trauma

Treating Traumatized Immigrant Children

Q&A with Julian Ford, Ph.D., Director, Center for Trauma Recovery and Juvenile Justice

Q

How is trauma impacting these young people?

They are impacted by violence in their countries of origin and on the journey to the U.S., as well as by race-related and institutional trauma in this country. Many develop a sense of fear, distrust, and even hopelessness that interferes with relationships, school, adjustment to new communities, and their physical health. These problems can persist for many years.


Q

What behaviors do they exhibit as a result?

These youth are often distrustful as a result of trauma, and can be very withdrawn or impulsive in an attempt to protect themselves from further trauma. This is a form of “survival coping,” which results from chronically not feeling safe. Justice involvement can occur when these youths feel that they must take extreme steps to protect themselves, which can lead to breaking rules — such as at school — or confrontations with law enforcement.


Q

How can physicians provide the best care to these patients?

Immigrant youths and their families, especially recent newcomers, have come to the United States in a period of turmoil and controversy that has heightened the stress they face in coming to a new country and new community. Many may feel reluctant to seek health care for fear of facing prejudice or discrimination. Providing a clear message of welcome and acceptance, in addition to showing interest in learning and respect for their culture and traditions, is essential to forging a positive treatment relationship — and can reduce patients’ anxieties and contribute to better health outcomes.

Expect that it will take some time, often several visits, for these youths and their families to feel sufficiently trusting and safe to fully and actively engage in dialogue and the treatment process. Patience and consistency on the part of the health care professional are a crucial counterbalance to the often harsh and even traumatic encounters many have had with putative helpers and institutional officials during their journey and once in the United States.

Explaining the nature and limits of confidentiality can help reduce fears about being subject to immigration sanctions.


Q

Is there a plan in place to help youths who suffer from this type of trauma?

The National Child Traumatic Stress Network has established more than 15 programs nationally for these youths. [The Center for Treatment of Developmental Trauma Disorders and The Center for Trauma Recovery and Juvenile Justice, of which Ford is the director, are members of the network.] This network was established by the federal government in 2001, and its centers provide public education, counseling, advocacy, and behavioral health treatment services for children and families, as well as consultation to community leaders and policymakers.

‘Talk to Your Mother’ Proves to be Healthy Advice

Daughter has serious conversation with mother outdoors


Bringing out the proverbial “skeleton in the closet” can provide health benefits, but the degree of benefit depends on who you confide in, says a new UConn study.

The study of 400 people, published in the Journal of Health Psychology, found that people who are living with issues such as mental illness, substance abuse, domestic violence, rape, or childhood abuse reap considerable health benefits from discussing those issues.

But they experience more health benefits – both psychological and physical – from disclosing the issue to mom, a romantic partner, or a best friend than from disclosing it to dad, siblings, or a close colleague, says Diane Quinn, UConn psychology professor and study author.

People have unseen scars and they may be reluctant to talk about their stigmatized identity or experience … but if they do choose to talk about it, then they will gain even more benefit from their social interactions than if they remain silent.

“It seems that people expect their mothers to love them unconditionally, and they just assume that she will handle letting the rest of the family – including the father –know about a problem,” says Quinn.

Researchers studied a group of people who averaged 32 years old and who had at least one past experience that they kept hidden from others.

Participants were asked to rate their social networks according to differing degrees of support. Those ranged from a basic level of support, such as an offer to go to lunch, to more substantial support, such as an offer of a place to stay during an emergency. They were also asked to rate their own physical health, both in terms of actual symptoms of illness and how they perceived their health in general. Finally, they were asked to quantify how “out” they were about their issue within their social network.

Results showed that people who characterized themselves as being the most “out” derived the greatest health benefits, especially when their confidantes included mom, a romantic partner, or a close friend.

“People have unseen scars and they may be reluctant to talk about their stigmatized identity or experience,” says co-author Bradley Weisz, a doctoral student in psychology, “but if they do choose to talk about it, then they will gain even more benefit from their social interactions than if they remain silent.”

But while being “out” about a stigmatized identity or a traumatic experience can be helpful in the long run, Quinn says that not everyone has to follow the same path. “It’s a matter of your personal comfort zone,” she says.

Funded by the National Institutes of Health (NIH), the study was also co-authored by UConn psychology professor Michelle Williams.