Jennifer Simmelink McCleary

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.

Resilience and trauma: Expanding definitions, uses, and contexts

Resilience concepts have gained widespread use in scholarship and practice, yet definitions, measures, and uses of resilience remain complex and multifaceted. Resilience has been described as both an outcome and a process and has been used to refer to both individuals and communities. Scholars have also critiqued resilience theories and practice models as being difficult to define, too heavily focused on individual psychometric properties, and obscuring structural causes of adversity. While there are significant and powerful benefits to a more strengths-based approach to trauma and recovery, vague and contradictory definitions and critical questioning of the social justice consequences of a reliance on resilience indicate a need for continued interrogation of the concept of resilience in trauma scholarship. A host of disciplines from social work to psychology to family social science incorporate resilience concepts into their knowledge bases and are all well positioned to engage in a critical conversation about the definition, utility, and future of the concept. This special issue is a collection of 14 articles that contribute to the discourse of trauma through the resilience lens. Most of the articles in this special issue report on original research that examines issues relevant to trauma psychology and trauma practice. The others add to the discourse on the mechanisms that account for how and why we are resilient following traumatic events and how best to prepare for and thrive after the next traumatic event.

Applying a Collective Resilience Framework to Refugees’ Perceptions of Recovery From Harmful Alcohol Use

Harmful alcohol use and lack of access to culturally relevant treatment has been identified as a significant problem facing the resettled Karen refugee community. Karen refugees face significant barriers to accessing and compiling with Western treatment programs that do not consider specific cultural and contextual factors related to recovery from harmful alcohol use. Therefore, there is a pressing need to develop programs that are culturally and contextually relevant to refugees in the United States seeking treatment for alcohol use. This paper utilizes a collective resilience framework to interpret 3 themes related to reducing harmful alcohol use in the Karen community. This paper reports on a subset of findings from a larger qualitative study of alcohol use in Karen refugee communities. Semistructured interviews were conducted with 34 participants in 6 focus groups to elicit Karen refugees’ perceptions of the causes and consequences of alcohol use in their communities and perceptions of effective methods for reducing or stopping harmful alcohol use. This paper utilizes a collective resilience framework to interpret 3 themes related to reducing harmful alcohol use in the Karen community. Findings indicate that rebuilding or repairing community structures and bonds destroyed by conflict and displacement is an essential ingredient for reducing harmful alcohol use. Implications for practice are discussed.

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.

The Karen Chemical Dependency Collaboration: Lessons Learned in Using a Collaborative Framework to Promote Refugee Integration

While refugee integration is defined as a bidirectional process of mutual learning and adaptation, in practice, the U.S. resettlement program continues to emphasize refugees’ acculturation processes and places little emphasis on cultural or logistical adaptation of existing services. When adaptation does happen, it is often structured around dominant notions of health and well-being. There is a need to explore bidirectional integration processes and existing systems adaptations to accommodate people with refugee backgrounds at the institutional level. This article details a framework to build a sustainable collaboration between a refugee community and existing health and social service systems to reduce harmful alcohol use. The conceptual framework emphasizes three components: 1) adaptation of refugees’ indigenous expertise, networks, systems, and resources; 2) adaptation of existing systems to serve new groups in culturally relevant and effective ways; and 3) the participatory processes through which refugees and existing systems collaborate to achieve mutual goals. This paper describes the application of this framework and concludes with a discussion of lessons to support replication of the framework in other settings. Lessons learned include: equalizing power, paying attention to relationships and roles, engaging in deep cultural adaption of interventions, and building individual and organizational capacity to support partners.

Ethical Considerations For Social Workers Working with Muslim Refugees

ABSTRACT In 2016 almost 39,000 Muslim refugees entered the United States, representing a record of admissions during a time of elevated anti-Muslim political rhetoric and public sentiment. Anti-Muslim attitudes and policies can affect refugees’ ability to successfully resettle and contribute to decreased health status. Given the current social and political moment there is an ethical imperative for social workers to engage in resistance to anti-Muslim sentiment and the encoding of Islamophobia in resettlement policy. In this article, the authors explore constraints on resettlement social workers’ engagement with advocacy and make suggestions for ethical practice that promotes social and emotional well-being.

An Opportunity for Social Work Researchers Climbing Out of Educational Loan Debt

Objectives: Recruitment of the needed doctoral level social workers is impeded upon when doctoral graduates experience greater educational debt burden, modest salaries, and limited opportunities for student loan debt repayment. The purpose of this article is to describe a promising opportunity to reduce doctoral level social workers’ educational debt, the National Institutes of Health Loan Repayment Program (NIH LRP). Methods: Based on the authors’ experiences in applying for the NIH LRP, we outline the major components of the program and discuss its usefulness—not only in its potential for loan forgiveness but also in outlining an early career trajectory. Results: The NIH LRP has the potential to provide instrumental support across multiple dimensions for early career PhD-level social workers. Conclusions: The NIH LRP application process requires the thoughtful consideration and planning necessary to achieve a successful early career experience for doctoral social workers to conduct research on social work practice.