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23 October 2026

18 Pages

An Exploration of the Cultural Relevance of Narrative Coherence Criteria with Banyamulenge Congolese Refugee Women

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Graduate School of Professional Psychology, Morrison Family College of Health, University of St. Thomas, Minneapolis, MN 55403, USA
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Department of Psychology and Counseling, School of Education, Social Work and Psychological Sciences, University of Missouri-Kansas City, Kansas City, MO 64110, USA
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Minnesota VA Healthcare System, Minneapolis, MN 55417, USA
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Indigo Solutions, Clemmons, NC 27012, USA
Behav. Sci.2026, 16(11), 1984;https://doi.org/10.3390/bs16111984
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Abstract

Due to the extensive violence occurring in the Democratic Republic of the Congo over the past three decades, Congolese refugees account for the largest number of refugees from one country resettled in the United States over the past decade, accounting for 20% of refugee admissions in 2024. Congolese refugees report high levels of trauma, anxiety, depression, and trauma/PTSD and more tools are needed to assess refugees’ mental health. In this qualitative content analysis (QCA) study, we critically examined nine interviews with Banyamulenge Congolese refugee women (ages 25–48) to explore the cultural relevance and applicability of Baerger and McAdams’ measure of narrative coherence. Narrative coherence theory posits the ability to share one’s story in a way that makes sense to the listener indicates the person has integrated and come to terms with their life experiences, which is subsequently related to health and well-being. Participants were also asked to describe their current number and forms of social support, which is documented as a measure of well-being; in this study, it was explored as a potential source of validation for narrative coherence. Responses were placed in two main categories: (a) coherent responses (44% of total responses) and (b) incoherent responses (46% of total responses), indicating that only one of the nine participants demonstrated fully coherent responses to all interview questions. A post-hoc analysis was conducted in an effort to provide a more complete picture of the quality of the narrative coherence among the participants. Hence, a third main category was created, coherent responses without criterion I8, showing a greater number of coherent ratings. These findings provide initial support for the use of a narrative coherence framework as a means of understanding refugee experiences. Clinical and research implications are discussed.

1. Introduction

A refugee is someone who has been forced to flee his or her country because of persecution, war, or violence (United Nations High Commissioner for Refugees, 2026). One group of refugees that has experienced high levels of violence is the Banyamulenge, an ethnic Congolese group of Rwandan origin that has been in the Democratic Republic of the Congo (DRC) since the late 1800s. The DRC has long been the site of major humanitarian crises (USCRI, 2020). These include the seldom-discussed genocide of approximately 10 million Congolese people (Gondola, 2002) between 1885–1908, the First Congo War (1996–1997) and the Second Congo War, or Africa’s World War (1998–2003). The ongoing Kivu conflicts in eastern DRC, which have plagued the country since 2004, are a continual source of violence and human rights violations (Center for Preventative Action, 2026). Within this region, a longtime tactic of these conflicts is sexual and gender-based violence (SGBV), most often against women and children (United Nations, 2025). Between January and September of 2025, over 80,000 cases of rape in eastern Congo were reported, an increase of 32% since the previous year (Human Rights Watch, 2026), depicting how eastern DRC continues to be “one of the most dangerous places in the world for women and children” (International Rescue Committee, 2023).
As a result of these conflicts, according to the Office of Homeland Security Statistics (OHSS), nearly 110,000 Congolese refugees were resettled from 2014–2024 in the United States, making it the largest resettled refugee group in the last decade (OHSS, 2025). However, because this group has been resettled in the U.S. primarily in recent years, limited information is available to inform understanding when working with this population (McMorrow & Saksena, 2017).
Due to their experiences of violence and trauma, many Congolese refugees report anxiety, depression, and trauma/PTSD (Camia & Zafar, 2021). One study of 580 Congolese refugee women found that 79% reported experiences of rape, 73% met criteria for PTSD, and 57% met criteria for depression (Familiar et al., 2021). Experiences of violence and trauma can also result in identity issues. Traumatic experiences, including sexual- and gender-based violence, can be such a disruption in someone’s life or story, which can make it difficult for the person to develop a coherent narrative (Capella, 2017; Sandole & Auerbach, 2013). In a qualitative study of narratives of female survivors of the 1994 genocide in Rwanda, who had experienced various traumas, including repeated sexual assaults, Sandole and Auerbach found these women experienced “trauma-induced identity transformations” after the genocide. Specifically, from an identity as a ‘Civilized Self’, they formed a ‘Survivor Self’ before becoming an ‘Aftermath Self’ (Sandole & Auerbach, 2013, p. 127). The ‘Aftermath Self’ developed because these women could no longer return to the person they were before the genocide occurred. Although the authors do not use the term coherence, the ‘Aftermath Self’ was conceptualized through structural dissociation theory (Van der Hart et al., 2006), which states that people’s personalities can fragment when they are unable to integrate such significant traumatic events (cited in Sandole & Auerbach, 2013). Capella (2017) found that sexual abuse experienced by adolescents resulted in disorganized personal narratives and personal identities. Essentially, sexual abuse made it impossible for participants to integrate their past, present, and future, resulting in narrative incoherence.
The theory of narrative coherence (McAdams, 1996) posits that a coherent narrative indicates a person has come to terms with positive and negative life experiences (Baerger & McAdams, 1999). Narrative coherence or coherence is defined as “the extent to which a given story makes sense on its own terms” (McAdams, 1996, p. 315). To measure coherence, Baerger and McAdams (1999) developed a model referred to as the Model of Life Story Coherence. The authors drew on previous research and conceptualizations of narrative coherence and proposed four main components of coherence: (a) orientation, which provides background information necessary for understanding; (b) structure, which requires that a story makes sense within its cultural context; (c) affect, or the emotionality a person shows while telling the story; and (d) integration, which involves the person making sense of their experiences and how they fit into their life. These components are well-accepted as elements of narrative coherence (McLean et al., 2020) and have been used with other populations (Adler, 2012), making the argument for the cross-cultural validity of narrative coherence as a construct. In their study, Baerger and McAdams (1999) found that higher total scores of narrative coherence were negatively associated with depression and positively related with happiness and life satisfaction. Since then, narrative coherence has been shown to be associated with fewer internalized symptoms and greater psychological well-being (Mitchell et al., 2020).
The literature available regarding coherence in refugees is limited, with only a few studies involving refugees and stories, primarily identifying themes of narratives to assess needs (Kirkland et al., 2022; Smith, 2015). Lenette et al. (2019) conducted a qualitative study in which refugee women engaged in digital storytelling. The authors took a collaborative approach, first building trust with participants through multiple interviews before working with the women to create life narratives. Although details varied, the authors argue each story was cohesive because it had a “past, present, and future” (p. 82), which is consistent with narrative coherence literature (Baerger & McAdams, 1999; Mitchell et al., 2020). Uy and Okubo (2018) drew on White and Epston’s (1990) seminal book proposing that interventions with refugee women should incorporate narrative processes (i.e., narrative reconstruction, which leads to coherence) to support posttraumatic growth. What is interesting about this lack of literature is that the use of narrative exposure therapy (NET) as a treatment approach with refugees is well-documented (e.g., Kaltenbach et al., 2020; Stenmark et al., 2013). The theory of narrative therapy proposes that the past and present must be integrated for a person to live their true story (White & Epston, 1990). Thus, in narrative exposure therapy (NET), the client creates a chronological narrative of her life story, focusing on traumatic experiences in an effort to integrate them into the overall story (Neuner et al., 2018). One recent study provided Syrian refugees with NET (Smaik et al., 2023). Compared to the waitlist group, participants showed a significant decrease in PTSD, depression, and anxiety symptoms.
Given the limited data available on narrative coherence in refugees, we included an exploratory question about participants’ social supports in this study as that could serve as an initial indicator of their wellbeing and could provide initial support for the use of narrative coherence to understand the experience of Congolese women. Defined as “interpersonal connectedness” or interactions that provide both practical emotional support (Walker et al., 2015, p. 326), studies have shown social support among refugees provides hope (Hussain & Bhushan, 2013), helps with resettlement challenges (Khawaja et al., 2008), and increases overall well-being (Baerger & McAdams, 1999; Braun-Lewensohn et al., 2019; Chen & Schweitzer, 2019; Walker et al., 2015). McMichael and Manderson (2004) argued that it is difficult for refugee women to maintain a sense of well-being, as relocation to a new country results in a loss of relationships that is difficult to replicate. This difficulty with accepting or building new systems of support mirrors what happens when people cannot integrate traumatic events into their overall story, resulting in incoherent narratives. Researchers have highlighted that a person’s cultural background is inextricably tied to their life story (de la Sablonnière et al., 2011; Yampolsky et al., 2013). The Congolese culture specifically has a strong oral tradition of storytelling to keep their culture alive and to provide wisdom or advice using folktales (Friends of the Congo, 2025; Heale & Lin, 2010), which may suggest that narrative coherence theory might be applicable for Congolese refugees as they adjust to life-changing conditions. Given the significance of cultural influences on meaning-making, the theory of coherence acknowledges that a person’s cultural background will influence their story. Additionally, the theory does not require that a person separate themselves from their culture or community and gives the person the freedom to explain the beliefs they hold about their experiences (Baerger & McAdams, 1999). What is not known is whether the current definition of narrative coherence (McAdams, 1996) and the criteria used to measure narrative coherence (Baerger & McAdams, 1999) can accurately capture and represent the life experiences of Congolese refugees within their cultural framework. Thus, an examination of these criteria with Congolese refugee women could provide a deeper understanding of coherence with this population, as well as indicate if future research should further examine the use of narrative coherence criteria when assessing for the impact of trauma exposure and experiences on the lives of these women.
The purpose of this study was to conduct a qualitative content analysis informed by the theory of narrative coherence, using the narrative coherence criteria developed by Baerger and McAdams (1999) to examine its applicability to Congolese refugees in the United States. Additionally, the current study explored possible connections between social support and coherence, as previous research indicates the importance of social support for refugees (e.g., Camia & Zafar, 2021; Chen & Schweitzer, 2019; Hussain & Bhushan, 2013).

2. Methods

2.1. Participants

The methodology for this study involved qualitative content analysis informed by the theory of narrative coherence. Qualitative content analysis (QCA) is a common form of methodology in psychological research (Carrera-Fernandez et al., 2014) and is used to examine textual data (Hsieh & Shannon, 2005). It can involve different approaches, depending on the goal of the researcher. In this study, a directed approach to QCA was used, which means the analysis began with a theory that is used to guide data coding (Hsieh & Shannon, 2005). When presenting the findings of the research, researchers should provide examples of the chosen text and codes, which may or may not uphold the identified theory. Because it is unknown if the Baerger and McAdams (1999) narrative coherence criteria can be applied to Banyamulenge Congolese refugee women, the current study used a QCA framework and applied these criteria to participant narratives in an exploratory effort to see if further examination of these criteria with this population might be warranted. Participants were recruited through purposeful criterion snowball sampling, with the inclusion criteria being: 18 years of age or older, being from the Democratic Republic of the Congo, having been resettled in the United States as a refugee and having lived in this country between one and six years. Participants were nine Congolese refugee women resettled in a Midwestern city. Participant ages ranged from 25 to 48 years (M = 35.9; SD = 7.88). All participants described themselves as Christian. At the time of the interview, all the women were married. The number of children ranged from one to seven (M = 4.6; SD = 2.15). Participants’ length of stay in the United States ranged from 1.5 to 6 years (M = 4; SD = 1.61), while their level of education ranged from third grade to three years of college. All women were refugees prior to resettling in the United States. One of the women did not require an interpreter for the interview and gave her responses in English, while eight utilized the interpreter to provide responses in English and Kinyamulenge, saying they were conversational in English but more comfortable answering in Kinyamulenge. Table 1 includes demographic information and a brief description of each participant. Given the homogeneity of the sample (all participants were Banyamulenge, all relocated to the Midwest United States), Congolese refugee women of different ethnicities resettling in other places in the U.S. may describe different kinds of experiences. With this acknowledgement, the primary researcher began noting similar themes and anticipating responses during the interviews. Thus, with this sample, we believe saturation was reached.
Table 1. Participant Descriptions.

2.2. Research Team and Training

The research team consisted of one faculty member, two PhDs, and four doctoral students in a counseling psychology program at a Midwestern university. Three of the researchers were first- and second-generation immigrants with Iranian, Indian-Pakistani, and Swedish backgrounds. One researcher identified as an agnostic theist, one as Muslim, one as coming from a Muslim and Christian background, and four as Christian. The primary researcher transcribed and deidentified all the data for the study. The research team met to discuss and reach a consensus regarding the coding of the data. The faculty member served as the internal auditor. Prior to starting the study, the primary researcher trained the research team on the narrative coherence criteria and how to score narratives. The team read and coded one interview together to ensure people understood the criteria and minimize individual differences in coding.

2.3. Research Ethics with Refugees

The team followed the guidelines put forth by Elliott et al. (1999) on recommendations for publishing qualitative research, including context regarding the sample, engaging in reflexivity, and interpretations with illustrative examples. To start, the primary researcher engaged in a self-reflexive process prior to conducting interviews. She considered her own identity and cultural background (White, female, Western perspective) and how this might impact her interactions with participants. She gave particular consideration to how her identity as a nonmember might influence participants’ level of comfort in responding to interview questions. The primary researcher also considered how her identity and role may place her in a position of power and how to work to ensure participants gave full consent to being interviewed and knew they could end the interview for any reason without consequences.
With the research team, the primary researcher provided historical and present-day context related to Congolese refugees to the team, both to help situate the sample and ground the examples. This included discussion of the history of European colonization and exploitation of the country and current human rights crises resulting in large numbers of Congolese seeking refugee status in the United States. The first author then led team members in a discussion to explore any biases or expectations related to the study’s participants and future findings. This strategy was used to reduce the risk of researcher bias and inaccurate reporting of evidence (Elliott et al., 1999; Hsieh & Shannon, 2005). Research team members anticipated seeing general comments related to hardships faced prior to arrival in the U.S., as well as differences in cultural values (i.e., more collectivistic rather than individualistic). Although the research team was made up of individuals from different cultural backgrounds, given their experiences and educational training in the U.S., they articulated the importance of not imposing Western ideologies or expectations on the narratives during their coding of the interviews. The research team met three times during this process: once before coding began, once during, and once after, to acknowledge individual reactions (i.e., wanting a narrative to be coherent, given challenges participants experienced after arrival in the U.S.) in an effort to maintain accurate coding of the narratives.
This project also incorporated community-based participatory action research, an approach that allows specific problems within a community to be resolved (Stringer, 1996) when attempting to work with vulnerable or hard-to-reach populations in a nonexploitative manner (e.g., Baird et al., 2015; Makhoul et al., 2014). To support this approach, a cultural advisory board was organized. This board included one social worker affiliated with a refugee resettlement agency and three adult Congolese professionals, including one female Congolese refugee and community advocate, and two Congolese interpreters (one female, one male), who were both competent in their first language and English. This cultural advisory board was informed of the purpose of the project, the approach and the interview questions, and encouraged to offer feedback and insight throughout the process.

2.4. Interview Protocol

Demographic sheets. Each participant completed a demographic form that provided information regarding their relationship status, age, ethnic identity, religious identity, years of education, number of children at home, current employment status, and year of arrival in the United States.
Interview questions. The interview questions are semi-structured and open-ended in nature. The questions were reviewed with the interpreter prior to the interviews to ensure the integrity and purpose of the questions were understood and able to be conveyed to the participants as needed. Participants primarily spoke uninterrupted unless they requested further clarification during their narrative.
Participants were asked to describe different experiences since arriving in the United States: (a) Describe your first day. If you like, you can tell it like a story you might listen to. Tell me what you did first, second, and continue throughout your day; (b) describe your first week; (c) describe an important moment since you have been living in the United States; (d) describe your life after three months or longer of living in the United States; (e) describe your best memory since living in the United States; (f) describe your worst memory since living in the United States; (g) select one memory of choice and describe it in as much detail as you can. This memory can be good or bad; it can have happened at any point since you arrived in the United States.
Social Support. Participants were also asked to describe their social supports. The question asked, “Please identify what social supports you have here in this city. These can be specific people (family members, neighbors), an organization (church, agency), or an activity (gardening, attending community events).” Previous studies have identified social support as an important coping mechanism when relocating to a new country (Braun-Lewensohn et al., 2019; Hussain & Bhushan, 2013). Previous research with refugees has primarily examined this construct through a qualitative approach (Hussain & Bhushan, 2013; Khawaja et al., 2008; Walker et al., 2015). Thus, in keeping with previous studies and due to the originality of the present study, the question was left open.

2.5. Procedures

Development of Interview Questions. The primary researcher developed the interview questions after a thorough review of the literature on Congolese refugees, narrative coherence, refugee mental health, and social support. The internal auditor and interpreter also provided feedback about the content and length of questions. Questions for this protocol were adapted from Baerger and McAdams (1999) and followed the example of Burnell et al. (2010). The focus of the study was on the appropriateness of narrative coherence criteria as it relates to Congolese refugee women, and thus questions were designed to encourage participants to take on a “storyteller role” and speak from the ‘I’ perspective, including details about other people or their feelings as relevant.
Interview Procedures. All participant interviews were conducted by the first author in participants’ homes. A Congolese interpreter with over five years of experience interpreting in social services and educational settings assisted with the interviews. Interpretations were performed in person, with participants giving their responses in Kinyamulenge, followed by the interpreter relaying their responses to the interviewer in English. Prior to the interview, participants were provided information regarding the study’s protocol and were asked to sign an informed consent form and choose a pseudonym for the study. Participants also verbally completed demographic questionnaires. The visits lasted from 30–75 min, with the time of the interviews ranging between 23 and 38 min (M = 30.34). Interviews were audio-recorded and transcribed. Only the English interpretation was transcribed. The first author also documented facial expressions and body language throughout each interview and shared these details with the research team in an effort to support the evaluation of the A6 criterion. The interview transcripts were stripped of any identifying information and were saved on a password-protected drive to protect participants’ confidentiality.

2.6. Data Analysis

The methodology for this study was a directed qualitative content analysis. For data analysis, this type of methodological approach involves examining the results through the lens of a particular theory (Hsieh & Shannon, 2005). For this study, the researchers’ reading, coding, and interpretation of the participants’ narratives were based on the Baerger and McAdams (1999) narrative coherence criteria, which were developed as part of the Model of Life Story Coherence.
First, this study used the operationalized definition of life story coherence (LSC) developed by Baerger and McAdams (1999) and the four indices created to explain the construct of coherence. These indices were orientation, structure, emotional tone, and integration. These indices have been used in previous research with diverse populations (Burnell et al., 2010; Freer et al., 2010; Yampolsky et al., 2013), making them an appropriate choice for this study.
Additionally, the procedure for data analysis was modeled after the work of Burnell et al. (2010), who adapted the criteria used in Baerger and McAdams’ (1999) study to fit a qualitative approach. The present study followed the example of Burnell et al. (2010) and used the following criteria for narrative coherence: (1) Orientation (O1 gives an introduction of main characters, scene setting; O2 provides historical, social, and/or personal context); (2) Structure (S3 looks at structural elements of an episodic system, i.e., shares an initial event, internal response, an action, and a result/consequence; S4 is a recognition of temporal coherence; if events do not follow a clear temporal order, this is explained to the listener); (3) Affect (A5 looks at what the events mean to the person through statements of emotion; A6 assesses if the person demonstrates a consistence or congruency of verbal and non-verbal content); and last, (4) Integration (I7 examines if the meaning of events/experiences is expressed within a larger story or bigger picture and demonstrates and ties experiences together with an overarching theme; e.g., all of these things have happened but I still have hope, still have my family; I8 explains contradictions of values, emotional responses, or attitude changes; e.g., I feel conflicted; on one hand, happy to be alive, on the other, guilty I survived when my friend did not); I9 is a fragmented narrative, which involves unfinished sentences/thoughts, or the information provided is incongruent or contradictory and does not make sense. If this happens, the narrative is automatically coded as incoherent.
For coding, each team member was assigned three interviews. The interviews were coded based on the interviewer’s transcription of the interpreter’s English translation of the participants’ interviews as described above. The research team utilized a hybrid coding approach. Interview questions were adapted from Baerger and McAdams’ (1999) model and coded using their coherence criteria (deductive coding), but due to the exploratory nature of the study, the criteria were adapted to best fit the data (inductive coding). A two-level analysis was conducted by the research team (Burnell et al., 2010). Each member of the team individually coded their assigned interviews based on the narrative coherence criteria. They also placed thoughts or notes in the margins to later discuss with their partner. Team members then paired up to discuss and resolve any discrepancies before coming to a consensus on the coding of each narrative. Although such instances were minimal, any disagreements that could not be resolved by the pair were brought to the entire team. Finally, an internal audit was conducted by a counseling psychologist to help ensure the results appeared logical and conceptually sound. Due to the auditor’s extensive experience with qualitative research, she provided guidance on when to meet to discuss discrepancies in coding and best practices for resolving these differences. The auditor also provided feedback after the first round of coding, when the research team wondered if the criteria were accurately capturing the level of coherence of the narratives. The decision to modify the narrative coherence laid out in the post-hoc analysis came from discussion with her and the research team. As the goal of multiple coders was not to achieve statistical alignment but to leverage multiple perspectives to deepen the interpretation of the data (Baird et al., 2015; Lenette et al., 2019), interrater reliability statistics were not deemed necessary for this study.
Participants’ responses to each interview question were coded using two main categories: (a) coherent; (b) incoherent; and also included a category for (c) no response (Burnell et al., 2010). The response was coded as coherent when all criteria were present. If any criteria were absent or if the narrative included fragmentation (e.g., unfinished thoughts/sentences), the narrative was coded as incoherent (I9). If a participant elected not to answer a question (i.e., they felt the question was redundant), this was labeled as No Response (NR).

3. Results

The nine participants and seven interview questions (not including social supports) produced a total of 63 items, including responses and no responses. The study yielded two main categories: (a) coherent responses (44% of total responses; all eight criteria present); and (b) incoherent responses (46% of total responses; at least one criterion absent). A no response category (10%) was also included. Each category contains narrative examples (stories from participants) to highlight differences and provide an understanding for comparison of the main categories. A summary of coherent, incoherent, and no response, including type of response and total percentages, can be found in Table 2.
Table 2. Coded Responses using Burnell et al. (2010) Full Criteria.

3.1. Coherent Responses

Responses were coded as coherent if all criteria from Baerger and McAdams (1999) were present. The criteria included four categories (eight criteria items, two items per category) of narrative coherence: (a) orientation (O1 and O2); (b) structure (S3 and S4); (c) affect (A5 and A6); and (d) integration (I7 and I8). The results showed that eight of the nine participants had at least two fully coherent responses to interview questions that met the complete narrative coherence criteria.
For the first category, orientation, the results showed that participants provided the necessary context to understand the story (McAdams, 1996). Specifically, all participants identified main characters (O1; i.e., social workers, family members, medical staff, church members) and set the scene for their stories (airports, apartments, hospitals, church, neighborhoods). Participants also provided historical, social, and/or personal context for the stories (O2; Burnell et al., 2010). Many participants reported that they were surprised they needed to lock their doors, due to believing America was ‘safe’. They compared their image of America to the reality, talking about the weather, learning to use household appliances, and applying for jobs. For example, Rosine said, “It was June. So I first get in the Dallas, Texas. So when I’m first in America, I am very surprised. I was received by someone, and it was just my first time to see him. They received me with joy, with love. That person was my case worker.”
For the second category, structure, responses needed to be told in a way that makes sense within a cultural context. First, participants’ responses included an event, an internal response, an action, and the outcome (S3; Burnell et al., 2010). For example, Mapendo said, “I came to the escalator, the one that is running so you can just step on it, and I was very scared [laughs remembering], until I held the social worker’s hand.” This example provides an event, response, and so on, as well as the cultural context, or the newness of riding an escalator. Second, the responses needed to make sense; in other words, the events of the story were either in order, or told in such a way that the listener or reader could follow and understand the story (S4; Burnell et al., 2010). This is important because a story without structure (resulting in a loss of understanding) cannot be coherent (McAdams, 1996).
The third category, affect, addresses verbal and nonverbal emotion present throughout the narrative, which emphasizes the importance of the story. First, the participants must describe what their experiences meant to them emotionally (A5; Burnell et al., 2010). Among the many emotions expressed were joy, gratitude, fear, hope, frustration, and happiness. Second, nonverbal expressions and cues of each participant are also assessed (A6; Burnell et al., 2010). This criterion was approached with flexibility, since undergoing traumatic experiences can result in difficulties with emotion expression (Chung et al., 2018). Participants varied in their presentation; some were soft-spoken, some laughed, some smiled, while others were more stoic. Despite these differences, it was determined that the mannerisms and gestures of all participants appeared to match their stories and thus met the requirements for this criterion.
Lastly, for the fourth category, integration, responses included two criteria items. First, integration means an experience or event is expressed within a bigger picture (I7; Burnell et al., 2010). Second, contradictory values, emotions or attitudes expressed during a story are explained (I8; Burnell et al., 2010). All coherent narratives included the examples and details needed to meet these criteria. An example of a coherent response, meeting all criteria, was provided by Ninah, a 34-year-old woman who has lived in the United States for six years:
According to what they tell us, sometime when we come to the U.S., people tell us, ‘Oh forget about it, you will not time also to pray, to worship.’ But when we come here, I go to the church, full of white people, and then there was worship just like ours, and we pray, and get the holy spirit, and it was wonderful. It was challenging [to go to church], but because I went to school, I speak some French. I did not get everything, but I got some of the words they say.
Additionally, a coherent response does not have to be positive. Dira, a 29-year-old woman who has lived in the United States for four and a half years, shared this story about her hardest memory of living in this country:
My memory is, how am I going to go to work, since I have kids? And my husband’s working too. I don’t know anyone to stay with my kids. That was a very big issue to me. I remember one day, a member of our church, he told me, ‘you can bring your kids to my home and then go to work.’ That was in Houston. And Houston has a lot of floods. And then I go to work, I was working second shift. And then it’s raining and flooding. I have to go to pick up my kids. I don’t have a car. I use buses. And then when I get to the bus station, there is water, flooding. It’s night, at that time it was like, twelve at night. I remember, I had three kids-my son was three years, a one year old, and one, four months. And then I carried one on my back, the man carried one for me, and my son walked in the water. And I cried. That’s the bad memory that I have. We walked in that water until we got to his car, and then we went home.
Of the 63 total number of responses, our analysis revealed that 44% were coherent when using all eight criteria. It is also noted that of the nine participants, only one participant responded coherently to all seven interview questions.

3.2. Incoherent Responses

Responses were coded as incoherent (I9) if any criteria were absent or if the narrative was fragmented (e.g., unfinished thoughts/sentences). Eight out of nine participants provided incoherent responses; seven of the nine had at least three incoherent responses. This type of response accounts for 46% of the total responses. Noticeably incoherent responses (a) were vague or general, with no detail or emotion provided; (b) focused on a single detail (e.g., when asked to describe life after three months in the United States, participants spoke only about driving or money); and/or (c) lacked structure, jumping from one topic to the next. When asked to describe her life after living in the United States for three months, Dira gave this response:
There’s a big difference. At that time, some things was hard. I couldn’t go to work by myself, driving. I got two years not driving, so it was hard, using buses, but now I can use my own car to go to work. It’s easy. On that time, you got money, and then you spend it for nothing. But now, I understand how to save money and spend it only for the important things that I need. I try to save money now rather than spend it on nothing.
Messie, who is 47 years old and has lived in the United States for four years, shared the following:
Before, with the working process, it was really hard for me to wake up in the morning and go to work. But now, if I have a job, it’s like my normal life. Going to work every day, it’s normal. And also, I have a way that I can use the money, more than I could before. Like right now, I have a lot of things, and I have experience about how to use the money more than before. And also, according to the education system, when the kids were coming before, you could see they were not comfortable. But right now, they go to school every day, in the morning, and they understand what they are doing, and they’re fine.
Compared to coherent responses, responses that are plainly incoherent have a lack of structure, vague explanations with limited details, or a hyperfocus on a singular topic. Additionally, there was no pattern to suggest certain questions were more likely to result in an incoherent response, indicating the question itself was not problematic.

3.3. No Response

If a participant elected not to answer a question, it was labeled as No Response (NR). One participant did not answer the question “Describe your best memory since arriving in the United States”, stating, “I have already answered that one. It was the woman helping me.” In addition, five participants chose not to answer “Choose any other memory and describe it in as much detail as you can. This memory can be good or bad; it can have happened at any time since you arrived in the United States.” It appeared that the participants viewed this question as either too vague or redundant. Common explanations for not answering this question were “I think I’ve already told you all the important memories” and “It’s already been answered.”

3.4. Post Hoc Analysis

Based on the initial results, we became uncertain whether the narrative coherence criteria (Baerger & McAdams, 1999) used in the present study appropriately determined the participants’ level of cohesiveness. Due to the exploratory nature of the study in examining the cultural appropriateness of these narrative coherence criteria, we believed it was important to examine the possibility of the criteria being too strictly applied. After coding the transcripts, the research team members noted that 24 of the 63 responses were “mostly coherent”; specifically, these responses were only missing the I8 criterion. The criterion item I8 is an aspect of the integration category, which requires participants to explain any contradiction of values, emotions, or attitudes (Burnell et al., 2010). Studies that used this narrative coherence criterion (Burnell et al., 2010) posed questions to participants that involved a before-and-after event (i.e., during the war and after returning from the war), giving participants more specific opportunities to express contradictory values, emotions, and attitudes. In the current study, participants were not asked to discuss or share their experiences prior to their arrival in the United States, including their time spent in refugee camps. This was an ethical decision made to minimize stirring up traumatic memories of events these women may have experienced, especially because the first author and interviewer was not a member of the community. As participants in this study were not posed questions about premigration experiences, there might have been fewer opportunities to demonstrate such contradictions. Previous studies have also described coherence on a continuum, with a narrative being ‘more’ or ‘less’ coherent, rather than a simple ‘yes’ or ‘no’ designation (Burnell et al., 2010; Esposito & Freda, 2016). Based on these results and after discussion with the auditor, a third category, Coherent Response (no criterion I8), was created following the data analysis. Qualitative methodology is meant to consider how best to represent the entire data set (Elliott et al., 1999; Wachter et al., 2016). Additionally, this is in line with a directed qualitative content analysis approach, in which data that cannot be coded (or accurately coded) is returned to and reanalyzed to see if they represent a new category (Hsieh & Shannon, 2005). Thus, adding this category was deemed methodologically appropriate and the most accurate way to capture the data.
As one such example, in the description of her arrival to America, Rosine, a 40-year old woman living in the United States three years, does not demonstrate any contradiction or change in values or attitudes:
It was June. When I’m first in America, I am very surprised. I was received by someone, and it was just my first time to see him. They received me with joy, with love. That person was my case worker. Me, if I would try to compare to the country where I come from, number one, it’s not a peaceful country, and then to see how someone who can saw you for the first day, they take us from the airport, they take us to the house. The other surprise I mean the food was ready. I think he (the social worker) was the one cooking everything. And there was already prepared, our beds, and everything else inside the house. They say, ‘This is your house where you are going to live.’ That’s something that I was thankful, for everything they did. And then, according to the program of refugees, there’s a lot of stuff they’re supposed to do for us. They take us to the hospital, we are getting check ups, we are getting shots, and also they found a school for my kids and I was happy about that. On the first visits, they are going with us, but later on, we were able to go by ourselves.
In another example, Mapendo, who is 48 years old and has lived in the United States for six years, discussed her life after three months (and later) of living in America:
There is a lot of change. I speak English now, and now I can drive on the highway and go anywhere if I want. And also I’m able to work and make my own money. I was really looking for a job. I was worried about how I am going to do the interview. And then my kids were teaching me how I can pass the interview. They told me, number one, they will ask you your name. And then number two, they are going to ask you your address. And then number three, they are going to ask you when you are going to start work. I was memorizing all this. I didn’t really focus on the questions they were asking, especially because I could not understand what they were asking. So at the interview, they asked, and I gave my name, and it was correct. Number two, they asked the address, and it was correct. Number three, they said ‘tell me about yourself.’ And then I said, I’m going to start tomorrow (laughs). [Interviewer (laughing): And did you get the job?] No! (laughs). And they said again, ‘tell me about yourself.’ And I said, I’m going to start tomorrow morning (laughs). I will never forget that.
These responses resemble coherent responses, with the exception of the absent I8 criterion. This is important, as the purpose of this study is to examine if narrative coherence is a culturally relevant method for understanding Congolese refugee women and their resettlement experiences, as well as if these criteria have the potential to assess their psychological well-being. In order to be effective, a method must sometimes be adapted to a population (Androutsopoulou et al., 2004; Burnell et al., 2010), and particularly with refugees (Khawaja et al., 2008; Wachter et al., 2016). Thus, the addition of this category was the best way to fully represent each woman’s experiences. A summary of the data with the added category incoherent (no I8) can be found in Table 3.
Table 3. Coded Responses using Burnell et al. (2010) without I8.

3.5. Social Support

Social support was defined as interactions that provide both practical and emotional support (Walker et al., 2015). In this study, participants were asked in an open-ended question to identify the number and type of perceived social supports. Their responses included family (i.e., spouse, children), neighbors and church friends, the church and other agencies (i.e., resettlement agency), and the government (i.e., social security or food stamps).
Four participants identified two sources of social support, and five participants reported three sources of support. Spouses and family members were the most common, which is in line with Congolese culture, followed by church and faith-related support (Smigelsky et al., 2017). All participants are married and reported attending a Christian (Protestant) church. Importantly, all but one participant reported relational types of support. This one participant was the only one interviewed whose husband is not currently living with her in the United States. Further, this participant had the highest number of incoherent responses (n = 2), and zero coherent responses with all eight criteria.

4. Discussion

The study initially yielded two main categories: (a) coherent responses (44% of the total responses) and (b) incoherent responses (46% of the total responses). Following the approach of directed qualitative content analysis and the option of developing a new category to best represent the data (Hsieh & Shannon, 2005), post-hoc analyses resulted in the creation of a third main category, coherent with no I8, which involved an adaptation of the coherence criteria. This category was created to describe the narratives that appeared coherent but lacked a single criterion, which the researchers deemed was likely because participants were not asked to share about their premigration experiences.
This change resulted in 38% of total responses belonging to the coherent with no I8. Specifically, the addition of the third category changed the number of incoherent responses to six from 29, and of the five participants with incoherent responses, all but one had a single incoherent response. This is a notable difference. While this adaptation of the criteria highlights the often necessary reality of adjusting approaches to capture the complexities of a refugee population (Androutsopoulou et al., 2004; Burnell et al., 2010; Khawaja et al., 2008; Wachter et al., 2016), it is worth considering if this is an appropriate change to increase the cultural relevancy of the criteria as it relates to Congolese women or if this is, in fact, a limitation of the criteria itself.
The lower percentage of incoherent responses brings attention to three important considerations. First, it reminds individuals of the importance of being aware of one’s biases when working with refugee populations and not assuming previous difficult experiences automatically result in poorer outcomes (Elliott et al., 1999). Second, it reiterates the need to utilize appropriate measures for understanding refugee populations (Donnelly & Leavey, 2022). And third, as narrative coherence has been previously correlated with higher well-being (Baerger & McAdams, 1999; Mitchell et al., 2020), these results lay the foundation for future studies to examine if these narrative coherence criteria could be a helpful tool in understanding and measuring Congolese refugee women’s well-being.
Finally, participants were asked an open-ended question about their social supports. All but one participant described relational support. This participant had been forced to leave her husband behind when coming with her children to the United States. Results showed this participant had the highest number of incoherent responses and zero coherent responses with all eight criteria. This suggests that relational support, including people from their own community, is likely important for female Congolese refugees as they resettle in a new country. In a study of social support among adolescent refugees, Sierau et al. (2019) found that family support was the most valued form of support, which may be true for Congolese women as well. This finding is also in line with previous studies documenting the role of social support and social networks in the coping experiences of female refugees. (Khawaja et al., 2008; McMichael & Manderson, 2004; Walker et al., 2015).

Limitations and Implications

There were clear limitations to the current study. Although purposeful criterion snowball sampling is common in qualitative research, it can result in the overrepresentation of individuals that share similar characteristics. The study’s sample was small and homogenous. In this case, the participants were married with children, Christian (Protestant), and identified as Banyamulenge. This method of recruitment likely contributed to the similar characteristics shared by participants.
While efforts were made to ensure that questions and interviewing were culturally appropriate, there are some limitations to be noted. Interpretations were conducted live, and transcriptions were made only of the English interpretation of the data. All questions were approved by the interpreter, who had significant interpreting experience, to avoid misunderstandings or loss of meaning. The primary researcher and the interpreter also met to discuss the purpose of the study, as done with previous research (Baird, 2011; Vara & Patel, 2012). Despite these efforts, it is possible that questions were not fully understood, or responses lost some meaning in translation. Additionally, given the importance of language and structure as it relates to narrative coherence, the coded narratives may not have captured nuance or details important for the criteria. This may have resulted in coding inaccuracies and impacted results.
Another limitation was the use of a male interpreter, as no female interpreter was available. Two female Congolese advocates (Congolese women who act as liaisons between resettlement agencies and the Congolese refugee community) told us that this was acceptable for Congolese women as long as the interviewer did not ask any questions about the participants’ lives prior to arriving in the United States, given the likelihood of sexual- and gender-based violence (United Nations, 2025; Human Rights Watch, 2026). However, the gender difference may have impacted participants’ responses, such that they were not as forthcoming with their experiences. Finally, a formal measure of social support could have strengthened the auxiliary finding of the study, given the potential for a relationship between narrative coherence and social support.
With these limitations in mind, there are multiple considerations for further research. First, this type of study has never been done. While the results of this study are promising, future studies should attempt to replicate these findings with a larger, more heterogeneous sample, including recruiting participants from other Congolese ethnic groups to determine if coherence is culturally robust for other Congolese refugees.
Future studies may also consider a mixed-methods approach, using Baerger and McAdams’ (1999) narrative coherence criteria as well as other measures of mental health and social support to further show these criteria are culturally relevant and applicable to Congolese refugee women. Refugees often find support in family members and the larger refugee community (Hussain & Bhushan, 2013). A study by Sierau et al. (2019) used a social support measure that asks about the quantity and quality of social support. While their measure was designed for adolescents, results found that family support was the most valued form of support, which is similar to that of Congolese refugees. Given that the only participant who did not report any relational support (e.g., spouse, family member, friend) had the highest number of incoherent responses, a measure that assesses both quantity and quality of support and recognizes the challenges refugees often face upon resettling is recommended for future studies. Additionally, it may be worth examining if the number of coherent or incoherent responses (as was looked at in this study) indicates how much a person has integrated their trauma history.
The clinical application of research is particularly important when discussing underserved groups. For this study, narrative coherence or a coherent narrative can be summarized by two primary descriptors: the story must make sense (McAdams, 1996) and show that a person has come to terms with the positive and negative experiences of one’s life (Baerger & McAdams, 1999). In this way, narrative coherence has been positively associated with well-being (Baerger & McAdams, 1999; Benish-Weisman, 2009; Yampolsky et al., 2013). To our knowledge, this is the first time the relevance and efficacy of these narrative coherence criteria have been examined with a group of refugees. Additionally, all participants but one reported having relational social supports. As noted, our measure of social support was limited, and hence we cannot infer a direct relationship between coherence and social support. However, there are numerous studies that have indicated social support is essential to refugee well-being (Walker et al., 2015; Braun-Lewensohn et al., 2019; Chen & Schweitzer, 2019). Hence, we recommend that researchers in future studies use a more formal measure of social support to ascertain if such a relationship exists. This would be an important next step to ascertain if narrative coherence could be used to provide insight on symptoms and possible interventions.
To conclude, the current study provided some initial support that the narrative coherence criteria developed by Baerger and McAdams (1999) may be an appropriate framework for understanding Congolese Banyamulenge refugee women living in the United States. These initial findings suggest that narrative coherence demonstrates new possibilities when working to understand resettlement experiences. Additionally, this study indicated some support for the role social support plays in the lives of Congolese refugee women. In this light, the present study lays important groundwork for further research examining the connections between narrative coherence and relational social support to continue to expand our support of and understanding of refugee women’s resettlement process.

Author Contributions

Conceptualization, M.J.G. and J.E.N.; methodology, M.J.G.; formal analysis, M.J.G., M.G., A.M., M.O., R.R. and J.R.; investigation, M.J.G.; writing—original draft, M.J.G.; writing—review & editing, M.J.G., J.E.N., M.G., A.M., M.O., R.R. and J.R.; supervision, J.E.N. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of the University of Missouri-Kansas City (protocol code 18-111 and date of approval: 11 June 2019).

Data Availability Statement

The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author.

Conflicts of Interest

Author Aurora Molitoris was employed by the company Indigo Solutions and author Rafay Raziuddin was employed by the company Hikma Counseling. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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