1. CHAPTER 22 COUNSELING REFUGEES

2. Refugees  Refugees leave their home country due to persecution  Individuals are granted asylum when they meet the criteria for refugee status and who are physically present in the U.S. or at a point of entry when granted permission to reside in the U.S.

3. Special Problems Involving Refugees  Refugees are under more stress than immigrants are  They have been exposed to more traumas than most immigrants  Central American refugees in one study showed high levels of mistrust towards service providers  Parents often worry about their children’s adaptation to the American way of life  Many will have difficulties communicating in English, will be underemployed and oftentimes— depressed

4. Special Problems Involving Refugees  Parents often worry about their children’s adaptation to the American way of life  Many will have difficulties communicating in English, will be underemployed and oftentimes—depressed

5. Considerations in Working with Refugees  Trauma  Loss  Feelings of displacement

6. Refugees and Assessment As a mental health worker, it will be important for you to assess: Effects of Past Persecution, Torture, or Trauma Culture and Health Safety issues Gender Issues and Domestic Violence Linguistic and Communication issues (e.g. the use of interpreters)

7. Guidelines for Clinical Practice Be aware that the client might have day-to-day stressors such as limited resources, a need for permanent shelter, lack of employment, or frustrating interactions with agencies--allow time to understand and provide support related to these immediate needs, or help the client locate resources related to specific needs Be knowledgeable and conversant with the refugee groups you work with, their pre-migration traumas, and psychological strategies used to cope with stress Understand symptom manifestations likely to indicate post- traumatic stress, and other mental disorders that may arise from experiences of war, imprisonment, persecution, rape and torture

8. Guidelines for Clinical Practice Allow time for clients to share their backgrounds, their pre-migration stories, and changes in their lives since immigrating Inquire about client belief’s regarding the cause of their difficulties, listening for sociopolitical, cultural, religious or spiritual interpretations Carefully explain the therapeutic approach that will be used, why that approach was selected, and how it will help the client make desired changes