Counseling Treatment Issues for Indigenous Americans and Refugee/Asylum- Seeking Students

Transcription

1 Counseling Treatment Issues for Indigenous Americans and Refugee/Asylum- Seeking Students Sarah Luedtke, Melissa Morris, Amy Shatila & Joanna Whelanx

2 ISSUES Counseling Issues to keep in mind when working with Indigenous Americans/Native American Students

3 INDIGENOUS AMERICANS Also known as Native Americans or American Indians In 2012, there were 5.2 million American Indians and Alaska Natives Constitutes 2% of the total population 49% are American Indian and Alaska Native only 51% are American Indian and Alaska Native in combination with one or more other races

4 MEDICINE WHEEL Medicine wheel depicts the importance of maintaining harmony and balance of mind, body and spirit within one s natural environment. The belief is that we are connected with everything that exists. The whole is always greater than its parts.

5 COMPARISON OF CULTURAL VALUES Traditional Indigenous American Cooperation Group needs more important than individual needs Privacy and noninterference Participation after observation Present time focus Delayed response to auditory messages Nonverbal Communication Contemporary Mainstream American Competition Personal goals considered important Need to control/affect others Trial-and-error learning Future time focus Immediate response to auditory messages Verbal skills highly praised

6 COOPERATION VS COMPETITION

7 PRIVACY/NON-INTERFERENCE VS. NEED FOR CONTROL Differing concepts of motivation May not seek help as readily when it s needed Teachers may not realize when Indigenous American students are falling behind

8 PARTICIPATION AFTER OBSERVATION VS TRIAL-AND-ERROR LEARNING

9 TIME Present Focused Disorganized Fixated on the now Apathetic Lack of study skills Future Focused Organized Forward thinking Motivated Good study skills

10 IMMEDIATE VS. DELAYED AUDITORY RESPONSES Central Auditory Processing Disorder? Apathetic towards learning environment? Hearing Impaired? Social difficulties? Increased processing time for increased cognitive load?

11 VERBAL VS. NONVERBAL COMMUNICATION

12 INTERVENTIONS Appropriate measures for working with Indigenous Americans/Native American Students

13 SOLUTION-FOCUSED THERAPY Brief therapy focusing on solutions rather than problems Assumes people have ability to change and will if they recognize the need Focus on future- not past Change is inevitable: all situations have positives and negatives Therapy is concerned with looking for what is working Therapists assist clients in finding exceptions to their problems There is a shift from problem-orientation to solution-focus Emphasis is on constructing solutions rather than problem solving The client is the expert on his or her own life

14 SOLUTION-FOCUSED THERAPY Techniques: Pre-therapy change (What have you done since you made the appointment that has made a difference in your problem?) Use compliments Tasks assigned to client on basis of preferred solutions Exception questions (Direct clients to times in their lives when the problem did not exist) Miracle question (If a miracle happened and the problem you have was solved while you were asleep, what would be different in your life?) Scaling questions (On a scale of zero to 10, where zero is the worst you have been and 10 represents the problem being solved, where are you with respect to?)

15 Benefits: SOLUTION-FOCUSED THERAPY Uses client s frame of reference which is culturally sensitive Solution-focused assumption about change is compatible with American Indians view of change: that it is continuous and unavoidable Because clients identify their own solutions, alternative methods used by American Indians are easily accepted (for example: alternative healing methods) Limitations: Miracle question is focused on the future, which may be contrary to present-time orientation valued by many American Indians The miracle question can be reworded to focus on a time when the client experienced harmony with all people and things.

16 Synthesis of contemporary counseling techniques and traditional Native American wisdom to create a Unity Model of group work Uses the Greater Circle (Medicine Wheel) and the objectives of the four Great Circle directions to develop student s: EAST: Self-esteem (how one feels about oneself and one s ability to grow and change) SOUTH: Self-determination (represented in one s ability to use one s will to explore and develop potentials) WEST: Body awareness (represented in how one experiences one s phyusical presence) NORTH: Self-Concept (what one thinks about oneself and one s potentials) MEDICINE WHEEL/UNITY MODEL OF GROUP WORK

17 Theory views each dimension as one of the four cardinal points counseling focuses attention on seeking a harmonious functioning of each one as an extension of the others MEDICINE WHEEL/UNITY MODEL OF GROUP WORK The counselor is the group leader, and functions as the facilitator, mentor, educator and support giver The Circle is a reminder of the interconnectedness that everyone shares with each other and the environment.

18 Group sessions are conducted using a Talking Circle. The Talking Circle serves as a forum for the expression of thoughts and feelings where there is complete acceptance among group members A Talking Stick is used to signify connectedness with nature and right to speak Activities/Exercises and Discussions are used to facilitate the development of the four dimensions MEDICINE WHEEL/UNITY MODEL OF GROUP WORK Example Activity: Medicine Bag (Self-Esteem/Self-Concept) Each child is asked to bring a special gift that he or she received from Mother Earth The child is asked to discuss what ways he or she is similar to the gift and group discussion will occur. Special skills or strengths are emphasized when decorating the medicine bag

19 Ties easily with Native American philosophy of being one with all beings Assists the child to form strong emotional bonds and to develop empathy. Through animal interaction, children learn to understand not only the feelings and needs of animals, but also the feelings and needs of other human beings Counselors and teachers can promote nurturance by keepings pets in the classroom and counseling center PET THERAPY

20 PET THERAPY Helps Child to: Express feelings: Through projecting their own feelings onto the animals Interpret Body Language and Non-Verbal Cues: Through learning to read and respond appropriately to animal s nonverbal cues Develop a strong sense of worth, lovability, connection and belonging: Through experiencing the unconditional acceptance and love demonstrated by an animal Decreases stress, heart rate, Learn coping and grieving skills necessary for loss later in life: Animal life spans are shorter than humans Even the death of a pet can serve as a reminder of the connection between child and the natural cycle of life Animal Assisted Reading Program Therapy Dogs Make a Difference

21 Develops a child s confidence in his or her ability to interact competently with nature through gardening, creating or maintaining an environment for wildlife, etc. Gardens can be developed to produce vegetables and flowers, which can be shared. Skill of gardening and internal reward of sharing harvests can be sources of pride Observations of the environment while working outdoors can contribute to the feeling of oneness and shared group sightings can bond children together NATURE THERAPY

22 SUGGESTIONS & RECOMMENDATIONS School Psychologist needs to educate him or herself about the tribe from which the client comes Listen to the client to ensure that the client s perspective and language is used throughout counseling. Counselors often interject as the client speaks during sessions, which may not be culturally appropriate wait until the client has finished speaking. Maintain a humble spirit valued trait in the American Indian Community When conducting evaluations, consider the cultural background of the student to ensure fair assessment practices

23 ISSUES Counseling Issues to keep in mind when working with refugee/asylumseeking students

24 According to the 1951 United Nations Convention Relating to the Status of Refugees, a refugee is a person who, owing to a wellfounded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of their nationality, and is unable to or, owing to such fear, is unwilling to avail him/herself of the protection of that country. WHO ARE REFUGEES?

25 REFUGEES BUILD NEW LIVES IN THE UNITED STATES In the United States, refugees: Establish new homes Educate their children Gain employment legally Engage in their new communities Develop new relationships There are over 10.4 million refugees in the world. 54% reside in Asia 22% in Africa 16% in Europe 4% in Latin America and the Caribbean 4% in North America

26 Refugees come to the U.S. to escape persecution or dangerous situations such as war. They rarely have time to make any arrangements, gather important documents, or say good-bye to loved ones. They may not know the fate or whereabouts of their family members. They often live in refugee camps in neighboring countries while waiting for their application for resettlement to be processed. When refugees arrive in the U.S. they receive services and support from national voluntary agencies that have contracts with the U.S. government in the U.S. Refugee Admissions Program. BACKGROUND INFORMATION

27 CHALLENGES FOR SCHOOL PSYCHOLOGISTS Many of the refugees resettled by the United States are school-aged children, and there is a great need to provide services to this population because many face significant challenges adapting to American schools, whether academically, culturally, or psychosocially. Refugee students may arrive with minimal previous formal education, interrupted schooling, and/or limited English. There is often little or no warning of the children s arrival and thus little time to prepare a comprehensive school-base service delivery plan. One of the biggest challenges of a refugee child is the language barrier. If the language is not understood, the educational system is not fully effective and the child is not learning up to his or her capability. The lack of stability and safety and constant disruptions can put children at profound developmental risk, often impairing cognitive abilities as well as emotional, academic, or behavioral functioning. Refugee parents support their children to the best of their ability, but cultural, linguistic, and other barriers may prevent them from being fully involved in their children s education.

28 COUNSELING TREATMENTS FOR REFUGEES: CHALLENGES/BARRIERS The establishment of trust and rapport may take longer. Some refugees come from cultures in which mental health problems and disability are highly stigmatized and parents may be reluctant to present children to services. The effects of exposure to trauma on the brain and memory processes and different cultural traditions of storytelling can also make it difficult for refugees to tell their story in a chronological and detailed way. There may be a conflict between the need to safeguard the privacy of youth and families, and the desire to involve them in public services. Concerns that greater system involvement could potentially re-expose refugees to traumatic events or information. Refugee youth and family members may not feel welcomed, respected, or supported. Lack of resources can also inhibit youth and family participation: They may not be able to take time off from work or have access to affordable transportation or child care that would enable them to attend meetings. The lack of appropriate tests for use with children who have had little access to education or English language make the assessment and diagnosis of intellectual disabilities in child refugees extremely difficult. Effective practice with interpreters. Also, may impede the therapeutic relationship. Refugees may also be unaware of the range and nature of services available or believe that services are only available in times of crisis. Standard interviewing formats can be ineffective with children with a cultural background that is different from that of the counselor.

29 RECOMMENDATIONS AND SUGGESTIONS Building a trusting relationship with parents and extended families and helping them adjust to their new life is a key to improving the mental health and the academic success of refugee students. Partner with families, do not just inform them. Assist families with access to refugee services, community services, and support networks. Create a welcoming school where families feel safe and supported. Create workshops and meetings for refugee parents where their culture is valued. Work with community, cultural, and religious leaders to learn more about how that culture views physical and mental healing. Culturally competent practices that includes non-western intervention methods consistent with the values and traditions of refugee communities must be developed.

30 RESOURCES FOR TEACHERS AND SCHOOL PERSONNEL Highlighted Resources: For Schools The following "Lists of Highlighted Resources" are lists of resources on various topics that are chosen by BRYCS staff. Each list includes resources that are frequently recommended by BRYCS staff when consulting with service providers and providing technical assistance. Involving Refugee Parents in their Children's Education Multilingual School-Related Resources for Refugee Families Immigrant/Refugee Awareness Instructional Materials Children's Books about the Refugee/Immigrant Experience Addressing Refugee Child Welfare Concerns in the Schools Items Created by Refugee School Impact Grantees Addressing Ethnic Conflicts Bullying Foreign Transcript Evaluation Interpretation/Translation in the Schools Refugee and Immigrant Students and Special Education Students with Interrupted Formal Education Highlighted Program Evaluation Resources

31 ADDITIONAL RESOURCES/SERVICES FOR FAMILIES Austin Refugee Round Table Center for Survivors of Torture (CST) Interfaith Action of Central Texas (iact) Multicultural Refugee Coalition (MRC) Refugee Health Screening Clinic Refugee Services of Texas (RST) UNHCR Caritas of Austin

32 INTERVENTIONS Appropriate measures for working with refugee/asylum-seeking students

33 INTERVENTIONS FOR REFUGEE STUDENTS On average, 47% of refugees met criteria for PTSD, 43% for depression, and 27% met criteria for anxiety disorders. Interventions for refugee children should prevent psychological distress and promote emotional, social, and cognitive development Services should simultaneously address: Psychological functioning Adaptation (social and cultural) Physical health Ongoing difficulties Behaviors should be observed in both structured and unstructured settings, over a long period of time, and with different peers and teachers

34 VERBAL AND NONVERBAL INTERVENTIONS Verbal Therapies Involve the verbal processing of past experiences to treat anger, traumatic grief, and behavioral/ emotional problems TB-CBT (Trauma-based CBT) NET (Narrative Exposure Therapy) EMDR (Eye Movement Desensitization and Reprocessing) Non-verbal Therapies Creative techniques used for treating one s sense of well-being and emotional/ relational problems Usually in groups or families Art Relaxation Movement/ Play Drama

35 TB-CBT Trauma-focused approach to Cognitive Behavioral Therapy Common treatment for PTSD in children and adolescents NET TB-CBT AND NET Narrative Exposure Therapy Commonly used to treat symptoms of PTSD Through narration, the child creates a life timeline (from birth- present), including details of traumatic events

36 PLAY THERAPY Develop skills that lead to intellectual and emotional intelligence: Control and independence Adaptability and flexibility Risk assessment and appropriate response Experience and self-regulate emotions without losing control Attention Arousal Acting-out behaviors How can intervention restore a child s ability to play and support the benefits it brings?

37 CREATIVE ART THERAPIES Children construct personal accounts of their lives, interact with others, and express emotion Have beneficial effects on self-esteem, conflict resolution, and problem solving Good way of helping children construct meaning around their experiences Creative Play

38 Sand Play Used for pre-school age children Improves social adjustment Represent challenges of their world through play At young ages, can reconstruct violent scenes and death Use sand and figurines that represent their culture to explain hostile situations and develop solutions Storytelling and Drawing Used for elementary age children Improves self-esteem, internalizing/externalizing behavior Activities combine verbal and non-verbal means of expression Illustrating and commenting on myths and legends of different cultures Illustrate and tell the story of a character who has migrated to a new place Bring stories and legends from their own family and community that represent them directly Help teachers better understand the child s experiences and difficulties Drama Therapy Used for adolescents Reduces the effects of trauma-related symptoms Improves academic performance Story director presents the traumatic story, as told by the teen; works with musician to and actors to play the story back to the group Teen is able to construct meaning from their experience and recognize their strengths and resilience

39 RECOMMENDATIONS & SUGGESTIONS School Psychologists play a critical role in identifying refugee students in need of mental health services Consider cross-cultural challenges in order to conduct valid, meaningful assessment Get to know the student as an individual- what looks like a learning disability may be the refugee student s lack of familiarity with the school environment Arrange a newcomer program specifically designed to help refugees adapt to the new school Teach coping strategies to both the refugee student and their family

40 REFERENCES Birkett, D. (2006). Cultural dynamics in counseling refugees. Healthcare Counselling & Psychotherapy Journal, 6(3), Fall, K. A., & Levitov, J. E. (2001). Modern applications to group work. Huntington, N.Y.: Nova Science Publishers. Fearn, M., & Howard, J. (2011). Play as a Resource for Children Facing Adversity: An Exploration of Indicative Case Studies. Children & Society, 26. Garrett, M., & Pichette, E. F. (2000). Red as an Apple: Native American Acculturation and Counseling With or Without Reservation. Journal Of Counseling & Development, 78(1), HENLEY, J., & ROBINSON, J. (2011). Mental health issues among refugee children and adolescents. Clinical Psychologist, 15(2), doi: /j x Hunter, D., & Sawyer, C. (2006). Blending Native American Spirituality with Individual Psychology in Work with Children. Journal Of Individual Psychology, 62(3), Kugler, E., & Price, O. (2009). Go beyond the Classroom to Help Immigrant and Refugee Students Succeed. Phi Delta Kappan, 91(3), Lacroix, M., & Sabbah, C. (2011). Posttraumatic Psychological Distress and Resettlement: The Need for a Different Practice in Assisting Refugee Families. Journal Of Family Social Work, 14(1), Meyer, D. D., & Cottone, R. (2013). Solution-Focused Therapy as a Culturally Acknowledging Approach With American Indians. Journal Of Multicultural Counseling & Development, 41(1), NCTSN Policy Brief: Family, Youth, and Consumer Involvement, September 2008 ( 2 Nugent, N., & Roberts, S. (2013). Child and adolescent refugees: From surviving to thriving. Brown University Child & Adolescent Behavior Letter, 29(9), 1-7. Pacione, L., Measham, T., & Rousseau, C. (2013). Refugee Children: Mental Health and Effective Interventions. Current Psychiatry Reports, 15(34). Refugee Children: A Guide for Parents. (2013). Brown University Child & Adolescent Behavior Letter, Rousseau, C., Lacroix, L., & Singh, A. (2005). Creative Expression Workshops in School: Prevention Programs for Immigrant and Refugee Children. The Canadian Child and Adolescent Psychiatry Review, 14(3). Tyrer, R., & Fazel, M. (2014). School and Community-Based Interventions for Refugee and Asylum Seeking Children: A Systematic Review. PLOS ONE, 9(2). United States Census Bureau. (2013). American Indian and Alaska Native Heritage Month: November Retrieved from facts_for_features_special_editions/cb13-ff26.html NASP Home Publications Communiqué Volume 39, Issue 5 Featured Articles From State Newspaper