Trauma Without Borders: The Necessity for School-Based Interventions in Treating Unaccompanied Refugee Minors

Diana Franco

doi:10.1007/s10560-018-0552-6

Abstract

This article explores migration trauma among Mexican and Central American unaccompanied refugee minors (URM) with the purpose of developing an understanding of migration as a tripartite process consisting of: pre-migration exposure to traumatic stressors, in-journey stressors, and post-migration stressors. The migration experience of these youth may be subjectively different depending on a wide range of factors. The complexities of migration are explored as a traumatic, tripartite process. These three salient components of migration may act as precursors, often resulting in psychological sequelae such as: post-traumatic stress disorder (PTSD), anxiety, and depression. Of all migrant groups, URM are more likely to develop psychiatric symptoms. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Intervention for Trauma in Schools (CBITS), and Mental Health for Immigrants Program (MHIP) are among the most effective interventions in the treatment of PTSD, anxiety, and depression in refugee minors. Social workers in schools are in unique positions to provide mental health services to URM. A case example illustrating a cultural adaptation of TF-CBT in an urban public high school is included. Clinical implications of culturally responsive and trauma-informed treatment of URM in schools will be discussed. Additionally, this article will emphasize the importance of bridging the gap between research and culturally responsive, trauma-informed interventions for URM in schools.

Highlights

The literature (Green, 2003; Krogstad, Barrera, & Lopez, 2014) emphasizes an increasingly steady influx of unaccompanied minors migrating to the US (Pierce, 2015), there is a dearth of empirical research (Greenman & Hall, 2013; Rasmussen et al, 2012; Yearwood et al, 2007) pertaining to trauma-informed mental health services and culturally responsive treatment for unaccompanied refugee minors (URM) in schools
This article explored migration as a traumatic, tripartite process as it relates to the unique needs of URM and schoolbased services (Fazel & Stein, 2002; Kirmayer et al, 2011; Perez-Foster, 2001; Sullivan & Simonson, 2016)
URM are reportedly at a higher risk for developing post-traumatic stress disorder (PTSD) and other psychological sequelae as a result of their migration process when compared to voluntary migrants

Summary

Literature Review

According to the 2016 United Nations (UN) Global Trend Report, of the world’s 65.3 million people who are forcibly displaced, more than half are young people under the age of 18 (UNHCR, 2016). Other pre-migration stressors that may contribute to PTSD and other reported psychological sequelae include: the physical and emotional effects of poverty, malnourishment, physical and mental health issues, substance/drug abuse, educational achievement, teen pregnancy, grief, personal losses (home, family, friends, belongings), leaving countries of origin suddenly without saying good-bye to loved ones, and being unaccompanied (Fong, 2007; Smid et al, 2011; Yearwood et al, 2007). Yaretzi emphasized a longing for “the beauty of her country,” her mother’s cooking, the smell of her home in El Salvador, the sadness she felt about being “forced to leave,” and “living in a strange country.” In the post-migration narrative, Yaretzi expressed feeling “stressed having to balance the role between being a student and having to work full time after school.” After a month of participating in the group and seeing the school social worker for individual sessions, Yaretzi’s effort in class improved, her attendance became more consistent, and she stopped sleeping in class

Findings

Discussion

Conclusion