Acculturation and Adjustment of Refugees and Refugee Mental Health Services

1. Acculturation and Adjustment of Refugees and Refugee Mental Health Services Dina Birman Associate Professor of Psychology University of Illinois at Chicago dbirman@uic.edu

3. Types of Immigrants Immigrants Refugees (Asylees) Undocumented

4. Waves of Immigration to U.S.: from Assimilation to Multiculturalism 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

5. History of immigration policies • 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

6. 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

8. 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”

9. Bhutanese • http://www.youtube.com/watch?v=k9Mhb6DBo2c&feature=fvsr

10. Burma

14. Burundi and Somalia

19. Kakuma, Kenya

26. “Slavic” Community • http://online.wsj.com/article/SB10001424052748704739504576067550205353230.html • Soviet Jews

27. US Resettlement Program • 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

28. 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

29. Stressors in Resettlement Migration Acculturation Trauma

30. What’s the best way to Acculturate?

31. Is there a best way to acculturate?

32. Acculturation

33. Acculturation • Assimilation • Traditional • Bicultural

34. Assimilation - Children with respect to Language Acculturation Time in U.S.

35. Language Acculturation:Russian and Vietnamese Adolescents

36. Language Acculturation:Russian and Vietnamese Parents

37. Cultural Maintenance Acculturation Time in U.S.

38. Acculturation Gap: Assimilation and Additive Acculturation Time in U.S.

39. Acculturation Gaps

40. Acculturation Gaps?

41. What are some implications of acculturation gaps?

42. 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

43. Culture Broker Role • Children helping parents with communication, phone calls, forms • “Role reversal” or “parentification” between adults and children? • Competence and maturity?

44. 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

45. 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

46. Migration Stress: • 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

47. Ways to help children cope with moving: • a) re-establish routines • b) anticipatory guidance • c) support from peer group • d) support from important adults

48. Traumatic Stress • Symptoms of PTSD • Traumatic Event is re-experienced • Dissociation and numbing, avoidance of stimuli • Increased arousal, irritability, startle reflex, concentration

49. 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)

50. Treatment Components “PRACTICE” • Parenting skills and Psychoeducation • Relaxation skills • Affective modulation skills • Cognitive Processing • Trauma narration • In vivo desensitization • Conjoint parent-child sessions • Enhancing safety