The purpose of the current study was to examine the contribution of behavioral health treatment and several contextual factors -employment, English language proficiency, family separation, and local family support --to psychological distress among newly resettled refugees over one year. Pre-and post-data were collected between July 2014 and January 2016 at an integrated care refugee clinic located in the western United States. The sample (N = 77) consisted of a diverse group of refugees, most of whom recently arrived from Burma, Iraq, Bhutan, Democratic Republic of Congo, and Somalia. The Refugee Health Screener-15 (RHS-15) was used to measure psychological distress at the initial screening and at 12 months for refugees who indicated distress at baseline. Findings indicated a significant increase in psychological distress for those who were employed, and a significant decrease in distress for those with at least some English language proficiency and for those who have family residing in or near their country of origin. Research recommendations include using a larger sample size and more robust assessment tools to further understand the influence of family separation on psychological distress. Practice recommendations include providing advanced employment options and increasing host country language class access for newly arrived refugees.

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