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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