Disrupted in Displacement: The Protective Effect of Friends as Proxy Family… DOI: http://dx.doi.org/10.5772/intechopen.103151*

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:

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-arrangementaligned, 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].

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


*a Ireland's reception system for asylum seekers*

#### **Table 1.**

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

**Figure 1.** *Mamoud's proxy family eco-map.*

**Figure 2.** *Amina's friendship eco-map.*

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.

*Adolescences Disrupted in Displacement: The Protective Effect of Friends as Proxy Family… DOI: http://dx.doi.org/10.5772/intechopen.103151*

**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.*
