“I Didn’t Want to be a Burden”: Improving Interactions between Refugees and Nonprofit Service Providers

As newly resettled refugees integrate into their new communities they often receive services from nonprofit organizations to supplement government assistance. However, there has been little research regarding how nonprofit service providers and refugees interact with one another and perceive these interactions. This qualitative study uses data gathered from 60 first-person, open-ended interviews with refugees and nonprofit service providers to fill this gap. The research questions are: How do refugees being served by nonprofits express their perceptions of the services they receive to nonprofit service providers? To what extent do refugees feel that nonprofit service providers are responsive to their needs? And, how do nonprofit staff and volunteers report responding to the needs of their refugee clients? This article is framed using empowerment theory, where refugee needs and perspectives are at the forefront of service provision decisions and where refugee empowerment is a primary goal.

In general, integration is the process by which refugees experience economic mobility and social inclusion for themselves and their children (Migration Policy Institute, 2019). There are multiple types of integration including language, political, residential, socioeconomic, and social (Jimenez, 2011). The literature typically views socioeconomic integration as the most important form of integration since it determines refugees' ability to integrate in other ways (Jimenez, 2011;Nawyn, Gjokaj, Agbenyiga, & Grace, 2012).
There are a number of other factors that affect refugees' ability to integrate. These factors are important considerations. Traumatic experiences, for one, can pose substantial challenges for refugees during their integration process (Bhui et. al., 2003;Jamil, Ventimiglia, Makki, & Arnetz, 2010). Studies have shown that trauma, especially when coupled with other mental health and physical health concerns, must first be addressed before a refugee is able to reach self-sufficiency (van Selm, 2003).
Once resettled in the United States, government integration services for refugees are provided for a limited time (typically 30 to 90 days). Because of this, nonprofit organizations are often called upon to fulfill service delivery gaps during the integration process. However, some governments of receiving countries (as well as members of the public) have been opposed to efforts made by nonprofits to promote refugee integration. Rather, they would prefer that refugees return to their home country when whatever crisis they were fleeing has ended (Karas & Alfred, 2019).
Receiving country governments and those native to receiving countries may fear that selfreliance efforts will make refugees more competitive in the workforce. This competition, some believe, extends to the job market where native-born job seekers are thought to then be at a disadvantage. Some native citizens also view refugees as "outsiders" intruding in their communities; and, some even believe that refugees will become dependent on welfare systems paid for with the tax dollars of native citizens (Jacobsen, 2014).
In recent years, public opinion regarding refugee resettlement in the United States has become less positive. In 2017, for example, one study found that 56% of Americans believed that the United States had a responsibility to accept refugees into the country. This is compared to 51% with the same belief in 2018 (Hartig, 2018). Common refugee admission objections include fiscal burdens on the communities where refugees resettle (Nezer, 2013) and perceived cultural threats, e.g., if the refugee is of a different religion (Singer & Wilson, 2006). As political support for refugee resettlement decreases at the federal level, many refugee serving nonprofits have lost funding and some have been forced to close (McCambridge, 2018).

Soliciting Refugee Perspectives of Nonprofit Services
The concept of street level bureaucracy can help us to examine how actions taken by nonprofit service providers impact the refugees they serve. It also helps to provide insight as to whether those working with refugees actually understand refugee needs and communicate those needs with individuals in positions of power within their organizations (Lipsky, 1980(Lipsky, , 2010. Lipsky's (1980Lipsky's ( , 2010 work considers those working in government agencies, rather than in nonprofit organizations, however, some basic concepts equally apply. In both cases there are service providers working with clients; and, in both cases service providers may (or may not) be able (or willing) to adapt their work to better meet client needs. This adaptation, or lack thereof, can in turn impact client outcomes.
Considering the case of nonprofits, specifically, employees and volunteers have daily contact with those receiving services. They also have an understanding of problems and hardships that these individuals face (van Selm, 2003). Therefore, nonprofits are often in a unique position to identify and recommend services that can be most helpful during the resettlement and integration process. Nonprofits can also help to identify ways that existing services might need to be adapted.
Benefits associated with the solicitation of client perspectives have been noted in several studies. For example, Guo and Saxton (2010) found that a nonprofit's impact increased as communication with constituents increased. Therefore, rather than make assumptions regarding what could help refugees integrate, it may be more impactful and empowering to allow refugees themselves to guide service delivery (to the extent that they are able) by asking them about their needs and implementing recommendations that they have. By making decisions related to service provision based on refugee perspectives, nonprofits can guard against the long history of Western "experts" and organizations merely assuming what is best for refugees (Sigona, 2014). Indeed, refugees (in many instances) are able to speak for themselves.

Research Questions
There were three specific research questions that guided this analysis. These questions are as follows: 1. How do refugees who are being served by nonprofits express their perceptions of these services to the nonprofits providing services? 2. To what extent do refugees feel that nonprofit service providers are responsive to their needs? 3. How do nonprofit staff and volunteers respond to the needs of their refugee clients?

Conceptual Framework
Empowerment theory guides this analysis. Empowerment is a participatory and active process (Mechanic, 1991;Zimmerman, 2000). It gives individuals a sense of control over their lives (Peterson, 2014).
Empowerment theory provides a way to better understand this process by providing insight into how individuals gain a sense of self-determination. It also provides an understanding of the extent to which people can make decisions that impact their individual and community lives (Zimmerman, 2000). In the nonprofit sector, there are some indicators that this occurs between service providers and those they serve. These indicators include: • Critically reflecting upon issues (Cornell Empowerment Group, 1989;Zimmerman, 2000), • Fostering a sense of mutual respect (Cornell Empowerment Group, 1989;Zimmerman, 2000), • Making mutual decisions (Cornell Empowerment Group, 1989;Zimmerman, 2000), and • Using a collaborative approach to service provision in which the service providers act as a guide or facilitator to help those receiving services determine what is needed (Zimmerman, 2000).
When considering empowerment theory through the lens of refugee resettlement, we gain a better understanding of how refugees become empowered and gain a greater sense of control over their integration and resettlement process. This is similar to the idea of refugee selfsufficiency where refugees are able to live independently. This notion has frequently been discussed in practitioner and academic literature (e.g., Bureau of Population, Refugees, and Migration, 2014;van Selm, 2003).
Indicators of empowerment as it relates to nonprofit service provision for resettled refugees could include, but are not limited to: • Fostering open lines of communication between refugees and service providers (Guo & Saxton, 2010) to allow for the critical discussion of and reflection upon issues that are being faced, • Demonstrating that refugee needs are heard, understood, and respected by adapting practices, programs, and services to better meet their needs (Lipsky, 1980(Lipsky, , 2010Kettner, Moroney, and Martin, 2017), and • Reconsidering power dynamics and identifying ways to empower refugees who have previously experienced disempowerment (Woelders and Abma, 2015) by seeing them as collaborators in service provision and making decisions together.
Ultimately, interactions between refugees and nonprofit service providers are evaluated in a way that aims to empower refugees, amplify their voices, and provide them with a sense of agency over their resettlement and integration process. This study considers the extent to which refugees receiving services from nonprofit organizations are able to participate in the service provision process. The study also explores the extent to which nonprofits act upon the service provision recommendations of refugees.

Identifying and Recruiting Participants
This qualitative study uses open-ended, first-person interviews to compare and analyze how nonprofits and their refugee clients in a city in the Southeastern United States (that includes urban and suburban areas) interact with one another. Qualitative research allows us to understand "the practices and experiences of individuals, groups, and institutions, as well as on the processes involved therein, for example, perception and…interaction" (Frankfort-Nachmias, Nachmias, & DeWaard, 2008, 242). The primary goals of this study were to better understand interactions between refugees and nonprofit service providers as well as refugee perceptions of services. Thus, a qualitative approach seemed appropriate.
Typical case sampling, in which average and/or normal cases are examined (Patton, 2001), and snowball sampling were used to identify and recruit participants. An e-mail invitation was sent to leaders of various refugee communities and to nonprofit service providers with information about the study, the researcher, and how to participate if interested. Once participants were identified, snowball sampling was used until the desired number of participants was located and data saturation was achieved.
There are many ways to measure and evaluate data saturation. Research has indicated that theoretical data saturation for qualitative interviews is generally reached at about 14 interviews (Hagaman & Wutich, 2017) and/or when no new themes emerge after three interviews (Francis et al., 2010). Both of these levels were reached (and surpassed) for this study.

Data Collection
A total of 60 individuals participated in this study. Interviews were conducted between November 2017 and August 2018. Primary data was gathered through in-depth, one-on-one, interviews at a public location that each participant chose. All interviews were conducted in English. Participants were given written and verbal information regarding the purpose of the study. They were then asked to provide verbal consent. Participants received no compensation.
In general, one-on-one interviews allow participants to give feedback without the influence of other participants (as may occur in a focus group). As such, I was able to obtain more information from each participant because only one participant was the focus at any one time.
In addition, some participants may feel more comfortable sharing information that they know will not be heard by others in their personal networks (Palmerino, 2006). Interviews, therefore, also allow participants to share more detailed information; and, they allow interviewers to ask more follow-up questions if needed (Turner, 2010).
Three sets of standardized questions were created: one for refugees, one for service providers working directly with clients (or "street level" service providers), and one for supervisory service providers who oversaw those at the street level (but did not work directly with clients). The questions asked of refugees examined: • Their goals, needs, and challenges, • Their perceptions of services provided by nonprofits, • If/how they shared their perceptions and needs with nonprofit service providers, and • If they felt that nonprofit service providers were responsive to their needs.
The questions asked of service providers examined: • How their actions seemed to impact their refugee clients (Lipsky, 1980(Lipsky, , 2010, • How they interacted and conversed with refugee clients and fellow service providers, and • The extent to which they were able to adapt services to meet refugee needs (Kettner, Moroney, & Martin, 2017).
Participants were also asked for demographic information, which is described in the following section. Detailed participant information is provided in Appendix A.

Participant Demographics
Thirty participants were refugees. These participants came from countries in Africa, Asia, and Europe. Some arrived in the United States as children under 10 years old and others arrived later in life (e.g., when they were in their early-to mid-50s). Their years of arrival variedranging from the early 1990s to as recently as 2016. Fourteen of the participants were male and 16 were female.
Participants reported varying interaction with nonprofits. Some only reported one nonprofit interaction and others reported between five and 10 interactions. Three participants reported that they had too many interactions with nonprofits to count; and, six participants simply did not know, or they were unsure of, how many interactions they had.
The other 30 participants were individuals working for a nonprofit service provider. Of these individuals, 15 were currently in a supervisory role and the other 15 currently worked directly with clients. Thirteen of these individuals were volunteers. Seventeen were paid by the nonprofit. They worked at their organizations ranging from one year to over 20 years. They represented seven nonprofit organizations total. Five of these nonprofits were local. The two others were nationwide organizations with a local branch.
Service provider participants held various roles including interns, staff members, volunteers, and executive directors. Four service provider participants came to the United States as refugees and, at the time of their interview, were working in service provision to assist other refugees.

Data Analysis
All participants were asked for permission to record their interviews. Twenty-nine of the 30 service provider participants agreed to be recorded and 18 of the 30 refugee participants agreed to be recorded. In addition to the recordings, notes were taken during interviews to serve as a backup for the recorded information. Recorded interviews were later transcribed. In instances where permission was not granted to record, detailed notes were taken during and after the interview.
The transcribed interviews and interview notes were analyzed using qualitative content analysis. Data was coded using both a priori codes and in vivo codes. These codes were used to develop emergent themes. This information was then used to draw conclusions regarding the impact of existing nonprofit services on refugee integration and service delivery gaps. The information was also used to make recommendations about how nonprofit programs could provide better services to refugees.
Data analysis was an iterative process. Specifically, the data were constantly revisited and reanalyzed to discover new themes. This iterative process eventually resulted in more meaningful findings.

Nonprofit Financial Information
According to a review of IRS 990 forms, the nonprofits represented in this study received their funding from several sources. The majority of small organizations without a national presence were primarily funded through individual donations and small grants. These organizations spent the majority of their funds on program services and administration and they generally had assets of less than $100,000 and an annual income of less than $50,000.
Some of the larger organizations received ongoing funding from the government. At times this was dependent on the number of clients they served. In other instances, funding was for a specific project. These organizations also received donations from individuals, and their assets and annual incomes were in the millions.
Larger organizations spent the majority of their funds on program services and administration. These organizations, however, also dedicated financial resources to fundraising expenses. One organization, in particular, received all of its funding (over $1 million) from program services. This organization received no funding from donations or grants. In general, the smaller more local organizations had larger volunteer bases. This is potentially because they did not have the necessary financial resources to hire a large paid staff.

Ethical Considerations
Power and perceptions of coercion must be considered when working with human subjects. This is especially true when working with vulnerable and/or marginalized populations and in instances where the researcher may have more power than those being studied (Frankfort-Nachmias, Nachmias, & DeWaard, 2008;Vandenberg & Hall, 2011). Refugees, new arrivals specifically, may be vulnerable; and, it was therefore important to ensure that these individuals understood the purpose of the research (Frankfort-Nachmias, Nachmias, & DeWaard, 2008).
Participants were informed that participation in this study was voluntary. They were also informed that they could stop the interview at any point and that all responses were confidential. Finally, the participants were informed that their decision to participate (or not to participate) would have no impact on the services that they received.

Study Limitations and Trade-Offs
Refugees participating had to have received at least one service from a nonprofit organization in order to participate. Although efforts made by nonprofits to serve refugees may (or, in some cases, may not) have aided in their integration process, refugees first had to be aware of these services in order to have taken advantage of them. While some nonprofits engage in outreach efforts to promote their services to refugee populations, such efforts may not always be effective or reach all who are intended to be reached.
In other cases, no outreach efforts may have occurred (even if there are nonprofits providing services) or there may be a lack of nonprofits providing services (e.g., in rural areas or in areas with limited resources). As such, it is possible that those who were already better integrated (e.g., those who understood English and were therefore able to understand what services a nonprofit could provide to them) may be the ones primarily receiving service assistance. If this assumption is correct, the perspectives of those who were less well integrated and who were arguably the most in need of assistance may not be as represented.
Because this was a qualitative study, concerns regarding a lack of generalizability of the findings also arises. In order to account for this and to make the findings more broadly applicable, I relied on data source triangulation. This type of triangulation involves collecting data from a variety of sources, including different individuals and different organizations in order to gain multiple perspectives. This process can assist in validating data (Maxwell, 2013).

Findings and Discussion
This section explores how, and the extent to which, nonprofits empower and promote selfsufficiency among refugees they serve through communication and program adaptation. Findings of interviews from refugees and nonprofit service providers are discussed and contextualized with a discussion of the broader literature. These findings are arranged thematically, as follows: • Refugees reported varying degrees to which nonprofit service providers were responsive to their needs • Refugees reported hesitation in sharing their perceptions of services with nonprofit service providers, • Refugees expressed feelings of gratitude for any services received, • Nonprofits using informal data collection methods were better able to understand the needs of their refugee clients, and • Those at the "street level" were well-positioned to solicit and share refugee needs.
Each of these is unpacked upon in the following sections.

Varying Degrees of Nonprofit Responsiveness
As much as possible, client needs and perspectives should drive service provision (Adler & Clark, 2008). According to empowerment theory, this approach can help ensure that service provision is collaborative (Zimmerman, 2000) and mutually agreed upon (Cornell Empowerment Group, 1989;Zimmerman, 2000). This approach can also ensure that refugee voices are considered, and that programs and services are truly reflective of refugee needs (Kettner, Moroney, & Martin, 2017;Lipsky, 1980Lipsky, , 2010.
Despite the benefits of this approach, this did not always manifest in participant responses. Although the refugees in this study had all been assisted in some way by a nonprofit, 17 of the 30 interviewed stated that they did not always feel supported by these service providers. To illustrate, one participant who came to the United States as a child described the detrimental impact of feeling like no one was available to help her mother.
My mom cried for like a month straight...She would just look out the window. We didn't know where, what, how. We didn't know where the grocery store or anything was, and no one was there.
Another refugee shared her personal experience of feeling that no one was there to provide support. In this case, the refugee had been living in the United States for a while and felt that refugees today receive more support than refugees did when she and her husband arrived.
Now I see a lot of people who are getting help, but not when I came. Like Medicaid, I had no idea how to do that. My husband worked two jobs, we had no insurance, nobody told me about Medicaid. Or food stamps. I did not know this before, but now too many people come in and they get food stamps. Nobody helped me.
In the cases of the refugees quoted above (and others who expressed similar points of view), it was not clear if there was actually help available or if the refugees simply perceived a lack of service availability. The important consideration here, however, is the refugees' perceptions. If they perceived that service assistance was unavailable, they may not have sought additional assistance. As such, they may not have received the kind of support that could have been helpful during their integration process. For these individuals, there was no communication; and, therefore there was no opportunity to share their perspectives or act as a collaborator in making decisions related to service provision. Ultimately, this decreased their empowerment. Indeed, they felt that support was unavailable; and, as such, they did not feel empowered to seek it out.
Not all refugees (n=13), however, felt this way. In the quote below, a refugee who arrived in the United States as a child described how two local nonprofits made him and his family feel welcome. Staff at the organization took the time to greet them and provided them with assistance upon arrival. They also sought ways to learn about their family and culture. In this instance, staff at the nonprofit did not only focus on the physical needs of this refugee family. They also made the family feel welcome by learning about their home country culture and inviting them to join in social groups.
In another instance, the feeling of being alone stopped after the refugee reached out to the nonprofit.
My wife and I did not know where we could buy groceries. One day when we went to [the church that had been working with us and providing services to us], I spoke with the pastor. I said, 'we do not know where to go to buy food' and after the service he drove us to the store. He then gave us some papers and maps with information about places for us to go, and the next week he asked us how things were going and what else we needed.
To identify areas of improvement, we can look to Guo and Saxton's (2010) work that demonstrates the importance of having clear and open lines of communication between nonprofit service providers and their clients. Increased communication can ensure that refugees not only know who (and how) to ask for help, but also that they feel comfortable doing so. It empowers them to seek support when needed, while providing a safety net for those who may not feel comfortable asking.
The quote above seems to be a good example of this. The refugee recognized that he needed help, he knew where to go for help and felt comfortable doing so. He received needed help after asking. This also demonstrates how the service provider was able to quickly tailor efforts to meet the unique needs of clients. The service provider followed up with clients to see if any new needs arose during the week.
Asking for additional assistance, however, may not be possible for all refugees. Indeed, due to cultural differences, trauma, and a variety of other factors, refugees may not always feel comfortable asking for help even if and when it is needed. This is discussed further in the next section.

Hesitation in Sharing Perceptions of Services
During the interviews, refugees were asked if they had needs that were not fulfilled by the nonprofits that were providing them support. If they responded yes, they were then asked if they let the service providers know about these unfulfilled needs.
They were also asked why they let the service providers know that they needed additional support (or, why they did not let the service providers know). Finally, they were asked if there was anything nonprofits could have done that would have encouraged them to share their needs and perspectives. Specifically, the questions asked: • Did you (i.e., refugees) perceive that there were open lines of communication between yourself and service providers (Guo & Saxton, 2010)? • Did you (i.e., refugees) feel empowered to share your perspectives (Woelders & Abma, 2015)? And, • Did you (i.e., refugees) feel that their opinions were respected (Cornell Empowerment Group, 1989;Zimmerman, 2000)?
Twenty-six refugees reported that they had unmet needs. Twenty-two of these 26 stated that they did not want to share their perspectives regarding nonprofit services or that they did not want to ask for additional help. Four of these refugees specifically indicated this was because they feared being a burden (or a similar term) on those working for the organization. As an example, [Author]: Okay. And why was that?

[Respondent]: I felt that I was putting a burden on them. That I would be putting a burden on them if they came and asked me if I needed any help and I said yes. I didn't want to be a burden on people.
Later in the conversation, this refugee was asked "Is there anything that the organization could have done to help you not feel like you were being a burden?" She responded, "no, probably not." Another participant stated that it did not seem right to ask for additional support because the organization had already provided her with assistance in the past. She, therefore, did not want to ask for more assistance. As she stated, "It did not feel right to me to ask [the nonprofit] to give me more than they already had." This is a sentiment that seemed to be present among a number of the refugee participants. Indeed, another participant shared how his friends and family felt the same way. "It seemed that they did so much already. For me, my family, and some of our friends. We did not want to ask for more help." Why were so many refugee participants hesitant to ask for help when needed? Power dynamics or feelings of disempowerment may be one explanation. However, differing cultures and/or cultural barriers may be another. This can include differing views about formal assistance programs and differing cultural norms regarding help-seeking behavior.
For example, refugees from different cultures may have different preferences regarding sources of assistance. Some may prefer to receive support from a social circle, while others may distrust formal aid agencies (Redvers, 2015). Some refugees (and perhaps immigrants in general) may also resist seeking additional assistance due to challenges understanding their new country's laws and policies (Reina, Lohman, & Maldonado, 2013).
Four refugees with unmet needs who received nonprofit services reported that they did feel comfortable asking for additional assistance. As described by the refugee participant below, service providers made an effort to make it clear they truly wanted to help. "Yes, we could always go to them. They were so wonderful and so helpful. They let us know that they wanted to help us." When considering how to improve services for resettled refugees, striving to embody the spirit of the quote above could be a noble goal. This refugee was able to determine when additional assistance was needed and felt welcome to share these needs. Conversely, a lack of communication between service providers and clients may make it challenging to prioritize client perspectives (Adler & Clark, 2008), see clients as collaborators (Zimmerman, 2000), and/or adapt programs to fit client needs (Kettner, Moroney, & Martin, 2017;Lipsky, 1980Lipsky, , 2010. Struggles in these areas may, in turn, lead to refugee disempowerment.
There were clearly differences regarding whether the refugees in this study expressed unmet needs to service providers. However, there was also a common sentiment of thanks and gratitude for any support given. This is explored further in the following section.

Gratitude for Services Received
Nearly all (n=28) refugees who participated in this study stated that they were thankful for any and all services they received, even in instances where all of their needs were not met. One participant stated that "[The nonprofit was] wonderful…we were very thankful." Another participant mentioned that the nonprofit provided them with more support than they had expected and that the nonprofit service providers "went above and beyond." In two cases, refugees described how they built long-term relationships with their service provider(s). As one participant discussed, "[W]e made sure to thank them and we are still friends with them today." These responses raise an important question. Why (when lines of communication were already established) did refugees not ask for additional support from the nonprofit in addition to expressing gratitude for assistance received? Although open lines of communication are an indicator of empowerment (Guo & Saxton, 2010), in some cases communication alone is not sufficient. It is possible that refugees who only expressed thanks and gratitude, even if they required additional service assistance, may have been engaging in "emotion management." That is, they may have felt that expressing some sentiments (e.g., needs) was not appropriate (Lively & Weed, 2014).
In other cases, however, it could be that they did not feel that their emotions were appropriate to express to certain individuals at certain times (but perhaps these emotions were appropriate to express to other refugees). Still, refugees may have believed that their emotions were inappropriate to express at all. In the case of the latter, this could mean that some refugees may be left entirely on their own, unlike those who may reach out to friends or family for assistance. The use of emotion management may also relate to the aforementioned cultural barriers, as refugees may be hesitant to express emotions that they believe to be culturally inappropriate (Lively & Weed, 2014).
The analysis thus far has demonstrated that refugees do not always have their needs met and they may not always be comfortable sharing their perceptions of services with nonprofit providers. However, literature (e.g., Adler & Clark, 2008;Sigona, 2014) and some refugee participants identified benefits of sharing these perceptions. Indeed, sharing these perceptions can help service providers better adapt practices and programs to client needs. As Lipsky (1980Lipsky ( , 2010 discusses in his exploration of street level bureaucracy and as van Selm (2003) and Kettner, Moroney, and Martin (2017) discuss regarding refugees specifically, this adaptation is beneficial.
It is, therefore, important to consider how nonprofits can better understand refugee needs while also respecting the comfort levels and cultural norms and/or preferences of their refugee clients. By doing so, indicators of empowerment such as critically examining current issues, working together to address these issues, and fostering a sense of respect can be achieved (Cornell Empowerment Group, 1989;Zimmerman, 2000).
The following two sections discuss ways that nonprofits encountered challenges and successes in communicating with, interacting with, and adapting their services to prioritize the needs of their refugee clients.

Using Informal Data Collection Methods to Shed Light on Refugee Perspectives
Recently, conversations related to evaluating the effectiveness of organizations working with the public have shifted. This shift has been from focusing on the organization and what it is providing and accomplishing to focusing on the impact of services on the target population (Adler & Clark, 2008;Balser & McClusky, 2005;Kettner, Moroney, & Martin, 2017;Zammuto, 1984). Seeking refugee perspectives is not only aligned with this emerging practice, but it also aligns with the idea of empowerment. Using this approach, empowerment is considered from the perspective of refugees rather than service providers as the primary determinant of a nonprofit's actions (Sigona, 2014). This approach also provides refugees an opportunity to voice their own perspectives and it provides nonprofits with information about what services these individuals need most (Cornell Empowerment Group, 1989;Zimmerman, 2000).
In this study, nonprofit service providers were asked if, and how, they solicited client feedback. They were also asked if clients ever shared their perspectives of services with them; and, if so, what actions they took based on those perspectives.
All nonprofit staff and volunteers reported attempts at identifying refugee needs and refugee perceptions of services. However, many (n=21) also noted challenges. These challenges included ineffective survey methods and cultural barriers that prevented refugees from sharing their true opinions and needs.
As a potential solution, informal data collection methods such as conversations and client observations may allow staff and volunteers to gain a better understanding of refugee needs (Lipsky 1980(Lipsky , 2010. It can also be helpful to ask questions that are qualitative (Charmaz, 2006) and evaluative in nature (Connolly, Conlon, & Deutsch, 1980).
Sixteen service providers discussed the idea of formalized surveys that used primarily quantitative methods (e.g., asking refugees to rate a nonprofit's programs and services). In one case, a participant who worked with a local branch of a nationwide refugee serving nonprofit described these surveys that were sent to clients, although she was unsure of the actual results. In another case, a service provider who worked at a small, local nonprofit was aware that refugees may not be willing to ask for additional support, possibly due to cultural barriers. The provider, however, also felt that the organization did not currently know a better way to gather data.
[W]e are looking to find better measurement tools. To be able to better measure our impact and success. We can say that refugees prefer our organization to others on a very regular basis, and so that is a sign that people know you and the work that we do. We have a lot of verbal gratitude, and thank-yous, and 'you've made a big difference,' but it's all sort of anecdotal in nature.
When we try to find ways to measure the impact of the work we do, like if we ask them to rate us, it's really hard to find, there's just a lot of cultural barriers.
There're language barriers. There's this cultural barrier that no matter what we do to ask them they're not going to complain.
In a different case, the parents of refugee children at a local nonprofit program were sent a written invitation to share their thoughts with service providers. The option for multiple communication methods (e.g., verbal and written) seemed to be helpful. This allowed for a more informal conversation rather than limiting responses to a survey. As a service provider from this nonprofit stated, Other service providers, such as one from the local branch of a nationwide refugee focused nonprofit, initiated unplanned conversations with refugee clients to learn more about their perspectives. In this instance, the provider entirely did away with any kind of formalized data collection process. As this provider stated, "…in conversation we'll ask the kids for their input.
Like hey, what do you want from the program? Have we been doing that so far?" The quote below from a service provider at a local nonprofit provides yet another example of the usefulness of informal data collection methods. As Balser and McClusky (2005) described, the nonprofits that work to build relationships with their clients are typically more effective. In this instance, the service provider realized that the refugee child needed assistance and had taken the time to speak with and listen to him. In doing so, she was able to notify those with more experience (i.e., social services) so that they could evaluate the situation and make a decision about what would be best for the child given the circumstances. This example also illustrates how in some cases this type of service provider can build relationships with refugee clients that others (e.g., teachers) may not be able or willing to do. However, because this participant took the time to listen to the refugee, she was able to address needs that others had overlooked. Although he may not have been willing to state his need directly, identifying his unexpressed needs through conversation proved to be a successful strategy.
Ideally, service providers make adaptations to better meet the needs of the community when current practices are ineffective (Kettner, Moroney, & Martin, 2017;Lipsky, 1980Lipsky, , 2010Zimmerman, 2000). In this case, standardized methods of soliciting refugee opinions may not be the best option. Therefore, nonprofits must reevaluate and adapt. As Connolly, Conlon, and Deutsch (1980) described, evaluative rather than normative survey methods tend to be more useful.
The findings from this study support this idea and suggest that conversations and other evaluative inquires may be able to yield better data than asking refugees to "rate" the effectiveness of a nonprofit's services. This process also provides refugees with a chance to share information in a way that they are comfortable with, rather than mandating that they share information in a structure dictated by the nonprofit (e.g., a structured survey). Instead, the refugee's preferences are respected and adhered to.

Being Well-Positioned to Solicit and Share Refugee Needs at the Street Level
While the data suggest that informal data collection methods are useful, another question arises. That is, who should collect this data? As the literature describes (Lipsky, 1980(Lipsky, , 2010van Selm, 2003), those at the street level work closest with clients. These individuals may, therefore, be in the best position to understand and advocate for client needs. They may also be well-positioned to make recommendations regarding program adaptations and implementation, when necessary.
Of the 15 service provider participants in street level positions, nine reported that they had positive interactions with their supervisors. They also reported that they felt comfortable making suggestions regarding service delivery improvements. As one service provider participant working with a small, local nonprofit stated, Another participant working at a local branch of a nationwide refugee serving nonprofit noted that although all of her suggestions to her supervisor may not be implemented, this was generally due to a lack of time or resources rather than a lack of respect or understanding: Here we can consider empowerment from two perspectives, that of refugees and that of service providers. On the one hand, refugees should be comfortable sharing their needs and ideas. On the other hand, however, service providers at the street level should: 1. Respect and value refugee input, and 2. Be comfortable working with supervisors to ensure that programs are meeting needs and/or in adapting programs to meet needs.
The quote above illustrates this, as the service provider at the street level was able to understand refugee needs and share those needs with her supervisor. The supervisor, in turn, responded by working to meet those needs. All parties played an important role in the decision-making process.

Summary of Findings
These interviews aimed to explore the extent to which refugees were empowered (or not) by nonprofit service providers. The study sought to specifically understand: 1. How refugees being served by nonprofits expressed their perceptions of the services they received, 2. To what extent refugees felt that nonprofit service providers were responsive to their needs, and 3. How nonprofit staff and volunteers reported responding to the needs expressed by their refugee clients.
In addressing the first two research questions, refugee participants reported that they often expressed thanks for any services received. The majority of refugee participants, however, also reported having unmet needs. The few refugees who did express their unmet needs appeared very satisfied with the service response from nonprofits. However, the majority of those with unmet needs reported hesitation in asking for additional service assistance. Some felt that they simply did not want to "be a burden." These responses suggest that, in some cases, it may be more a question of "if" refugees choose to share their perceptions of nonprofit effectiveness rather than "how" they choose to share their perceptions.
In addressing the third research question, service providers reported attempts at identifying refugee needs and refugee perceptions of services. However, they also noted challenges. These challenges included ineffective survey methods and cultural barriers that prevented refugees from sharing their true opinions and needs. While they also noted expressions of thanks, they understood that there could be client needs that were not being addressed. The findings indicated that informal data collection methods are a promising way of soliciting refugee opinions since these methods are likely more to be in line with refugee preferences. The findings also indicated that those at the street level who worked directly with clients were best in a position to have these informal conversations.
The following section provides recommendations for improving interactions between refugees and nonprofit service providers. These recommendations are intended to be useful when working with refugees to receive the support that they need and to empower them to drive their own integration process.

Recommendations
In making these recommendations, the primary focus concerns what will ultimately lead to the most positive outcomes for refugees receiving services from nonprofits and how newly resettled refugees can best be empowered to play a role in service provision and community integration. To achieve this, nonprofits need a clear understanding of refugee needs as well as refugee perceptions of current services provided. The findings from this study indicated that not all refugees may feel comfortable sharing their needs. Therefore, nonprofits will likely need to adapt their current methods for seeking refugee opinions and input.
Some of the refugee participants described hesitation to share their needs and perceptions of services. To address this, nonprofits may need to consider seeking refugee perspectives in more indirect and informal ways. As Lipsky (1980Lipsky ( , 2010 discussed from a more general perspective and as van Selm (2003) indicated in the case of refugees specifically, service providers at the street level may be in the best position to solicit this information and understand client needs. In turn, these street level providers may better understand what services their clients need (e.g., continuing or adapting existing programs or creating new programs).
Those receiving services can, and should, be seen as collaborators in service provision (Zimmerman, 2000). Viewing refugee clients in this manner can allow refugees more opportunity to voice and demonstrate that their input is valued and respected. In addition, this may help to address the issue of emotion management (i.e., where refugees may feel that they should not express their needs in effort to become less of a burden to others).
The use of indirect and informal data collection methods can also allow refugees to view service providers as a member of their social network, rather than as an authority figure. If the Refugees able to identify and express needs to nonprofit, work with nonprofit to design programs/services, and still receive support when necessary. They may also begin to live with some level of selfsufficiency and independence as they move away from requiring substantial assistance.

Consult with Refugee Clients
Nonprofits solicit refugee perspectives and make decisions regarding service delivery based on these perspectives.
Refugees able to identify and express needs, which in turn informs service provision. Refugees may still need substantial support from nonprofit, but support is effective. Direct Refugee Clients Nonprofits tell refugees what to do and what services will be provided to them.
Refugees told what to do and what support will be given to them, though they have little input in what services they receive. Services may or may not be what is needed. Disregard Refugee Clients Nonprofits neither reach out to nor follow up with refugee clients, despite promises to do so.
Refugees may or may not receive assistance from nonprofit after initial contact and are unable to ask for services when needed.
perception of the service provider role is authoritative, those with service needs (in this case refugee clients) may feel that sharing their needs is inappropriate (Lively & Weed, 2014).
When service providers are able to build relationships with their refugee clients they may be able to seek information through conversations. In this way, the traditional hierarchical structure of service provider and service receiver is reformed into a structure that is more equal and collaborative and provides a sense of empowerment (Zimmerman, 2000). Still, it is important for service providers to solicit client perceptions, rather than create hierarchical structures where service providers are the only ones with power to determine what assistance is provided (Woelders & Abma, 2015). This collaborative structure can allow service providers to better understand needs and be more effective and responsive in their service delivery (Balser & McClusky, 2005).
Based on the themes that arose during this study, Table 1 provides examples of ways that nonprofits can collaborate and interact with refugees as well as ways that the nonprofit/refugee relationship can evolve. In instances where refugees interact with multiple service providers, the "status of refugee/nonprofit relationship" column can be influenced by other external entities.
Ultimately, the extent to which nonprofit service providers interact with and consider the perspectives of their refugee clients will determine the extent to which refugees are able to express their needs and play a role in service delivery. As Guo and Saxton (2010) have discussed, increased levels of communication between clients and service providers leads to more positive outcomes.
In addition to open lines of communication between service providers and clients, there should also be open lines of communication between service providers at the street level and the supervisory level. Creating these positive relationships can help those at the street level become more comfortable with sharing their recommendations with supervisors who ultimately make decisions about the services that nonprofits provide.

Conclusions
As of the writing of this article, the number of refugees being admitted into the United States is the lowest it has been since 1980 (Siegler, 2019). In addition, 51 refugee resettlement programs have closed in recent years; and, an additional 41 programs across 23 states have suspended their work (RCUSA, 2019). For those working in the field of refugee resettlement, these numbers are alarming; and, the future remains uncertain. With limited funding and a decreasing number of programs, the remaining refuge-serving nonprofits and their programs play a crucial role in supporting the integration process of newly resettled refugees.
Empowerment, and empowerment theory, is a value orientation (Zimmerman, 2000); and, by placing a focus on empowerment, service providers can demonstrate that they value the role that refugees play in our communities. It, therefore, seems important to remember that integration is a two-way process. That is, although nonprofits and receiving communities provide support to refugees as they work to integrate and become self-sufficient, they also have much to gain. When refugees and communities give to one another and take from one another, everyone's life can be enriched.

Disclosure Statement
The author declares that there are no conflicts of interest that relate to the research, authorship, or publication of this article.