Many of our English Learner students and their families – particularly those who are refugees – have undoubtedly been through situations that many of us educators would classify as traumatic. For example, some of our students and their families have witnessed family members being killed or tortured; others have experienced starvation and long journeys to arrive to safety. While we educators and service providers might assume students with these types of experiences are traumatized and need therapy, it is important to consider additional culturally-based and/or community-based approaches if available.
When I attended Columbia University’s School of Social Work, I had the opportunity to take my electives at the School of Public Health. Though the two schools were only a few dozen blocks apart, they were light years apart in terms of their approaches to mental health and healing for children and families who had fled war and persecution. Each morning I would attend classes at the School of Social Work that focused on individualized approaches, such as therapy, to help children and adults in the U.S. to heal, including immigrants and refugees who came from very different cultures. Some characterize this as the “medical model” of care. Each afternoon, I would hop on the train and go to the School of Public Health where I took coursework on how to provide community- and culturally-based psychosocial support to refugees and other displaced persons outside of the U.S. It was odd. We were essentially talking about the same populations, granted in different contexts, and yet such different approaches were recommended. Furthermore, both approaches were evidence-based in their respective fields.
In the humanitarian and public health fields, international NGOs rarely support the idea of individual therapy, particularly from someone who isn’t deeply familiar with the culture. Humanitarian agencies tend to support broader, community-based psychosocial programming, which involves supporting the larger family, building on communities’ existing coping strategies, incorporating traditional healing practices, and restoring normalcy. (For more information on this, see these international guidelines.) This isn’t to say there isn’t a time and place for the medical model of therapy, but it is interesting to learn about examples of community- and culturally-based programs being carried out successfully.
Example of a Community- and Culturally-Based Approach Used Overseas
In Angola after the civil war ended in 2002, an international non-governmental organization (NGO) worked in collaboration with local members the community, including the sobas (local chiefs) and local healers, to put together a program for children who were struggling to heal.* The activities that were created for the children included drawing, singing, story-telling, drama, sports, and dancing. They also encouraged play, the expression of feelings, and social integration. The adults involved were taught how to work with the children in their daily settings and how to identify children who were having problems. These adults then worked on engaging isolated children without labeling them.
This particular international NGO also recognized that in rural Angola, there is a focus on ancestors and their spirits. It is believed that if ancestors are not honored through appropriate rituals, that their spirits cause problems such as poor health, social issues, and even war. In one case, a group of unaccompanied children reported an inability to sleep because they believed a spirit haunted the orphanage they were staying at. Knowing the local belief system, the international NGO asked a local healer to get involved and he conducted a traditional ritual for correcting spiritual discord, which restored the children’s sense of well-being.
Various Understandings of Mental Illness and Distress
While those raised or trained in the U.S. may disagree with the approach utilized above, it is important to recognize that there are many different ways that mental illness is conceptualized around the world. In the Angolan case described above, the children’s belief as to what was causing their sleeplessness was most important because people’s reactions to stressors largely depend on the meanings they attribute to them.
Western mental health practitioners are trained to help individuals share what has happened to them and emotionally process related feelings. This approach clearly benefits many, but it is important to recognize that sitting down to talk to a stranger and revisit difficult emotions is a very foreign concept in many cultures. For example, a Rwandan individual recounted his experience with western mental health practitioners after the genocide and said,
“Their practice did not involve being outside in the sun where you begin to feel better. There was no music or drumming to get your blood flowing again. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. Instead they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to ask them to leave.” **
Example of a Community- and Culturally-Based Approach Used in the U.S.
One example of a program for immigrant youth in the U.S. that builds on communities’ existing coping strategies and incorporates traditional healing practices is from the National Compadres Network. They place culture at the center of all healing and incorporate an intergenerational focus of elders and extended kinship network (“compadres”). They use “circulos de palabra” (talking/healing circles) as natural approaches to reclaim the dignity, health, character, and strength of youth, families, and communities.
Two of their programs are “El Joven Noble” (for young men) and Xinachtli (for young women). El Joven Noble is a comprehensive, indigenous-based, youth leadership development program that supports and guides youth through their “rites of passage” process while focusing on the prevention of substance abuse, teen pregnancy, relationship violence, gang violence, and school failure. Xinachtli is an indigenous, culturally-based female rites of passage program that provides a supportive process for young girls to develop a positive identity, life skills, and a support system.
For all of their programs, the idea is for youth, families, and communities to heal through building on positive cultural traditions. These approaches and curricula are being used throughout the United States.
Recommendations for Teachers:
From 2007-2010, the Caring Across Communities: Addressing Mental Health Needs of Diverse Children and Youth program brought school-connected mental health services to immigrants and refugees at 15 sites in eight states. Four essential components of mental health services for immigrant and refugee children were found, including some that are appropriate for teachers:
Engage students’ families and communities: The program evaluation found family engagement to be the foundational component to supporting refugee and immigrant children’s mental health. Considering that family engagement has also been shown to support students’ academic achievement, it is a “win-win” all around.
Meeting their basic needs: While educators sometimes assume the most stressful or traumatic events that their immigrant students have been through were in their home countries or migration journeys, sometimes it is their hunger or homelessness right here in the U.S. Teachers may refer families to the school counselor or social worker or community agencies for support.
Supporting their efforts to adapt to a new culture: This is typically done through cultural brokers or bilingual family liaisons whom students and families trust. Anyone who is bilingual and/or bicultural and who knows the refugee and immigrant communities can help families navigate their new culture, understand the school system, respond to emergencies, and gain access to community resources. Teachers who have immigrant backgrounds may informally play this role or can advocate to administrators that more such people be hired.
Providing emotional or behavioral supports: It is only a small group of immigrant/refugee students who may need more specific or direct emotional or behavioral supports. Teachers should refer students to their school counselor, psychologist, or social worker, who can take into account the following recommendations.
Recommendations for School Counselors, Psychologists, and Social Workers:
Seek an understanding of how mental illness and treatment is conceptualized in the cultures of your students before putting any programs into place. Ask students, families, and community leaders. “If someone feels this way back home, what do they do to feel better?” and “What do you believe causes someone to feel or act this way?”
Create relationships and consider collaborating with those providing indigenous or traditional healing practices. Ask how you might build on or complement what they are doing.
Help students and their families identify their own coping strategies and talk about how you can support strengthening those.
Help students and families rebuild or recreate extended family systems or informal community networks. Many families are separated across borders and may need help rebuilding their sense of social support.
Recommendations for Administrators:
Allow your school to be a space for community building, community self-help, and social support.
Move towards a Community School model. Community Schools are the hub of their neighborhoods, uniting families, educators, and community partners to provide all students with top-quality academics, enrichment, health and social services, and opportunities to succeed in school and in life.
*Wessells, M. & Monteiro, C. (2000). Healing wounds of war in Angola: a community-based approach. In D. Donald, A. Dawes, & J. Louw (Eds.), Addressing childhood adversity (pp. 176-201).
**Leach, Anna. (2015, Feb. 5). Exporting trauma: can the talking cure do more harm than good?