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Key considerations for working with trauma-affected newcomers

Sunday, November 20, 2016Laura Kelly

With the influx of newcomers and refugees settling in Ontario there is a growing need to support their mental health and well-being. In some instances, newcomer children, youth and families, particularly refugees, arrive in Canada after having been exposed to tremendous trauma in their home countries. As a result, their mental health needs may differ significantly from other populations. Unfortunately, even after arrival, the stresses and challenges often continue during and after settlement.  
 
The Centre’s recent Evidence In-Sight report Best practices for working with trauma-affected newcomers, describes different therapies and interventions shown to support newcomer children and youth with trauma and attachment difficulties. When working with trauma-affected newcomers, regardless of the chosen therapy or intervention, there are four key strategies to consider.
 
1.       Provide culturally competent services
It is crucial to tailor culturally appropriate services for clients in order to ensure they are meaningful, relevant and effective.

  • Provide language support. In order to work in the client’s preferred language, seek the help of a well-trained, professional cultural interpreter or knowledge broker who is familiar with mental health terminology and cultural idioms of distress.
  •  Avoid using scientific or clinical jargon. It’s also important t keep in mind that explicit diagnostic labels can bring about intense shame, embarrassment and fear of stigma for individuals in certain cultures.
  • Be aware of cultural biases. Provide agency staff with cultural competency trainings or health beliefs training tailored to specific cultures.
  • Ensure agency policies and procedures (e.g. any paper work given to clients) are in plain and simple language. Reminder phone calls should also be made by interpreters instead of English or French-speaking staff or the agency’s automated system.
  • Be careful of labelling somatic problems (i.e. bodily expressions of emotional distress such as headaches, body and stomach pains, numbness, etc.) as purely psychological in nature. In these cases, it may be important to seek the help of torture victim specialists.
  • Engage qualified members of the refugee or newcomer communities to build trust, to gain cultural expertise to inform programming and to improve mutual understanding between service providers and clients.

 
2.       Harness resilience through protective factors  
Therapeutic interventions should explore the sources of resilience that have helped children and youth go on despite the adversity they faced.

  • Help youth identify protective factors such as unique healing and coping processes, sources of meaning and hope, personal strengths and skills, supportive relationships and belief and value systems when listening to their stories and trauma narratives.
  • Mobilize and strengthen key protective factors, such as caregiver support, caregiver well-being, cultural identity, community belonging and positive school experiences during treatment.

 
3.       Address past and current stressors  
Addressing current stressors (e.g. acculturative stress, language barriers, financial difficulties, loss of social connections, loss of previous socio-economic status, etc.) should be part of any comprehensive treatment plan.  

  • Understand that some newcomers may prioritize survival needs (e.g. financial, housing) over mental health needs. The in-depth exploration of past trauma may also be too painful and aversive for some clients to address in the beginning of the intervention, if at all.
  • Acknowledge and address post-resettlement difficulties related to discrimination, including micro-aggressions, such as teasing and harassment. Help children and youth understand how social injustices are impacting them, validate their hurt and pain from these experiences, and work with them to restore self-efficacy, self-esteem and a sense of social belonging. 

 
4.       Reduce perceived power differentials
Newcomers who have experienced political or community violence have often been robbed of control over many aspects of their lives. Consequently, power dynamics within treatment can be a sensitive issue and barrier for newcomers.

  • Avoid using overly directive approaches in therapy as this may inadvertently suggest that refugee youth and families lack the capacity to help or heal themselves, thereby contributing to their sense of disempowerment. 
  • Develop a genuine partnership with young people and their families, collaborate wherever possible and seek their active involvement in developing treatment plans.
  • Respect a youth and family’s views, wishes and decisions regarding treatment. The preferences and priorities of families and youth must always be meaningfully integrated into treatment plans, even if they are not the priorities identified by service providers. 

To learn more about working with trauma-affected newcomers, read the Centre’s full Evidence In-Sight report

 

 

 

Ontario Centre of Excellence for Child and Youth Mental Health

695 Industrial Avenue, Ottawa Ontario, K1G 0Z1
Tel.: 613-737-2297   Fax: 613-738-4894
Email: centre@cheo.on.ca

 

Please note: We do not provide mental health advice, counselling or treatment.
If you, or if someone you know is in crisis right now, please call the Kids Help Phone at 1-800-668-6868.

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