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THERAPEUTIC CARE OF
SEPARATED CHILDREN
SEEKING ASYLUM
Gillian Hughes
Consultant Clinical Psychologist
Child and Family Refugee Team
Working with trauma
• Bracken, Giller & Summerfield (1995) – Psychological
responses to war and atrocity:
‘..the fact that symptoms and signs can be reliably
identified in different settings is no guarantee that they
mean the same thing in those settings’.
• Western beliefs: the person as a distinct and independent
individual capable of self-transformation in relative
isolation from social contexts.
• Western models of trauma – focus on intra-psychic
events, psychological and neurological processing.
Bracken, Giller & Summerfield (1995) Social,
political and cultural realities
• Social: family circumstances, available social
networks, economic position and employment
status
• Political: engagement in a political
movement, social position defined by gender,
class, ethnicity etc., victims of organised
violence.
• Cultural: spiritual beliefs, language, concepts
of self, community & illness, ontological beliefs
Specific challenges faced by
separated children seeking asylum
• Witnessing trauma in home country
• Loss of family and home
• Traumatic journey to the UK
• Settling in a new country without the
support of family
• Facing ‘negative identity definitions’
‘Negative identity definitions’
Psychological
well being &
functioning
IDENTITY
Stories lived & told
Stories told about separated children
seeking asylum and by them
• Foucault (1980) – social discourses shape
our relationships with each other, and the
rules governing social behaviour (legal
system, govt. policy).
• Negative discourses about refugees
become ‘internalised’ (White &
Epston,1990)
Context creates negative definitions of
identity:
• Right to be in UK being questioned
• Not being believed in court
• Re-telling traumatic stories, ‘victim’
identity
• Public discourses ‘bogus asylum
seekers’ ‘dole scroungers’
Approaching 18….
Loss of aspects reinforcing positive
identity:
• Loss of hopes for the future - access to
education, future career
• Loss of foster families
• Loss of social support networks – child
services, school friends & teachers.
• Potential loss of British identity and friends
How to respond?
Focus on vulnerability or
resilience?
How to respond? Narrative approaches
• Create a ‘safe place to stand’ – the
riverbank metaphor.
• Put people in touch with hopes, aspirations,
values for living.
• Emphasise ‘subjugated narratives’ (White,
2005), stories of survival
• Audience for preferred stories - ‘spreading
the news’, (Freedman & Combs, 1996)
How to respond? Liberation Practices
• Witness, name, and highlight injustice, (Martín-
Baró, 1996) - place distress in context to avoid
‘internalising discourses’
• ‘Community resilience’ and ‘cultural virtues’ – how
do people practice resilience and how developed
in context of history & culture (Afuape & Hughes,
2016)
• Coming alongside people, holding our expertise
lightly (Hughes & Bisimwa, 2016)
How to respond? Community Psychology
• Bring people together, create connections
• Social action psychotherapy (Holland,
1992)
• Re-position people as having something to
contribute, eg. Richmond Park project,
letters to Calais migrant camp
• Use of creative media to facilitate ways of
sharing preferred stories (Clayton &
Hughes, 2016)
Group for Afghani young people
(separated adolescents seeking asylum)
‘Tree of Life’ narrative
metaphor
(Ncube & Denborough, 2008)
Hopes and aspirations (branches),
resilience/ abilities (trunk),
social and cultural history of
these (roots)
Comments from young people who
attended the narrative group
• Before, I was hopeless and now I am thinking ‘yes, I can
do it!’
• The best thing was it gave me encouragement to carry on
and not give up
• It felt good to share ideas with others about hopes for the
future
• It gave me hope meeting others in the same position
Richmond Park
• Young people create their own story
• Shared experience
• Fun (picnic, football)
• A document to share with others –
‘spreading the news’ (Freedman & Combs,
1996)
• Hand held cameras, prompts
Film made by the young people
What the day enabled
‘Richmond Park was fantastic, fantastic….’
• Gave the young people a voice
• Environment that connected them with home
• Fun, created sense of community
• Re-positioned them as having something to
contribute
Summary of guiding principles
•
•
•
•
•
•
•
Focus on resilience before addressing vulnerability
- ‘a safe place to stand’
Identify preferred views of self, rooted in
community, culture and social history
Hold expertise lightly – coming alongside people
Create connections, audiences for preferred
stories,
Emphasise social, political and cultural contexts
Focus on community (community resilience)
Re-position people as having valuable knowledge
to share.
References
• Afuape, T. & Hughes, G. (2016) (Eds.), Liberation Practices: Towards
Emotional Wellbeing Through Dialogue. London: Routledge.
(Chapters: Hughes & Bismwa; Clayton & Hughes)
• Bracken, P.J., Giller, J.E., & Summerfield, D. (1995) Psychological
responses to war and atrocity: The limitations of current concepts.
Social Science and Medicine, 40 (8), 1073-1082.
• Denborough, D. (2008). Collective Narrative Practice: Responding to
individuals, groups, and communities who have experienced trauma.
Dulwich Centre Publications, Adelaide.
• Freedman, J., & Combs, G. (1996) Narrative Therapy. The Social
Construction of Preferred Realities, Norton
References cont.
• Holland, S. (1992) ‘From social abuse to social action’, in
Ussher, J. and Nicholson, P. (eds), Gender Issues in Clinical
Psychology, London, Routledge, 68–77
• Hughes, G (2014) Finding a voice through ‘The Tree of Life’: A
strength-based approach to mental health for refugee children
and families in schools. Clinical Child Psychology and
Psychiatry, Vol 19(1) 139–153.
• Martίn-Barό, Ignacio. (1996). Writing for a Liberation
Psychology. Cambridge, MA: Harvard University Press.
• Ncube, N. (2007). Tree of Life: An Approach to working with
vulnerable children, DVD, Dulwich Centre Publications.
Ncube-Milo, N. and Denborough, D. (2008) The Tree of Life
Manual, REPPSI. www.repssi.net