Abstract:Globally, large numbers of children and adolescents are displaced by armed conflict, which poses significant threats to their mental health, psychosocial well-being, and protection. Although humanitarian work to support mental health, psychosocial well-being, and protection has done considerable good, this paper analyzes how humanitarian action is limited by excessive reliance on a top-down approach. Although the focus is on settings of armed conflict, the analysis offered in this paper applies also to the wid… Show more
“…Afghan refugees often hold rich funds of knowledge regarding how to holistically navigate the challenges of post resettlement, much of which may be rooted in their unique culturally and spiritually informed notions of coping and healing. Peripheral adaptations can fall short in benefiting from these relevant and necessary sources of wisdom, potentially contributing to limitations in the extent to which EBI can be effective (Wessells, 2021). We join forces with other scholars who advocate for further rigorous explorations into how levels and types of cultural adaptations can impact program effectiveness and success (Taylor et al, 2023).…”
Under the United Nations High Commissioner for Refugees’ (UNHCR) seven-decade mandate, Afghan refugees have faced some of the largest and most protracted experiences with forced displacement. This intergenerational exposure to forced migration has had innumerable consequences for the mental health of this population across different stages of their displacement. Afghan refugees who have resettled into Western nations face a unique set of challenges as they must navigate resettlement into societies that are linguistically, culturally, and spiritually distinct from their own backgrounds. This systematic review explores the (a) effectiveness and (b) cultural adaptation of interventions that have addressed the mental health of Afghan refugees resettled into Western countries since the year 2000. This systematic review will employ the Cultural Treatment Adaptation Framework (CTAF) to organize the extent of cultural adaptations. Through the systematic search of four databases, 1709 studies emerged from our search terms, seven of which met the criteria for this review, for example, study includes more than 2/3 Afghan participants; study includes outcome variables. Studies included programs in Germany, Serbia, Sweden, and Austria. The most common outcomes that interventions addressed included posttraumatic stress disorder (PTSD) ( n = 5), depression ( n = 3), and quality of life ( n = 3). Program modalities ranged between Cognitive Behavioral Therapy ( n = 4), emotion regulation ( n = 1), family therapy ( n = 1), and multimodal interventions ( n = 2). Most studies only incorporated peripheral changes to interventions in the service of cultural adaptation, and only one intervention included core changes. This program reported the highest effect sizes in reducing PTSD and depressive symptoms when compared with the rest of the studies. These findings provide a direction for future studies as they consider whether the extent of cultural adaptations can influence the effectiveness of programs for Afghan refugee populations. We provide recommendations for mental health practice with this population, including a special attention to the role of daily stressors, the significance of faith and culture-based meaning making in the service of coping, and the salience of isolation.
“…Afghan refugees often hold rich funds of knowledge regarding how to holistically navigate the challenges of post resettlement, much of which may be rooted in their unique culturally and spiritually informed notions of coping and healing. Peripheral adaptations can fall short in benefiting from these relevant and necessary sources of wisdom, potentially contributing to limitations in the extent to which EBI can be effective (Wessells, 2021). We join forces with other scholars who advocate for further rigorous explorations into how levels and types of cultural adaptations can impact program effectiveness and success (Taylor et al, 2023).…”
Under the United Nations High Commissioner for Refugees’ (UNHCR) seven-decade mandate, Afghan refugees have faced some of the largest and most protracted experiences with forced displacement. This intergenerational exposure to forced migration has had innumerable consequences for the mental health of this population across different stages of their displacement. Afghan refugees who have resettled into Western nations face a unique set of challenges as they must navigate resettlement into societies that are linguistically, culturally, and spiritually distinct from their own backgrounds. This systematic review explores the (a) effectiveness and (b) cultural adaptation of interventions that have addressed the mental health of Afghan refugees resettled into Western countries since the year 2000. This systematic review will employ the Cultural Treatment Adaptation Framework (CTAF) to organize the extent of cultural adaptations. Through the systematic search of four databases, 1709 studies emerged from our search terms, seven of which met the criteria for this review, for example, study includes more than 2/3 Afghan participants; study includes outcome variables. Studies included programs in Germany, Serbia, Sweden, and Austria. The most common outcomes that interventions addressed included posttraumatic stress disorder (PTSD) ( n = 5), depression ( n = 3), and quality of life ( n = 3). Program modalities ranged between Cognitive Behavioral Therapy ( n = 4), emotion regulation ( n = 1), family therapy ( n = 1), and multimodal interventions ( n = 2). Most studies only incorporated peripheral changes to interventions in the service of cultural adaptation, and only one intervention included core changes. This program reported the highest effect sizes in reducing PTSD and depressive symptoms when compared with the rest of the studies. These findings provide a direction for future studies as they consider whether the extent of cultural adaptations can influence the effectiveness of programs for Afghan refugee populations. We provide recommendations for mental health practice with this population, including a special attention to the role of daily stressors, the significance of faith and culture-based meaning making in the service of coping, and the salience of isolation.
“…These stories might involve distress and suffering, but may also be filled with beauty and resilience (Watkins, 2015, p. 330). Accompaniment involves the accompanier listening intently to what the accompanied person says, without attempting to intervene or provide solutions (Kapitan, 2023), and setting aside the ‘vertical hierarchy of expertism’ and moving instead to a ‘practice of horizontality’ (Watkins, 2015, p. 330) where the accompanier is in a position to learn from the person they are accompanying (Wessells, 2021). Freire frames these dialogues in terms of love and writes:Dialogue cannot exist, however, in the absence of a profound love for the world and for people.…”
Section: Accompaniment and Positionalitymentioning
This paper presents an overview of the arts‐based methodology used in a research project that aimed to explore the impact of the lived experiences of racism on 10‐ and 11‐year‐old children in the United Kingdom. The research responds to the relative lack of literature concerning the racialised experiences of young children. We discuss how we developed the arts‐based method of body mapping as an ethical approach to foregrounding the children's voices. We consider that this approach contributes to knowledge and understanding about exploring the nuanced and complex relationship between the children's external worlds and their internal feelings, and supporting them to process and communicate this. We suggest that the method presented is transferable, and present our ethically engaged, arts‐based planning framework that can be used if others wish to adopt this way of working.
“…An example of inadequacy is that the majority of psychological interventions have been primarily developed and tested for homogeneous White populations, without critical examination of the significant limitations of psychologists’ own knowledge and practices with populations who may have different priorities, preferences, core cultural beliefs, and explanatory models, with consequences for mental health utilization which is lower among refugees than the general population (Lamkaddem et al, 2014; Satinsky et al, 2019). Despite interest and alignment for refugees themselves, conspicuously few opportunities exist for indigenous and culturally relevant healing practices to be uplifted and utilized (Khairat et al, 2023; Wessells, 2021). Notably, a critical systemic review of research on Middle Eastern refugee women found that, across studies, stigma, embarrassment, and shame played a role in service utilization, and refugee women expressed a preference to utilize cultural and faith-based practices, such as prayer and social support, and traditional healing (Tahir et al, 2022).…”
Section: Dismantling Racism Through Truth-telling: Critical Reflectio...mentioning
The enormous and ever-increasing problem of forced displacement warrants the attention of psychological science to play a role in leading efforts to address the needs of refugee communities. As a nation of immigrants, the United States has a long and complicated history of refugee admissions, including both generous and racist policies and sentiments. Examining the past can increase our capacity to transform the future. Taking conscious action to dismantle racism is of central importance to begin to make reparations and find pathways toward healing. Recognizing the instrumental role of systemic forces, three guideposts to support an antiracist foundation for research and practice in psychology are drawn from existing frameworks and applied to the case of refugees. These include (a) remembrance as an act of historical and sociopolitical analysis, (b) truth-telling to engage in critical self-reflection within the field of psychology, and (c) accompaniment alongside refugee communities to develop partnerships that reinforce their strengths and agency and directly benefit them. These guideposts underscore the importance of upholding community priorities and empowering refugee communities to reclaim their own cultural knowledge and strengths and to create effective and sustainable programs, with the potential for significant public health impact. As such, psychologists can play a critical role in transforming social systems over time and actively working to dismantle racism.
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