Acculturation and Adjustment Acculturation and Adjustment of Refugees and Refugee of Refugees and Refugee Mental Health ServicesMental Health Services

Acculturation and Adjustment Acculturation and Adjustment of Refugees and Refugee of Refugees and Refugee Mental Health ServicesMental Health Services

Dina BirmanDina BirmanAssociate Professor of PsychologyAssociate Professor of Psychology

University of Illinois at ChicagoUniversity of Illinois at Chicagodbirman@uic.edudbirman@uic.edu

Types of Immigrants

• Immigrants• Refugees (Asylees)• Undocumented

Waves of Immigration to U.S.:

from Assimilation to Multiculturalism

• Early in U.S. history- “the English”• 1840’s – 1860’s – N. Europeans• Early 1900’s - S. and E. Europeans• 1975 – present – Asians, Latin

Americans, and Africans

History of immigration policies

• 1882 Chinese Exclusion Act• 1924 Immigration and Nationalities Act• 1948 Displaced Persons Act • 1951 UN Convention for the Rights of

Refugees• 1967 UN Convention for the Rights of

Refugees expanded • 1965 Immigration and Naturalization Act• 1980 Refugee Act• 1990 Immigration Act

1951 UN Convention• Created UNHCR: UN High Commissioner

of Refugees• Defined Refugees: persons who owing to

a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country

US Refugee Admissions• Refugee Policy – Arm of US Foreign Policy• Refugees flee from countries that are “enemies” of

US• Post WWII• Fall of Saigon in 1975 – Vietnamese migration• 1970’s – 90’s Jews and later Evangelical Christians

from Soviet Union, Cubans• mid-1990’s – Bosnians, others from former

Yugoslavia• 2000’s – Afghanistan, Iraq; Somalia, Burma; n

“warehoused populations”

Bhutanese• http://www.youtube.com/watch?

v=k9Mhb6DBo2c&feature=fvsr

Burma

Burundi and Somalia

Kakuma, Kenya

“Slavic” Community• http://online.wsj.com/article/SB100

01424052748704739504576067550205353230.html

•Soviet Jews

US Resettlement Program

• Orientation before arrival• Met at airport• Apartment• $900 per person cash assistance• Job placement services• ESL for adults• Registering for school• Some offer afterschool, summer programs

• REFUGEE RESOURCES:

• BRYCS: Bridging Refugee Youth and Children's Services

• http://www.brycs.org/• CAL: Center for Applied Linguistics • http://www.cal.org/• Spring Institute for Intercultural Learning• http://www.springinstitute.org/• ORR: Office for Refugee Resettlement:• http://www.acf.hhs.gov/programs/orr/index.html

Stressors in Resettlement

• Migration• Acculturation• Trauma

What’s the best way to Acculturate?

Is there a best way to acculturate?

Acculturation

Acculturation• Assimilation• Traditional• Bicultural

Assimilation - Children with respect to

Language

Time in U.S.

Acc

ult

ura

tion

Language Acculturation:Russian and Vietnamese

Adolescents

.431.081.662.002.432.673.084.004.424.595.175.586.176.847.508.348.759.169.439.9110.1710.4210.83

TIME in US

1.00

1.50

2.00

2.50

3.00

3.50

4.00Mean

Russian

American

.753.083.584.685.255.916.506.757.337.588.178.759.009.8310.4110.8311.0911.6812.3312.9216.50

TIME in US

1.00

1.50

2.00

2.50

3.00

3.50

4.00Mean

Vietnamese

American

Language Acculturation:Russian and Vietnamese

Parents

.431.081.662.002.432.673.084.004.424.595.175.586.176.847.508.348.759.169.439.9110.1710.4210.83

TIME in US

1.00

1.50

2.00

2.50

3.00

3.50

4.00Mean

Russian

American

.753.083.584.685.255.916.506.757.337.588.178.759.009.8310.4110.8311.0911.6812.3312.9216.50

TIME in US

1.00

1.50

2.00

2.50

3.00

3.50

4.00Mean

Vietnamese

American

Cultural Maintenance

Time in U.S.

Acc

ult

ura

tion

Acculturation Gap: Assimilation and Additive

Time in U.S.

Acc

ult

ura

tion

Acculturation Gaps

Acculturation Gaps?

What are some implications of acculturation gaps?

What are some implications of acculturation gaps?

• Parents don’t know about their children’s lives outside the home

• Diminishes parents’ capacity to help their children

• Undermines their authority• Children feel parents can’t

understand or help them

Culture Broker Role• Children helping parents with

communication, phone calls, forms• “Role reversal” or

“parentification” between adults and children?

• Competence and maturity?

Native Language Support

• Difficult for children to learn literacy skills in a language they are not verbally fluent in

• Learning literacy in native language helps promote academic achievement in English

• Research also suggests that acculturation gaps in native language predict conflict

Ways to reduce acculturative stress

• Helping parents understand children’s experience

• Helping parents learn about the lives of their children (for e.g. at school)

• Helping children retain their native language

• Not asking children to serve as brokers in settings where not appropriate

Migration Stress: • Moving• Worse when unexpected or not by choice• Loss of family and friends• Loss of familiar possessions and

surroundings• Disruptions on family arrangements• Changes in loved ones as a result of

stress

Ways to help children cope with moving:

• a) re-establish routines • b) anticipatory guidance • c) support from peer group• d) support from important adults

Traumatic Stress• Symptoms of PTSD

– Traumatic Event is re-experienced– Dissociation and numbing, avoidance

of stimuli– Increased arousal, irritability, startle

reflex, concentration

Treatment for PTSD– Cognitive-Behavioral Approaches

• TF-CBT (Trauma Focused Cognitive Behavior Therapy) http://tfcbt.musc.edu/

• CBITS (Cognitive Behavioral Intervention for Trauma in Schools

• Support for Students Exposed to Trauma• SPARCS (Structured Adolescents Exposed

to Chronic Stress)

Treatment Components “PRACTICE”

• Parenting skills and Psychoeducation• Relaxation skills• Affective modulation skills• Cognitive Processing• Trauma narration• In vivo desensitization• Conjoint parent-child sessions• Enhancing safety

The CBT Triangle• : Feelings

• Thoughts Actions

Treatment Adaptations for Refugees

• Extensive outreach and engagement

• Provide services in the community• Done with cultural sensitivity• Groups for lower symptoms,

individual for more symptomatic kids

School Transitions for School Transitions for Refugee ChildrenRefugee Children

School Transitions for School Transitions for Refugee ChildrenRefugee Children

School Transitions for Immigrants and

Refugees: Differences in

– student – teacher relationships– roles of teachers and parent– School’s role in discipline– Expectations for discussion and

analysis vs. rote learning– Peer norms

ESL Classroom as a Safe Place

• smaller classroom or small group work

• peers who are going through similar experiences,

• attentive adult

Understanding U.S. schools:

• Most of the rules and norms in U.S. schools and classrooms are implicit.

• Lack of strict rules and expectations for autonomy create the impression that there are no rules.

• For refugee children even the most simple and basic of rules may need to be made explicit

Children with no prior schooling:

• Somali Bantu, some girls from Afghanistan• Need to learn about:

- being in a school building- sitting at a desk- holding a pencil

- reading or looking through books- playing with toys

Strategies for working Strategies for working with traumatized with traumatized refugee childrenrefugee children

Strategies for working Strategies for working with traumatized with traumatized refugee childrenrefugee children

What Can Schools Do for refugee children?

• Educate them about the culture, language, and academics

• Provide Structure• Re-establish routines• Provide access to caring adults• Help integrate into peer group

Should teachers be expected to help children talk about their

traumatic experiences? • It is not the teachers’ job to help

children tell their story of trauma. • If and when it does come up, the most

important part to remember is not that the story be told, but that the child experience trust and support while telling it or trying to tell it.

Should teachers discipline children who have been

traumatized? • Children who’ve never been in school

need to learn about how to be in school• When done in a caring way, setting limits

and helping the child observe and monitor her own behavior is extremely helpful to the child, helps normalize the situation, and gives the child skills to cope with trauma as well as every day life.

How to structure classrooms for refugee

children• STRUCTURE and expectations, routines• Structure in unstructured time• Integrate content and English language

learning• Make content meaningful• Warmth and Praise• Personal relationships and opportunities to

deepen relationships

Relationships MatterRelationships MatterRelationships MatterRelationships Matter