For a school paper researched Unaccompanied Refugee Trauma

1. Unaccompanied Refugee Minor Trauma
David Grenn
Liberty University
TRMA-810
1

2. Outline
Definition of terms
Incidence rates and statistics
Types of trauma involved
Mental Health Needs and Psychological
considerations
Bio-psychosocial Evaluation
Preferred Theoretical Modalities
Pastoral Care & Migration

3. Refugee
Definition
“someone who is unable or
unwilling to return to their
country of origin owing to a
well-founded fear of being
persecuted for reasons of race,
religion, nationality,
membership of a particular
social group, or political
opinion”
(United Nations, n.d, p.2)
3
Retrieved at
https://www.pewtrusts.org/en/research-and-
analysis/blogs/stateline/2015/08/24/unaccom
panied-children-from-central-america-one-
year-later

4. Asylum seekers
Definition
Refugees from other countries
that come to the United States
requesting asylum must
establish race, religion,
nationality,
membership in a particular
group, or political opinion
was or will be at least one
central reason for persecuting
the applicant
(Malwitz, 2018, p. 10)
4
Retrieved at
https://www.americanprogress.org/issues/immigrat
ion/reports/2016/05/05/136610/a-short-term-plan-
to-address-the-central-american-refugee-situation/

5. Unaccompanied Refugee
Minor
Definition
A youth under 18 years old,
who enters
The United States
unaccompanied
by a parent or guardian
and without legal status
seeking asylum
(Roth & Grace, 2015, p. 244)
5
Retrieved at https://sputniknews.com/europe/201605021038961550-eurostat-eu-asylum-seekers/

6. Global Crisis
21. 3 million refugees
worldwide
Half are under 18
35% present mental health
problems
Related to posttraumatic stress
disorder (PTSD)
(Tello, Castellon, Aguilar, & Sawyer, 2017, p.
360)
6
Retrieved at https://ctbi.org.uk/how-the-churches-are-
responding-to-the-refugee-crisis/

7. URM Northern Triangle
Crisis
Northern Triangle consists of:
El Salvador
Guatemala
Honduras
(Tello, Castellon, Aguilar, & Sawyer, 2017, p.
360)
7
Retrieved at
https://www.unrefugees.org/emergencies/central-america/

8. URM Northern
Triangle Crisis
El Salvador
(1960 to 996 civil war)
Guatemala
(36-year-old civil war)
Honduras
(2009 military coup)
(Tello, Castellon, Aguilar, & Sawyer, 2017, p. 360)
8
Retrieved from
https://resourcecentre.savethechildren.net/library/forced-flee-
central-americas-northern-triangle-neglected-humanitarian-crisis

9. General Statistics
URM Children Age
Age FY2018 FY2017 FY2016 FY2015 FY2014 FY2013 FY2012
0-12 15% 17% 18% 17% 21% 14% 11%
13-14 12% 13% 14% 14% 16% 13% 11%
15-18 37% 37% 37% 38% 36% 40% 39%
17 35% 32% 31% 30% 27% 34% 38%
Retrieved at
https://www.acf.hhs.gov/orr/about/ucs/fact
s-and-data
9

10. General Statistics
URM Children Country of Origin
Country of
Origin
FY2018 FY2017 FY2016 FY2015 FY2014 FY2013 FY2012
Honduras 26% 23% 21% 17% 34% 30% 27%
Guatemala 54% 45% 40% 45% 32% 37% 34%
El Salvador 12% 27% 34% 29% 29% 26% 27%
Mexico <5% 3% 2% 3% 3% 5% 4%
Retrieved
at https://www.acf.hhs.gov/orr/about/ucs/f
acts-and-data
10

11. General Statistics
URM Children Referrals
Year Referrals
FY2018 49,100
FY2017 40,810
FY2016 59,170
FY2015 33,726
FY2014 57,668
FY2013 24,668
FY2012 13,625
Retrieved
at https://www.acf.hhs.gov/orr/about/ucs/f
acts-and-data
11

12. Changing Migration Trends
Of URM Children
Countries of Origin
In 2009 82% were from Mexico
In 2014 75% came from
Northern Triangle
(Ciaccia & John, 2016, p. 231)
Increased Numbers
During 2000s URM averaged
7,000-8,000
Beginning 2012 increased to
13,625
In 2014 escalated to 68,541
(Ciaccia & John, 2016, p. 231)
12
Retrieved at https://www.vox.com/2014/6/16/5813406/explain-
child-migrant-crisis-central-america-unaccompanied-
children-immigrants-daca

13. Reasons for Migration
Violence
Poverty and unemployment
Parent reunification
Financially help family
Land of opportunity
(Ciaccia & John, 2016, p. 231)
13
http://www.emigration.link/push-pull-factors-chinese-migration.htm

14. Violence
Central America highest
homicide rate in the world
Violent gangs and drug cartels
Physical and sexual
exploitation
Human trafficking
(Ciaccia & John, 2016, p. 231)
14
https://www.americanprogress.org/issues/immigration/news/2016/02/24/131645
/they-are-refugees-an-increasing-number-of-people-are-fleeing-violence-in-the-
northern-triangle/

15. Poverty and
unemployment
Social inequalities, natural
disasters
El Salvador and Honduras 63%
poverty
Guatemala 59% poverty
Unemployment in Northern
Triangle 50%
Youth that never worked or studied
25%
(Tello, Castellon, Aguilar, & Sawyer, 2017, p.
360)
15
https://www.globalcitizen.org/en/content/hunger-is-driving-central-
americans-to-cross-the-u/

16. Parent Reunification
Many URM children have not
seen parents for years
Raised by extended family
Period of adjustment
(Ciaccia & John, 2016, p. 231)
16
Retrieved
at https://www.yahoo.com/lifestyle/decoding-
homeland-security-plan-reuniting-193849297.html

17. Financially help the family
Most residents from Northern
Triangle
Uneducated and untrained
Little vocational training
Extreme poverty with no hope
(Tello, Castellon, Aguilar, & Sawyer, 2017, p.
360)
17
https://www.responsibletravel.com/holiday/1
6046/northern-laos-holiday

18. Land of Opportunity
United States offers
Employment
Education
Job training
And hope
(Tello, Castellon, Aguilar, & Sawyer, 2017, p.
360)
18
https://www.responsibletravel.com/holiday/1
6046/northern-laos-holiday

19. Prevalence and Severity
Mental Health Needs of URM
Children
Psychological Considerations
19
Retrieved
at https://en.calameo.com/books/004070067ac6ac71fe151

20. Mental health needs
URM Children May
Experience Mental Health
Disorders
Post-traumatic stress disorder
35%
Depression and Anxiety 28%
emotional and behavioral
problems 52%
(Tello, Castellon, Aguilar, & Sawyer, 2017, p. 360)
20
Retrieved at https://coyotelegal.com/2014/01/23/why-we-need-to-
stand-up-for-unaccompanied-immigrant-children

21. Mental health
Symptoms
21
Sleep problems
Concentration disorders
Nightmares
Depression
Withdrawal
Anxiety
Severe grief reactions
Sadness
Severe guilt feelings
(Katsounari, 2013, p.353)
https://kccmediahub.net/unaccompanied-
asylum-seeking-children-in-kent745

22. Psychological
Considerations
Extensive challenges at each
stage of migration process
Psychosocial stressors place
children at risk
Family separation
Migration related trauma
(Katsounari, 2013, p. 352)
22
https://www.usatoday.com/story/opinion/201
8/06/28/immigrant-children-trauma-families-
trump-executive-order-reunification-
column/731637002/

23. Psychological
Considerations
Risk factors include:
Frequency of adverse life
events
Past traumatic experiences
History of personal injury
Social isolation
(Criscola, 2018, p. 47)
23
Retrieved
athttps://medium.com/@AreYouSyrious/c
hildren-left-without-shelter-after-large-
fires-in-the-jungle-dd9301cff389

24. Trauma Pre-Migration
Parental abuse and
abandonment
Community and family
violence
Most education ends after
grammar school
Long work hours with little
income
(Iii, Cardoso, & Crea, 2019)
24
Retrieved at https://salud-america.org/study-
how-latino-youth-cope-with-stress-parental-
separation/

25. Trauma Pre-Migration
Sexual assault
Poverty (lack of basic needs)
Violence
Health risks (lack of medical
care)
Losses (family, home, way of
life)
Gang and drug violence
Lack of protection from
government
(Ciscola, 2018, p. 231)
25
Retrieved
at https://www.aljazeera.com/news/2018/12/
murder-honduran-teens-highlight-dangers-
refugees-border-181220212804745.html

26. Trauma Mid-Migration
Dangerous modes of
transportation
Fear of apprehension and
detainment
Encountered intimidation
Assault
Rape and human trafficking
Perils of the desert
Physical and emotional pain
(Criscola, 2018, p. 232)
26
Retrieved
at https://www.aljazeera.com/news/2018/12/
murder-honduran-teens-highlight-dangers-
refugees-border-181220212804745.html

27. Physical and emotional
pain
Many URM children
experience
Being beaten and robbed
Physical and sexual assault
Fallen from "La Bestia" (non-
passenger train)
Feet and ankles sore and
injured walking
(Tello, Castellon, Aguilar, & Sawyer, 2017, p. 360)
27
https://www.usatoday.com/story/opinion/2018/06/28/immigr
ant-children-trauma-families-trump-executive-order-
reunification-column/731637002/
Click to add text

28. Trauma Post-Migration
Acculturation struggles
Loss of social network
Language barriers
Worries about the future
(Katsounari, 2013)
28
Retrieved at https://www.businessinsider.com/migrant-kids-detention-center-pictures-
details-us-mexico-border-casa-padre-2018-6

29. Acculturation struggles
Language barriers
Cultural shock
Academic stress
Racism and discrimination
Cultural bereavement
(Katsounari, 2013)
29
Retrieved from https://latintrends.com/new-project-launched-to-help-
detained-latino-children-immigrants/

30. Worries about the future
Navigating through complex
legal system
Social cultural, and linguistic
differences
May have experienced
multiple losses
No guarantees of legal status
(Katsounari, 2013)
30
Retrieved at
https://courtneydefeo.om/anxious-kids-
sissy-goff/

31. Bio-psychosocial
Evaluation
URM children arrive with
little or no medical or family
history
Assess for:
Medical
Mental health
Vision
Hearing
Dental
Trafficking issues
(Katsounari, 2013)
31
Retrieved at
https://www.theatlantic.com/health/archive/2014/12/a-
child-an-immigration-hearing-and-a-doctors-
testimony/383169/

32. Physical Exam
Full personal and family
medical history
Complete physical examination
Laboratory screening tests
Immunizations given
(Criscola, 2018)
32
Retrieved at https://www.theatlantic.com/health/archive/2014/12/a-child-an-
immigration-hearing-and-a-doctors-testimony/383169/

33. Educational assessment
Limited education
Undocumented refugee children
often have limited education most
only know how to read and write
(Katsounari, 2013)
33
Retrieved at https://fxb.harvard.edu/2016/06/23/protecting-
and-integrating-children-on-the-move/

34. Preferred Theoretical
Modalities
How to help undocumented
refugee children
Relaxation skills
Mindfulness-based interventions
Trauma-focused CBT
Expressive counseling
Narrative Exposure Therapy
Resilience building
Creating a place of safety
(Unterhitzenberger, et al., 2015)
34
Retrieved at
http://www.fluxtrends.com/mental-health-
care-for-refugees//

35. Individual Counseling
Creating a safe place
Guided imagery
Present moment
Acceptance
Feeling safe
35
Retrieved at https://www.goodtherapy.org/blog/using-emdr-to-find-your-safe-place-in-
trauma-recovery-0815164 (Gucht, Glas, Haene, Kuppens, &
Raes, 2019)

36. Trauma-Focused CBT
Empirically supported
treatment
Trauma-Focused CBT was
identified as being the most
successful treatment for trauma-
related symptoms in
unaccompanied refugee children
with reported decrease of
posttraumatic stress symptoms
(Katsounari, 2013)
36
Retrieved at https://tfcbt.org/

37. Processing Trauma
Processing trauma by telling
one's story
Narrative Behavioral Therapy
helps to give meaning to one’s
story allowing the youth to share
trauma and to remember joy
together in one time line
(Unterhitzenberger, et al., 2015)
37
Retrieved at https://www.sciencemag.org/news/2017/05/surviving-genocide-
storytelling-and-ritual-help-communities-heal

38. Pastoral Care & Migration
Pastoral mission
Restore hope to the hopeless
Welcome all that come to our door
Showing love, healing and grace
a place of refuge
(Chisale, 2016)
38
Retrieved at http://www.usccb.org/about/children-and-migration/upload/childrens-services-reponse-to-
humanitarian-crisis.pdf/

39. Unaccompanied Minors
And Pastoral Care
The church mission
“Therefore go and make disciples
of all nations” (Matthew 28:19 New
International Version)
“Do not mistreat or oppress a
foreigner, for you were foreigners
in Egypt” (Exodus 22:21 New International
Version)
“Learn to do good; seek justice,
correct oppression; bring justice to
the fatherless, and please the
widow's cause,” (Isaiah 1:17 New
International Version)
39
Retrieved at https://christianchronicle.org/for-thousands-of-nicaragua-s-poor-mission-a-gift-from-god/

40. Pastoral Care & Mercy
Pastoral care and
children
“Faith is not faith if it does not
respond to the poor,
marginalized, victims and
vulnerable, such as
undocumented refugee minors”
(Chisale, 2016, p. 34)
When a child is in crisis, hungry,
naked, and without shelter you
cannot say, may God bless you,
without providing care”
(Chisale, 2016, p. 34)
40
Retrieved at https://www.thedailybeast.com/charities-can-reject-foster-parents-for-immigrant-kids-over-
religion

41. Pastoral Care & Social
Justice
Pastoral care and
justice
“Open your mouth for the mute,
for the rights of all who are
destitute. Open your mouth,
judge righteously, defend the
rights of the poor and needy”
(Proverbs 31:8-9 New International Version)
Speak out against injustice,
oppression, economic and political
inequalities ”
(Chisale, 2016, p. 34)
41
Retrieved at http://uubangor.org/index.php/outreach/

42. 42
References
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231-240. doi: 10.1016/j.pedhc.2015.12.009
Chisale, S. S. (2016). Bishop Paul Verryn’s pastoral response towards unaccompanied refugee minors. HTS Teologiese
Studies / Theological Studies, 72(2). doi:10.4102/hts.v72i2.3411
Gucht, K. V., Glas, J., Haene, L. D., Kuppens, P., & Raes, F. (2019). A Mindfulness-Based Intervention for Unaccompanied Refugee
Minors: A Pilot Study with Mixed Methods Evaluation. Journal of Child and Family Studies,28(4), 1084-1093. doi:10.1007/s10826-
019-01336-5
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convention.html
Unterhitzenberger, J., Eberle-Sejari, R., Rassenhofer, M., Sukale, T., Rosner, R., & Goldbeck, L. (2015). Trauma-focused cognitive
behavioral therapy with unaccompanied refugee minors: A case series. BMC Psychiatry, 15(1). doi:10.1186/s12888-015-0645-0