Silencing or silent transmission? An exploratory study on trauma communication in Kurdish refugee families.

Trauma communication in refugee families is increasingly recognized as an important relational dynamic influencing psychosocial well-being, yet studies exploring interactional dynamics and meaning making at play in intra-family trauma communication remain scarce. This article reports on a qualitative study with Kurdish refugee families including parents (N = 10) and children (N = 17) resettled in Belgium, aiming to explore practices on trauma communication within refugee family relationships. In a multiple-phased qualitative design, semi-structured family interviews and participant observation administered in the homes of the participant families are followed by parental interviews involving a tape-assisted recall procedure to investigate observed intergenerational trauma communication and parent-child interactions. Data analysis shows parents and children seldom explicitly talked about the families' lived experiences of trauma. This silence was especially related to parental wishes to avoid their children's future involvement in violence. However, findings also indicate how the intra-family transmission of memories of collective violence occurs in many subtle ways. Four modes of indirect trauma communication could be distinguished: (1) focusing on the repetition of violence in the present; (2) transmission of the collective trauma history; (3) family storytelling; and (4) interaction with meaningful objects of the past. These findings shed light onto the interwoven nature of personal-familial and collective trauma and loss and illuminate the meanings of silence and disclosure in the context of the Kurdish diaspora. In the final section, we discuss our findings and outline its clinical implications for family therapeutic practices in refugee trauma care.

The role of school-based creative expression interventions in the aftermath of migration: A qualitative exploration of parents' and teachers' perspectives.

This study explored supportive relational processes for immigrant children's well-being between peers, teachers, and parents in the development of school-based creative interventions in European multi-ethnic societies. Within the present study, we integrated the perspectives of teachers and parents to broaden the dominant focus on the assessment of individual symptomatology within the existing body of studies of school-based interventions studies. As a part of a larger multi-method study on the implementation of a creative expression program for immigrant children ages 8-12 years in three schools in Belgium, we conducted focus group discussions to learn parents' and teachers' perspectives on the role of school-based creative interventions in children's coping with histories of migration and life in exile. Parents and teachers identified the need for the intervention to foster emotional expression impacting children's self-esteem and social connectedness with peers and to foster emotional connections between parents, teachers, and children. Parents also stressed the importance of the intervention within society as a forum to engage with social conditions, promote cultural belonging, and social integration. Results identified the importance of school-based interventions in terms of individual benefits as well as connectedness and coherence in entire communities, thereby strengthening the development of transcultural research evidence for school-based interventions in multi-ethnic societies.

The effect of a school-based creative expression program on immigrant and refugee children's mental health and classroom social relationships: A cluster randomized trial in elementary school.

This study evaluated the effects of a school-based creative expression program on mental health and classroom social relationships in elementary school children with refugee and nonrefugee migration backgrounds. It was hypothesized that children receiving the intervention would report less externalizing and internalizing problem behaviors, less posttraumatic functioning, and more positive classroom social relationships at posttest than children receiving education as usual, particularly for refugee children. Classes in three multiethnic Belgian elementary schools were randomly assigned to a creative intervention (7 classes, 68 students) or control condition (6 classes, 52 students). All participants (8-12 years old) had a migration background. Almost half (47%) were refugees, 53% were first- to third-generation nonrefugee immigrants. Data collection included pre- and posttest assessment with children, parents, and teachers. Multilevel analysis was used to assess outcomes. Children in the intervention condition rated the classroom climate at posttest more positive than their control peers (d = .33). Children who received the intervention did not show less symptomatic functioning than children in the education-as-usual condition. However, post hoc analysis by baseline severity showed that students with high baseline levels of posttraumatic stress reported less trauma symptoms at posttest in the intervention group than in the control group (d = -.97). This effect was moderated by children's refugee background, indicating a differential effect in which refugee children show more reduction of trauma symptoms as compared to nonrefugee immigrant children. The intervention supported classroom climate and alleviated posttraumatic stress in children with increased posttraumatic symptomatology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mental health problems in refugee and immigrant primary school children in Flanders, Belgium.

BACKGROUND: European countries face the challenge of promoting refugee and immigrant children's well-being within their host communities, invoking the necessity of adequate mental health assessment. This study aims to contribute to document the psychosocial well-being of primary school refugee and non-refugee immigrant children in Flanders, Belgium. METHOD: A total of 120 children (8-12 years old) with migration backgrounds participated in the study. Through self-report, parent and teacher questionnaires we scrutinized externalizing and internalizing behavioral problems, post-traumatic stress problems, and classroom relationships. RESULTS: Thirty percent of the participants reported high levels of post-traumatic stress; around 25% reported a high or very high prevalence of internalizing and externalizing behavioral problems. Self-reported mental health problems are elevated in comparison to the general population. Refugee children did not report more difficulties than their immigrant peers. In the perception of parents and teachers, respectively 20% and 5% of children showed high or very high amounts of internalizing and externalizing behavioral difficulties. Almost 70% of the participants perceived the class climate as unsafe. CONCLUSIONS: Refugee and immigrant children are at risk for mental health difficulties, and experience classroom dynamics as markedly distressful. School-based intervention might be particularly suited to support these children's psychosocial well-being in resettlement.

Working With the Encounter: A Descriptive Account and Case Analysis of School-Based Collaborative Mental Health Care for Refugee Children in Leuven, Belgium.

Scholars increasingly point toward schools as meaningful contexts in which to provide psychosocial care for refugee children. Collaborative mental health care in school forms a particular practice of school-based mental health care provision. Developed in Canada and inspired by systemic intervention approaches, collaborative mental health care in schools involves the formation of an interdisciplinary care network, in which mental health care providers and school partners collaborate with each other and the refugee family in a joint assessment of child development and mental health, as well as joint intervention planning and provision. It aims to move away from an individual perspective on refugee children's development, toward an engagement with refugee families' perspectives on their migration histories, cultural background and social condition in shaping assessment and intervention, as such fostering refugee empowerment, equality, and participation in the host society. Relating to the first stage of van Yperen's four-stage model for establishing evidence-based youth care, this article aims to engage in an initial exploration of the effectiveness of a developing school-based collaborative mental health care practice in Leuven, Belgium. First, we propose a detailed description, co-developed through reflection on case documents, written process reflections, intervision, an initial identification of intervention themes, and articulating interconnections with scholarly literature on transcultural and systemic refugee trauma care. Second, we engage in an in-depth exploration of processes and working mechanisms, obtained through co-constructed clinical case analysis of case work collected through our practice in schools in Leuven, Belgium. Our descriptive analysis indicates the role of central processes that may operate as working mechanisms in school-based collaborative mental health care and points to how collaborative mental health care may mobilize the school and the family-school interaction as a vehicle of restoring safety and stability in the aftermath of cumulative traumatization. Our analysis furthermore forms an important starting point for reflections on future research opportunities, and central clinical dynamics touching upon power disparities and low-threshold access to mental health care for refugee families.

A contextualized perspective on research participation in collaborative refugee research: A multi-site exploration of relational dynamics in collaborative research.

OBJECTIVE: An increasing body of literature emphasizes the role of refugees' social context, with social conditions both at home and in the host society having an impact on the possibility of power redistribution and the mobilization of agency in collaborative research practices. Our aim is to develop a contextualized understanding of research participation for refugees in collaborative research in order to further enhance insights on the potential strengths and pitfalls of collaborative refugee research. METHOD: We closely study the various relational contexts that shape refugees' research participation and that may have an influence on power dynamics in collaborative research. In the present study, we explore participants' adaptation of research participation by means of an interpretive cross-case analysis of three psychosocial intervention studies sharing a collaborative approach with refugee participants, refugee families, refugee communities, and professional partners at different stages in the research process. RESULTS: We identify the developed collaborative strategies in our three case studies and provide an outline of the ways refugees mobilize research participation through these identified collaborative strategies, from within the relational contexts of the family, community, and institutional actors. CONCLUSIONS: This analysis shows how research participation operates as a relational forum in which refugees continuously navigate and negotiate within and between multiple relational contexts. We argue that performing research participation, as a way of relating to a relational context, is both an interactive and a dynamic process. For research practice, our analysis addresses the importance of an in-depth understanding of participants' relational contexts to foster both a reflective research practice and trustful research relationships between researchers and participants. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Stories of trauma in family therapy with refugees: Supporting safe relational spaces of narration and silence.

With the sharp increase of refugees' arrival and resettlement in western communities, adequate mental health care forms a pivotal dimension in host societies' responses to those individuals and communities seeking protection within their borders. Here, clinical literature shows a growing interest in the development of family therapy approaches with refugees, in which therapeutic practice engages with the pivotal role of refugee family dynamics in posttrauma reconstruction and adaptation in resettlement and aims at supporting posttrauma reconstruction through strengthening capacities to restore safety, meaning and connectedness within family relationships. In this article, we focus on the narrative restoration of meaning as central mode of posttrauma reparation and explore its specific dynamics and relational complexities in the context of therapeutic practice with refugee families. Hereto, we integrate theoretical and clinical scholarly work on trauma narration and its intersection with empirical findings on trauma communication in refugee families. Furthermore, we develop case reflections to illustrate different processes of engaging with trauma narration in refugee family therapy. This analysis develops an understanding of the multivoiced ways in which refugee families engage with traumatic suffering through different modes of expression that may entail both narration and silence and explores how family therapeutic practices can engage and mobilize voices of narration and silence as relational stories of restoration.

Unraveling the Mobilization of Memory in Research With Refugees.

In this article, we explore how narrative accounts of trauma are co-constructed through the interaction between researcher and participant. Using a narrative multiple-case study with Kurdish refugee families, we address how this process takes place, investigating how researcher and participants were engaged in relational, moral, collective, and sociopolitical dimensions of remembering, and how this led to the emergence of particular ethical questions. Case examples indicate that acknowledging the multilayered co-construction of remembering in the research relationship profoundly complicates existing deontological guidelines that predominantly emphasize the researcher's responsibility in sensitively dealing with participants' alleged autobiographical trauma narratives. Instead, our analysis invites qualitative researchers to engage in a continued, context-specific ethical reflection on the potential risks and benefits that are invoked in studies with survivors of collective violence.

Remembering Collective Violence: Broadening the Notion of Traumatic Memory in Post-Conflict Rehabilitation.

In the aftermath of war and armed conflict, individuals and communities face the challenge of dealing with recollections of violence and atrocity. This article aims to contribute to a better understanding of processes of remembering and forgetting histories of violence in post-conflict communities and to reflect on related implications for trauma rehabilitation in post-conflict settings. Starting from the observation that memory operates at the core of PTSD symptomatology, we more closely explore how this notion of traumatic memory is conceptualized within PTSD-centered research and interventions. Subsequently, we aim to broaden this understanding of traumatic memory and post-trauma care by connecting to findings from social memory studies and transcultural trauma research. Drawing on an analysis of scholarly literature, this analysis develops into a perspective on memory that moves beyond a symptomatic framing toward an understanding of memory that emphasizes its relational, political, moral, and cultural nature. Post-conflict memory is presented as inextricably embedded in communal relations, involving ongoing trade-offs between individual and collective responses to trauma and a complex negotiation of speech and silence. In a concluding discussion, we develop implications of this broadened understanding for post-conflict trauma-focused rehabilitation.