Working towards Culturally Responsive Trauma-Informed Care in the Refugee Resettlement Process: Qualitative Inquiry with Refugee-Serving Professionals in the United States

Abstract

Trauma-informed care (TIC) approaches have gained popularity in various contexts of human services over the past decades. However, relatively little has been explored about how it is applicable and built into services for refugee populations in resettlement programs. This study explores the current status of the application of TIC in refugee-serving agencies and identifies perceived and experienced challenges and opportunities for culturally responsive TIC in the United States. As designed as part of the evaluation of state-wide refugee health promotion programs, this study conducted individual interviews with 78 refugee service providers from five resettlement sites. Despite the burgeoning interest and attempt to embrace TIC, our findings show that there is clear inconsistency and inexperience in TIC adaptation in resettlement programs. This study highlights that TIC that is culturally responsive and relevant to refugee trauma and acculturation experiences is a vital way to address the chasms between refugee-specific programs and mainstream services including mental health care systems. This study also discusses community resources and opportunities to bridge the deep divide and substantial gaps between mental health services and refugee resettlement services and to address comprehensive needs around mental health and wellness in the refugee community.

Refugee and Asylum Seeker Trauma Informed Care Training for Oral Healthcare Professionals in NSW, Australia

“…This study aligns with current evidence and supports the need for TIC training to be scaled statewide [ 10 ]. In a study by Raja and colleagues, core TIC principles include patient-centered care, understanding trauma and biases, inter-professional collaboration and screening [ 8 ].…”

“…A previous study reported the significant need for health professional training to enhance awareness of refugee-specific needs, including the need for collaboration and the establishment of mutual expectations between healthcare providers and, more broadly, the re-settlement community [ 10 ]. While this study highlighted the beneficial impact of TIC in supporting RAS populations, this study did not specifically focus on oral healthcare professionals.…”

“You Have to Go Gently”: Mentors’ Perspectives of a Peer Mentoring Empowerment Program to Reduce Marginalization in Refugee and Migrant Women

“…Im and Swan (2021) note that trauma-informed care could be useful in addressing the gaps between current mental health care services and the needs of refugees and can also be used with services that offer non-professional psychosocial support [ 53 ]. The key consideration is that trauma-informed care needs to be culturally informed and appropriate.…”

“…Peer mentors from similar cultural backgrounds to the mentees can bring cultural sensitivity and responsiveness to the mentoring relationship. Acknowledging the strengths of cultural capital and the role of families is, in itself, a form of trauma-informed care and can promote resilience and social integration [ 53 ]. In this regard, peer mentors have the foundations for delivering trauma-informed psychosocial programs recommended by Im, Rodriguez and Grumbine (2021) and would benefit from specific training and resources to build on these strengths [ 54 ].…”

Next Steps: Applying a Trauma-Informed Model to Create an Anti-Racist Organizational Culture

“…Reinforced in light of COVID-19 and civil unrest, there is a renewed focus on intentionally naming anti-racism, the process of actively identifying and opposing racism [ 5 ], and anti-oppression within the overarching umbrella of a trauma-informed approach. Without looking beyond the lens of individual trauma, professionals, organizations, and systems risk retraumatization of individuals and communities who have experienced trauma resulting from interpersonal, systemic, and structural racism and oppression [ 6 , 7 ].…”