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Refugee Services: Children in Need » Women's Courage

Refugee Services: Children in Need

February 28th, 2013 by mkohara Leave a reply »

In discussing women in areas of widespread violence, the physical dangers of their location often take precedence over other implications toward health.  In the midst of war, this makes sense.  Protection from actual fighting, guns, bombs, landmines, raids, and other physical threats if crucial.  After this, acquisition of adequate supplies such as food, water, heat, shelter and sanitation are essential.  But once women and their families survive these traumatic environments, what happens to them? If they become refugees, are they left to fend for themselves, or possibly given assistance in finding housing if they are in an extremely hospitable area?  Refugees, especially those fleeing to new countries with drastically different cultures than their home countries, have a unique set of stressors and needs for satisfactory health.

A growing trend in the United States is beginning to address the needs of this population by providing mental health services to refugee children from conflict zones.  While studies have not been conducted to assess the most effective or cost-efficient methods for treating children, the need to protect and counsel children at risk for mental health issues as a result of seeking refuge in a country outside of their own is irrefutable.  Service providers recognize the need for treatments, and thus treat a wide variety of children from all cultures, and often assist in other venues outside of health care, including legal services and social work.

As a population, child refugees experience a different set of challenges and traumas from adult refugees.  They are uprooted from their homes, experience violence, either ongoing or short in duration, and are forced to adjust to a new culture outside of their own.  While adult refugees experience this as well, children have even less control than adults in finding a new home and building a life in their new country of refuge.  Because these changes happen during crucial times of development for children, they are at a great risk for suffering mental consequences from the massive changes and trauma associated with being a refugee.  Many children may not yet have developed the cognitive processes for coping with change and stress, and thus are more likely to experience physical and mental distress as a result.  This can come in many forms, not necessarily as severe mental disorders, but as problems with concentration, emotional instability, excitability, depression, panic attacks, behavioral changes, dizziness, lethargy, and sleeping disturbances, among other issues.

 

The Interventions

The National Child Traumatic Stress Network Refugee Trauma Task Force surveyed a number of providers across the United States to find the treatments being provided for refugee children.  As mentioned previously, while there have been few studies conducted to determine a standard plan of treatment for refugee children, the Refugee Trauma Task Force found that the methods used fell in to three main categories: school-based cognitive behavioral therapy, psychoeducational and parenting interventions for mothers, and art and expressive therapy.

 

School-based CBT

These interventions usually follow a standard course of around 10 weeks of group sessions, possibly with multiple sessions per week.  The sessions address the trauma experienced by participants, and focuses on methods such as therapeutic exposure, stress management techniques, cognitive restructuring, and current life-issue problem solving.  These interventions have been shown in decrease depression symptoms in the participating children.

 

Psychoeducational and Parenting Interventions

Interventions targeting the mothers of refugee children, presumably refugees themselves, these parenting interventions aim to improve the mental health of both the mother and the child.  Similar to the school-based CBT, psychoeducational and parenting interventions focus on trauma education and discussion, but also have a component focused on facilitating interactions between parent and child.  These interventions have been shown to improve the happiness of mothers and improve the conditions of the children involved as well.

 

Art and Expressive Therapy

Part of the uniqueness of dealing with a child population is the creativity necessary for treatment.  Creative art therapies allow for children to express their emotions without fear of embarrassment or the need for extensive language mastery that they may not possess.  Art can allow children to assert their feelings, identity, and sense of self without the need for words or other seemingly emotionally invasive measures. These interventions have not been the subject of many studies, and thus the outcomes appear to be somewhat ambiguous.  Without structure, the process can be confusing or stressful to children not inclined to be expressive through art, thus exacerbating the issue.  However, art therapies have the potential to be highly effective methods for coping in refugee children, especially if their native culture was one with high regard for storytelling.

 

Each intervention mentioned provides a different facet through which to combat mental distress in refugee children.  While these services are not universal yet, the fact that more and more health care providers are offering mental health care for refugee children is promising for the future.  Primary interventions aimed at improving the mental health of children before disorders occur and providing children with coping techniques and mechanisms to improve mental health are essential to supporting the overall health of a growing refugee population.

 

 

 

Sources

http://www.msf.org/source/mentalhealth/guidelines/MSF_mentalhealthguidelines.pdf

http://www.nctsnet.org/nctsn_assets/pdfs/promising_practices/MH_Interventions_for_Refugee_Children.pdf

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2 comments

  1. Kathryn says:

    I really liked how you discussed different mental health interventions for refugee children. I thought your discussion of psychosocial and parenting interventions was particularly interesting, and I think it’s important to help parents communicate and support their child especially in cases of severe stress or trauma. I was also interested in your discussion of art therapy, and I was surprised that the outcomes of studies have been somewhat ambiguous because I would assume that art would help act as an emotional outlet for stress. But I think it’s important that you brought up the individuality of children, and the fact that some may not be expressive through art, which highlights the importance of tailoring interventions to the specific needs of the population you’re working with.

  2. Magali says:

    Hi Meghan! I thought your post on these services for refugee children was really intriguing. I found the art aspect to therapy especially important. I listened to a talk today from the founder of the International Medical Corps, and he talked about a program in Serbia that focused n helping refugee children overcome their past through art. After a year, children went from drawing machine guns to birds, something children their ages do normally. It was amazing to see how children transformed with a relatively low-cost therapy program. I agree though. It would be important to have studies done to measure exactly how beneficial it is for children.

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