THE INTERNATIONAL TRAUMA STUDIES PROGRAM CLASS OF 2006

PROJECT ABSTRACTS


AN UP TOP, INSIDE AND OUT PERSPECTIVE ON TRAUMA AND SUBSTANCE ABUSE TREATMENT MODELS - Lillian Lennox, MA, Onaje Mu’id, MSW, CASAC, Geraldine Russo

MONITORING INTERNATIONAL PSYCHOSOCIAL INTERVENTIONS - PREVENTION AND RESPONSE TO SEXUAL VIOLENCE IN THE DRC: A CASE STUDY - Nancy Clifford

INTEGRATING NARRATIVES OF SUFFERING WITH THE PROCESSES OF COEXISTENCE - Ann Schumacher

ENHANCING COMMUNICATION AND GENERAL WELL-BEING IN KOSOVAR FAMILIES - Neki Juniku, Ph.D.

“...And then I wondered if we’d be left to die”: TRAUMA, TERROR AND BETRAYAL IN THE AFTERMATH OF HURRICANE KATRINA - Monica J. Indart, Psy.D.

SELF CARE: GROUP WORK WITH PARENTS & MENTAL HEALTH WORKERS - Arielle Goldman, LMSW

BUILDING VIRTUAL COMMUNITIES: A LOOK AT THE 9/11 ONLINE CHAT PROGRAM - Dan Fielder

THE FORMER CHILD SOLDIER AS A REFUGEE - Eugene R. Packer, Ph.D.

PTSD GROUPS FOR PARENTS AND CHILDREN - Elizabeth Duffield, LCSW

DISSOCIATION AND THE AMERICAN DREAM - Aviv Dor

KNOWLEDGE SHARING STRATEGIES FOR THE FIELD OF TRAUMA INTERVENTION - Sheila Pottebaum, Ph.D., Judith Rhinehart

UTILISATION FOCUSED EVALUATION: The Londiani self-determination experience in healing and cleansing ritual for two communities after intertribal killings of 2002 in Kenya: Learning from Striving for Sanctuary model in dealing with ambiguous loss - Nancy Birir, Protasia C.N.Gathendoh, Lisette Soini

AFRICAN REFUGE CENTER HEALING MURAL PROJECT - Angela Tripi-Weiss, Director of Arts In Action Visual Arts Program Inc, Connie Viana, Cynthia Grguric, LMHC

TRAUMA FOCUSED EDUCATIONAL PRESENTATIONS FOR MENTAL HEALTH PROFESSIONALS - Brannon L. Weeks, M.D.

AMBIGUOUS LOSS AS EXPERIENCED BY UNDOCUMENTED MEXICAN IMMIGRANTS - Donna Gabriel Ellaby

EFFECTS OF CONFINEMENT ON DETAINED IMMIGRANTS, A PSYCHO-SOCIAL EVALUATION - Stephanie Palau, LMSW

AN UP TOP, INSIDE AND OUT PERSPECTIVE ON TRAUMA AND SUBSTANCE ABUSE TREATMENT MODELS - Lillian Lennox, MA, Onaje Mu’id, MSW, CASAC, Geraldine Russo


The relationship between interpersonal violence, the resulting traumas and their causality in creating substance use disorders is significant and complex, yet a topic that is just beginning to be researched to any appreciable degree. This presentation- and the forthcoming paper- is an appraisal of three trauma based models by three practitioners who are dissimilarly situated - one is an administrator, one an agency based clinician, and the other an independent clinician. From an agency centric frame of reference (hence the title, “An Up Top, Inside, and Out Perspective on Trauma and Substance Treatment Models”), they will critique the efficacy of the models, which they have independently chosen for the purpose of integrating trauma theory in their current professional setting. The administrator, Onaje Mu’id, the Clinical Associate Director of Reality House, Inc., was concerned most with the issue of changing agency culture to accommodate a paradigm shift to make trauma sensitive services effective, where not least of the problems is the proper training of the staff. To this end, the Ugaza Jamii-Healing Circle Model was chosen to accomplish this goal. Lillian Lennox, the agency based clinician employed at Brien Center for Mental Health and Substance Abuse, inherited the challenge of choosing the best model for her clientele and the awesome task of synchronizing the use of trauma theory amongst peers. She in turn, chose Seeking Safety for the model of implementation. The independent clinician in private practice, Geraldine Russo, absent the dilemma of organizational culture, is directly confronted with the adaptability of a group model to her particular clientele that is primarily contracting independent counseling services, thus the Addictions and Trauma Recovery Integrated Model (Atrium) model was chosen for assessment. This presentation will answer three research questions: (1) What obstacles/barriers might get in the way of running a trauma and addiction sensitive group program in these different settings? (2) What are the specific benefits/disadvantages of each model? (3) What latent ethical standards might be mined from this emerging body of literature on trauma and addiction? Additionally, the presentation is accompanied by observations by each contributor, a future look into the emerging field of trauma and substance treatment, and then concluded with a slide on resources.

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MONITORING INTERNATIONAL PSYCHOSOCIAL INTERVENTIONS - PREVENTION AND RESPONSE TO SEXUAL VIOLENCE IN THE DRC: A CASE STUDY

Nancy Clifford

The mental health needs of developing countries have often been dismissed by international development agencies as relatively unimportant given the overall health needs of developing country populations. In recent years, however, mental health, and in particular the health of trauma-exposed populations, is gaining increased recognition as these agencies try to address issues such as HIV/AIDS, genocide, war-affected populations and natural disasters. Large sums of money have been provided by international development agencies to non-governmental organizations, UN agencies and others to address the psychological needs of trauma-exposed populations in developing countries. Given this growing involvement in psychosocial programming, it is imperative that the international development community keep abreast of current research, thinking and developments in trauma and mental health and, at the same time, contribute to the growing body of knowledge in this area.

The Canadian International Development Agency (CIDA) will be funding a four-year program to address the needs of victims of rape and sexual violence in the Democratic Republic of the Congo (DRC). The program includes four interrelated components: health, justice, economic development and psychosocial interventions. The psychosocial component is a relatively new area of programming for CIDA, especially as it relates to the needs of victims of rape and sexual violence. The purpose of this case study, therefore, is to lay out key considerations that could affect psychosocial programming for victims of rape and sexual violence in the DRC. The framework is intended to form the basis for ongoing assessment of the project. It will be used to gather information, identify lessons learned, key challenges and successful approaches to psychosocial programming generally, and for rape victims in particular. At the same time, the case study is intended to highlight mental health as an area that needs to be recognized, validated and addressed by bilateral donor agencies such as CIDA.

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INTEGRATING NARRATIVES OF SUFFERING WITH THE PROCESSES OF COEXISTENCE

Ann Schumacher

This two-phase project focuses on understanding the complexities of conflict and the narratives of suffering that prevent coexistence between two disputing parties. Coexistence is defined as two or more groups living together peacefully by respecting differences and resolving conflict nonviolently.

The first phase of the project involved listening to and summarizing the main points of two ten-hour seminars on coexistence and trauma conducted by Vamik D. Volkan in 2004, and by Carlos Sluzski and Sara Cobb in 2005 at the ITSP. These summarized notes, organized in notebook form, are now part of the ITSP reference library.

The second phase of the project is the creation of a comprehensive course outline, entitled Integrating Narratives of Suffering with the Processes of Coexistence, which could serve as a preliminary draft for a future course at ITSP. The course examines the complexity of conflict by looking at the relationship between three different, but closely allied fields -- coexistence/conflict resolution, narrative therapy/mediation and trauma/grief studies. This psychosocial and political approach to understanding and potentially altering multifarious interethnic, intercommunity or interpersonal relations has its roots in recent coexistence research by both scholars and practitioners.

Too often, conflict is simplified to an either/or rather than a both/and condition that is polarizing and destructive, leading to victimization and revenge. This course, with its emphasis on a multidimensional understanding of conflict, acknowledges an integrated approach to promoting peace in strife-ridden communities through building community resilience, teaching conflict resolution skills, changing narratives of suffering and victimization, and creating psychosocial and politically viable coexistence structures. Such a course would be of interest to those working in trauma and grief counseling, conflict resolution, diplomacy, refugee care, the arts, industry, and academia (history, political science, international relations, psychology).

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ENHANCING COMMUNICATION AND GENERAL WELL-BEING IN KOSOVAN FAMILIES

Neki Juniku, Ph.D.

During the war in Kosova, an extremely large number of families were severely traumatized. Many of them were lucky to emigrate to the U.S.A. and continue to live here. The traumatic experiences while in Kosova and the radical cultural changes as well as the separation from the loved ones may have caused certain difficulties in their current communication.

Our team planned to interview twelve families. So far we have completed nine. Four out of seven families I interviewed myself were facing serious troubles with their teenage children. In three of them, the typical difficulties were: very poor communication, both parent's and children's aggressiveness, and withdrawal. One teenager has been involved in crimes already. Obviously, a psychosocial, community-based intervention plan, as a part of this project, is urgently needed.

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“ . . . And then I wondered if we’d be left to die”: TRAUMA, TERROR AND BETRAYAL IN THE AFTERMATH OF HURRICANE KATRINA

Monica J. Indart, Psy.D.

This project, still in progress, proposed to gain understanding of the very personal consequences of Hurricane Katrina on the lives of ten New Orleans residents who relocated to New Jersey in the days following the floods that devastated that city in August 2005. A narrative approach to the understanding of trauma and grief was used as the primary methodology, allowing the individuals to “tell their truths” in a manner that helps to capture rather than obscure the phenomenology of their experience. Many of the current “best practice” models of trauma assessment, treatment and research rely upon psychometric measures and structured diagnostic interviews; while research based upon these methods has made immeasurable contributions to the field, the individual, phenomenological and narrative understanding of trauma and suffering has sometimes been neglected, relegated more often to the arts and literature than to science. This project sought to let the voices of a few individuals deeply affected by Hurricane Katrina be heard. Ten individual interviews will provide an in-depth examination of the experience of trauma, terror, and profound grief. A semi-structured interview guide was utilized to elicit certain key domains of information regarding the trauma and grief experience, as well as how these experiences are integrated and understood within the context of an individual’s life story.
Interviews conducted yielded expected themes of traumatic experiences and profound grief, as well as betrayal, bitterness and disillusionment. Self-efficacy, strong spiritual beliefs (including faith in a divine presence and plan), and what can best be described in the words of one 70-year-old woman as “plain old southern stubbornness” emerged as clear sources of personal resiliency. Issues that are similar to those experienced by internally displaced persons (IDP’s) also emerged, including a sense of cultural displacement, the shock of suddenly acquiring a “refugee” status in the eyes of the social system, and the profound experience of “psychological homelessness.” A disproportionate number of this small sample of individuals suffered from pre-morbid psychological disorders (panic disorder, major depression, schizophrenia, bipolar disorder). The entire sample has experienced and/or been exposed to significant interpersonal violence, both prior to Hurricane Katrina as well as during the evacuation process itself.

Qualitative coding of the interviews will comprise the next phase of this project. All participants expressed an interest in making a videotape of the project that would serve as a historical archive of their narrative experience.

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SELF CARE: GROUP WORK WITH PARENTS & MENTAL HEALTH WORKERS

Arielle Goldman, LMSW

This project was created to address the need for psychosocial support within two populations at The Association to Benefit Children (ABC): the parents who receive mental health and preventive services and the workers who work with these parents and their families.

The Parent Support Group carved a space within the agency for parents to share their experiences within the context of peers and two social worker group facilitators on a weekly basis. The facilitators utilized the strengths of the group in order to empower members to find solutions to problems. The group space was created not as a space to teach parents skills, but as a space for parents to teach and support one another. The diversity within the group, including varied ages, ethnicities and gender, facilitated this process as each member contributed their own wisdom as a parent and also as an individual person. The facilitators encourage the discussion within the group of structural problems within society and the way that these structures affect their lives. The Parent Support Group has become a space for “self care”, and though the membership shifts, it is known as a place for parents to share their frustrations and their joys.

The Self Care Group for Workers created a space within the agency for mental health workers to support one another in their work. During the planning stages for the group, administrative support for the group was secured. The bi-weekly group initially focused on external self care interventions and ways to incorporate these into one’s life. However, as the group evolved workers began to talk about the ways that work affects their lives. The Self Care Group is currently becoming a “protected” space in which workers can process their feelings about working with clients who have experienced multiple traumatic situations, including poverty, homelessness, foster care, oppression and sexual abuse. This Self Care Group is becoming a space for workers to acknowledge that their work touches them and shapes their lives.

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BUILDING VIRTUAL COMMUNITIES: A LOOK AT THE 9/11 ONLINE CHAT PROGRAM

Dan Fielder

This presentation will take a look at the Families of September 11 (FOS11) Chat Program, which began in August 2004 after a steady stream of feedback from members who expressed a growing sense of disconnection and isolation three years after the attacks of September 11, 2001. I will examine the many themes that arose during the chat sessions, including experiences unique to some affected groups, damaged or severed family relationships, the public/private aspects of grief related to 9/11, and the impact of traumatic loss. In addition, I will discuss the overall effectiveness of using an online chat program as a tool for building community and promoting healing after loss.

A total of 193 FOS11 members enrolled in nine one-hour chats considered for this presentation, with a total of 63 actually participating. Of the 63 participants, 49 participated in one session only while nine participated in two or more sessions. The vast majority of participants were siblings of victims. Participants represented victims from flights UA175, AA11, AA77, and from the World Trade Center and the Pentagon (there were no chat participants representing victims from flight UA93).

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THE FORMER CHILD SOLDIER AS A REFUGEE

Eugene R. Packer, Ph.D.

The status of children in countries at war is examined. A brief summary of the involvement of children in insurgencies is described, along with international and psychological assessments of that involvement. Consequences to the children, their families, and society are explored, with several case studies offered as illustration. Some long-term effects are discussed, including the results for society when such children become refugees. Developmental and educational consequences are discussed.

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PTSD GROUPS FOR PARENTS AND CHILDREN

Elizabeth Duffield, LCSW

PROJECT DESCRIPTION-

What:
Two groups will be run simultaneously, one with boys ages 8-12 years who have been diagnosed with PTSD, or are dealing with ongoing trauma, due to foster care placement or chaos in the home. Exposure to a traumatic event - not only a diagnosis of PTSD - will determine eligibility. The group will run weekly.

A second parents group will run alongside of the boys group. It will have a psycho education component to address issues of child development/parenting skills, mental illness, trauma and the interaction between these three components. It will also be supportive in nature and the participants will dictate the level of support/education.

A measure will be used to test the level of parental stress and satisfaction upon entering the group as well as their level of knowledge about trauma, mental illness & child development.

A parents education/support group will run every other week, or as frequently as the parent’s deem necessary.

Purpose:
The purpose of this study will be to show the power of peer interactions and reinforcement as well as reparative social experience with children who are dealing with ongoing trauma.

The purpose of this study is also to show the how parents can aid in this process when there is an increase in their perceived level of parent satisfaction, parenting skills as well as feelings of parental competency.

Significance:
It will also be used to see if an increase in parents perceived knowledge about their children’s disorder as well as feeling of support as stated above is correlated with a decrease in PTSD/trauma related symptoms in their children (i.e.: emergency room visits, school suspension, extreme conflict in the home)

We also hope to show the role of socialization and peer support as a means of helping children to process and deal with trauma, as based on the number of aggressive altercations they are involved in with peers.

Plan of Work:
We plan to run the boys group independent of the parents group for 3 months, beginning in the summer of 2006, when space becomes available.

Expected Results:
A decrease in explosive incidents/emergency hospitalizations of the children involved. There will be a decrease in the parent’s stress levels and an increase in their level of satisfaction in the home lives as well as a decrease in explosive incidents/emergency hospitalizations of the children involved.

Ideally, these results will be used to implement a trauma training based on this curriculum. This training could be used with staff as well as parents.

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DISSOCIATION AND THE AMERICAN DREAM

Aviv Dor

Every nation has a national identity formed by its history, traditions, memories, and inevitably, myths. The myths of the U.S. bear more weight than most countries'; and these myths have had a huge impact on our self-perception and consequent political, economic and military actions at home and abroad.

The US was born of the myth of a land without people for a people without land, in the settlers' escape from Britain. In truth, its inception was tainted with great violence and oppression. Yet our history books tell us of our founding fathers, who were seeking freedom of oppression and miraculously found it here. This initial myth ushered in what has become our national identity, and has maintained its strength in our psyche. There has never been an integration of who we are and what we have done. A policy of doing and not knowing is dissociation at its most formidable, and has lead us to this moment, which is highlighted by the immigration debate, race issues, and income gaps.

Is it not the pride of our land to be a haven for immigrants and refugees, the oppressed and those seeking freedoms? Has our narrative changed, or are we finally being demystified? How do we identify who we are without integrating what we have done?

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KNOWLEDGE SHARING STRATEGIES FOR THE FIELD OF TRAUMA INTERVENTION

Sheila Pottebaum, Ph.D.

Judith Rhinehart

With a global environment of ever-increasing human suffering related to war, public health crises, natural disasters, and political repression, the need to continually redefine conceptual frameworks to assist in reducing subsequent traumatic sequelae is increasing in tandem. While there is a vast body of explicit knowledge surrounding methods to address trauma-induced suffering, the tacit knowledge crystallized through dialogue, discussion, experience sharing, and observation is equally valuable in both defining sustainable interventions as well as capitalizing on the dynamics of actual implementation of trauma interventions within the field. The focus of this project is work toward defining a set of processes to continuously connect those responsible for direct intervention with those advancing the conceptual development of trauma studies to mutually foster innovations that have a demonstrable impact on the affected communities.

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UTILISATION FOCUSED EVALUATION: The Londiani self-determination experience in healing and cleansing ritual for two communities after intertribal killings of 2002 in Kenya: Learning from Striving for Sanctuary model in dealing with ambiguous loss

Nancy Birir

Protasia C.N.Gathendoh

Purpose:
First, we are seeking to boost the existing modalities by an integrated model of psycho-educational methods with a common language and shared assumptions, in which trauma recovery can occur.
Second, this evaluation is also a process to assess the benefits of the implemented psychosocial leaders’ training in March and April 2002 and document the opportunities and lessons learned to make sure that these relate to cultural norms in nonviolent conflict management in these communities.

Project Description:
The goal of our group project is to develop and document a comparative learning for an evaluation of ethnic institution and self-determination experience in communal healing. This peace building agenda is promoted by knowledge of an event that affected a Kipsigis and Gikuyu communities who are different but who have lived side by side as neighbors in Londiani for over 30 years. Kipsigis is one of the tribes of the Kalegin in the Rift valley in Kenya. Specifically it is known in this community that it is a taboo to harm or inflict injury by shedding human blood. On the afternoon of March 3rd, 2002 a group of more than 20 men resulted to violence after the women in the village relayed distress cry that “the Gikuyus” had killed some of their “Kipsigis” children (boys) who were looking after their herds in a communal forest land. The men acted on behalf of their community but the council of elders had not mandated them to do so. They attacked a whole village and caught families unaware. Two unarmed men were killed, 12 homesteads; (house, detached kitchen and granary) burned to ashes and 18 homes vandalized. Several animals were stolen, particularly two prized bulls. The communities believed the offenders went deep into the forest and slaughtered the bulls for a feast.

The effort to save them from this stigma and curse may ironically be inducing ongoing traumatic stress. However not to address this underlying sense of loss is a greater threat with many negative reactions contingent on the loss of one’s personal sense of identity. Our enthusiasm is based on universal response with deeply rooted passion to make peace with the offended. In this case, injured and bereaved families living across the ridge are likely to meet almost daily. This is a reality because the two villages share the same river, and water, attend the same churches, sell and buy farm products at the same market place or travel in the same public transport. Another observable pattern would be to seek and listen to any form of the silence by the women. This manifestation may lead on to identifying form of continued ambiguous loss and fearful concerns about the curse psychologically and emotionally present as a threat to the lives of their husbands or sons.

To heal this trauma of loss as best we can, we will gather resources, identifying and find old or new ways in which our youth can reconnect with the wisdom of lessons learned. Our intention is to work with the council of elders for community evaluation of healing the community spirit of vested authority, respect and integrity. Our assumptions are based on the belief that the young men are perceived in their expected roles as protectors - “Warriors” as primary responsibility and only when mandated to be “Fighters” for their families. This is a profound human need, which underlies the quality and progress of every life.

Three interventions conducted in March and April 2002 are:

    • 3 days - Leaders Conference with over 105 participants
    • 1 day - visit to the bereaved, the injured and the displaced families
    • 5 days - community education and training
Immediate needs:
    • Institute food chest for about six months for families whose granaries were burned
    • Women groups to visit the widows and orphans
    • Men from both communities to proved skilled and non-skilled house repair and reconstruction
    • Forester and area chief coordinate procurement of building material from the forest (poles, rafters, timber and grass thatch)
    • Community contribution of cash to purchase maize, potatoes and beans seeds for all the affected families because it was planting season. It takes six months for maize crop to mature and about four months for the beans and potato crop
    • Provide police presence with a local police post
    • Organize community cleansing for the offenders who were not allowed to return home because of the taboo about human killing

Broad objectives of learning about the ethics of evaluation are to:
    • Understand the principles of utilization-focused and learning-oriented evaluation as applied to the field of psychosocial foundations in peace building as development agenda
    • Design an appropriate assessment or evaluation strategy for real program context including purpose, working with the users, getting to invest in appropriately usable values and norms and marketing the experience to a larger audience in partial fulfillment of the international trauma studies program

To study perspectives, worldviews and frames of reference of the appropriate traditional and modern ways of managing conflicts. We will explore community-based initiatives supporting restitution and establishing on going community learning in building just, fair and peaceful community.

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ART THERAPY IN THE AFTERMATH OF THE TSUNAMI

Lisette Soini

The Indian Ocean Tsunami of 2004 greatly affected the lives of hundreds of thousands in South Asia. In Sri Lanka alone it is estimated that this disaster caused 35,322 deaths and several thousand more have been displaced. In the summer of 2005, six months after the tsunami hit, I had the experience of conducting a mental health intervention within a public school in Payagala, a small town on the Sri Lankan coast which was largely destroyed by the tsunami. I spent five weeks leading art therapy groups with students who experienced great trauma and loss. The art therapy sessions provided these children and adolescents with an alternative and culturally sensitive means by which to express their innermost feelings and to externalize their trauma. It was later found, through a visual analysis of their images, that many of these youths’ fears and anxieties have been eloquently conveyed in their drawings—specifically as embodied in their imagery of water. Furthermore, it was noted that the drawings that do not overtly represent the traumatic experience are equally as eloquent in their expression of trauma as those explicit images of the tsunami. This paper therefore encourages art therapists to search for the hidden expressions of trauma as they too speak volumes.

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AFRICAN REFUGE CENTER HEALING MURAL PROJECT

Angela Tripi-Weiss, Director of Arts In Action Visual Arts Program Inc
Connie Viana
Cynthia Grguric, LMHC


Project Scope:
The objective for facilitating the creation of a wall mural for the African Refugee Drop-in center was to build community trust, connectedness, mutual intergenerational and experiential understanding. The goal was not just the mural itself but the healing process through its construction. In any refugee community the intercommunity needs and level of bonding is a unique constellation of cultural ideas, host country resources for each generation/group/individual, and pre and post experiences in the country of origin. The individual needs and issues will also depend on age, health, goals, losses, economics, support from community, family, and abilities to adapt. These issues emphasized by the integration of different generations and new and old immigrants into the community placed a strain on the Liberian community in Staten Island. The mural design and its creative process sought to build cohesiveness through narrative and artistic expression of personal concerns, adaptive struggles, and needs and develop a foundational understanding of what one must learn in order to create a mural. As in any closed community (organization, family) the overall ability of an immigrant population to thrive in the host country depends on the security and intercommunity support as well as resources made available to them.

Methodology:
To facilitate this process, individuals ages 6 to 65, new and old immigrants, male and females were recruited to participate. One on-site and one off-site workshop was held that produced 27 individual drawings and narratives expressing past, current, and future adaptation issues. These drawings were then sorted by themes and culled into 3 Master Mural Design compositions that the community voted on. The selected mural representing the 27 individual drawings was then drawn and painted by the community under the direction of a facilitator.

Expected Results:
The expectation was to facilitate healing, dialogue, and understanding as each person and/or group had the opportunity to express his or her thoughts, emotions, cultural pride, current cultural struggles, and experiences. The symbolism of placing all the represented themes into one platform models a cohesive experience to the community. Everyone would be given an opportunity to be understood and release thoughts/emotions they have been struggling with. This process hopes to facilitate empowerment through the visual arts. An additional aim was to increase ownership and awareness of the African Refugee center and its services.

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TRAUMA FOCUSED EDUCATIONAL PRESENTATIONS FOR MENTAL HEALTH PROFESSIONALS

Brannon L. Weeks, M.D.

The purpose of the project is to provide information about the trauma studies field to various mental health workers. The topics of the presentations were chosen based on the needs of the target audience and were intended to expand on the participants basic knowledge of the trauma field, to introduce various conceptual frameworks, and to generate discussion among the participants. The project consists of a series of five presentations, each of which follow a different format and are directed at various target audiences. Each presentation is described in greater detail in the sections that follow. The first three presentations in the series have been completed. The last two presentations are scheduled, but could not be completed prior to the deadline for the International Trauma Studies Program.

The first seminar in this series was a case presentation for child and adolescent psychiatry residents, and faculty and staff of the child and adolescent psychiatry training program. The case of a nine-year-old boy who had been, over a period of months, sexually assaulted by an older boy was presented. Information relating to developmental issues and trauma were discussed as were issues related to engaging the family in treatment and the utilization of school and community resources.

The target audience for the next presentation was general psychiatry residents, child and adolescent psychiatry residents, psychology interns, social workers, employees of the Department of Mental Health, and faculty of the psychiatry and psychology training programs. An overview of the concept of ambiguous loss was presented with a question and answer period following.

The third segment of the series focused on the trauma of divorce with particular attention to the effects of custody battles on children. Issues of forensic psychiatry and the effects of court testimony on the therapeutic alliance with the child were discussed. Participants in this presentation were child and adolescent psychiatry residents and faculty of the training program. The format consisted of a thirty minute long presentation and a thirty to forty-five minute discussion and debate among the participants.

The next presentation is scheduled for the end of May. The target audience will be child and adolescent psychiatry residents and faculty of the child and adolescent psychiatry training program. The focus of the presentation will be the use of art and media in the treatment of individuals who have experienced trauma. There will be both a lecture portion and an experiential portion of the presentation.

The final segment of the project is scheduled for the beginning of June. This seminar will focus on individual, family, and community interventions after massive disasters. The participants will be general psychiatry residents and faculty and staff of the general psychiatry training program.

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AMBIGUOUS LOSS AS EXPERIENCED BY UNDOCUMENTED MEXICAN IMMIGRANTS

Donna Gabriel Ellaby

On December 16, 2005, the U.S. House of Representatives passed HR. 4437, considered by many pro-immigrant advocates and experts to be the most restrictive immigration legislation since the Chinese Exclusion Act of 1882. Under HR. 4437 residing in the United States without legal status would become a felony. Moreover, anyone providing assistance and support to an undocumented immigrant, including a child, could face prosecution. Passage of HR.4437 took many immigrants, both documented and undocumented, by complete surprise. It is in the context of HR.4437’s passage that I interviewed twelve undocumented Mexican immigrants. I chose Mexicans because historically they have been active participants in a labor migration to the United States that dates back to the Chinese Exclusion Act. The “ebb and flow” of Mexicans across the border has frequently been the result of government sanctioned programs to compensate for labor shortages, particularly during the wartime. As a result, generations of Mexicans have grown accustomed to moving freely across the border in search of a better life. It is only in recent years that border restrictions have made it extremely difficult if not impossible for the undocumented to visit families and homeland.

All of my interviewees have the following characteristics: Mexican, undocumented, at least five years in the United States, between twenty and thirty years of age, present in New York City on 911. I felt a five-year minimum residency was important because siblings left behind would have advanced to a new developmental stage, and separation may be more deeply experienced. I focused on younger immigrants because according to a number of ethnographic studies, decisions about resettlement often remain unexplored in immigrants thirty and younger. The events of 911 changed the tenor of debate about immigration and also succeeded in placing comprehensive immigration reform on the back burner. By exploring the experience of 911 and its subsequent impact on immigrants with my interviewees I was able to introduce the concept of loss, as both a personal and a social phenomenon.

The questionnaire I put together examined family, community, identity, aspirations, hope, and loss with regard to life in Mexico and life in the U.S. All of those interviewed have close family members still in Mexico. All have missed celebratory family events. Five were unable to attend family funerals of a sibling, parent, grandparent, uncle or cousin. All consciously chose to come to the U.S. yet felt they had few, if any options. Life in Mexico was compared by some interviewees to a slow death. With regard to the passage of HR.4437, their responses revealed a mixture of anger and sadness. While all of my interviewees expressed a sense of loss for absent family members, I feel their loss of hope for the future and the criminalization of their identity as a result of HR.4437 is an ambiguous loss with potentially traumatizing consequences. Through my interviews I sought to explore the concept of ambiguous loss and its relevance to a small sample of undocumented Mexicans in the context of HR.4437.

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EFFECTS OF CONFINEMENT ON DETAINED IMMIGRANTS, A PSYCHO-SOCIAL EVALUATION

Stephanie Palau, LMSW

Thousands of immigrants and refugees are detained at Immigration and Customs Enforcement facilities across the country. Their future depends heavily on which detention center they are housed in, which Immigration Judge they are appointed to, and whether they are lucky enough to have an attorney representing them, either pro-bono, or hired depending on their means. Many immigrants appear before the court totally unrepresented and many of them are denied entry to the United States.

Throughout my years of experience visiting immigrant detainees in various immigration detention centers in New York, New Jersey, and Arizona, I have found both similarities and differences in psychosocial well-being among individual detainees.

I am interested in better understanding the psycho-social effects of confinement on detained immigrants. Since 2004 I have worked mainly with individuals seeking political asylum from primarily West African countries, including DR Congo, Cameroon, Gambia, Guinea, and Nigeria. Depending on detention center location and conditions within the individual center, I have observed varying degrees of adjustment and psycho-social well being regardless of country of origin.

It appears to me, thus far, that the number one factor contributing to ones adjustment and psycho-social wellbeing in US detention while awaiting the outcome of their asylum plea may be the conditions of the detention center where they are housed.

Other factors which have an impact on ones psycho-social well being include;

    • Treatment by detention center officers/guards (degree of respect)
    • Degree of freedom within the detention center, including recreation time, rules of work, library, services available, etc.
    • Whether they have an attorney representing them
    • Contact with family/friends in home country
    • Contact with someone in US
    • Able to communicate with someone in their dormitory (same language)
    • Safety & Hope (Do they feel safe in detention? Do they maintain hope?)
My initial expectation for detained asylum seekers was that they would be at greatest risk for being re-traumatized. My initial findings have found detained individuals do have high degree of PTSD symptoms (difficulty sleeping, nightmares, no appetite, flashbacks, increased anxiety, etc) but that their attitude of how they are treated within the detention center is highly correlated with their coping abilities and psycho-social well being.

I look forward to gaining a better understanding of the psycho-social effects of confinement on immigrant detainees as I continue to evaluate and provide treatment to detained individuals in AZ. I would also like to expand my research to include:
    • Psychological Effects of Solitary Confinement in Detention
    • Effects of Illegal Border Crossing via Arizona Dessert
    • Children in Detention
    • Occurrence of PTSD, Re-Traumatization in Detention



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