Monthly Archives: February 2012 - Page 2

Run A Little Walk A Little

Important lesson learned from Katrina is that mental health providers must “be willing to openly discuss the effect of institutional racism and the role of power and oppression” in the lives of their African American clients.
“Healthy cultural suspicion” African Americans demonstrate towards therapists and counselors who are involved in providing cross-racial treatment. The legacy of mistrust can lead to profound experiences of anger and rage. Clinicians should not take these responses to racism personally.
Health provider lessons:
1) Understand African Americans’ worldview, language, communication style values re: community and interpersonal relationships.
2) Acknowledge the role that religion and spirituality may play in healing
3) Relief-effort coordinators strive to include responders that reflect the survivors’ ethnic, racial, and social backgrounds.  (2 concerns about health providers in Katrina were that there were few persons of color and they were not culturally sensitive)
Concept of Home and Homeplace: For Katrina, the memory of home was kept alive through storytelling for African American. they developed physical, spiritual, and emotional survival skills that fostered multigenerational resilience.
Home or Homeplace is a safe place where African Americans could “strive to be subjects, not objects, where we could be affirmed in our minds and hearts despite poverty, hardship, and deprivation, where we could restore ourselves the dignity denies us on the outside in the public world” . homeplace elicits feelings of empowerment, belonging, commitment, rootedness, ownership, safety, and renewal.
80% of African Americans may never be able to return to their homes. During the disaster the ability to leave was a result of a lack of transportation, money, credit cards, or alternative housing.
Religion, Spirituality, and the role of black churches: spiritual metaphors as way to express survival and psychological resilience. Therapist should ask directly about religious and spiritual beliefs.
Katrina – inability to locate relatives and give them a proper burial. It would help the survivor to pray for those lost and missing.
Red Cross needs to connect with churches, relief centers and shelters to add to aid during a disaster.

ch 33 Working with families who are homeless
Model used to create and refine the way therapists maintain awareness and reduce the negative impact of our social location for helping families who are homeless
1) focus on a creating a respectful, collaborative relationship with families and shelter staff
2) “institutionalized” regular consultations with senior colleagues of color on all aspects of the program and research by making these consultations the first principle of the collaborative family program development model
3) as the supervisor to my student staff, I attempt through the feelings I share and the questions I ask, to create a climate in which we allow ourselves to be deeply affected professionally and personally by our encounters with families in the shelter.
Homeless does not fit into a stereotypical box
Challenges homeless face: Lack most of the material foundations that enable human growth – housing with adequate space, informal networks of social support and child care, safe places for children to play, affordable and reliable transportation, steady income.
Homeless families experience stigmas of: lazy, mentally ill. The policies of homeless shelters represent a major source of stigma in how they are enforced.
children may be parentified to do tasks of an adult to help the family.
therapists should adopt and maintain the collaborative, resilience-oriented stance. And  establish a “re humanizing” relationship for the families strength to reemerge.
Usefulness of shelter-based multiple family group programs: helps create “micro-communities” of support and care within the shelter that extend beyond the group, to help reach many families at once.
Externalize Homelessness: Helps families to separate their fundamental identity format their current conditions and stressors, creating more space to expand on descriptions and activities that reassert their preferred identity and putting the experience of homelessness in its place.
Family Play and Creative Activities: Challenge and coping mobiles and collages, work and housing genogram, family and work goals time line, Letters to or from the Future.

Physical Therapy Helps

Therapist’s position: We must take a proactive stance to connect families with the resources they need, whether a church, advocate for school system, or social service
The PreMigration Experience:
First look at the degree of trauma experienced in the pre-migration. terror and multiple losses. 85% of children are separated from at least one parent during the immigration process and 49% separated from both parents.
Reunification can be difficult for both the child and the mother. Mother dreams of seeing child, while child has made friends, language, comforting foods, and a way of life disrupted by unfamiliar parents.
The Post migration Experience: Cultural bereavement is central to the lives of refugees and immigrants. Continually seek to make meaning of their lives.
Class and Race: Degree of racism and shortage of opportunities in the new country for immigrants. 76% of African immigrants come as professional and then decide to stay, are unable to secure jobs in their area of skill or profession. Get low status jobs.
Health: Immigration is associated with a decline in health for Latinos, including depression among children separated from their families. Those coming from developing countries and countries where the majority is Black is at highest risk for schizophrenia.
Culture of Origin, Acculturation and Biculturality: primary issue for immigrant families is the level of difference in values b/w the culture of origin and the dominant culture of the US. Sometimes clients have trouble in their culture of origin as well, and it is useful to find out whether a family’s values and behaviors are representative of their culture of origin or idiosyncratic within that culture.
Parent-Child Struggles: common cause of this concerns rates of acculturation. Different expectations between the parent and child of how they should act contributes to interfamilial conflict. Biculturality Effectiveness Training define the conflict not as between generations but as between cultures.
Politics, Critical Issues, and Nascent Trends: Immigrants who come out of war they cannot explain or understand are often asked to act as the spokespersons for their home countries. They feel targeted for conditions and events over which they have no influence.
Impact on US laws and their enforcement on both documented and undocumented immigrants, many of whom feel unsafe, unwanted, and targeted.
We must explore experiences of loss and trauma, and be able to look at discriminatory policies, racism, classism, and xenophobia.

Ch 29 Working with African Americans and Trauma
African American, particularly those living in poverty are vulnerable to trauma situations such as natural disasters.
Ongoing debate of whether racism can qualify as a cause for PTSD.
Katrina is an example of the double trauma that can occur during disaster situations for African Americans and other people of color: 1) the disaster-related traumas of loss of life, home, and community, physical dislocation, and separation from loved ones. 2) a second level of trauma caused by the effects of racism and poverty.