Promoting Resilience in the Context of Global Adversity: Refugee and Immigrant Youth, Families, and Communities
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Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara
Learning Objectives:
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A Global Crisis of Mass Displacement
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- Increased hate and anti-immigrant sentiment today
- Est. 2018 we are experiencing the highest levels of displacement on record globally (about 1 person every 2 secs)
- Also displacement can be due to disaster (i.e., cyclones, forest fires, hurricanes, droughts etc...)
- Highest numbers in China, Philippines, US, Cuba, and India
- In 27 countries, children can be left stateless and denied several rights
- Children make up half of the refugees worldwide
- Phases of Migration:
- Pre: Violence, persecution, loss, and separation
- Migration: can be long duration- instability and unsafe living conditions esp. For children
- Post: Not a final destination
- Resignation Syndrome in Children
- First diagnosed in Sweden - exists only among refugees – characterized by the loss of the will to live
- Outcomes
- Depression, anxiety, sleep disturbances, PTSD
- Prevalent amongst unaccompanied minors and dependent on migration environment
- Immigrant Paradox:
- Foreign-born Latinx are healthier and less likely to suffer from chronic disease and/or premature death
- High levels of resilience amongst refugees families facing trauma and adversity (related to family cohesion, belonging, autonomy)
- Interventions: PTSD are individually based- not fully effective; school based is mixed- does not always reduce PTSD symptoms but does reduce other symptoms like depression; and family engagement in school-based interventions is promising in reducing maternal depression and increase family solving skills
- Propose an Empathic Centered Design
- Shift from expert-outsider perspective to solution partner practice
- Deficit → Strength
- Risk → Promise
- Vulnerable → Empowered
- Recipient → Partner
- Focus on 5 Ss
- Stigma
- Somatization
- Strengths
- Social Needs
- Settings
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After Trauma: Understanding the Needs of Children
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Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University
Understanding and Responding to the Needs of Children after Traumatic Events
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- Early Ideas about Trauma and Children
- Symptoms were mild, transient, and no intervention required until the 1980s school shooting in California
- First time they spoke to children re: their experiences
- One in four children will experience at least one traumatic event before the age of 16
- 80% of abused children will face at least one mental health challenge before age 21
- Adverse Child Experiences
- >4 ACEs appears to be tipping point for increased risks in life
- ¼ of children experience mental health problems but over half go untreated
- Trauma impacts learning: impacts kindergartners the most (expulsion and suspension)
- Increased worries/fears - guilt/shame - changes in behavior (i.e., ADHD symptoms, bullying, withdrawal) - physiological responses (i.e., sensitivity to sounds and somatic complaints)
- Majority of children are resilient after traumatic events BUT, still need support, create a positive environment, and increase positive coping skills for the future
- Protective Factors
- Positive family, teacher, and peer relationships, willingness to ask for help, having pets, good social skills and self-esteem etc…
- Interventions for Children who have Experienced Trauma
- TF- CBT: Trauma-focused cognitive behavioral therapy
- PCIT: Parent Child Interaction Therapy
- CBT: Cognitive Behavioral Therapy in Schools
- CARE: Child-Adult Relationship Enhancement: skills for engaging children with trauma exposure
- PTSD symptoms need to present for at least a month for effective intervention
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Improving Services for Kids and Families Through Implementation Science: Working on the Irrigation System
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Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University
New Sources of Stress for Children
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- New Sources of Stress for Children
- Increased competition for schools
- Easy accessibility to information
- Prevalence of social pressures
- Stressful national and global situation
- Up to 80% of children and/or adolescents that need services do not receive them
- Racial, income, and geographic barriers greatly impact this
- Severe shortage of psychiatrists and other health professionals in vast majority of the US, including Florida
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Future Directions, Outcomes & Workforce
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- Future Directions
- Use evidence-based treatment design and service system and workforce development
- Treatment design:
- Managing and Adapting Practice (MAP)
- Similarities and differences to modular and transdiagnostic approach
- Multiple Evidence Bases
- Think about individual cases and progress using local knowledge
- Outcomes
- MAP showed decreases in symptoms from pre to post (ie. anxiety, depression, PTSD)
- Service system:
- Medicaid and state funding will pay more for evidence base services depending on the state
- R-MAP will match clients to relevant evidence base services based on age , gender, problem, race/ethnicity but it does not capture every case
- Conclusions:
- Standard Evidence-Based Treatments (EBT) alone may not be sufficient to create high-performance systems (about ⅓ don’t benefit)
- Hybrid models help:
- EBT
- PLUS approaches
- Know what is readily available
- Workforce:
- Multiple approaches are needed
- 3 Rs: Routes, Regulations (i.e., receiving mental health or healthcare training in military), Rates (increase salaries for providers)
- Pipeline: Grad Training (Masters Social Work- MSW)
- MAP class v. standard curriculum
- Increase of strategies from Pre-Study to Post-Study in MAP group
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Addressing Psychological Well-being Among Refugee and Immigrant Youth and Families
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Presenter: Maryam Kia-Keating, Ph.D., Associate Professor of Clinical Psychology, University of California, Santa Barbara
Child-Adult Relationship Enhancement (CARE): Strengthening relationships with children/teens who have experienced trauma
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Presenter: Robin Gurwitch, Ph.D., Professor in Psychiatry and Behavioral Sciences, Duke University
Clinical Strategies for Developing Socioemotional Competence in Youth
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Presenter: Michael Southam-Gerow, Ph.D., Professor and Chair, Clinical Psychology, Virginia Commonwealth University
Learning Objectives:
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Emotional Competence
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- Emotional Competence
- Awareness and labeling
- Emotion vocabulary
- Clear emotional displays
- Interventions involve intensity ratings + identification of emotions
- Understanding
- Causes and consequences of emotion experiences
- Involves recursive thinking and social cognition
- Multiple emotions
- Opposite feelings can occur at the same time
- Emotion regulation: regulator and regulated
- You cannot control emotions but can gain awareness and do something about it
- Development from less conscious to planful
- Emotions usually point towards what’s important to us
- Interventions involve cognitive component (specifically on anger, worry sadness, and fear)
- Focus is on changing at least some of the thoughts
- Expression: advanced
- Expression of feelings makes it easier to deal with them (e.g., through expressive writing)
- Emotion socialization
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Culture and Emotion
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- Culture and Emotion
- Individualistic
- Less likely to suppress emotions
- Collectivism
- Increased likelihood of suppressed emotions
- Emotion regulation is not universal
- Active engagement (i.e., problem solving, reframing) can help with coping strategies for those undergoing chronic stress
- Those in poverty, need an individualistic/unique treatment plan
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Conclusion
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- Conclusion:
- Emotion is central to human experience
- Help children/adolescents develop emotional competence
- Can be promoted via context of family therapy
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Tech Parenting: How to Support Parents in Managing Children’s Screen Time
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Presenter: Justin Parent Ph.D., Assistant Professor, Florida International University
Conducting Semi-Structured Assessment of Suicide Risk in Youth in Clinical Settings: Balancing Standardization with Clinical Utility
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Presenter: Ashley M. Shaw, Ph.D., Clinic Director, Licensed Clinical Psychologist, & Postdoctoral Associate, Mental Health Interventions and Technology (MINT) Anxiety Program, Florida International University