«The ongoing wars around the world have led to an ever increasing exodus of refugee populations for resettlement in developed countries, including the ...»
Among many Africans from different cultural backgrounds today, not all concepts underlying Ubuntugogy are practiced. Some of the practices such as initiation ceremonies, teachings offered by specialists, structural oral transmission of knowledge from the older to younger generation, tests for graduation from childhood to adulthood, and some gender specific roles are rarely practiced. However, values such as interdependence and a sense of community, support from family and members of the extended family, discipline of children by immediate and extended family members, respect of elders, the importance of peace and harmony, and need to embrace cultural identity are common among many Africans. These values are adhered to even among refugees who may be far from their original countries.
There are some similarities among Erikson‟s (1968) psychosocial stages of development with some aspects of child and adolescent education within the African cultural context, however, the manner of upbringing and some specific age group tasks markedly differ in both contexts (i.e., the Western and African context). For African adolescent refugees, some of these age specific tasks and responsibilities are interrupted as a result of forced migration from their home countries due to wars.
Impact of Migration on African Adolescent Refugees Some researchers (e.g., Beiser, Dion, Gotowic, Hyman, & Vu, 1995) have observed that, due to the importance of identity formation during adolescent development, migration during adolescence could be riskier than any other period in an individual‟s life. More recently, the UNHCR (2006) has recognized the delicate nature of refugee
guidelines for provision of care and welfare programs are three critical aspects: their vulnerability, dependability, and development. It was also noted that because children and adolescents are developing, it can be assumed that the disruption, uprooting, and insecurity inherent in migration adversely affects their physical, intellectual, and social development processes (UNHCR, 2006). This is even more so for African adolescent refugees whose identity formation process during development involves multiple aspects that form the foundation of their individuality as persons-in-relation to others.
As a result of forced departure from their countries of origin, African refugee adolescents have to deal with a dual form of transition: normative adolescent developmental transition and physical relocation to a new environment. These two experiences obviously make demands on their physical, emotional, social, and even spiritual capacities to successfully handle the challenges that may arise. Due to migration as a result of wars and the resulting political turmoil, the once established support system is disrupted and broken. The adolescents‟ social fabric (e.g., parents, extended family members, peers, and community), values, customs, and practices that initially guided their development and well-being are lost during the wars and at the time of flight. To some adolescents, the loss of parents may be particularly difficult because parents are considered the immediate caregivers and role models to the youth (Bangura, 2005).
Importantly, the culturally-accepted parent-child relationships are disrupted, including the support that is necessary during difficult times.
Additionally, some of the adolescents either lose their peers (e.g., members of the
subjected to loneliness and isolation during their flight to resettlement countries and possibly thereafter. Also, they lose opportunities for the formation and nurturing of peer relationships that are characteristic of many age-group activities in their growth and development. Besides, the stressors in the host environment (e.g., discrimination due to refugee status, language difficulties, and traditional role reversal from adults/parents to youth) also may be detrimental to their successful adjustment. Coupled with these challenges are the different cultural adaptations adolescent refugees encounter. Many Western countries of resettlement (e.g., U.S.) are more individualistic (i.e., value separation, independence) as compared to African refugees who come from a collectivistic (i.e., value for connectedness, interdependence) background.
The transition from a collectivistic to a more independent environment is particularly difficult for adolescents whose support system that was readily available to them may be no longer available. Consequently, it may be safe to assume that African adolescent refugees potentially face enormous challenges during adjustment in the host country as a result of the multiple disruptions and losses. Therefore, the need for a support system to mediate their adjustment in a new environment is understandably urgent. Although research on adjustment of adolescent refugees is scarce, in the few exceptions, researchers have documented psychosocial adjustment as one of the central aspects during resettlement in the host country. For adolescent refugees in resettlement, the process of psychosocial adjustment has been found to be impacted by several other
Psychosocial adjustment has been identified as one of the central aspects in the resettlement of refugee populations in host countries (Bemak, Chung, & Pedersen, 2003).
Psychosocial adjustment is defined as feeling comfortable in and accepted by the new majority culture while retaining pride in one‟s own cultural origins (Stoll & Johnson, 2007). For refugees, this adjustment may be particularly difficult due to pre-migration (e.g., war trauma, violence) and post-migration (e.g., stressors and challenges arising from immediate needs) experiences. Although refugees‟ values, customs, and beliefs may differ from one group to another, these similar experiences adversely impact their general adjustment in resettlement. Consequently, the literature on refugee studies has been guided, on the one hand, by an investigation of past traumatic experiences and their deleterious impact on refugees (e.g., trauma-focused or medical model advocates) and, on the other hand, an analysis of the immediate needs/stressors of refugees (e.g., psychosocial approaches) in resettlement. Understandably, these two perspectives have given rise to a prolonged discussion on what ought to be the urgent focus in the interventions for refugees in resettlement.
Proponents of psychosocial approaches (e.g., Miller & Rasmussen, 2010; Ryan & Dooley, 2008) have advanced the overarching goal of eventual psychosocial adjustment and overall well-being of refugee populations. To achieve this goal, their main focus is
material support, the ostracism and struggle for survival of groups such as former child soldiers, widows, sexual assault survivors, orphans, and people with war-related disabilities (Miller & Rasmussen, 2010, p. 7, italics added).
Psychosocial advocates (e.g., Barenbaum et al., 2004; Miller & Rasmussen, 2010;
Ryan, Dooley, & Benson, 2008; Summerfield, 1999; Watters, 2001) do not downplay the impact of past war traumatic exposure. Rather, they believe that present and immediate stressors in resettlement are more urgent and equally important, unlike war trauma that may have occurred in the distant past (e.g., months, year/s) and may not be a present threat to the individual. Therefore, for refugees resettled in developed countries, including the U.S., issues such as lack of social support from family and friends, housing, cultural differences, and the need to learn new skills for survival may be more salient. It is argued that these issues hold far much greater weight in causing stressors and eventual distress than past traumatic experiences which are not experienced on a daily basis (Miller & Rasmussen, 2010; Ryan, Dooley, & Benson, 2008). These difficult experiences eventually impact the adjustment and well-being of refugees. Notably, as a result of these ongoing experiences during resettlement, refugees‟ coping resources (e.g., mental, social, emotional) may significantly diminish with time, an occurrence that may threaten and delay their psychosocial adjustment.
Against this background, psychosocial advocates propose that interventions with refugee populations that are more focused on their psychosocial functioning and wellbeing may have a far greater impact than clinical treatment of past trauma. That is, while
symptoms as having greater promise in coping with resettlement stressors, psychosocial advocates argue that altering those stressful conditions is likely to improve people‟s mental health, while also fostering their inherent capacity to recover with adequate social support and the passing of time- from the lingering effects of exposure to war-related violence and loss (Miller & Rasmussen, 2010, p. 7).
Additionally, other researchers (e.g., Amone P-O‟lak, 2007; Lustig et al., 2004) also have observed that some refugees (i.e., both young and adults) have exhibited resiliency in the wake of war and its aftermath and survived war-trauma experiences. Other refugees may have been caught between the cross fires of wars but not necessarily encountered the resulting violence. In the resettlement, these refugees may not identify with the trauma-focused clinical interventions provided for refugees. Rather, postmigration stressful experiences may be even more traumatic and depressive and thus negatively impact refugees‟ adjustment process more than past traumatic experiences.
That is, immediate needs and stressors in the host environment, if not equal to premigration war trauma, may be even greater predictors of the difficulties and subsequent outcomes (e.g., mental health problems) that negatively affect psychosocial adjustment (Miller & Rasmussen, 2010).
On the contrary, advocates of the trauma-focused/medical model/approach to the study of refugees focus on past traumatic experiences and the interventions that are targeted towards reducing the outcomes (e.g., Posttraumatic Stress Disorders/symptoms, depression, anxiety, and distress). That is, “the critical factor is direct exposure to the
approaches and subsequent diagnoses as understood from Western countries (e.g., North America, Europe, Australia, Canada, and United Kingdom) have its foundation in the aftermath of the Vietnam War. The approach was used to determine the extent of the impact of traumatic events on returning veterans during the war, events that were characteristically uncontrollable for the veterans. Thus, for proponents of the trauma model, it seemed fitting that refugees, who have encountered numerous traumatic and violent experiences in their countries of origin and during flight, most likely would present or manifest PTSD and/or symptoms, distress, and all other accompanying symptoms similar to war veterans (Miller & Rasmussen, 2010).
Furthermore, because war stories from war veterans and refugees appeared to be a salient issue, it was believed that refugees‟ exposure to violence and destruction due to war were primary causes of the high levels of distress they exhibited in the resettlement countries. Against this background, researchers with refugee populations have concentrated mainly on the assessment of PTSD (e.g., Ellis et al., 2006; Ferren, 1999;
Kia-Keating & Ellis, 2007; Jaranson et al., 2004; Mghir et al., 1995; Murray et al., 2008;
Smith et al., 2002). This focus also is commonly known as the “dose-effect,” a relationship between direct war exposure and psychopathology, primarily PTSD symptom levels… and also depression, anxiety, and functional impairment…with the emphasis on examining the extent to which degree of war exposure predicted or accounted for severity of PTSD symptoms or a likelihood of receiving a diagnosis of PTSD (Miller & Rasmussen 2010, p. 10).
The consistent evidence and findings of PTSD and/or PTSD symptoms over a period
Charney, & Cabra, 2006; Jaranson et al., 2004; Robertson et al., 2006). However, because of the salience of immediate post-migration needs, challenges, and stressors that may cause distress among refugees in resettlement, psychosocial advocates have posited that a focus on treatment of past war-related trauma and symptoms (e.g., PTSD, anxiety, depression) may be very narrow and not sufficient in addressing the urgent needs (Miller, 1999; Silove, 1999). From a review of the literature, researchers have observed that the trauma-focused model is overly simplistic conceptual model that has unfortunately led trauma-focused advocates to overestimate the magnitude of the direct effects of direct war exposure in explaining distress within refugee communities…this in turn has contributed to an emphasis on trauma-focused interventions aimed at alleviating war-related PTSD in situations where greater attention to daily stressors may have yielded greater benefits (Miller & Rasmussen, 2010, p. 8).
In addition, it has been observed that the narrow focus on treating trauma and its symptoms may represent the interests of community mental health providers (e.g., assumption of mental health problems and need for clinical treatment) as compared to the refugees‟ perceptions of their own immediate needs (Barenbaum et al., 2004; Miller et al., 2004; Miller & Rasmussen, 2010; Summerfield, 1999). Therefore, for successful transition and adjustment of refugees in resettlement, psychosocial intervention approaches may have greater promise in alleviating some of the immediate needs and stressors that heavily tax their emotional well-being (Miller & Rasmussen, 2010).
In the interventions, psychosocial advocates propose that alleviating and addressing immediate needs may positively enhance refugees‟ emotional and /or mental health,
the process of forming new social support ties and eventually better psychosocial functioning. Other researchers (e.g., Barenbaum & Betancourt, 2004) have found that improving refugee environments, such as reduction of daily post-migration demands and needs and improvement of their emotional well-being would create some level of safety and facilitate the process of dealing with past war experiences and losses. Thus, provision of clinical diagnostic treatment interventions may be minimized and only targeted to individuals who may not be positively impacted by the psychosocial interventions (Miller & Rasmussen, 2010).