• What it is a refugee/asylee?
• What have refugee families experienced?
• What are the cultural considerations when working with trauma affected youth?
• What are the stressors associated with being a refugee?

What it is a refugee/asylee?

Refugee
“A refugee is someone who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and in unable to or, owing to such fear, is unwilling to avail himself of the protection of that country.”
-Article 1 of the 1951 Convention Relating to the Status of Refugees

Asylum-Seeker
“Persons who have applied for asylum or refugee status, but who have not yet received a final decision on their application”
-The State of the World’s Refugees 2006: Human Displacement in the New Millennium by The Office of the United Nations High Commissioner for Refugees

“Individuals who meet the legal definition of refugee, but who apply for asylum status after they are already present in the U.S. or at a port of entry. Asylum applicants can have any (or no) immigration status when they apply. Asylum status can be granted by either a USCIS asylum officer or by an Immigration Judge with the U.S. Department of Justice’s Executive Office of Immigration Review."
- Section 208 of the Immigration and Nationality Act

Top

What have refugee families experienced?

Many refugees, especially children, have experienced events related to war or persecution that may affect their mental and physical health long after the events have occurred. These events may occur while the refugees are in their country of origin, during their displacement from their countries of origin, or in the resettlement process here in the US. Below are just a few examples of the many experiences which refugee children may have been exposed

While in their countries of origin refugee children may have experienced:

• violence (as witnesses, victims, and perpetrators)
• war
• lack of food, water, and shelter
• physical injuries, infections, and diseases
• torture
• forced labor
• sexual assault
• lack of medical care
• loss of loved ones

During their displacement, refugee children often face many of the same types of events that they faced in their countries of origin, as well as new experiences such as:

• living in refugee camps
• separation from family
• loss of community
• uncertainty about the future
• harassment by local authorities
• traveling long distances by foot
• detention.

In many ways refugee children may feel relieved to reach their destination when they are resettled in the US. However, the difficulties they face do not end upon their arrival. Some difficulties that refugees face during their resettlement in the US include:

• traumatic stress
• resettlement stressors
• acculturation stressors
• social isolation/alienation and discrimination

Top

What are the cultural considerations when working with trauma affected youth?

Providing care for refugee children and their families is both challenging and rewarding. Refugee families come from cultures that may differ in fundamental ways from the US. There also may be important differences within cultures related to gender, socioeconomic status, and ethnicity. These differences may affect:

• Explanations of health and mental health
• Beliefs about the best course of treatment
• Expectations of outcomes of treatment

In order to provide the best possible care it is essential that providers make efforts to understand and respect refugee families’ culturally informed interpretations of behavior. Some ways that providers can enhance their cultural competence include:

• Reading basic information about country and culture of origin.
• When possible, use an interpreter who knows the culture as well as the language (a cultural broker). Interpreters can help providers understand subtle nuances of particular words or phrases.
• Make efforts to understand and respect understanding and interpretation of symptoms. This may be as simple as asking, “Why do you think you are feeling this way?”
• Try to determine if symptoms represent culturally acceptable ways to express mental health distress. Again this may be as simple as asking “Do you know anyone else who has had these same problems?”
• Make efforts to explain mental health symptoms in ways that are non-stigmatizing and recognize the extreme difficulties that children and their families have been through.
• While it is very important to pay attention to cultural aspects of trauma and other stressors experienced by refugees, it is also important to remember that individual differences play a key role.

For more information about cultural sensitivity please visit these web sites:

BRYCS

Cultural Orientation Resource Center

Top

What are the stressors associated with being a refugee?

Traumatic Stress: occurs when a child experiences an intense event that threatens or causes harm to his or her emotional and physical well-being. Refugees can experience traumatic stress related to:

• War and persecution Displacement from their home
• Flight and migration
• Poverty
• Family/Community Violence

Resettlement stress: stressors that refugee children and families experience as they try to make a new life for themselves:

• Financial stressors Difficulties finding adequate housing
• Difficulties finding employment
• Loss of community support
• Lack of access to resources
• Transportation difficulties

Acculturation Stress: stressors that refugee children and families experience as they try to navigate between their new culture and their culture of origin:

• Conflicts between children and parents over new and old cultural values
• Conflicts with peers related to cultural misunderstandings
• The necessity to translate for family members who are not fluent in English
• Problems trying to fit in at school
• Struggle to form an integrated identity including elements of their new culture and their culture of origin

Isolation stress: stressors that refugee children and families experience as minorities in a new country:

• Feelings of loneliness and loss of social support network Discrimination
• Experiences of harassment from peers, adults, or law enforcement
• Experiences with others who do not trust the refugee child and family
• Feelings of not “fitting in” with others
• Loss of social status

Top