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Creative Expression Workshops for Immigrant and Refugee Children

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Abstract

The number of immigrant and refugee children coming from war-torn countries is increasing in North America. Schools are in a favorable position to implement prevention and intervention programs to address the integration of the past experiences of newcomer children and their adjustment to a new reality. Over the past decades, creative expression activities have been increasingly recognized as a useful way to work with migrant and refugee children. The creative expression workshops that we developed and implemented in Montreal's multiethnic schools are integrated into mainstream academic activities. They have been designed to become transitional spaces allowing newcomer children to bridge partially the gap between the past and the present, the culture of origin and the host country culture, home and school, and the internal and external world of the child. We will describe our program briefly and then focus on four key aspects of the workshops: constructing a safe space, acknowledging and valuing multiplicity, establishing continuity, and transforming adversity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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... School-based cognitive behavioral interventions (e.g., Ehntholt et al., 2005) generally show positive outcomes; multitier interventions (e.g., Ellis et al., 2013), which include several levels of service (ranging from preventive strategies to specialized mental health treatment), reveal mixed results. For the broader group of immigrant and refugee children, existing school-based interventions demonstrate promising results in the improvement of individual mental health through a range of treatment modalities, including mindfulness (e.g., Fung et al., 2019), cognitive behavioral therapy interventions (e.g., Barrett et al., 2003;Kataoka et al., 2003), comprehensive service models (e.g., Beehler et al., 2012), and creative expression programs (e.g., Rousseau et al., 2004). Rousseau and colleagues developed a series of creative expression interventions for refugee and immigrant children in different developmental phases Rousseau et al., 2004Rousseau et al., , 2007. ...
... For the broader group of immigrant and refugee children, existing school-based interventions demonstrate promising results in the improvement of individual mental health through a range of treatment modalities, including mindfulness (e.g., Fung et al., 2019), cognitive behavioral therapy interventions (e.g., Barrett et al., 2003;Kataoka et al., 2003), comprehensive service models (e.g., Beehler et al., 2012), and creative expression programs (e.g., Rousseau et al., 2004). Rousseau and colleagues developed a series of creative expression interventions for refugee and immigrant children in different developmental phases Rousseau et al., 2004Rousseau et al., , 2007. These semiprotocolled programs use creative processes designed to provide children with tools to express feelings and process emotions regarding migration and exile and have been explored in different studies (e.g., Rousseau et al., 2005). ...
... This project aims at furthering the evidence base on the role of school-based intervention in promoting refugee and immigrant children's mental health, school well-being, and peer relationships. It entails an intervention study in which a creative arts-based expression program aiming at promoting positive mental health outcomes (Rousseau et al., 2004) is implemented with refugee and nonrefugee immigrant children in multiethnic classes in elementary schools. The study assesses the intervention's effect on (a) mental health outcome variables and (b) classroom social relationships. ...
Article
This study evaluated the effects of a school-based creative expression program on mental health and classroom social relationships in elementary school children with refugee and nonrefugee migration backgrounds. It was hypothesized that children receiving the intervention would report less externalizing and internalizing problem behaviors, less posttraumatic functioning, and more positive classroom social relationships at posttest than children receiving education as usual, particularly for refugee children. Classes in three multiethnic Belgian elementary schools were randomly assigned to a creative intervention (7 classes, 68 students) or control condition (6 classes, 52 students). All participants (8-12 years old) had a migration background. Almost half (47%) were refugees, 53% were first- to third-generation nonrefugee immigrants. Data collection included pre- and posttest assessment with children, parents, and teachers. Multilevel analysis was used to assess outcomes. Children in the intervention condition rated the classroom climate at posttest more positive than their control peers (d = .33). Children who received the intervention did not show less symptomatic functioning than children in the education-as-usual condition. However, post hoc analysis by baseline severity showed that students with high baseline levels of posttraumatic stress reported less trauma symptoms at posttest in the intervention group than in the control group (d = -.97). This effect was moderated by children's refugee background, indicating a differential effect in which refugee children show more reduction of trauma symptoms as compared to nonrefugee immigrant children. The intervention supported classroom climate and alleviated posttraumatic stress in children with increased posttraumatic symptomatology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... As noted above, schools have been identified as an important setting for delivering mental health services to children in general (Hoagwood & Erwin, 1997Bemak & Cornely, 2002; Hodes, 2000 Hodes, , 2002). In addition to the school-based CBT group treatments described above, a number of other school-based interventions for refugee children have been reported (Hones, 2002; O'Shea, Hodes, Down, & Bramley, 2000; Rousseau et al., 2003; Rousseau, Singh, Lacroix, Bagilishya, & Measham, 2004). One intervention specifically focused on providing mental health treatment to traumatized refugees in a primary school in London (O'Shea et al., 2000). ...
... 1182). In like manner, Rousseau et al. (Rousseau et al., 2004) describe the development of creative expression workshops to provide refugee and immigrant children with an opportunity " to construct meaning, to structure identity, and to work through their losses and reestablish social ties. " (p. ...
... Nonetheless, we suggest that the field has much to gain from beginning to identify and describe these interventions. Clinicians and other interventionists working in local communities have accumulated great local wisdom with respect to their work (see for example clinical reports by Hodes, 2002; Rousseau et al., 2004). A focus on studying existing practices with refugee children can serve the long term goal of developing evidence-based interventions for traumatized refugees in several ways. ...
... This study is part of a larger research project on the impact of a creative arts-based expression program (Rousseau et al., 2004) on refugee children's mental health and peer relationships. The study reports on the baseline assessment of mental health problems and classroom relationships. ...
Article
Background European countries face the challenge of promoting refugee and immigrant children’s well-being within their host communities, invoking the necessity of adequate mental health assessment. This study aims to contribute to document the psychosocial well-being of primary school refugee and non-refugee immigrant children in Flanders, Belgium. Method A total of 120 children (8–12 years old) with migration backgrounds participated in the study. Through self-report, parent and teacher questionnaires we scrutinized externalizing and internalizing behavioral problems, post-traumatic stress problems, and classroom relationships. Results Thirty percent of the participants reported high levels of post-traumatic stress; around 25% reported a high or very high prevalence of internalizing and externalizing behavioral problems. Self-reported mental health problems are elevated in comparison to the general population. Refugee children did not report more difficulties than their immigrant peers. In the perception of parents and teachers, respectively 20% and 5% of children showed high or very high amounts of internalizing and externalizing behavioral difficulties. Almost 70% of the participants perceived the class climate as unsafe. Conclusions Refugee and immigrant children are at risk for mental health difficulties, and experience classroom dynamics as markedly distressful. School-based intervention might be particularly suited to support these children’s psychosocial well-being in resettlement.
... Workshops for preschoolers are organized around sand play. Drawing and storytelling are the central components of the program for elementary schoolchildren (Rousseau, 1999; Rousseau, Lacroix, Bagilishya, & Heusch, 2003; Rousseau, Singh, Lacroix, Bagilishya, & Measham, 2004 )/ whereas theatre is the chosen mode of expression for adolescents (Rousseau, de la Aldea, Viger Rojas, &)· The theater program is based on Augusto Boal/s "Forum theatre" (1995/ 1979/2000) and Jonathan Fox's "playback theater" (Fox, 1981Fox, / 1994 Fox & Dauber, 1999). Playback theater is a type of improvisational theater that aims to achieve personal and social transformation through sharing a theater experience within a ritual space (Fox, 1981). ...
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I continue to think of revenge. But this thought of revenge, it doesn't know how to stop. And we should not have this thought or the matter will grow and keep going on and on for a long time. We should be a person who thinks and acts in accordance with dhamma. [A person who seeks revenge] only creates misery for our society. It is a germ in society. But I continue to think of revenge … The people who killed my brother, who put down his name to get into the truck, are all alive, living in my village. To this day, I still really want revenge. I keep observing them. But, I don't know what to do…. The government forbids it. - Chlat, whose brother's family was executed by Khmer Rouge There were many ways to die during Democratic Kampuchea (DK), the genocidal period of Khmer Rouge rule in Cambodia (1975-1979). Some starved to death. Others died from malnutrition and illness. Many more were executed, often en masse, in a genocide that took the lives of more than 1.7 of Cambodia's 8 million inhabitants (Kiernan, 1996) - almost a quarter of the population. Such numbers are almost incomprehensible, yet they fail to take account of the toll such death and destruction took on the survivors, who suffered the loss of friends and loved ones; struggled on in a world of privation and relentless work; tried to survive for another day in a time in which fear, terror, and trauma were omnipresent; and, after DK, attempted to piece together their fractured lives in a society that had been turned upside down.
... The FRIENDS program is one example of a stressresilience program applied to culturally diverse migrant groups residing in Australia and was found to be effective in lowering anxiety and promoting positive future outlook (Barrett et al. 2001). Another drama workshop program conducted in the US was effective in facilitating the adjustment of newly arrived migrant teens, although assessed using only qualitative methods (Rousseau et al. 2004). A study conducted in Israel testing a program for young children of migrant workers during a crisis situation of threat of deportation, was effective in lowering anxiety and depression and in teaching new coping strategies (Meir et al. 2012a, b). ...
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Background The social–ecological environment of undocumented children of migrant workers includes varying levels of risk factors. Growing up in these conditions compromises children’s development on all levels. Many of these children are in need of psychotherapy, however, due to limited resources, only a few of them receive mental health aid. Objective The present research undertook to construct and examine the effectiveness of a specialized group intervention program to enhance children’s self-efficacy and mental health. Methods Participants were 70 children aged 8–12 of illegal migrant workers in Israel. The repeated measures design included completion of a self-efficacy scale and emotional, behavioral and social difficulties child-report and teacher-report measures. Children were randomly allocated to either an intervention or control group. Results The first hypotheses predicting a greater improvement in self-efficacy between the pre-test and post-test for children in the intervention as opposed to control group was confirmed. The second hypothesis predicting a greater reduction in the self- and teacher-reports of emotional, social and behavioral difficulties was confirmed. The third hypothesis predicting a moderating relation between self-efficacy, group type and time on the dependent variables was confirmed only for children’s self-report of their difficulties. Conclusions Findings provide evidence for the effectiveness of this short term playful intervention program for this group of disadvantaged children, suggesting its application to other at-risk groups of children.
... School-based interventions delivered in a safe and informal setting potentially offer non-stigmatizing services which families may be more likely to accept given the increased likelihood of building relationships with school staff and the relatively easy access to children within school [17]. Birman et al., noted the school context is where the process of acculturation develops and therefore providing support either on an individual basis or using a multimodal approach may serve to enhance socialization and support psychological adjustment and development [18,19]. Working with groups of children who have come together naturally in the school context can strengthen the child's relationship to the group through shared responsibilities, non-competitive activities and team work while simultaneously providing practical support [12]. ...
Article
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Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children. Comprehensive searches were conducted in seven databases and further information was obtained through searching reference lists, grey literature, and contacting experts in the field. Studies were included if they reported on the efficacy of a school or community-based mental health intervention for refugee or asylum-seeking children. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively. The marked heterogeneity of studies excluded conducting a meta-analysis but study effect-sizes were calculated where possible. Twenty one studies met inclusion criteria for the review reporting on interventions for approximately 1800 refugee children. Fourteen studies were carried out in high-income countries in either a school (n = 11) or community (n = 3) setting and seven studies were carried out in refugee camps. Interventions were either primarily focused on the verbal processing of past experiences (n = 9), or on an array of creative art techniques (n = 7) and others used a combination of these interventions (n = 5). While both intervention types reported significant changes in symptomatology, effect sizes ranged from 0.31 to 0.93 and could mainly be calculated for interventions focusing on the verbal processing of past experiences. Only a small number of studies fulfilled inclusion criteria and the majority of these were in the school setting. The findings suggest that interventions delivered within the school setting can be successful in helping children overcome difficulties associated with forced migration.
... Twenty-two of the 32 children ⁄ cents references focused on mental health (69%) (e.g. Beiser et al., 1995; Berman, 1999 Berman, , 2001 Hyman, 2000; Nadeau and Measham, 2006; Offord, 1995; Rousseau and Drapeau, 1998, 2000; Rousseau et al., 2004c; Tousignant et al., 1999). Studies focusing on women (12%) (e.g. ...
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While the global number of resettled refugees rises annually, the summaries of research on refugee health needs in countries of asylum remain sparse. We conducted a systematic review of published research on refugee health in Canada in order to: (i) identify studies addressing health outcomes among refugees recently resettled in Canada; (ii) identify general trends in health research conducted in Canada among refugee populations; (iii) identify significant gaps in current knowledge of health-related issues among refugees recently resettled in Canada; (iv) evaluate the quality and consistency of available information; (v) develop a summary of available research results; and (vi) identify priorities for future research. A search of several major citation indices resulted in the analysis of 196 research reports after reviewing more than 5,000 articles. This review is timely, systematic and inclusive; furthermore, potential biases in methodology are clearly assessed. The results indicate an immediate need to address specific gaps in health knowledge for refugee populations and lead us to draw five primary conclusions. First, mental health outcomes dominate the research landscape. Second, cross-sectional studies are most commonly the study design of choice. Third, studies examining some aspect of health among refugees from Asia dominate the literature. Fourth, there is a notable lack of information on cardiovascular diseases and its antecedents. Fifth, indications show that screenings for pre-existing conditions are biased towards communicable diseases. These findings have implications for health monitoring, evaluation and policy affecting the health of refugees resettled in Canada and elsewhere.
... The sandplay project is a preventive program for preschoolers. It is part of a larger series of art therapy workshops using different forms of creative expression designed for schools in multiethnic neighborhoods ( Rousseau, Lacroix, Singh, Gauthier, & Benoit, 2005; Rousseau, Singh, Lacroix, Bagilishya, & Measham, 2004). Coincidentally, the sandplay project began only 2 weeks after the tsunami in Asia (26 December 2004), in a neighborhood with a predominantly South Asian population. ...
Article
Extensive media exposure to natural disasters such as tsunamis may cause adverse effects including psychological distress and even posttraumatic symptoms in young children, particularly those who have suffered previous losses and trauma. This paper analyzes spontaneous representations of the 2004 tsunami through sandplay by a group of immigrant and refugee preschoolers, beginning 2 weeks after the tragedy. The children used a variety of coping strategies, making both nonverbal and verbal references to the tsunami. It was represented using a variety of figurines, including religious ones. We considered the children in light of four categories based on family homeland and psychological affinity to the tsunami experience. Our results suggest that sandplay provides an appropriate space to express and work through emotions stemming from the interaction of past and present experiences of adversity.
... 5.5.3. Mental health care Refugees requiring mental health services are confronted with numerous challenges, including frequent misdiagnosis, language barriers and inappropriate use of interpreters, poor services access, lack of resources to pay for services, lack of familiarity with mental health systems, inappropriate treatment methods, and difficulties of providing culturally sensitive interventions (see e.g., Davies & Webb, 2000; Rousseau, Singh, Lacroix, Bagilishy, & Measham, 2004). On an organisation level, it is important, as Watters and Ingleby (2004) stipulate, to draw attention to the interrelation between state policies on migration and the context in which mental health services are delivered: for example, in countries with relatively large numbers of asylum seekers who are held in induction or accommodation centres while their claim is processed (e.g., Germany), mental health care is likely to be delivered in these formal settings and disengaged from mainstream health care. ...
Article
Unaccompanied refugee children and adolescents are a vulnerable group: they live not only in a relatively difficult situation as minor refugees staying in another country, but also face other risks due to the absence of their parents, such as traumatic experiences, exploitation or abuse. The difficult living situation of these unaccompanied refugee children and adolescents might therefore threaten their emotional well-being, resulting in important emotional and behavioural problems. This 'psychological' perspective shows the necessity of a strongly elaborated reception and care system for these children and adolescents in order to meet their specific situation and needs. Nevertheless, the case study of unaccompanied refugee minors living in Belgium, as explored in this paper, shows that the legal perspective on these youths - considering them as 'refugees' and 'migrants', not as 'children' - is predominantly the starting point to build the care system on. Moreover, this legal perspective contrasts sharply with the psychological perspective, as such that these children and adolescents do not receive appropriate support and care as they need.
... It was decided that a mediation process should take place to reach an agreement on the common goal of the children's education and well-being. However, the international situation deteriorated, and, as the rumors of war were spreading, the Transcultural Psychiatry Team of the Montreal Children's Hospital, which had been working with some schools for a long time to offer creative workshops (Rousseau, Singh, Lacroix, Bagilishya, & Measham, 2004), proposed a classroom project to address the adverse effects of this context on the recently arrived immigrant and refugee children It should be noted that the Canadian government's position toward the war was ambiguous both before and during it. After long debate and much waffling, the government of Canada, which wanted to be seen as a mediator, finally announced that it would not participate militarily in the war. ...
Article
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This article describes a school-based preventive pilot project for recent immigrant children, designed to decrease anxiety and intergroup tensions associated with the Iraq war. Results suggest that clinicians should address the multiplicity of meanings associated with international events when planning a prevention program in multiethnic schools to help children to cope with the increasingly common gap between the ways traumatic events covered by the media are understood at home and at school.
... Repeated qualitative evaluations identified four key elements indicative of the effects of the workshops: constructing a safe space, acknowledging and valuing multiplicity, establishing continuity, and transforming adversity [55]. A quantitative evaluation (experimental versus control) of the three programs (preschool, elementary, and high school) showed that all had a significant effect on child and youth mental health. ...
Article
Because refugee families tend to underutilize mental health services, schools have a key mediation role in helping refugee children adapt to their host country and may become the main access point to prevention and treatment services for mental health problems. Many obstacles hamper the development of school-based prevention programs. Despite these difficulties, a review of existing school-based prevention programs points to a number of promising initiatives that are described in this article. More interdisciplinary work is needed to develop and evaluate rigorously joint school-based education and mental health initiatives that can respond to the diverse needs of refugee children.
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There is a lack of understanding about displaced children’s experiences of places and play in the field of children’s geographies and built environment. This paper contributes to emerging knowledge in the fields of displacement, place and play by summarising and identifying gaps in the existing evidence regarding displaced children’s experiences of place in temporary and/or informal settlements, or in new environments. The scoping review deployed a combination of search terms related to displacement (displaced, informal settlement, temporary settlement, refugee) and themes related to place and play (child friendly places/spaces, experience of place, place attachment). A total of 1001 studies were identified from ScienceDirect and Proquest, with 33 studies included in the review. From the limited number of relevant studies, it was found that place attachment provides a sense of stability amidst change, contributes to wellbeing and identity, and supports the cognitive, physical and social development of displaced children. Overall, play and opportunities for play can help children to adapt to a new place following displacement. The review concludes that more research is needed to explore displaced children’s experience of place in both their original and new environment, as well as comparing the experiences of place for ‘placed’ and ‘displaced’ children.
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Within the context of lifelong learning, it is necessary for teachers to improve their competencies, including the competencies in the use of digital media. The paper presents partial results of research carried out within the VEGA 1/0913/15 project on Media Literacy of Young School-Age Children in the Context of Family and School Cooperation, while it also analyses the need to develop digital literacy, which is part of the VEGA 1/0748/20 project on Diagnosing Digital Literacy of Primary School Teachers in the Context of Undergraduate Training and Educational Reality. The empirical research had a diagnostic as well as quantitative and qualitative character. The subject of the research was media education of younger school-age pupils implemented in both formal and informal ways in Slovakia. The research involved 28 schools from all over Slovakia. The paper focuses mainly on the findings obtained from the questionnaires filled out by primary school teachers, interviews conducted with school management and content analysis of school educational programs.
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The results of our own research indicate the heterogeneity of hearing children of deaf parents (koda) in the development of language in context of special educational needs. Koda acquire language and speech in an unusual communication environment. The aim of the research is to analyse the linguistic development of koda in terms of active and passive vocabulary, comprehension and use of grammatical forms, and comprehension of a longer text. The results of children obtained in the normalised Linguistic Development Test were analysed. Koda may have difficulty in mastering speech in its various planes and aspects, develop language competences and skills discordantly.
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Dans un contexte où le contact entre différents groupes culturels peut être marqué par l’appréhension, la peur, ou même un certain rejet de « l’autre culturel », les processus liés à l’appréhension de la différence culturelle peuvent s’avérer difficiles, notamment pour les enfants qui font partie de minorités et vivent dans des quartiers défavorisés. Le manque de maitrise de codes culturels et de connaissances concernant le patrimoine peut accentuer une mise à l’écart de ces enfants, ainsi que la survenue de difficultés à établir des liens entre l’espace du familier à la maison et les espaces culturels de la ville. Ceci est notamment le cas quand les enfants appartiennent à des minorités exposés à un regard dévalorisant, car un tel regard peut impacter l’estime de soi et la construction identitaire (Cyrulnik 2002). La médiation artistique semble être un outil intéressant pour favoriser la construction de liens entre les différents « univers culturels » auxquels les enfants sont exposés dans la famille, à l’école et dans les lieux culturels de la ville, permettant ainsi de valoriser leurs appartenances plurielles (Rousseau et al. 2004).
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Background: We examine the experience of participating in creative arts groups for Palestinians living under the shadow of military conflict. Methods: 14 men and women aged 17–50 were recruited from community creative arts groups to participate in one of three semi-structured group interviews. Interviews explored participants’ perceptions of the creative arts groups, including how they came to participate in the group and how they felt about their involvement. Results: An inductive thematic analysis identified three central themes: “An emptying”, “Growth in the face of challenge”, and “A rare freedom”. The themes capture the extreme challenges participants faced and the protective effects of the creative arts groups on wellbeing. Participating in creative arts activities, such as writing, drawing, and music, encourages self-expression and release, personal exploration and escapism. Conclusions: In the face of traumatic experiences, restrictions, and poverty associated with living in an occupied land, creative arts groups can be liberating and support wellbeing.
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Background: Schools can play a vital role in the resettlement of refugee children and their families. Yet, the body of research examining school environmental factors that support the mental health and acculturation of refugee children is methodologically heterogeneous, investigates numerous and disparate school factors, and is often "hidden" in broader qualitative studies. This limits the capacity to apply the findings in a practical manner. Methods: Based on PRISMA statement principles, we review the relevant literature to investigate the relationship between school climate and the emotional wellbeing and resettlement outcomes of refugee students. Six electronic databases will be systematically searched: MEDLINE, PsycINFO, Embase, CINAL, Web of Science, and ERIC, supplemented by a systematic review of the grey literature, relevant international websites, and sequential, site-specific internet searches. Finally, subject area experts will be consulted and backward and forward citation searches of included articles will be completed. Two independent reviewers will screen identified articles against eligibility criteria and extract data for included studies. Quality of included studies will be assessed using the Mixed Methods Appraisal Tool (MMAT) for mixed studies reviews. Data will be synthesised using a convergent qualitative narrative approach. Discussion: Given the centrality of school in the daily lives of resettled refugee children, it is vital to assess the impact of school climate on the psychosocial wellbeing and resettlement trajectories of this population. This review will identify evidence-based school factors which support good mental health and resettlement outcomes for refugee students and make recommendations for translation of this knowledge into the school environment. Systematic review registration: PROSPERO CRD42017077570.
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Within a preventive framework, we outline a school-based intervention aimed at strengthening skills of survival and psychological functioning in children who have experienced war and political violence in the Gaza Strip. In accordance with a socio-ecological perspective on wellbeing and resilience, the pilot study aimed at evaluating the outcomes of a psychosocial narrative school-based intervention with a group of school-aged children in the aftermath of war. The intervention was oriented at empowering positive emotions, life satisfaction, and optimism in children as protective factors in preventing posttraumatic reactions after war. Findings showed the efficacy of the intervention in favoring life satisfaction in different ecological domains. Children in the intervention group showed greater appreciation for friends, school, family, themselves, and their living environment. At the end of the activity, children were increased the level of positive emotions, but negative feelings were stronger than before the narrative intervention. Clinical implications and future direction or community work are, then, discussed.
Chapter
This chapter focuses on the effective treatments for Post-Traumatic Stress Disorder (PTSD) which are used with young people, particularly young refugees. Comprehensive accounts of treatments and treatment efficacy for PTSD in young people have been provided elsewhere (Dwivedi 2000; Perrin et al. 2000; Cohen and Mannarino 2004; National Collaborating Centre for Mental Health (NCCMH) 2005). The aims of this chapter are therefore twofold: first to describe the more established treatments for young people with PTSD, and second to look at all innovative treatment approaches that have been developed for young refugees. The chapter has an evidence-based perspective, and so provides data regarding the efficacy of the treatments described.
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Background: Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children.
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Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable.
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Focus of on-going cross-cultural investigation has throughout the time shown that inadequate language skills paired with absence of knowledge of cultural practices and norms within the receiving society would create a number of stress behaviors among immigrants, often manifested as lowered mental health status- depression, anxiety, confusion; feelings of marginality and alienation; psychosomatic symptoms and identity confusion (Berry and Annis, 1988; Greenberg and Greenberg, 1989; Kessler, Turner and House, 1988; Shams and Jackson, 1994; Vega et al., 1986; Vinokur, Price and Caplan, 1991; Winefield, Winefield, Tiggermann and Goldney, 1991). It was further noticed that refugee populations across the world are adapting to the receiving societies in a much slower rate then other migrating groups (Greenberg and Greenberg, 1989), and yet due to sensibilities surrounding research of a refugee population, there are still questions surrounding this process. In addition, it appears that the attempts to demystify acculturation and uncover objective underpinnings of it, has further reduced the current concept undermining validity and reliability of the findings. Therefore need for subjective experience and definition of acculturation, as well as reconsideration of complexity of the phenomenon (acculturation) was recognised by this research. This study was designed to offer a qualitative insight into the acculturative differences within a family unit among refugees from former Yugoslavia. 21 women, recent refugee- arrivals were requested to participate in the open- end interview. In the semi- structured interview the women were asked to give a detailed account of their personal, their partners' and their children's experiences concerning the emotional, social, economical, occupational and psychological aspects of their and their family- members' acculturation processes. The obtained data was analysed through the means of narrative and Erickson's analytic induction. The results showed that cultural incompatibilities have spread into diverse spheres of living, thus complexity of the acculturation-related problems was acknowledged. The results showed that (1) split families (due to immigration), (2) inability to establish new social ties in the novel environment and (3) decay in professional status were often reported in connection with eroded physical and mental well-being of the participants and their families. The research also looked at cultural diversities, and gender differences, concentrating on concepts of resilience and coping strategies within the acculturative practice. It appears that cognitive restructuring and the ability to let go of the previous lives was the best coping mechanism.
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Immigrant and refugee families underutilize mental health services and schools are in a good position to develop prevention programs to help children adapt to their new environment. The transcultural psychiatry team at the Montreal Children's Hospital, in partnership with schools, has implemented creative expression workshops for kindergarten, elementary schools, and high school to help the children bridge the gap between past and present, culture of origin and host society. The workshops provide a safe space for expression, acknowledge and value diversity, allow the establishment of continuity, and facilitate the transformation of adversity. Refugee and immigrant children's needs should be addressed through intersectoral programs that target exclusion and support a sense of agency.
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The authors aim to summarize the pedagogical approaches and curriculum used in the training of researchers in cultural psychiatry at the Division of Social and Transcultural Psychiatry at McGill University. We reviewed available published and unpublished reports on the history and development of the McGill cultural psychiatry programs to identify the main orientations (conceptual and methodological), teaching methods, curriculum and course content. Student evaluations of teaching were reviewed. Follow-up data on research and other academic activities and employment of trainees who graduated from the program was obtained by e-mail questionnaire. The McGill program includes a Master of Science program, an intensive summer school, annual Advanced Study Institutes, and the McGill-CIHR Strategic Training Program in Culture and Mental Health Services Research. The interdisciplinary training setting emphasizes the cultural history and embedding of psychiatric knowledge and practice; the social construction of ethnicity, race, and cultural identity; the impact of globalization, migration, and ideologies of citizenship on individual identity and the configuration of cultural communities; and the integration of quantitative and qualitative ethnographic methods in basic and evaluative research. This critical transdisciplinary approach provides researchers with conceptual tools to address the impact of the changing meanings of culture and ethnicity difference in the contemporary world on mental health services.
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This evaluative study assesses the effects of a school drama therapy program for immigrant and refugee adolescents designed to prevent emotional and behavioral problems and to enhance school performance. The 9-week program involved 136 newcomers, aged 12 to 18, attending integration classes in a multiethnic school. Pretest and posttest data were collected from the students and their teachers. The self-report and teacher's forms of the Strengths and Difficulties Questionnaire were used to assess emotional and behavioral symptoms. At the end of the program, although there were no reported improvement in self-esteem or emotional and behavioral symptoms, the adolescents in the experimental group reported lower mean levels of impairment by symptoms than those in the control group, when baseline data were controlled for. Their performance in mathematics also increased significantly compared to that of their control peers. The findings suggest that the workshops may have an impact on social adjustment of recently arrived immigrants and refugees. This drama therapy program appears to be a promising way of working preventively and in a nonstigmatizing manner with adolescents who have been exposed to diverse forms of adversity, among which are war and violence.
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A follow-up to a previous study, this paper describes creative expression workshops using myth to facilitate storytelling and drawing activities for recently arrived immigrant and refugee children. A qualitative analysis of the children's creative output suggests that the use of a wide variety of mythic referents frequently helps children better represent the gaps between home and school, past and present, and offers the possibility of hybridizing their worlds. Our results also suggest that myths serve as a link between inner reality, interpersonal relationships, and the social order. Using myths in creative expression workshops seems to provide immigrant and refugee children with a useful framework for expressing and sharing their experiences.
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This program, designed for a multiethnic classroom setting, uses drawing and storytelling to help immigrant and refugee children build bridges between the past and the future by attaching meaning to experience. Three main themes—family, friends, and myths— run through the children's work. The family represents continuity of attachments and values, friends make up the human environment of the host country, and myths of the homeland seem to provide a framework for experiences and emotions. Expression of these themes appears to indicate not only that these factors can protect against psychological distress, but also the children's ability to adjust to existence in a bicultural world. On the other hand, the time sequence analysis of the stories suggests that an absence of solid ties to the past prevents children from imagining a future for themselves.
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Around 1982, thousands of Guatemalan Mayas fled their villagesand lands to escape the Ros Montt scorched-earth policyimplemented in rural areas. After more than a decade of exile,many of those refugees have returned to their homeland. Thispaper looks at the ways in which young Mayan refugees who havereturned home after extended exile in Mexico appropriate anddistance themselves from the collective project of going home. Two Mayan communities of retornados (returnees), whose paths into exile and home again differ slightly, are compared. Outsidesupport from international organizations and cohesion in therefugee camps enabled the young people of La Victoria to seedisclosure of the traumatic past from a position of strength andconfrontation as the key to social change. In La Esperanza, thepast is rebuilt by the youth around avoidance of recent history,and tradition appears as a bridge between past and future. Theway the youth of the two communities construct their homecomingdemonstrates how small changes in the migration experience mayresult in considerable differences in the choice of strategies,and raises important questions about assistance programs thatmight be developed for these populations.
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Describes a mental health intervention program undertaken in Guatemala, focusing on the mental health and psychosocial development of Guatemalan refugee children. The program uses a variety of expressive arts techniques to assist children in safely and creatively exploring salient issues related to the experience of growing up in exile, including individual and collective drawing, sociodrama, and role-playing. The goals of the intervention include providing the children with expressive arts techniques through which to share their thoughts and feelings, creating a supportive context in which they can examine positive aspects of their homeland and culture, and facilitating the development of children's capacity for creative thinking and activity.
There are at least 50000 refugee children and adolescents in the UK, mostly living in London. These young people and their families will have been exposed to high levels of violence, disruption of social life and losses, all of which will increase their risk for psychiatric disorders. Up to 40% may have psychiatric disorders, mostly depression, posttraumatic stress disorder and other anxiety related difficulties. Multi-agency support to refugee youngsters and families is important. Some refugee children and adolescents will require help from specialist mental health services that will need to be flexible in view of the refugees' cultural diversity, mobility and the need for the full range of treatments. Special efforts are required to reach this vulnerable group, and links with social services and schools in particular should be considered.
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Narrative (or storytelling) approaches to understanding human action have recently become more popular in several areas of psychology. Treating human thinking as instances of story elaboration offers numerous implications for many domains of psychological theory, research, and practice. For example, several instances of cultural diversity take on a different hue when viewed from a narrative perspective. Finally, several authors (e.g., Bruner, 1986; Howard, 1989; Mair, 1989; McAdams, 1985; Polkinghorne, 1988; Sarbin, 1986) see the development of identity as an issue of life-story construction; psychopathology as instances of life stories gone awry; and psychotherapy as exercises in story repair.
Twenty-five normal schoolchildren were asked about their futures, expectations, the likelihood of any disasters, repeated terror dreams or death dreams, and their sense of dream prediction. Each child was asked for any particularly terrifying past episodes. Although there were a few isolated findings of limitation in life philosophy or death dreams without any connectable past fright or helplessness, the vast majority of positive findings in these normal children were directly related to past terror or psychic trauma.
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Many recent immigrant children are at risk for violence exposure and related psychological distress resulting from experiences before, during, and after immigration. This study examines the rates of violence exposure and associated symptoms among recent immigrant children in Los Angeles. 1,004 recent immigrant schoolchildren (aged 8-15 years) were surveyed about their prior exposure to violence and symptoms of posttraumatic stress disorder (PTSD) and depression. Participants included children whose native language was Spanish, Korean, Russian, or Western Armenian. Participants reported high levels of violence exposure, both personal victimization and witnessing violence, in the previous year and in their lifetimes. Thirty-two percent of children reported PTSD symptoms in the clinical range, and 16% reported depressive symptoms in the clinical range. Although boys and older children were more likely to have experienced violence, girls reported more PTSD and depressive symptoms. Linear multiple regressions revealed that PTSD symptoms were predicted by both recent and lifetime violence exposure (p values < .001 and p < .05, respectively), when depressive symptoms and gender were controlled. On the other hand, depressive symptoms were predicted by recent victimization only (p < .001) when PTSD and gender were controlled. These findings document the need for interventions addressing the psychological sequelae of violence exposure in immigrant children.
Mettre des mots sur sa douleur. Le mauvais sort de Nazaire, mineur non accompagne refugie au Canada en provenance dAfrique
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Jouer en classe autour dune histoire. Ateliers dexpression creatrice pour les enfants immigrants exposes a la violence sociale
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