The Effects of Refugee Trauma and How to Treat It
Refugee trauma is particularly difficult to heal from. Children who have experienced war or persecution will have complex and deep trauma due to the violence and death they have witnessed as well as the displacement from their home country. Because of the chaotic nature of escaping a country, experiencing a refugee camp, and the complex process of going through resettlement, these events can often cause further trauma.
The Experiences of Refugees
To understand the trauma of refugee children, let’s first take a look at the experiences they may have had that caused that trauma. These traumatic events may occur while the refugees are in their country of origin, during displacement, or during the resettlement process.
Traumatic events in the country of origin can include:
- Violence (as witnesses, victims, and/or perpetrators)
- Physical injuries, infections, and diseases
- Forced labor
- Sexual assault
- Lack of medical care
- Loss of loved ones
- Disruption in or lack of access to schooling
Traumatic events during displacement include:
- Living in refugee camps
- Separation from family
- Loss of community
- Uncertainty about the future
- Harassment by local authorities
- Traveling long distances by foot
The Trauma Doesn’t Stop Once they Flee the Traumatic Events
It’s important to note the difficulties child refugees face do not end once they are resettled or adopted. The effects of their trauma continue even after being resettled in a safe place. This is largely due to facing stressors in four major categories that can trigger retraumatization, including:
- Traumatic Stress: displacement, flight and migration, poverty, violence
- Acculturation Stress: conflicts with peers related to cultural misunderstandings, necessity to translate language, issues fitting in at school, struggle with cultural integration and identity
- Resettlement Stress: financial stressors, loss of community, lack of access to resources
- Isolation: feelings of loneliness, discrimination, harassment from others, feelings of not fitting in, loss of social status
Effects of Child Refugee Trauma
Trauma affects each individual differently. However, there are some common effects of refugee trauma, which can manifest differently in different age groups. Here are some of the common effects of refugee trauma broken down by developmental age.
- Bed wetting
- Thumb sucking
- Acting younger than their age
- Temper tantrums
- Aggressive behaviors like hitting, kicking, throwing, or biting
- Not playing with other kids their age
- Repetitive playing out of events related to trauma exposure
Elementary Aged Children
- Changes in their behavior such as aggression, anger, irritability, withdrawal from others, and sadness
- Trouble at school and/or with peers
- Fear of something bad happening
Middle and High School Aged Youth
- A sense of responsibility or guilt for the bad things that have happened
- Feelings of shame or embarrassment
- Feelings of helplessness
- Changes in how they think about the world
- Loss of faith
- Problems in relationships with peers, family, and/or teachers
- Conduct problems
Interventions for Children with Refugee Trauma
Despite their trauma, refugee children and adolescents often exhibit resilience. However, refugee trauma can affect the child’s emotional and behavioral development. Mental health providers should consider how the refugee experience may contribute to a child or adolescent’s emotional or behavioral presentation in a clinic, school, or community setting.
When engaging with refugee children in the treatment process who are still with their family, it is important to work to build trust with family members, not just to increase the benefits of treatment, but to also ensure the family will accept your recommendations and referrals. Listen to the family’s concerns and acknowledge the importance of their expressed primary problems. For those who have been adopted, it is key that the adopted family is part of the treatment process to ensure that stressors or triggers are eliminated as much as possible in the various environments the child is in, such as home, school, and church.
It is important to address the most basic and urgent needs first. For adopted children with trauma, getting them into a stable home environment often meets those initial needs. Once those basic and urgent needs are met, you can then begin to focus on the mental health services aspect and later, supporting the child’s academic success.
TST-R, or Trauma Systems Therapy for Refugees, is a comprehensive method of treating traumatic stress in children and adolescents. It adds to individually-based approaches by specifically addressing social environmental or system-of-care factors that are believed to be driving a child’s traumatic stress problems.
This particular therapy or intervention is adapted specifically for refugee youth and families who have experienced war and violence prior to resettlement or adoption and continue to face ongoing acculturation or resettlement stress. It consists of three components of prevention and intervention. It is designed to systematically target the needs of the child, while collaborating with cultural brokers from the refugee community, their school, and family unit. It is a promising treatment model used to address mental health disparities revolving around direct and vicarious trauma and has been implemented with various refugee communities previously.