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Refugee Services Toolkit

Refugee Services Toolkit Trauma Acculturation Resettlement Isolation

Case Example

Rachel

The following case example is a fictional composite of a refugee adolescent presenting to our school-based mental health program. As a composite example, she represents many of the experiences that refugee youth encounter.

Rachel is a 14 year old girl who was referred to our program by a teacher. She was born in Africa and was the fifth and youngest child in her family. Rachel was an infant when war broke out in her native country. A lot of her family members were killed during the war and her mother walked for a month to a refugee camp in Kenya when Rachel was a small child.

When she was 4 years old, Rachel was molested in the refugee camp by a relative. She tried to tell her family about this but was told to never mention it because of the shame it could bring to her family. As well, Rachel’s mother Rachel experienced much trauma and exposure to violence in the war and suffers from mental illness due to these traumas. She was mostly bed-ridden and was not able to care and comfort Rachel during her formative years.

The family migrated to the U.S when Rachel was 10 years old. Soon after the family arrived here, Rachel started having problems with kids at school. Kids were calling her names because of her accent and because how she dressed. This led to her getting into fights and being suspended from school. As well, Rachel and her mother started getting into argument because her mother felt that she was starting to act in a way that went against her culture. These fights accelerated into physical fights. Rachel’s mother started talking to other community members about what ‘a bad child’ Rachel was which further damaged their relationship.

As community members heard more and more about Rachel’s troubles from her mother, they started forbidding their children to play with her. This pushed Rachel even farther away from the community. Thus Rachel found herself isolated, unwelcomed by the new community in which she lived and ostracized by the community from which she came from.

Apart from the conflict between Rachel and her mother, the family was facing many other stressors. The family was facing eviction from their public housing unit because of Rachel’s behavior which made the family in danger of losing their Federal housing. The family was facing financial crisis because they had been here for many years and were about to lose their major source of income the mother’s social security since she has not been able to pass her citizenship test.. Furthermore, Rachel was no longer attending school because she had been placed in a class that was not suited to her academic level and she felt ‘stupid’ because she could not do the work.

Some examples of interventions that could help this child: