Emily H. Becher

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.

Developing self-care practices in a trauma treatment course

This article describes the development of self-care practices of social work students who were part of a larger study of students’ experiences in a graduate course on the treatment of trauma. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicated that students benefited from being introduced to evidence-based practices for mediating the stress of trauma education, including journaling and mindfulness-based stress reduction. Although students reported struggling with developing effective self-care practices, they demonstrated an ability to integrate self-care into their professional practice behaviors. The authors review recommendations for research and pedagogy of self-care practices in courses on trauma treatment.

Parents Forever: Evaluation of an Online Divorce Education Program

Divorce education programs are conducting increasingly rigorous impact evaluations to assess if their curriculum improves parenting practices, reduces conflict in the coparenting relationship, and improves outcomes for children. This article presents a 6-month follow-up evaluation of the online version of Parents Forever, an 8-hour divorce education course developed by the University of Minnesota Extension. At follow-up, parents (N = 232) reported significant improvements on several questions about postdivorce parenting and well-being, indicating that the online version of Parents Forever is effective in promoting positive behavioral change for parents.

Strengthening the Role of Unmarried Fathers: Findings from the Co-Parent Court Project

While the importance of fathers in unmarried coparent families is a strong area of social and political interest, a dearth of community-based interventions exists for supporting the role of fathers in at-risk families. The Co-Parent Court (CPC) was a 3-year demonstration project evaluating the effectiveness of a collaborative intervention to support unmarried coparents establishing paternity and improving their coparenting relationships and paternal involvement in their childs life. A randomized-control experimental design was employed. The paper will explore father involvement and coparent relationship outcomes.

Experiences of Stress in a Trauma Treatment Course

This study explores the reactions of social work students in a course on trauma treatment and how those reactions changed over time. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicate that students experienced a range of responses to traumatic material, including both positive and negative emotional, cognitive, behavioral, physical, and relational reactions. Student survivors of trauma reported reactions related to their own trauma. Although student reactions became less acute over time during the course, recommendations for the pedagogy of trauma are offered, including curriculum related to the management of vicarious and secondary trauma reactions as well as the development of evidence-based practices for self-care.

The intersections of culture and power in clinician and interpreter relationships: A qualitative study

Ongoing racial/ethnic health disparities place increasing emphasis on the importance of interpreters in mental health treatment. Yet there is a limited body of research examining how interpreters and clinicians work together in delivering care. This article used an ethno-culturally informed qualitative procedure to ask interpreters and clinicians about their experiences in cross-language mental health treatment. Seventeen semistructured interviews were conducted with 10 interpreters and 7 clinicians. The interplay of power was experienced differently by interpreters and clinicians as exemplified by 3 categories of meaning: Interpreters speaking out, The relationship matters, and Who has the power? The authors recommend future research focus on the clinician-interpreter relationship as an essential piece of cross-cultural mental health delivery.

Exploring mental health screening feasibility and training of refugee health coordinators

Forty-four refugee health coordinators responded to a subset of questions from a 28-item, national survey exploring the mental health training of refugee health coordinators and the feasibility of refugee mental health screening. Most participants reported that it would be possible to administer a brief mental health screen; however, only half had received any mental health training. A minority of participants identified symptoms of posttraumatic stress disorder or major depression as their top concerns related to refugee mental health. The majority requested training on the mental health needs of arriving refugees. Training participation was associated with screening and positive referral outcomes.

Review of Post-Traumatic Stress Disorder in Refugee Communities: The Importance of Culturally Sensitive Screening, Diagnosis, and Treatment, by Theodore W. McDonald and Jaime N. Sand

McDonald and Sands text is the most recent edition of the Psychiatry—Theory, Applications and Treatment series published by Nova Science. As a new reader to the series I am surprised at the length...