PROJECT
ABSTRACTS
AN UP TOP, INSIDE AND OUT PERSPECTIVE ON TRAUMA AND SUBSTANCE
ABUSE TREATMENT MODELS - Lillian Lennox, MA, Onaje Mu’id,
MSW, CASAC, Geraldine Russo
MONITORING INTERNATIONAL PSYCHOSOCIAL INTERVENTIONS - PREVENTION
AND RESPONSE TO SEXUAL VIOLENCE IN THE DRC: A CASE STUDY - Nancy
Clifford
INTEGRATING NARRATIVES OF SUFFERING WITH THE PROCESSES OF COEXISTENCE
- Ann Schumacher
ENHANCING COMMUNICATION AND GENERAL WELL-BEING IN KOSOVAR FAMILIES
- Neki Juniku, Ph.D.
“...And then I wondered if we’d be left to die”:
TRAUMA, TERROR AND BETRAYAL IN THE AFTERMATH OF HURRICANE KATRINA
- Monica J. Indart, Psy.D.
SELF CARE: GROUP WORK WITH PARENTS & MENTAL HEALTH WORKERS
- Arielle Goldman, LMSW
BUILDING VIRTUAL COMMUNITIES: A LOOK AT THE 9/11 ONLINE CHAT PROGRAM
- Dan Fielder
THE FORMER CHILD SOLDIER AS A REFUGEE - Eugene R. Packer,
Ph.D.
PTSD GROUPS FOR PARENTS AND CHILDREN - Elizabeth Duffield,
LCSW
DISSOCIATION AND THE AMERICAN DREAM - Aviv Dor
KNOWLEDGE SHARING STRATEGIES FOR THE FIELD OF TRAUMA INTERVENTION
- Sheila Pottebaum, Ph.D., Judith Rhinehart
UTILISATION FOCUSED EVALUATION: The Londiani self-determination
experience in healing and cleansing ritual for two communities
after intertribal killings of 2002 in Kenya: Learning from Striving
for Sanctuary model in dealing with ambiguous loss - Nancy
Birir, Protasia C.N.Gathendoh, Lisette Soini
AFRICAN REFUGE CENTER HEALING MURAL PROJECT - Angela Tripi-Weiss,
Director of Arts In Action Visual Arts Program Inc, Connie
Viana, Cynthia Grguric, LMHC
TRAUMA FOCUSED EDUCATIONAL PRESENTATIONS FOR MENTAL HEALTH PROFESSIONALS
- Brannon L. Weeks, M.D.
AMBIGUOUS
LOSS AS EXPERIENCED BY UNDOCUMENTED MEXICAN IMMIGRANTS - Donna
Gabriel Ellaby
EFFECTS
OF CONFINEMENT ON DETAINED IMMIGRANTS, A PSYCHO-SOCIAL EVALUATION
- Stephanie Palau, LMSW
AN UP TOP, INSIDE AND OUT PERSPECTIVE ON TRAUMA AND SUBSTANCE
ABUSE TREATMENT MODELS - Lillian Lennox, MA,
Onaje Mu’id, MSW, CASAC, Geraldine
Russo
The relationship between interpersonal violence, the resulting
traumas and their causality in creating substance use disorders
is significant and complex, yet a topic that is just beginning
to be researched to any appreciable degree. This presentation-
and the forthcoming paper- is an appraisal of three trauma based
models by three practitioners who are dissimilarly situated -
one is an administrator, one an agency based clinician, and the
other an independent clinician. From an agency centric frame of
reference (hence the title, “An Up Top, Inside, and Out
Perspective on Trauma and Substance Treatment Models”),
they will critique the efficacy of the models, which they have
independently chosen for the purpose of integrating trauma theory
in their current professional setting. The administrator, Onaje
Mu’id, the Clinical Associate Director of Reality House,
Inc., was concerned most with the issue of changing agency culture
to accommodate a paradigm shift to make trauma sensitive services
effective, where not least of the problems is the proper training
of the staff. To this end, the Ugaza Jamii-Healing Circle Model
was chosen to accomplish this goal. Lillian Lennox, the agency
based clinician employed at Brien Center for Mental Health and
Substance Abuse, inherited the challenge of choosing the best
model for her clientele and the awesome task of synchronizing
the use of trauma theory amongst peers. She in turn, chose Seeking
Safety for the model of implementation. The independent clinician
in private practice, Geraldine Russo, absent the dilemma of organizational
culture, is directly confronted with the adaptability of a group
model to her particular clientele that is primarily contracting
independent counseling services, thus the Addictions and Trauma
Recovery Integrated Model (Atrium) model was chosen for assessment.
This presentation will answer three research questions: (1) What
obstacles/barriers might get in the way of running a trauma and
addiction sensitive group program in these different settings?
(2) What are the specific benefits/disadvantages of each model?
(3) What latent ethical standards might be mined from this emerging
body of literature on trauma and addiction? Additionally, the
presentation is accompanied by observations by each contributor,
a future look into the emerging field of trauma and substance
treatment, and then concluded with a slide on resources.
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MONITORING INTERNATIONAL PSYCHOSOCIAL INTERVENTIONS - PREVENTION
AND RESPONSE TO SEXUAL VIOLENCE IN THE DRC: A CASE STUDY
Nancy Clifford
The mental health needs of developing countries have often been
dismissed by international development agencies as relatively
unimportant given the overall health needs of developing country
populations. In recent years, however, mental health, and in particular
the health of trauma-exposed populations, is gaining increased
recognition as these agencies try to address issues such as HIV/AIDS,
genocide, war-affected populations and natural disasters. Large
sums of money have been provided by international development
agencies to non-governmental organizations, UN agencies and others
to address the psychological needs of trauma-exposed populations
in developing countries. Given this growing involvement in psychosocial
programming, it is imperative that the international development
community keep abreast of current research, thinking and developments
in trauma and mental health and, at the same time, contribute
to the growing body of knowledge in this area.
The Canadian International Development Agency (CIDA) will be funding
a four-year program to address the needs of victims of rape and
sexual violence in the Democratic Republic of the Congo (DRC).
The program includes four interrelated components: health, justice,
economic development and psychosocial interventions. The psychosocial
component is a relatively new area of programming for CIDA, especially
as it relates to the needs of victims of rape and sexual violence.
The purpose of this case study, therefore, is to lay out key considerations
that could affect psychosocial programming for victims of rape
and sexual violence in the DRC. The framework is intended to form
the basis for ongoing assessment of the project. It will be used
to gather information, identify lessons learned, key challenges
and successful approaches to psychosocial programming generally,
and for rape victims in particular. At the same time, the case
study is intended to highlight mental health as an area that needs
to be recognized, validated and addressed by bilateral donor agencies
such as CIDA.
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INTEGRATING
NARRATIVES OF SUFFERING WITH THE PROCESSES OF COEXISTENCE
Ann Schumacher
This two-phase project focuses on understanding the complexities
of conflict and the narratives of suffering that prevent coexistence
between two disputing parties. Coexistence is defined as two or
more groups living together peacefully by respecting differences
and resolving conflict nonviolently.
The first phase of the project involved listening to and summarizing
the main points of two ten-hour seminars on coexistence
and trauma conducted by Vamik D. Volkan in 2004, and
by Carlos Sluzski and Sara Cobb in 2005 at the ITSP. These summarized
notes, organized in notebook form, are now part of the ITSP reference
library.
The second phase of the project is the creation of a comprehensive
course outline, entitled Integrating Narratives of
Suffering with the Processes of Coexistence, which
could serve as a preliminary draft for a future course at ITSP.
The course examines the complexity of conflict by looking
at the relationship between three different, but closely allied
fields -- coexistence/conflict resolution, narrative
therapy/mediation and trauma/grief studies. This psychosocial
and political approach to understanding and potentially altering
multifarious interethnic, intercommunity or interpersonal relations
has its roots in recent coexistence research by both scholars
and practitioners.
Too often, conflict is simplified to an either/or rather
than a both/and condition that is polarizing and destructive,
leading to victimization and revenge. This course, with its emphasis
on a multidimensional understanding of conflict, acknowledges
an integrated approach to promoting peace in strife-ridden communities
through building community resilience, teaching conflict resolution
skills, changing narratives of suffering and victimization, and
creating psychosocial and politically viable coexistence structures.
Such a course would be of interest to those working in trauma
and grief counseling, conflict resolution, diplomacy, refugee
care, the arts, industry, and academia (history, political science,
international relations, psychology).
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ENHANCING COMMUNICATION AND GENERAL WELL-BEING IN KOSOVAN FAMILIES
Neki Juniku, Ph.D.
During the war in Kosova, an extremely large number of families
were severely traumatized. Many of them were lucky to emigrate
to the U.S.A. and continue to live here. The traumatic experiences
while in Kosova and the radical cultural changes as well as the
separation from the loved ones may have caused certain difficulties
in their current communication.
Our team planned to interview twelve families. So far we have
completed nine. Four out of seven families I interviewed myself
were facing serious troubles with their teenage children. In three
of them, the typical difficulties were: very poor communication,
both parent's and children's aggressiveness, and withdrawal.
One teenager has been involved in crimes already. Obviously, a
psychosocial, community-based intervention plan, as a part of
this project, is urgently needed.
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“
. . . And then I wondered if we’d be left to die”:
TRAUMA, TERROR AND BETRAYAL IN THE AFTERMATH OF HURRICANE KATRINA
Monica J. Indart, Psy.D.
This project, still in progress, proposed to gain understanding
of the very personal consequences of Hurricane Katrina on the
lives of ten New Orleans residents who relocated to New Jersey
in the days following the floods that devastated that city in
August 2005. A narrative approach to the understanding of trauma
and grief was used as the primary methodology, allowing the individuals
to “tell their truths” in a manner that helps to capture
rather than obscure the phenomenology of their experience. Many
of the current “best practice” models of trauma assessment,
treatment and research rely upon psychometric measures and structured
diagnostic interviews; while research based upon these methods
has made immeasurable contributions to the field, the individual,
phenomenological and narrative understanding of trauma and suffering
has sometimes been neglected, relegated more often to the arts
and literature than to science. This project sought to let the
voices of a few individuals deeply affected by Hurricane Katrina
be heard. Ten individual interviews will provide an in-depth examination
of the experience of trauma, terror, and profound grief. A semi-structured
interview guide was utilized to elicit certain key domains of
information regarding the trauma and grief experience, as well
as how these experiences are integrated and understood within
the context of an individual’s life story.
Interviews conducted yielded expected themes of traumatic experiences
and profound grief, as well as betrayal, bitterness and disillusionment.
Self-efficacy, strong spiritual beliefs (including faith in a
divine presence and plan), and what can best be described in the
words of one 70-year-old woman as “plain old southern stubbornness”
emerged as clear sources of personal resiliency. Issues that are
similar to those experienced by internally displaced persons (IDP’s)
also emerged, including a sense of cultural displacement, the
shock of suddenly acquiring a “refugee” status in
the eyes of the social system, and the profound experience of
“psychological homelessness.” A disproportionate number
of this small sample of individuals suffered from pre-morbid psychological
disorders (panic disorder, major depression, schizophrenia, bipolar
disorder). The entire sample has experienced and/or been exposed
to significant interpersonal violence, both prior to Hurricane
Katrina as well as during the evacuation process itself.
Qualitative coding of the interviews will comprise the next phase
of this project. All participants expressed an interest in making
a videotape of the project that would serve as a historical archive
of their narrative experience.
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SELF CARE: GROUP WORK WITH PARENTS & MENTAL HEALTH WORKERS
Arielle Goldman, LMSW
This project was created to address the need for psychosocial
support within two populations at The Association to Benefit Children
(ABC): the parents who receive mental health and preventive services
and the workers who work with these parents and their families.
The Parent Support Group carved a space within the agency for
parents to share their experiences within the context of peers
and two social worker group facilitators on a weekly basis. The
facilitators utilized the strengths of the group in order to empower
members to find solutions to problems. The group space was created
not as a space to teach parents skills, but as a space for parents
to teach and support one another. The diversity within the group,
including varied ages, ethnicities and gender, facilitated this
process as each member contributed their own wisdom as a parent
and also as an individual person. The facilitators encourage the
discussion within the group of structural problems within society
and the way that these structures affect their lives. The Parent
Support Group has become a space for “self care”,
and though the membership shifts, it is known as a place for parents
to share their frustrations and their joys.
The Self Care Group for Workers created a space within the agency
for mental health workers to support one another in their work.
During the planning stages for the group, administrative support
for the group was secured. The bi-weekly group initially focused
on external self care interventions and ways to incorporate these
into one’s life. However, as the group evolved workers began
to talk about the ways that work affects their lives. The Self
Care Group is currently becoming a “protected” space
in which workers can process their feelings about working with
clients who have experienced multiple traumatic situations, including
poverty, homelessness, foster care, oppression and sexual abuse.
This Self Care Group is becoming a space for workers to acknowledge
that their work touches them and shapes their lives.
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BUILDING VIRTUAL COMMUNITIES: A LOOK AT THE 9/11 ONLINE CHAT PROGRAM
Dan Fielder
This presentation will take a look at the Families of September
11 (FOS11) Chat Program, which began in August 2004 after a steady
stream of feedback from members who expressed a growing sense
of disconnection and isolation three years after the attacks of
September 11, 2001. I will examine the many themes that arose
during the chat sessions, including experiences unique to some
affected groups, damaged or severed family relationships, the
public/private aspects of grief related to 9/11, and the impact
of traumatic loss. In addition, I will discuss the overall effectiveness
of using an online chat program as a tool for building community
and promoting healing after loss.
A total of 193 FOS11 members enrolled in nine one-hour chats considered
for this presentation, with a total of 63 actually participating.
Of the 63 participants, 49 participated in one session only while
nine participated in two or more sessions. The vast majority of
participants were siblings of victims. Participants represented
victims from flights UA175, AA11, AA77, and from the World Trade
Center and the Pentagon (there were no chat participants representing
victims from flight UA93).
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THE
FORMER CHILD SOLDIER AS A REFUGEE
Eugene R. Packer, Ph.D.
The status of children in countries at war is examined. A brief
summary of the involvement of children in insurgencies is described,
along with international and psychological assessments of that
involvement. Consequences to the children, their families, and
society are explored, with several case studies offered as illustration.
Some long-term effects are discussed, including the results for
society when such children become refugees. Developmental and
educational consequences are discussed.
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PTSD
GROUPS FOR PARENTS AND CHILDREN
Elizabeth Duffield, LCSW
PROJECT DESCRIPTION-
What:
Two groups will be run simultaneously, one with boys ages
8-12 years who have been diagnosed with PTSD, or are dealing with
ongoing trauma, due to foster care placement or chaos in the home.
Exposure to a traumatic event - not only a diagnosis of PTSD -
will determine eligibility. The group will run weekly.
A second parents group will run alongside of the boys group. It
will have a psycho education component to address issues of child
development/parenting skills, mental illness, trauma and the interaction
between these three components. It will also be supportive in
nature and the participants will dictate the level of support/education.
A measure will be used to test the level of parental stress and
satisfaction upon entering the group as well as their level of
knowledge about trauma, mental illness & child development.
A parents education/support group will run every other week, or
as frequently as the parent’s deem necessary.
Purpose:
The purpose of this study will be to show the power of peer interactions
and reinforcement as well as reparative social experience with
children who are dealing with ongoing trauma.
The purpose of this study is also to show the how parents can
aid in this process when there is an increase in their perceived
level of parent satisfaction, parenting skills as well as feelings
of parental competency.
Significance:
It will also be used to see if an increase in parents perceived
knowledge about their children’s disorder as well as feeling
of support as stated above is correlated with a decrease in PTSD/trauma
related symptoms in their children (i.e.: emergency room visits,
school suspension, extreme conflict in the home)
We also hope to show the role of socialization and peer support
as a means of helping children to process and deal with trauma,
as based on the number of aggressive altercations they are involved
in with peers.
Plan of Work:
We plan to run the boys group independent of the parents group
for 3 months, beginning in the summer of 2006, when space becomes
available.
Expected Results:
A decrease in explosive incidents/emergency hospitalizations of
the children involved. There will be a decrease in the parent’s
stress levels and an increase in their level of satisfaction in
the home lives as well as a decrease in explosive incidents/emergency
hospitalizations of the children involved.
Ideally, these results will be used to implement a trauma training
based on this curriculum. This training could be used with staff
as well as parents.
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DISSOCIATION AND THE AMERICAN DREAM
Aviv Dor
Every nation has a national identity formed by its history,
traditions, memories, and inevitably, myths. The myths of the
U.S. bear more weight than most countries'; and these myths have
had a huge impact on our self-perception and consequent political,
economic and military actions at home and abroad.
The US was born of the myth of a land without people for a people
without land, in the settlers' escape from Britain. In truth,
its inception was tainted with great violence and oppression.
Yet our history books tell us of our founding fathers, who were
seeking freedom of oppression and miraculously found it here.
This initial myth ushered in what has become our national identity,
and has maintained its strength in our psyche. There has never
been an integration of who we are and what we have done. A policy
of doing and not knowing is dissociation at its most formidable,
and has lead us to this moment, which is highlighted by the immigration
debate, race issues, and income gaps.
Is it not the pride of our land to be a haven for immigrants and
refugees, the oppressed and those seeking freedoms? Has our narrative
changed, or are we finally being demystified? How do we identify
who we are without integrating what we have done?
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KNOWLEDGE SHARING STRATEGIES FOR THE FIELD OF TRAUMA INTERVENTION
Sheila Pottebaum, Ph.D.
Judith Rhinehart
With a global environment of ever-increasing human suffering
related to war, public health crises, natural disasters, and political
repression, the need to continually redefine conceptual frameworks
to assist in reducing subsequent traumatic sequelae is increasing
in tandem. While there is a vast body of explicit knowledge surrounding
methods to address trauma-induced suffering, the tacit knowledge
crystallized through dialogue, discussion, experience sharing,
and observation is equally valuable in both defining sustainable
interventions as well as capitalizing on the dynamics of actual
implementation of trauma interventions within the field. The focus
of this project is work toward defining a set of processes to
continuously connect those responsible for direct intervention
with those advancing the conceptual development of trauma studies
to mutually foster innovations that have a demonstrable impact
on the affected communities.
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UTILISATION FOCUSED EVALUATION: The Londiani self-determination
experience in healing and cleansing ritual for two communities
after intertribal killings of 2002 in Kenya: Learning from Striving
for Sanctuary model in dealing with ambiguous loss
Nancy Birir
Protasia C.N.Gathendoh
Purpose:
First, we are seeking to boost the existing modalities by an integrated
model of psycho-educational methods with a common language and
shared assumptions, in which trauma recovery can occur.
Second, this evaluation is also a process to assess the benefits
of the implemented psychosocial leaders’ training in March
and April 2002 and document the opportunities and lessons learned
to make sure that these relate to cultural norms in nonviolent
conflict management in these communities.
Project Description:
The goal of our group project is to develop and document a comparative
learning for an evaluation of ethnic institution and self-determination
experience in communal healing. This peace building agenda is
promoted by knowledge of an event that affected a Kipsigis and
Gikuyu communities who are different but who have lived side by
side as neighbors in Londiani for over 30 years. Kipsigis is one
of the tribes of the Kalegin in the Rift valley in Kenya. Specifically
it is known in this community that it is a taboo to harm or inflict
injury by shedding human blood. On the afternoon of March 3rd,
2002 a group of more than 20 men resulted to violence after the
women in the village relayed distress cry that “the Gikuyus”
had killed some of their “Kipsigis” children (boys)
who were looking after their herds in a communal forest land.
The men acted on behalf of their community but the council of
elders had not mandated them to do so. They attacked a whole village
and caught families unaware. Two unarmed men were killed, 12 homesteads;
(house, detached kitchen and granary) burned to ashes and 18 homes
vandalized. Several animals were stolen, particularly two prized
bulls. The communities believed the offenders went deep into the
forest and slaughtered the bulls for a feast.
The effort to save them from this stigma and curse may ironically
be inducing ongoing traumatic stress. However not to address this
underlying sense of loss is a greater threat with many negative
reactions contingent on the loss of one’s personal sense
of identity. Our enthusiasm is based on universal response with
deeply rooted passion to make peace with the offended. In this
case, injured and bereaved families living across the ridge are
likely to meet almost daily. This is a reality because the two
villages share the same river, and water, attend the same churches,
sell and buy farm products at the same market place or travel
in the same public transport. Another observable pattern would
be to seek and listen to any form of the silence by the women.
This manifestation may lead on to identifying form of continued
ambiguous loss and fearful concerns about the curse psychologically
and emotionally present as a threat to the lives of their husbands
or sons.
To heal this trauma of loss as best we can, we will gather resources,
identifying and find old or new ways in which our youth can reconnect
with the wisdom of lessons learned. Our intention is to work with
the council of elders for community evaluation of healing the
community spirit of vested authority, respect and integrity. Our
assumptions are based on the belief that the young men are perceived
in their expected roles as protectors - “Warriors”
as primary responsibility and only when mandated to be “Fighters”
for their families. This is a profound human need, which underlies
the quality and progress of every life.
Three interventions conducted in March and April 2002 are:
•
3 days - Leaders Conference with over 105 participants
• 1 day - visit to the bereaved, the injured and the displaced
families
• 5 days - community education and training
Immediate
needs:
•
Institute food chest for about six months for families whose granaries
were burned
• Women groups to visit the widows and orphans
• Men from both communities to proved skilled and non-skilled
house repair and reconstruction
• Forester and area chief coordinate procurement of building
material from the forest (poles, rafters, timber and grass thatch)
• Community contribution of cash to purchase maize, potatoes
and beans seeds for all the affected families because it was planting
season. It takes six months for maize crop to mature and about
four months for the beans and potato crop
• Provide police presence with a local police post
• Organize community cleansing for the offenders who were
not allowed to return home because of the taboo about human killing
Broad
objectives of learning about the ethics of evaluation are to:
•
Understand the principles of utilization-focused and learning-oriented
evaluation as applied to the field of psychosocial foundations
in peace building as development agenda
• Design an appropriate assessment or evaluation strategy
for real program context including purpose, working with the users,
getting to invest in appropriately usable values and norms and
marketing the experience to a larger audience in partial fulfillment
of the international trauma studies program
To study perspectives, worldviews and frames of reference of the
appropriate traditional and modern ways of managing conflicts.
We will explore community-based initiatives supporting restitution
and establishing on going community learning in building just,
fair and peaceful community.
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ART THERAPY IN THE AFTERMATH OF THE TSUNAMI
Lisette Soini
The Indian Ocean Tsunami of 2004 greatly affected the lives of
hundreds of thousands in South Asia. In Sri Lanka alone it is
estimated that this disaster caused 35,322 deaths and several
thousand more have been displaced. In the summer of 2005, six
months after the tsunami hit, I had the experience of conducting
a mental health intervention within a public school in Payagala,
a small town on the Sri Lankan coast which was largely destroyed
by the tsunami. I spent five weeks leading art therapy groups
with students who experienced great trauma and loss. The art therapy
sessions provided these children and adolescents with an alternative
and culturally sensitive means by which to express their innermost
feelings and to externalize their trauma. It was later found,
through a visual analysis of their images, that many of these
youths’ fears and anxieties have been eloquently conveyed
in their drawings—specifically as embodied in their imagery
of water. Furthermore, it was noted that the drawings that do
not overtly represent the traumatic experience are equally as
eloquent in their expression of trauma as those explicit images
of the tsunami. This paper therefore encourages art therapists
to search for the hidden expressions of trauma as they too speak
volumes.
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AFRICAN REFUGE CENTER HEALING MURAL PROJECT
Angela Tripi-Weiss, Director of Arts In Action
Visual Arts Program Inc
Connie Viana
Cynthia Grguric, LMHC
Project Scope:
The objective for facilitating the creation of a wall mural for
the African Refugee Drop-in center was to build community trust,
connectedness, mutual intergenerational and experiential understanding.
The goal was not just the mural itself but the healing process
through its construction. In any refugee community the intercommunity
needs and level of bonding is a unique constellation of cultural
ideas, host country resources for each generation/group/individual,
and pre and post experiences in the country of origin. The individual
needs and issues will also depend on age, health, goals, losses,
economics, support from community, family, and abilities to adapt.
These issues emphasized by the integration of different generations
and new and old immigrants into the community placed a strain
on the Liberian community in Staten Island. The mural design and
its creative process sought to build cohesiveness through narrative
and artistic expression of personal concerns, adaptive struggles,
and needs and develop a foundational understanding of what one
must learn in order to create a mural. As in any closed community
(organization, family) the overall ability of an immigrant population
to thrive in the host country depends on the security and intercommunity
support as well as resources made available to them.
Methodology:
To facilitate this process, individuals ages 6 to 65, new and
old immigrants, male and females were recruited to participate.
One on-site and one off-site workshop was held that produced 27
individual drawings and narratives expressing past, current, and
future adaptation issues. These drawings were then sorted by themes
and culled into 3 Master Mural Design compositions that the community
voted on. The selected mural representing the 27 individual drawings
was then drawn and painted by the community under the direction
of a facilitator.
Expected Results:
The expectation was to facilitate healing, dialogue, and understanding
as each person and/or group had the opportunity to express his
or her thoughts, emotions, cultural pride, current cultural struggles,
and experiences. The symbolism of placing all the represented
themes into one platform models a cohesive experience to the community.
Everyone would be given an opportunity to be understood and release
thoughts/emotions they have been struggling with. This process
hopes to facilitate empowerment through the visual arts. An additional
aim was to increase ownership and awareness of the African Refugee
center and its services.
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TRAUMA FOCUSED EDUCATIONAL PRESENTATIONS FOR MENTAL HEALTH PROFESSIONALS
Brannon L. Weeks, M.D.
The purpose of the project is to provide information about the
trauma studies field to various mental health workers. The topics
of the presentations were chosen based on the needs of the target
audience and were intended to expand on the participants basic
knowledge of the trauma field, to introduce various conceptual
frameworks, and to generate discussion among the participants.
The project consists of a series of five presentations, each of
which follow a different format and are directed at various target
audiences. Each presentation is described in greater detail in
the sections that follow. The first three presentations in the
series have been completed. The last two presentations are scheduled,
but could not be completed prior to the deadline for the International
Trauma Studies Program.
The first seminar in this series was a case presentation for child
and adolescent psychiatry residents, and faculty and staff of
the child and adolescent psychiatry training program. The case
of a nine-year-old boy who had been, over a period of months,
sexually assaulted by an older boy was presented. Information
relating to developmental issues and trauma were discussed as
were issues related to engaging the family in treatment and the
utilization of school and community resources.
The target audience for the next presentation was general psychiatry
residents, child and adolescent psychiatry residents, psychology
interns, social workers, employees of the Department of Mental
Health, and faculty of the psychiatry and psychology training
programs. An overview of the concept of ambiguous loss was presented
with a question and answer period following.
The third segment of the series focused on the trauma of divorce
with particular attention to the effects of custody battles on
children. Issues of forensic psychiatry and the effects of court
testimony on the therapeutic alliance with the child were discussed.
Participants in this presentation were child and adolescent psychiatry
residents and faculty of the training program. The format consisted
of a thirty minute long presentation and a thirty to forty-five
minute discussion and debate among the participants.
The next presentation is scheduled for the end of May. The target
audience will be child and adolescent psychiatry residents and
faculty of the child and adolescent psychiatry training program.
The focus of the presentation will be the use of art and media
in the treatment of individuals who have experienced trauma. There
will be both a lecture portion and an experiential portion of
the presentation.
The final segment of the project is scheduled for the beginning
of June. This seminar will focus on individual, family, and community
interventions after massive disasters. The participants will be
general psychiatry residents and faculty and staff of the general
psychiatry training program.
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AMBIGUOUS LOSS AS EXPERIENCED BY UNDOCUMENTED MEXICAN IMMIGRANTS
Donna Gabriel Ellaby
On December 16, 2005, the U.S. House of Representatives passed
HR. 4437, considered by many pro-immigrant advocates and experts
to be the most restrictive immigration legislation since the Chinese
Exclusion Act of 1882. Under HR. 4437 residing in the United States
without legal status would become a felony. Moreover, anyone providing
assistance and support to an undocumented immigrant, including
a child, could face prosecution. Passage of HR.4437 took many
immigrants, both documented and undocumented, by complete surprise.
It is in the context of HR.4437’s passage that I interviewed
twelve undocumented Mexican immigrants. I chose Mexicans because
historically they have been active participants in a labor migration
to the United States that dates back to the Chinese Exclusion
Act. The “ebb and flow” of Mexicans across the border
has frequently been the result of government sanctioned programs
to compensate for labor shortages, particularly during the wartime.
As a result, generations of Mexicans have grown accustomed to
moving freely across the border in search of a better life. It
is only in recent years that border restrictions have made it
extremely difficult if not impossible for the undocumented to
visit families and homeland.
All of my interviewees have the following characteristics: Mexican,
undocumented, at least five years in the United States, between
twenty and thirty years of age, present in New York City on 911.
I felt a five-year minimum residency was important because siblings
left behind would have advanced to a new developmental stage,
and separation may be more deeply experienced. I focused on younger
immigrants because according to a number of ethnographic studies,
decisions about resettlement often remain unexplored in immigrants
thirty and younger. The events of 911 changed the tenor of debate
about immigration and also succeeded in placing comprehensive
immigration reform on the back burner. By exploring the experience
of 911 and its subsequent impact on immigrants with my interviewees
I was able to introduce the concept of loss, as both a personal
and a social phenomenon.
The questionnaire I put together examined family, community, identity,
aspirations, hope, and loss with regard to life in Mexico and
life in the U.S. All of those interviewed have close family members
still in Mexico. All have missed celebratory family events. Five
were unable to attend family funerals of a sibling, parent, grandparent,
uncle or cousin. All consciously chose to come to the U.S. yet
felt they had few, if any options. Life in Mexico was compared
by some interviewees to a slow death. With regard to the passage
of HR.4437, their responses revealed a mixture of anger and sadness.
While all of my interviewees expressed a sense of loss for absent
family members, I feel their loss of hope for the future and the
criminalization of their identity as a result of HR.4437 is an
ambiguous loss with potentially traumatizing consequences. Through
my interviews I sought to explore the concept of ambiguous loss
and its relevance to a small sample of undocumented Mexicans in
the context of HR.4437.
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EFFECTS OF CONFINEMENT ON DETAINED IMMIGRANTS, A PSYCHO-SOCIAL
EVALUATION
Stephanie Palau, LMSW
Thousands of immigrants and refugees are detained at Immigration
and Customs Enforcement facilities across the country. Their future
depends heavily on which detention center they are housed in,
which Immigration Judge they are appointed to, and whether they
are lucky enough to have an attorney representing them, either
pro-bono, or hired depending on their means. Many immigrants appear
before the court totally unrepresented and many of them are denied
entry to the United States.
Throughout my years of experience visiting immigrant detainees
in various immigration detention centers in New York, New Jersey,
and Arizona, I have found both similarities and differences in
psychosocial well-being among individual detainees.
I am interested in better understanding the psycho-social effects
of confinement on detained immigrants. Since 2004 I have worked
mainly with individuals seeking political asylum from primarily
West African countries, including DR Congo, Cameroon, Gambia,
Guinea, and Nigeria. Depending on detention center location and
conditions within the individual center, I have observed varying
degrees of adjustment and psycho-social well being regardless
of country of origin.
It appears to me, thus far, that the number one factor contributing
to ones adjustment and psycho-social wellbeing in US detention
while awaiting the outcome of their asylum plea may be the conditions
of the detention center where they are housed.
Other factors which have an impact on ones psycho-social well
being include;
•
Treatment by detention center officers/guards (degree of respect)
• Degree of freedom within the detention center, including
recreation time, rules of work, library, services available, etc.
• Whether they have an attorney representing them
• Contact with family/friends in home country
• Contact with someone in US
• Able to communicate with someone in their dormitory (same
language)
• Safety & Hope (Do they feel safe in detention? Do
they maintain hope?)
My
initial expectation for detained asylum seekers was that they would
be at greatest risk for being re-traumatized. My initial findings
have found detained individuals do have high degree of PTSD symptoms
(difficulty sleeping, nightmares, no appetite, flashbacks, increased
anxiety, etc) but that their attitude of how they are treated within
the detention center is highly correlated with their coping abilities
and psycho-social well being.
I look forward to gaining a better understanding of the psycho-social
effects of confinement on immigrant detainees as I continue to evaluate
and provide treatment to detained individuals in AZ. I would also
like to expand my research to include:
•
Psychological Effects of Solitary Confinement in Detention
• Effects of Illegal Border Crossing via Arizona Dessert
• Children in Detention
• Occurrence of PTSD, Re-Traumatization in Detention
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