Adeyinka M. Akinsulure-Smith

Intimate Partner Violence among West African Immigrants

Although the number of African immigrants arriving to the United States has increased significantly, there has been little investigation regarding their experiences of intimate partner violence or coping strategies. This study used focus groups and individual interviews to explore intimate partner violence among 32 heterosexual West African immigrants. Results suggest that although cultural expectations influence their coping strategies, West African–born men and women face different realities, with women reporting multiple instances of abuse and a sense of frustration with the existing options for assistance. Although participants discussed multilevel support structures within the immediate West African community to address intimate partner violence, all of these options maintained a gender hierarchy, leaving women dissatisfied. Challenges and barriers to partner violence resolution and coping strategies are identified. Results are examined in terms of their implications for addressing the needs of this underserved population. Implications for future research and services are discussed and highlighted.

Healing in the Midst of Chaos: Nah We Yone's African Women's Wellness Group

This article discusses the creative use of the group treatment modality to provide psychosocial support to African women refugees and asylum seekers with a history of refugee trauma, war, and human rights abuses who have fled to the United States. In particular, this article describes the African Womens Wellness Group developed by Nah We Yone, Inc., a small grassroots organization in the New York City area. This womens group draws on the tenets of traditional Western group psychotherapy while using African cultural awareness to provide healing. The rationale for this type of treatment, group design, specific techniques used to provide healing, along with various group-related themes and challenges are described. This type of treatment provides an example of the usefulness of group therapy technique with traumatized displaced women struggling to survive in a new cultural setting.

The Status of Racial/Ethnic Research in Counseling Psychology: Committed or Complacent?.

There has been a growing demandfor research that explores racial/ethnic issues within psychology. However, analyses of leading counseling psychology journals suggest that attention devoted to racial/ethnic issues is disproportionately less in comparison to other topics. This study is a content analysis of racial and ethnic issues in three journals along specific areas for their level of commitment versus complacency: studyframe, method, analysis, and discussion. Preliminary results indicate that research in this area is more complacent than committed. Results and recommendations forfuture study will be discussed in light of thesefindings.

Using Group Work to Rebuild Family and Community Ties Among Displaced African Men

The number of refugees and asylum seekers admitted to the United States has grown, with significant numbers arriving from sub-Saharan Africa. Given this reality, it is important that mental health professionals are equipped to provide culturally relevant services. This article describes the development and implementation of a group treatment model for African male forced migrants in a large urban hospital. Therapeutic techniques that draw on African cultural traditions in order to rebuild lives, reduce symptoms, recreate familial and community connections, and support adjustment are discussed. Suggestions for future treatment and research to address African refugee mental health needs are highlighted.

Working with interpreters: tools for clinicians conducting psychotherapy with forced immigrants

Purpose – The purpose of this paper is to draw attention to the important and unique challenges that arise when using interpreters while conducting psychotherapy with forced migrants who have experienced a range of human rights abuse.Design/methodology/approach – The paper employs a practice‐based evidence methodology that offers guidance to both clinicians and researchers.Findings – Working with interpreters in the clinical setting is often a challenging and complex process for which mental health professionals are rarely prepared. This paper outlines key strategies to address these challenges and limitations.Research limitations/implications – Empirically‐based research is lacking and is certainly warranted.Practical implications – It is the responsibility of programs, training sites, supervisors, and institutions to help teach how to work with interpreters.Originality/value – This paper addresses how to navigate the key issues that arise through the use of interpreters in a mental health setting with f...

Brief Psychoeducational Group Treatment With Re-Traumatized Refugees and Asylum Seekers

This article describes the implementation of a psychoeducational group treatment with students with a history of refugee trauma, war, and human rights abuses who were further traumatized by the 9/11 attacks in New York City. The rationale for group intervention and specific techniques utilized to promote emotional and behavioral stabilization and relief, including trauma education and stress management, are discussed. In addition, group-related issues, themes, and challenges are considered. This psychoeducational treatment modality provides an example of the usefulness of group intervention with a re-traumatized population.

Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone

Background Little attention has been paid to potential relationships between mental health, trauma, and personal exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between war exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised war exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and war exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of war exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior (b = −0.24; 95% CI −0.43, −0.06; p = 0.009). Conclusions In post-conflict settings, past war trauma and mental health problems are associated with health behaviors related to combatting EVD. The associations between war trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms. Considering the role of mental health in the prevention of disease transmission may help fight continuing and future Ebola outbreaks in post-conflict Sierra Leone. This sample is specific to Freetown and the Western Area and may not be representative of all of Sierra Leone. In addition, our main outcomes as well as personal EVD exposure, war exposures, and mental health predictors rely on self-report, and therefore raise the possibility of common methods bias. However, the findings of this study may be relevant for understanding dynamics related to EVD and mental health in other major capital cities in the EVD-affected countries of West Africa.

Exploring Female Genital Cutting Among Survivors of Torture.

Though the practice of female genital cutting (FGC) has been framed as a form of gender-based torture, few studies have examined the prevalence and impact of the practice among documented survivors of torture. This article presents a secondary analysis of data from 514 African-born women at an interdisciplinary clinic for survivors of torture. Results indicate few demographic differences between those who experienced FGC and those who had not, though a larger proportion of the FGC group were West African and identified as Muslim. Many with FGC were in the process of applying for asylum, reported sexual and psychological torture, and cited gender as a basis for their persecution. The FGC group evidenced unique correlates related to immigration status and psychological and sexual torture experiences that the non-FGC group did not. Findings indicate that female survivors of torture with FGC represent a distinct group with specific mental health needs.

The Social Ecology of Resolving Family Conflict Among West African Immigrants in New York: A Grounded Theory Approach

The current study employs a grounded theory approach to examine West African immigrants’ resolution of parent–child conflict and intimate partner conflict. Data from 59 participants present an interactive social ecological framework, where a lack of resolution at one level results in attempts to resolve problems at higher levels. Four levels are identified within West African immigrants’ problem solving ecology, each with specific actors in positions of authority: individual/dyadic (parents and spouses), extended family (which includes distant relatives and relatives living in home countries), community leadership (non-family elders and religious leaders), and state authorities. From participants’ descriptions of family challenges emerged a picture of a social ecology in flux, with traditional, socially conservative modes of resolving family conflict transposed across migration into the more liberal and state-oriented familial context of the United States. This transposition results in a loss spiral for the traditional social ecology, differentially affecting individual actors within families. Implications for helping professionals working with new immigrant communities include identifying variability in openness to adapting structures that are not working well (e.g., patriarchal protection of abusive husbands) and supporting structures known to be associated with well being (e.g., collective monitoring of youth).

Responding to secondary traumatic stress: A pilot study of torture treatment programs in the United States

Providers who care for torture survivors may be at risk for secondary traumatic stress, yet there has been little documentation of the effects of repeated exposure to traumatic issues on their emotional health or exploration of the support systems and resources available to address their emotional needs. This study assessed the secondary stress experiences of service providers (N = 43) within the National Consortium of Torture Treatment Programs in the United States and examined the supports offered by their organizations. The study found a significant correlation between rates of anxiety and depression among providers, r(34) = .49, p = .003. Although these participants reported that their work with survivors of torture was stressful, 91% indicated that their organizations offered a variety of stress-reduction activities. Overall, participants reported that their own personal activities were the most-effective stress reducers. The results are discussed in light of challenges that professionals who work with this population face and the effectiveness of support systems available to support their work.