Immigrant and Refugee Youth Trauma Bree Pearsall LSW
Immigrant and Refugee Youth: Trauma Bree Pearsall, LSW Bluegrass Rape Crisis Center Liz Epperson, MSW, CSW Bluegrass Community Health Center
Immigrant Children The term “immigrant children” includes: Foreign-born children, regardless of immigration or refugee status; U. S. -born citizen children of foreign-born parent(s).
Kentucky’s growing immigrant population From 1990 -2005, KY emerged as one of top ten states in the rate of increase in the foreign born population Many immigrant families arrive in KY from other states Approximately 43, 000 children in KY are immigrants or the child of an immigrant
Refugee Children Approximately 3, 700 refugee children, representing more than thirty nationalities or ethnicities, currently reside in the Commonwealth. A refugee is a person who is unable or unwilling to return to their country of origin because of a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion. The Department of Homeland Security determines refugee status before a person is eligible for resettlement in the United States. Refugees are a category of immigrants who arrive with legal resident status in the United States
Refugee Children Most refugees have been resettled in Louisville, Bowling Green, and Lexington The three major groups of refugee children in KY are Bosnian, Cuban, and Somali Bantu Other large groups: Burundi, Bhutan, Dem. Republic of Congo, Iraq, Liberia, and Thailand
Unaccompanied Juvenile Immigrants Children arrive in the U. S. without guardians or parents, perhaps after having been separated from family during the migration, or sent by their family. The average of an unaccompanied minor in the US is fifteen years old. Since 2001, U. S. Customs and Border Protection (CBP) reports the number of unauthorized, accompanied and unaccompanied, juvenile apprehensions exceeded 86, 000 annually.
(Louisville)
Stressors/traumatic events specific to immigrant and refugee children Migration stress: refers to the displacement and disorientation that comes with moving and adjusting to a new school and new friend or peer networks – all without the resources previously available from extended family, friends and neighbors. (Birman, D. & Chan, W. I. , 2008)
Stressors/traumatic events specific to immigrant and refugee children Acculturative stress. Migration stress may be accompanied by acculturative stress -- adjusting to new circumstances in a new cultural context. (Birman, D. & Chan, W. I. , 2008)
Traumatic stress can be an additional stressor for refugees and some immigrants. 1. 2. 3. Refugee children are likely to have had extensive exposure to traumatic events prior to migration and this exposure has been linked to a high prevalence of symptoms of mental disorder (Birman et al. , 2005; Lustig et al. , 2003). Refugee children may have experienced war and moved frequently in search of safety, often living in multiple refugee camps. Refugee camps themselves are often not only places of ethnic conflict and violence, but also may have food shortages and lack schools or organized activities for children. Once in the U. S. , many refugees and immigrants may also experience traumatic events as they resettle in high poverty areas where housing is affordable but where they are vulnerable to higher crime rates (Kataoka et al. , 2003). (Birman, D. & Chan, W. I. , 2008)
What constitutes trauma? Features distinguishing traumatic events from stressful events: 1. Shocking nature 2. Death or threat to life or bodily integrity 3. Subjective feelings of intense terror, horror or helplessness (Cohen, J. , Mannarino, A. , & Deblinger, E, 2006)
Examples of traumatic events Physical or sexual abuse Witnessing or being the direct victim of domestic, community, or school violence Motor vehicle or other accidents Life-threatening illnesses (cancer, burns, organ transplantation) Natural and human-made disasters Sudden death of parent, sibling, peer Exposure to war, terrorism, or refugee conditions (Cohen, J. , Mannarino, A. , & Deblinger, E, 2006)
Reasons for Migration/Trauma during migration LAMHA 2007 Survey- UNC Chapel Hill Most adolescents report that their family came for one of two reasons: better job opportunities (47%) or to be reunited with family (22%). Most (52%) described being concerned for their personal safety during the actual migration journey and 60% described the move/journey as somewhat or very stressful. (Chapman & Perreira, 2007, pp. 10)
How did you get here? “in a van” “we walked for a long time” “we had to run really fast”
Trauma symptoms(Cohen et. al) Refers to behavioral, cognitive, physical, and or/emotional difficulties Usually correspond to PTSD symptoms but also include depression, anxiety, or behavioral symptoms Include self-injurious behavior, substance abuse, impaired interpersonal trust and affective (mood) instability Children with trauma symptoms experience a profound change in how they VIEW THEMSELVES, THE WORLD, AND OTHER PEOPLE Grouped in several categories : affective, behavioral, cognitive, complex PTSD and psychobiological trauma CRAFTS acronym
Cognitive Trauma Symptoms Maladaptive patterns of thinking about self, others, and situations, including distortions or inaccurate thoughts (e. g. selfblame for traumatic events) and unhelpful thoughts (e. g. dwelling on the worst possibilities)
Relationship problems Difficulties getting along with peers, poor problem-solving skills, poor social skills, hypersensitivity in interpersonal reactions, maladaptive strategies for making friends, impaired interpersonal trust
Affective Trauma Symptoms Sadness, anxiety, fear, anger, poor ability to tolerate or regulate negative affective states, inability to self-soothe
Family problems Parenting skill deficits, poor parent-child communication, disturbances in parent-child bonding, disruption in family function/relationships due to familial abuse or violence
Traumatic behavior symptoms Avoidance of trauma reminders; trauma-related, sexualized, aggressive, or oppositional behaviors; unsafe behaviors
Somatic problems Sleep difficulties, physiological hyperarousal (startle response) and hypervigilance toward possible trauma cues, physical tension, somatic symptoms (headaches, stomachaches) (Cohen, J. , Mannarino, A. , & Deblinger, E, 2006)
Impact of trauma on child development Reactions for the three major age groups. Young children- Separation Anxiety, Developmental Regression School-aged children- Sleep Disturbance, Poor Attention, Somatic Complaints, Externalizing problems: aggressive or reckless behavior, Internalizing problems: Depression, anxiety, pre-occupation with safety, trauma-related guilt (Chadwick Center for Children and Families)
Adolescents: Engage in self-destructive or high-risk behavior, Heightened Shame, Guilt, Withdrawal from family and friends Long-term effects of trauma: 1. Alcohol and drug abuse 2. Depression 3. Heart disease 4. Domestic violence 5. Sexually transmitted diseases 6. Suicide attempts* * One out of every seven Latina teens, or 14 percent, attempts suicide according to a 2007 Centers for Disease Control and Prevention. (Chadwick Center for Children and Families)
Recommendations Provide assurance that undocumented families need not fear being reported to immigration authorities (ICE) by staff or deported if they receive services at our agencies Familiarize yourself with knowledge of immigration laws, policies, and resources Connect families with case management services to meet basic needs Provide families with the opportunity to connect with other families for support (women’s groups, parent’s groups, etc. )
Ensure that child and/or family receives a thorough assessment by a trained clinician in which: 1. They are screened for trauma history in using EBPs (evidence-based practices) and asked questions about immigration experiences 2. Separate parent/caregiver interviews are conducted to screen for family violence and trauma history
Conduct a thorough assessment that includes: ⇒ Cultural/family values ⇒ Immigration and documentation status ⇒ Language needs ⇒ Immigration experiences including trauma during the immigration process ⇒ Discrimination ⇒ Trauma experienced in their country of origin ⇒ Acculturative stress ⇒ Specific life experiences for Latino/Hispanic children and families who are involved in child welfare (trauma associated with out-of-home placement/multiple placement that many Latino/Hispanic children experience while in foster care. (Chadwick Center for Children and Families)
In conclusion… We must be aware of the unique set of circumstances affecting undocumented/refugee children and families. We have no way of knowing what a child’s experiences may have been if we are unaware or don’t ask….
References Adaptation Guidelines for Serving Latino Children and Families Affected by Trauma (2008). Chadwick Center for Children and Families. Birman, D. & Chan, W. I. (2008) Screening and Assessing Immigrant and Refugee Youth in School-Based Mental Health Programs, Health Care in Schools Issue Brief. Robert Wood Johnson Foundation. Cohen, J. , Mannarino, A. , & Deblinger, E. (2006) Treating Trauma and Traumatic Grief in Children and Adolescents. Guilford Press, New York.
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