A study by the American Psychological Association (APA) is reaffirming the critical role community-level psychologists and therapist play in the rehabilitation of adults and children who flee to the United States during times of war and civil unrest. While the nature of war has changed – terrorism and armed ethnic conflict is replacing organized military campaigns – the flood of refugees into the U.S. is undiminished. Each year, tens of thousands of refugees seek safe haven in America, and 40% of those refugees are children, according to the report.
To help this expanding population recover from often horrific exposure to violence and trauma, the APA report, titled Resilience and Recovery After War: Refugee Children and Families in the United States, advocates a combination of clinical expertise, heightened ethical sensitivity, and caution as treatment of this type poses unique risks to the psychologist.
Before treatment begins, the APA study recognizes the need for critical analysis of the underlying clinical techniques psychologists plan to employ with war refugees. The vast majority of psychology theory and treatment models are developed in wealthy nations immersed in Western culture, and these techniques may not be suitable for refugees from completely different cultural circumstances. Because modern refugees are often escaping authoritarian dictatorships, the APA study recommends a greater awareness of the innate position of power psychologists hold over patients. Therapists must watch carefully for strong transference reactions among patients and dutifully maintain proper professional boundaries.
The APA study recommends the involvement of refugee community members in outreach, interpretation/translation and counseling for new refugees. However, the APA cautions that strict ethical practices are often difficult to uphold by community volunteers. In the tight-knit refugee community, issues regarding confidentiality and informed consent are common due to a variety of cultural, educational and linguistic factors.
Treatment of refugee children and their families can have substantial effects on the psychologist, as well. The APA report found frequent exposure to stories of war-related atrocities and suffering often cause psychologists to feel angry, depressed or overly detached from their work. To minimize these risks, more rigorous self-care techniques are recommended for therapists working with war-affected populations, as is constant contact with colleagues and other providers for support.
To better understand the value of psychological counseling to refugees, the APA recommends a more longitudinal approach to future research. Many existing studies of war-affected adults and children are cross-sectional in nature, providing only a one-time snapshot of patients' mental health and psychological well-being. A longer-term study, one that follows refugees as they integrate into a new culture and society, could shed new light on the most effective way to help refugee families best recover from the psychological effects of war.
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Source: American Psychological Association report: "Resilience and Recovery After War: Refugee Children and Families in the United States"