Elizabeth Wieling

Parenting practices as potential mechanisms for child adjustment following mass trauma

Trauma research has identified a link between parental adjustment and childrens functioning and the sometimes ensuing intergenerational impact of traumatic events. The effects of traumatic events on children have been demonstrated to be mediated through their impact on childrens parents. However, until now, little consideration has been given to the separate and more proximal mechanism of parenting practices as potential mediators between childrens adjustment and traumatic events. To shed some light in this arena, we review literature on trauma, adversity, and resilience, and discuss how parenting practices may mediate trauma and adverse environmental contexts. Using a social interaction learning perspective (Forgatch & Knutson, 2002; Patterson, 2005), we propose a prevention research framework to examine the role that parenting practices may play in influencing childrens adjustment in the wake of trauma exposure. The article concludes by providing a specific model and role for evidence-based parenting interventions for children exposed to mass trauma.

Linking human systems: strengthening individuals, families, and communities in the wake of mass trauma.

This article presents an overview of the philosophy and practical principles underlying the Linking Human Systems Approach based on the theory of resilience in individuals, families, and communities facing crisis, trauma, and disaster. The Link Approach focuses on tapping into the inherent strength of individuals and their families and emphasizes resilience rather than vulnerability. It has been successfully used in combating critical public health problems, such as addiction, HIV/AIDS, and recovery from major trauma or disaster. Also, three specific models of Link intervention aimed at the individual, family, and community levels are discussed, with special emphasis on the family-level intervention. These interventions are directed toward mobilizing resources for long-term physical, emotional, psychological, and spiritual healing.

CROSS-CULTURAL SUPERVISION IN MARRIAGE AND FAMILY THERAPY

The purpose of this study was to gain an understanding of the various cultural factors that influence the supervisor-trainee relationship when at least one of these individuals is a member of an ethnic minority group in the United States. Marriage and Family Therapy supervisors and students were asked to compare and contrast their experiences working with ethnic minority and white persons. Findings indicate that both supervisors and students express great value in cross-cultural supervisory experiences, but report that these opportunities are very limited.

Screening for War Trauma, Torture, and Mental Health Symptoms Among Newly Arrived Refugees: A National Survey of U.S. Refugee Health Coordinators

A total of 44 state refugee health coordinators returned a survey assessing mental health screening practices and barriers to screening. Results show that less than half the states ask refugees about a history of war trauma or torture. Of the 25 states that provide mental health screening, 17 (70.8%) utilize informal conversation rather than standardized measures. Screening practices are highly associated with the number of refugees and community discretionary grants and with the presence of a Services for Survivors of Torture Program. Refugee health coordinators identified the need for short, culturally appropriate mental health screening tools to identify refugees who need assessment and treatment services.

Beyond Stigma: Barriers to Discussing Mental Health in Refugee Populations

Mental health stigma remains one of the most commonly cited reason for why refugees fail to access mental health services. This study looks beyond stigma to explore refugees’ perspectives on why it is difficult to discuss mental health. Ethnocultural methodologies informed 13 focus groups with 111 refugees from Burma, Bhutan, Somali, and Ethiopia. Findings describing reasons why it is difficult to discuss mental health include a history of political repression, fear, the belief that talking does not help, lack of knowledge about mental health, avoidance of symptoms, shame, and culture. Recommendations for empowering and educating refugees are discussed.

Exploring the Mental Health Effects of Political Trauma With Newly Arrived Refugees

We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress.

The use of communication technology in private practice: Ethical implications and boundary dilemmas in therapy

This study investigates the use of communication technology (CT) by therapists in private practice. CT has exploded in the last decade and therapists have begun to implement this technology in their work. It is important to understand better the types of technology therapists are using and how they decide which devices are most useful for clinical practice. Additionally, the availability of the therapist has long been debated and CT provides media to make therapists readily available. Results show that therapists have boundary concerns and ethical dilemmas regarding CT and often feel unprepared to handle inappropriate out-of-session contacts when they occur.

Immigrant Chinese American Women: Negotiating Values and Perceptions of Self in the Cultural Borderlands of East and West: A Qualitative Study:

This phenomenological study looked at how immigrant Chinese American women negotiate differences in values and perceptions of the self in the cultural borderlands of East andWest. In-depth interviews were conducted with 10 women. Participants were raised in the East and are now residing and raising their children in aWestern context. Predominant themes that emerged were the contradictions and ambiguities experienced in the struggle to be both adaptive and culturally appropriate in the new context. Also, it was found that organizing principles remained largely unchanged over the two generations. The experiences of these women suggest that assimilation is a long-term and ongoing process.

Torture, War Trauma, and Mental Health Symptoms of Newly Arrived Karen Refugees

This article documents frequencies of torture, war trauma, and associations with mental health distress reported by Karen refugees during their initial public health screening in the United States. A total of 179 Karen refugees completed a demographic questionnaire and 25-item mental health screening tool scored on a 4-point Likert scale. Frequencies of primary and secondary torture were 27.4% and 51.4%, respectively. War trauma was reported by 86% of the participants. Torture, older age, and female gender were significantly associated with increased total distress, posttraumatic stress, depression, and somatic complaints. Recommendations are reviewed for discussing mental health symptoms with Karen refugees.

Voices of marriage and family therapists of color: An exploratory survey

Abstract A survey was sent to members of the AALANA (African American, Latino/a, Asian and Native American) group, and other Marriage and Family Therapists (MFTs) of color. The survey contained questions regarding the participants experiences around multicultural training in their graduate programs, the impact of their own ethnic identity on their work, their experiences within AAMFT (American Association for Marriage and Family Therapy), and areas related to multi-Elizabeth culturalism that they believe need further research. Fifteen participants responded to the survey. The data were analyzed using qualitative methods. Results indicated that the participants rated their multicultural training as being inadequate and expressed the need for a more diverse training environment. All participants felt their own ethnicity had a tremendous impact on who they were and on their clinical work. Experiences within AAMFT were reportedly mixed with some positive and negative responses. The participants identified a variety of important areas for further research. The findings suggested in this study have important implications for training programs, educators, AAMFT, and the field in general.