Transcript Slide 1

Acculturation and Adjustment
of Refugees and Refugee Mental
Health Services
Dina Birman
Associate Professor of Psychology
University of Illinois at Chicago
[email protected]
Types of Immigrants
• Immigrants
• Refugees (Asylees)
• Undocumented
Waves of Immigration to
U.S.:
from Assimilation to
Multiculturalism
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Early in U.S. history- “the English”
1840’s – 1860’s – N. Europeans
Early 1900’s - S. and E. Europeans
1975 – present – Asians, Latin
Americans, and Africans
History of immigration
policies
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1882 Chinese Exclusion Act
1924 Immigration and Nationalities Act
1948 Displaced Persons Act
1951 UN Convention for the Rights of Refugees
1967 UN Convention for the Rights of Refugees
expanded
• 1965 Immigration and Naturalization Act
• 1980 Refugee Act
• 1990 Immigration Act
1951 UN Convention
• Created UNHCR: UN High Commissioner of
Refugees
• Defined Refugees: persons who owing to a
well-founded fear of being persecuted for
reasons of race, religion, nationality,
membership of a particular social group, or
political opinion, is outside the country of
his nationality, and is unable to or, owing to
such fear, is unwilling to avail himself of the
protection of that country
US Refugee Admissions
• Refugee Policy – Arm of US Foreign Policy
• Refugees flee from countries that are “enemies” of
US
• Post WWII
• Fall of Saigon in 1975 – Vietnamese migration
• 1970’s – 90’s Jews and later Evangelical Christians
from Soviet Union, Cubans
• mid-1990’s – Bosnians, others from former Yugoslavia
• 2000’s – Afghanistan, Iraq; Somalia, Burma; n
“warehoused populations”
Bhutanese
• http://www.youtube.com/watch?v=k9
Mhb6DBo2c&feature=fvsr
Burma
Burundi and Somalia
Kakuma, Kenya
“Slavic” Community
• http://online.wsj.com/article/SB100
01424052748704739504576067550
205353230.html
• Soviet Jews
US Resettlement
Program
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Orientation before arrival
Met at airport
Apartment
$900 per person cash assistance
Job placement services
ESL for adults
Registering for school
Some offer afterschool, summer programs
• REFUGEE RESOURCES:
• BRYCS: Bridging Refugee Youth and Children's
Services
• http://www.brycs.org/
• CAL: Center for Applied Linguistics
• http://www.cal.org/
• Spring Institute for Intercultural Learning
• http://www.springinstitute.org/
• ORR: Office for Refugee Resettlement:
• http://www.acf.hhs.gov/programs/orr/index.html
Stressors in
Resettlement
• Migration
• Acculturation
• Trauma
What’s the best way to
Acculturate?
Is there a best way to
acculturate?
Acculturation
Acculturation
• Assimilation
• Traditional
• Bicultural
Assimilation Children with respect to
Language
Time in U.S.
Language Acculturation:
Russian and Vietnamese
Adolescents
3.50
3.50
3.00
3.00
2.50
2.50
2.00
2.00
1.50
1.50
1.00
1.00
16.50
12.92
12.33
11.68
11.09
10.83
10.41
9.83
9.00
8.75
8.17
7.58
7.33
6.75
6.50
5.91
5.25
4.68
3.58
3.08
.75
10.83
10.42
10.17
9.91
9.43
9.16
8.75
8.34
7.50
6.84
6.17
5.58
5.17
4.59
4.42
4.00
3.08
2.67
2.43
2.00
1.66
1.08
.43
TIME in US
TIME in US
Vietnamese
Russian
Mean
4.00
Mean
4.00
American
American
Language Acculturation:
Russian and Vietnamese Parents
3.50
3.50
3.00
3.00
2.50
2.50
2.00
2.00
1.50
1.50
1.00
1.00
16.50
12.92
12.33
11.68
11.09
10.83
10.41
9.83
9.00
8.75
8.17
7.58
7.33
6.75
6.50
5.91
5.25
4.68
3.58
3.08
.75
10.83
10.42
10.17
9.91
9.43
9.16
8.75
8.34
7.50
6.84
6.17
5.58
5.17
4.59
4.42
4.00
3.08
2.67
2.43
2.00
1.66
1.08
.43
TIME in US
TIME in US
Mean
Mean
Vietnamese
4.00
Russian
4.00
American
American
Cultural Maintenance
Time in U.S.
Acculturation Gap:
Assimilation and Additive
Time in U.S.
Acculturation Gaps
Acculturation Gaps?
What are some implications of
acculturation gaps?
What are some implications of
acculturation gaps?
• Parents don’t know about their
children’s lives outside the home
• Diminishes parents’ capacity to help
their children
• Undermines their authority
• Children feel parents can’t
understand or help them
Culture Broker Role
• Children helping parents with
communication, phone calls, forms
• “Role reversal” or “parentification”
between adults and children?
• Competence and maturity?
Native Language Support
• Difficult for children to learn literacy
skills in a language they are not verbally
fluent in
• Learning literacy in native language helps
promote academic achievement in English
• Research also suggests that acculturation
gaps in native language predict conflict
Ways to reduce
acculturative stress
• Helping parents understand children’s
experience
• Helping parents learn about the lives of
their children (for e.g. at school)
• Helping children retain their native
language
• Not asking children to serve as brokers in
settings where not appropriate
Migration Stress:
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Moving
Worse when unexpected or not by choice
Loss of family and friends
Loss of familiar possessions and
surroundings
• Disruptions on family arrangements
• Changes in loved ones as a result of stress
Ways to help children
cope with moving:
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a) re-establish routines
b) anticipatory guidance
c) support from peer group
d) support from important adults
Traumatic Stress
• Symptoms of PTSD
– Traumatic Event is re-experienced
– Dissociation and numbing, avoidance of
stimuli
– Increased arousal, irritability, startle
reflex, concentration
Treatment for PTSD
– Cognitive-Behavioral Approaches
• TF-CBT (Trauma Focused Cognitive
Behavior Therapy) http://tfcbt.musc.edu/
• CBITS (Cognitive Behavioral Intervention
for Trauma in Schools
• Support for Students Exposed to Trauma
• SPARCS (Structured Adolescents Exposed
to Chronic Stress)
Treatment Components
“PRACTICE”
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Parenting skills and Psychoeducation
Relaxation skills
Affective modulation skills
Cognitive Processing
Trauma narration
In vivo desensitization
Conjoint parent-child sessions
Enhancing safety
The CBT Triangle
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Feelings
Thoughts
Actions
Treatment Adaptations
for Refugees
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Extensive outreach and engagement
Provide services in the community
Done with cultural sensitivity
Groups for lower symptoms,
individual for more symptomatic kids
School Transitions for
Refugee Children
School Transitions for
Immigrants and Refugees:
Differences in
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student – teacher relationships
roles of teachers and parent
School’s role in discipline
Expectations for discussion and
analysis vs. rote learning
Peer norms
ESL Classroom as a Safe
Place
• smaller classroom or small group work
• peers who are going through similar
experiences,
• attentive adult
Understanding U.S.
schools:
• Most of the rules and norms in U.S.
schools and classrooms are implicit.
• Lack of strict rules and expectations for
autonomy create the impression that there
are no rules.
• For refugee children even the most simple
and basic of rules may need to be made
explicit
Children with no prior
schooling:
• Somali Bantu, some girls from Afghanistan
• Need to learn about:
- being in a school building
- sitting at a desk
- holding a pencil
- reading or looking through books
- playing with toys
Strategies for working
with traumatized
refugee children
What Can Schools Do for
refugee children?
• Educate them about the culture,
language, and academics
• Provide Structure
• Re-establish routines
• Provide access to caring adults
• Help integrate into peer group
Should teachers be expected to
help children talk about their
traumatic experiences?
• It is not the teachers’ job to help children
tell their story of trauma.
• If and when it does come up, the most
important part to remember is not that
the story be told, but that the child
experience trust and support while telling
it or trying to tell it.
Should teachers discipline
children who have been
traumatized?
• Children who’ve never been in school need
to learn about how to be in school
• When done in a caring way, setting limits
and helping the child observe and monitor
her own behavior is extremely helpful to
the child, helps normalize the situation,
and gives the child skills to cope with
trauma as well as every day life.
How to structure classrooms
for refugee children
• STRUCTURE and expectations,
routines
• Structure in unstructured time
• Integrate content and English
language learning
• Make content meaningful
• Warmth and Praise
• Personal relationships and
opportunities to deepen relationships
Relationships Matter