Strong Mind, Strong Body: The Promise of Mind-Body Interventions to Address Growing Mental Health Needs Among Youth.

As the prevalence of childhood and adolescent anxiety, depression, and other mental health concerns continues to rise, there has been an unprecedented increase in support of mind-body practices like yoga, dance, meditation, mindfulness, aerobic exercise, and more-in part driven by the mental health burden imposed by the COVID-19 pandemic. While a growing body of evidence supports the safety and effectiveness of mind-body approaches, gaps in funding for and empirical research on mechanistic underpinnings, methodology development to assess multi-component therapeutic practices, dissemination and implementation, and diversity in researchers, practitioners, and recipients remain. As a consequence, the neurobiological impacts of mind-body techniques are not well understood nor broadly accepted as standard forms of care by clinicians and insurers-often being considered as 'alternative' rather than 'complementary' or 'integrative'. In this commentary, we summarize work from our labs and others highlighting the promise of mind-body approaches for improving mental health in youth, in line with the National Institute of Mental Health's strategic plan to address health disparities. We offer a potential framework for implementation and research-the Expressive Therapies Continuum. We also propose solutions to key research and policy gaps, that by could have positive public health impacts for those who are struggling and to prevent emergence of psychiatric illness, especially in developing youth.

Photovoice techniques and art therapy approaches with refugee and immigrant adolescents.

This paper describes a program informed by art therapy and Photovoice approaches and techniques aimed at helping new immigrant and refugee teens to navigate personal and cultural identities by reflecting on their experiences as new residents in the US. Photovoice is a photography and social action method that encourages participants to photograph aspects of their daily lives, reflect on their meaning and significance and galvanize necessary changes. The program began in February 2020 at the Arab-American National Museum (AANM), but was adapted for an online format and re-framed towards a reflection on the COVID-19 pandemic. Broad questions teens explored included: What is good? What is challenging? What is sustaining during challenging times? What needs to change? and What about your culture and background are you proud of and wish to share with other US residents? Highlights of the sessions demonstrate how art therapy interventions paralleled photography-assigned themes of self, home, and community and encouraged group interaction and mutual support. A virtual museum exhibition culminated the program and reached community leaders. Self-reports from select participants highlight changes in posttraumatic stress, anxiety, and somatic symptoms over the course of programming.

Mental Health of Refugees and Torture Survivors: A Critical Review of Prevalence, Predictors, and Integrated Care.

Civilian war trauma and torture rank among the most traumatic life experiences; exposure to such experiences is pervasive in nations experiencing both internal and external conflict. This has led to a high volume of refugees resettling throughout the world with mental health needs that primary care physicians may not be screening for and prepared to effectively address. In this article, we review the literature on demographics, predictors, mental health outcomes of torture, and integrated care for the mental health needs of refugees. We searched PubMed and PSYCINFO databases for original research articles on refugees and mental health published in the English language between 2010 and present. Nine percent of 720 adults in conflict areas in Nepal, with predominance of literate married males, met the threshold for Post-Traumatic Stress Disorder (PTSD), 27.5% for depression, and 22.9% for anxiety. While, PTSD rate has been documented as high as 88.3% among torture survivors from Middle East (ME), Central Africa (CA), South Asia (SA), Southeast Europe (SE). Depression was recorded as high as 94.7% among 131 African torture survivors and anxiety as high as 91% among 55 South African torture survivors. Torture severity, post-migration difficulties, and wait time to receive clinical services were significantly associated with higher rate of mental health symptoms. Mental health screening is not a standard component of initial physical exams for refugees, yet these individuals have had high trauma exposure that should inform clinical care. Integrated care models are lacking but would greatly benefit this community to prevent progression to greater severity of mental health symptoms.

Moving Through the Trauma: Dance/Movement Therapy as a Somatic-Based Intervention for Addressing Trauma and Stress Among Syrian Refugee Children.

Traumatic experiences are common in youth, with some reporting that 20% of youth have experienced trauma.1 Some populations have higher exposure. More than 50% of refugee youth with exposure to civilian war trauma and forced migration experience high anxiety; up to 30% screen positive for posttraumatic stress disorder (PTSD).2,3 Trauma exposure during critical developmental periods can have detrimental social, educational, and physical consequences. Current evidence-based therapeutics have primarily been researched in adults; child anxiety disorders are undertreated and underresearched.4,5 Psychotherapy for refugee and other highly vulnerable populations may be limited by high cost and scarcity of skilled trauma specialists; culturally informed and language-capable clinicians who can meet the needs of refugee populations are even more rare. Furthermore, pharmacotherapy is limited by a sparse evidence base, parental and child preferences, and cost-all factors that again are more prevalent in refugee populations. Overall, evidence for treatment of PTSD and anxiety in refugee children is limited and largely extrapolated from treatment for children with other types of trauma exposure. Dance/movement therapy (DMT) is a manualized, multimodal intervention that aims to strengthen emotional, cognitive, physical, and social integration. DMT sessions are led by a licensed dance/movement therapist with joint education in counseling.6 Owing to its integration of exposure, mindfulness, and somatic components, DMT may be a candidate for a multifaceted, multitarget treatment approach to trauma and stress addressing psychological and somatic symptoms, both of which can be present in trauma-related conditions. However, evidence of use of DMT to help traumatized children is lacking. With the state of Michigan's high volume of Syrian refugees and knowing the need for intervention with understanding of barriers of culture, language, and access, our team selected to test acceptance and feasibility of DMT as a possible way to address trauma-related symptoms in Syrian refugee youth.