L6 - Refugees and Mental Health 2

Question 1

What are 5 potential interventions we can use to treat refugees who suffer from trauma related issues?

Answer 1

1. CBT
2. Family Therapy (collectivist cultures)
3. Arts-based therapy
4. Animal-assisted therapies (doesn’t rely on literacy and can be client directed)
5. “Tool boxes” - to support therapy with children
   * Need to remember cultural variations in relation to these therapies*

Question 2

Family therapy is good for which type of culture?

Answer 2

Collectivist culture

Question 3

What type of therapy is good for healing intergenerational trauma

Answer 3

Family therapy

Question 4

Which intervention is good for resolving family conflict?

Answer 4

Family therapy

Question 5

Is family therapy rigid or flexible?

Answer 5

Flexible

• sometimes just talking, problem solving together*
• You go to the communities rather than the communities come to you*

Question 6

What are the benefits for the client in regards to using arts-based or animal-based therapies?

Answer 6

Allows the refugee clients to direct the therapy - helps build trust

Doesn’t rely on literacy

Builds on clients strengths

• client led approach - tell them what might help but let them decide*
• • leads to building trust*

Question 7

Trauma informed yoga is part of what type of theraputic approach

Answer 7

Arts-based therapy

Question 8

What is the “tool boxes” for children approach to therapy?

Answer 8

Using toys (e.g. dolls) which have the names of emotions on their faces to help kids identify what they might be feeling

using these tools to identify what emotions kids are feeling in order to help diagnose and treat them

Question 9

Which therapy is best for focusing on a childs emotional literacy and on managing emotions & avoiding increased emotional arousal?

Answer 9

“Tool Boxes” for children

Question 10

What is the aim of trauma-based therapies like tool boxes for children in regards to outcomes in children?

Answer 10

Help children “retrain” their automatic fight/flight response and reduce fear and anxiety and trauma

Question 11

What does the Australian Centre for Posttraumatic Mental
Health (ACPMH) (2007) guidelines for working with people with PTSDadvocate for as the best approach to use for working with refugee clients?

Answer 11

Holistic Approach

• e.g. working with schools, families etc. - not individualistic but social determinants of health approach*
• But are consistent with DSM model of PTSD, and hence argue that primary focus should be on treatment of trauma symptoms*

Question 12

What guidelines does the ACPMH recommend for working with refugees?

Answer 12

1. Using culturally appropriate screening for refugees and asylum seekers at high risk of developing PTSD
2. Interpreters should be available and used as required
3. Acknowledge holistic appraoches
4. Highlight need to recognise guilt and shame

Question 13

What is the main issue with screening for PTSD in refugees currently?

Answer 13

Not many culturally appropriate measures

Question 14

Should we apply the same empirical approach to all refugees?

Answer 14

No - we cannot provide a ‘one size fits all’ approach - must be culturally relevant

Question 15

Refugees should be worked on in a case-by-case basis and not given a universally applicable treatment

True/False

Answer 15

True

Question 16

What are the benefits of using a translator

Answer 16

1. Builds Trust with Refugee
2. Cultural interpretation of words (e.g. heavy heart can = depression)
3. Overcoming language boundaries

Question 17

What are some issues with using an interpreter?

Answer 17

o Issues of confidentiality
o Issue of impact upon therapeutic alliance – though this can be positive
o “Cultural broking”
o Norms of communication
o Consideration of health and wellbeing for interpreters – eg when discussing sensitive topics
o Use of family members
o Small – new and emerging - communities

Question 18

The social determinants of health approach focuses on what aspect of the client in order to help their mental health?

Answer 18

Social Determinants

Such as improving their housing, education, employment etc. situation

Question 19

When dealing with refugees, we should use ______ informed care

Answer 19

trauma-informed care

Question 20

What is trauma-informed care?

Answer 20

Breaking down what caused their trauma then building them back up again so they can handle their trauma in their lives

• Helping the client understand the trauma that the situation has had on the clients lives so they can move past it*
• must be culturally relevant*

Question 21

Assessments when working with refugees must take into account both ______ and _____ needs.

Answer 21

Psychological

and

Practical needs (holistic approaches)

Question 22

Social Determinants of Health Approach is what type of approach?

Answer 22

holistic approach

Question 23

A high prevence of psychosomatic “complaints” may be evidence of ______

Answer 23

trauma

Question 24

What must we understand when we are starting mental health treatment regarding young refugees?

3 things

Answer 24

1. How trauma may manifest itself in young children

(e.g. behavioural changes)

2. That this cohort of children are often resilient

(interventions should build on their strength)

3. The importance of building rapport and trust

Question 25

Family situations

Types of Trauma experienced

Cultural background

These all have a great impact on what treatment will be best for the child refugee - this shows the importance of understanding ______ when treating children

Answer 25

context

Question 26

What are the 6 competencies we must have when working with refugee children with psychological trauma

Answer 26

• *1. Knowledge of complexity of needs of refugees**
• *2. Holistic approaches**
• *3. Ability to work across sectors/others in child’s network**
• *4. Ability to build therapeutic relationships**
• • Trust and rapport*
• *5. Ability to make clients feel listened to**
• • Client-led approach*
• *6. Cultural competency**