Trauma-informed approaches to prevent re-traumatization of youth and to foster their resilience and healing require cross-collaboration among staff within organizations and with community partners. Collaboration increases abilities to problem-solve, obtain up-to-date knowledge of resources, and increase easier access to those resources. Establish and Maintain Community Partnerships
- Attend networking opportunities to connect with attorneys, mental health providers, community youth workers, and healthcare providers,
- Stay updated on the current policies and practices of the local police department/law enforcement agencies and their engagement with the undocumented community; consider opportunities to engage in dialogue with law enforcement.
Internal Workplace Partnerships
- Develop mechanisms to regularly communicate internally with other staff about community resources and training opportunities
54
Discussion
The key informant interviews provided in-depth narratives of approaches to address trauma and promote healing among Central American unaccompanied minors. Approaches ranged from individual skill-based practices to changes in organizational procedures and workplace culture. There were several informative key points that could be useful for researchers, funders, practitioners, organizations working with this young population to consider.
First, findings suggest that trauma not only affects Central American
unaccompanied youth, but that it affects them in multiple ways (e.g. socially, cognitively, psychologically, physically, etc.) and can manifest differently depending on the settings that they are in (e.g. legal clinic, classroom, with family). It is critical that primary direct- service practitioners be aware of the multiple ways in which trauma may manifest itself with this population in order to provide the best preventative care and treatment possible. Moreover, having a broader understanding of the potential competing challenges youth might be facing could help a practitioner identify where and how they might be able to connect youth across systems and services.
Second, findings also indicate that there is a wide range of trauma-informed approaches that can be adopted in various service settings – not just ones that are mental health treatment focused. These findings could provide a starting point for organizations and practitioners that have limited experience working with unaccompanied minors. Findings applied to the trauma-informed framework used in this paper can provide a way to reflect on and determine what practice and systems changes organizations are already doing, what they would like to explore more, and what they should be prioritizing as they
55 implement programs and/or processes. Findings also highlight empowerment as a healing approach that practitioners and organizations can use. While some key informants may not view their roles as healers (i.e. lawyers or school educators), these findings might provide a re-frame of what approaches may have a healing effect. More evidence-based research is needed to validate these approaches to healing.
Thirdly, findings from the key informants highlight the importance of including staff-care at both the individual and organizational levels when thinking about a holistic trauma-informed approach. Given that some staff may be affected by repeatedly
witnessing and hearing about the traumas and adversities of unaccompanied youth, investing in trauma-informed practices and policies for staff can be an approach that ultimately and concurrently cares for the youth. As the San Francisco Department of Public Health explains through their trauma-informed systems model:
“as [an organization] goes about serving the community, [it can] experience direct and indirect effects of prolonged and significant exposure to communities affected by trauma. Organizational trauma can be described as a circular “’ripple effect’”, transmitted between interactions with clients, families and communities and staff, to their supervisors, support staff, administration, across the organization and across service delivery systems. The impact of organizational prolonged trauma exposure can result from a “’parallel process’” where systems in working relationship with traumatized clients concurrently develop similar affects, cognition, and behaviors and transmit symptoms back and forth.”40(p3)
Therefore, organizations working with potentially trauma-exposed
unaccompanied youth should consider what it means to apply a trauma-informed lens within their workplace for the benefit of staff members and administration. This could be especially important for direct-service practitioners who themselves identity with the communities they are serving and could be also be trauma survivors.
Finally, these findings contribute to a continuum view of the trauma-informed approach, one that acknowledges that being trauma-informed is not the end goal for
56 practitioners nor service organizations, but rather a pre-requisite to becoming healing- centered.23 Treating trauma and preventing re-traumatization is critical, but it should also be coupled with an approach that fosters a young person’s strengths and voice to promote empowerment and healing. Healing-centered approaches will look different depending on the context of an organization and a practitioner’s skill set. While healing-centered
approaches were not the focus of this paper, its importance is inseparable to a trauma- informed approach.
Strengths and Limitations
Strengths of this study include in-depth information collection from key
informants about specific approaches used in the field to address trauma for young people who have immigrated to the U.S. alone. In addition, the study was able to elicit a range of trauma-informed approaches across a spectrum of direct-service practitioners from
varying professions, as well as examine approaches applicable to an individual to
organizational levels. This study also explicitly included healing-centered approaches for this population and emphasized their value to a the trauma-informed continuum.23
Finally, while the quantity of interviews conducted may be small, they were with individuals with a comprehensive and high-quality understanding of this population.
However, there were limitations to the study. There is the possibility of research bias since the qualitative data was reviewed, coded, and interpreted solely by the author. Even though the author has prior professional experience working with Central American unaccompanied adolescents, an inter-rater review process could strength this study. One final limitation could be response bias since key informants self-selected to be
57 interviewed and four informants were professional colleagues of the author in the past. As a result, findings were representative of those interviewed and may not represent the opinions of a broader range of direct-service practitioners and advocates.
Implications
This paper contributes to the intersecting fields of social work, public health, and adolescent immigrant health, with an emphasis on the growing community of Central American unaccompanied youth. While this paper focuses on trauma-informed considerations for direct-service practitioners and organizations supporting Central American unaccompanied youth, the author acknowledges that some considerations could also be helpful to unaccompanied minors coming from other countries, trauma- exposed youth engaging with similar service organizations, and the youth population in general. For example, trainings for staff and providers on general trauma content and practice skills will benefit all youth that encounter that service agency or practitioner.
This paper offers an initial guide for practitioners and organizations that would like to apply a trauma-informed approach, centered on the experience of Central
American unaccompanied youth, to their practices and organizational procedures. Several of the approaches that emerged from the key informant interviews are also corroborated by current literature on violence prevention and intervention.26 However, few articles make the connection of also considering the complex competing concerns that youth face (e.g. pending immigration cases, strained family relationships, US-based gang
58 product of this paper is a non-exhaustive, general list of trauma-informed considerations centered from work supporting Central American unaccompanied youth.
Conclusion
As of October 2018, roughly 4,991 unaccompanied youth were apprehended at the U.S.’s southwest border.41 Youth and families will continue to be flee the instability and violence of their home communities. Youth immigrants from Latin America and all over the world will continue to make the journey to the United States – many for reasons out of their control - seeking safety, survival, healing, and community. Currently, the U.S. is awaiting the arrival of thousands of Central American migrants emigrating to the southwest border (controversially referred to as the caravan). Among them are certainly unaccompanied youth. Having direct-service practitioners and service organizations intentionally and meaningfully adopt trauma-informed approaches when engaging with Central American unaccompanied youth can foster young people’s strengths and resiliency to promote healing. Asserting a trauma-informed approach at both an individual and a system-wide organizational setting has significant potential to create knowledge, relationships, spaces, and procedures that care for unaccompanied youth from Central America and ease their already challenging process of adjustment and integration to the United States.
59
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63
Acknowledgements:
I would like to acknowledge and thank all the incredibly passionate key informants for sharing your wisdom, frustrations, and resilience as you continue to support and advocate for Central American unaccompanied youth. Sharing your own stories and insights have made me a better social worker and public health practitioner.
I would like to acknowledge and thank my professors, practicum instructors, and
incredible cohorts throughout my graduate school experience at UNC Gillings School of Global Public Health and UNC School of Social Work. I learned the importance of staying curious and critical, elevating the voices of those most marginalized, and developing knowledge when there is insufficient information available. Additionally, much thanks to my faculty readers, Dorothy and Josh, for your time, constructive feedback, and edits.
Thank you to my friends (Nina, Omar, Nikki, Jazmin) who helped read over this paper and keep me on track; to my querida madre and father for their unconditional motivation and belief that I was capable enough; and also to my incredible partner, Freddie, for his encouragement and for making sure I had enough to eat and sleep throughout this process.
Finally, I would like to acknowledge and thank all the Central American youth and families that I have worked with in the past, who have traveled, are traveling, and will travel to the U.S. and other counties in search of safety, hope, liberation, and family. Con amor, paz, y poder.
64
Appendix A
Key Informant Interview Guide
This interview solicited response to questions to better understand practice skills and
organizational procedures that address trauma and promote empowerment and healing among Central American unaccompanied youth. Based on these responses, key themes of trauma- informed considerations were summarized for practitioners and organizations that work with Central American unaccompanied youth.
1. Tell me about your experiences of working with unaccompanied youth from Central America.
a. What is your official job title/role? (Attorney, Mental Health Professional, School Educator, Community Advocate/Case Management)
b. How many years have you been working with unaccompanied youth from Central America?
2. Based on your experience, do you think trauma-related issues affects the Central American youth you work with?
3. How familiar are you with a “trauma-informed approach” when working with unaccompanied youth?
4. In your specific role as a [direct-service practitioner] how have you witnessed the effects of trauma on Central American unaccompanied youth?
5. Based on your experience, what approaches have you noticed are effective in working with/supporting UM who have experienced trauma?
6. What approaches have you observed to be effective in empowering youth and helping in their healing process?
7. What approaches, if any, have you noticed are not effective when working with
unaccompanied youth who have experienced trauma?
8. In organizations (if applicable) similar to the one where you work, how could services be changed (or already are) to prevent re-traumatization of youth?
9. In organizations similar to the one where you work, how could services or policies be changed (or already are) to better support [direct-service practitioners] who are working with Central American unaccompanied youth who have experienced trauma? Is there anything I have not asked you about that you would like to share/add?