QPASTT Queensland Program of Assistance to Survivors of Torture and Trauma Trauma informed practice with young people who have been through immigration detention MYAN, July 2013 Naomi Kikkawa & Katharine Knoetze
Overview QPASTT programs & services Our clients in context what is trauma informed practice? Possible symptom progression in detention environment Effects of trauma on emotions and cognitions Transitions and successful settlement Supporting recovery
Who is QPASTT QPASTT is a member of the Forum of Australian Services for Survivors of Torture and Trauma (FASSTT) A community-based state-wide organisation established in 1995 to provide counselling support and community development activities for refugee survivors of torture and trauma at an individual, family and community level Asylum seekers form part of our client group QPASTT aims to help our clients to recover from pre-arrival experiences of trauma and build new lives in Australia Services include: direct counselling, advocacy, psycho-educational groups (well-being, coping strategies, exercise and parenting), recreational programs, carer support and capacity building services
QPASTT Programs and Services Children and Youth Team Communities Team Regional Services Team Counselling Services Team Asylum Seeker Support Team Counselling for children and young people, suicide prevention program for young people from refugee backgrounds, Youth Support Coordinator, Youth Workers, Homework Club, Holiday Activities, Group Work and Youth Voice Counselling for whole family and carers of people with mental health issues, Psycho-education groups, Community Development, Whole of School Approach, Capacity Building Counselling for adults, youth and children covering Logan, Gold Coast, Ipswich, Toowoomba, Gatton, Rockhampton, Townsville and Cairns Counselling for adults & families and group work Counselling for children, young people & adults seeking asylum and group work (Scherger IDC, BITA, Community Detention, Bridging Visas)
Asylum Seeker Support Team Stats 6% of referrals in the last 12 months has have been UAMs Countries of origin: Sri Lanka (Tamil), Afghanistan (Hazara), Burma (Rohingya) Gender: Male
Our clients in context Life Trauma Migration and Settlement (or Detention / CD)
Violence and persecution Detention Environment Core Components of the Trauma Reaction Recovery principles: Containment & reduction of ongoing mental ill health Life threat Killings, assaults Threats of harm to family, friends Poor nutrition Threat to future safety Witnessing self harm & violence Uncertainty about visa outcomes Chronic fear and alarm Anxiety Feelings of helplessness Loss of control Restore safety Enhance control Reduce fear and anxiety Loss Death Separation Isolation, dislocation Separation from family members Isolation Disruption of connections to family, friends, community, and cultural beliefs Relationships changed Grief & Depression Restore attachment and connections to others Offer emotional support and care Exposure to boundless human brutality on mass scale Policy context of deterrence & illegality Destruction of central values of human existence & previously held assumptions: Trust, meaning, identity, esteem & future Restore meaning and purpose to life Value transgression Invasion of personal boundaries Impossible choices Humiliations Transgression of sacred values Humiliation & Degradation Guilt & shame Restore dignity and value Reduce excessive shame and guilt
Effects of Trauma on Emotions & Cognitions Heightened sense of vulnerability Anxious attachment Regression Extreme self criticism and self judging Generalised fear Excessive crying Moodiness as they deal with feelings of inadequacy Feelings of anger as they need to establish control Capacity to manage frustration and tension is reduced Poor concentration and retention Sleeping disturbances - difficulty falling asleep, waking up every few hours, waking up early, nightmares Feeling like events are happening again (flashbacks)
Possible progression of symptoms in detention (and community detention) Initially enormous relief and hope Fear, anxiety and tension begins to build and may lead to chronic anxiety & depression Severity of symptoms is likely to increase with the length of time spent in the detention environment WHAT IS MEANINGFUL SUPPORT? FASSTT
Transitions and Successful Settlement CD settlement Expectations of Australian systems vs those of the families of young people and young people themselves. Turning 18 Significant change in level of support from formal systems. So, what does successful adjustment / settlement look like?
Maybe like this?
Recovery Goals Increase safety and control Foster connections Restore identity, meaning and purpose Restore dignity and value and reduce guilt and shame NEXUS Objectives Connectedness Internal locus of control build resilience Address high academic and employment expectations Decrease suicide risk in young people who have attempted suicide Improve community attitudes
What Does this Look Like at QPASTT? Counselling Group work (UHM boys group, Karate, Community Computer Workshops, Dare to Dream) School outreach Youth Support Coordinator Ucan2 Holiday Activities Homework Club Youth Voice Committee Youth Job Club
The Healing Relationship THE CORE EXPERIENCES of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections. Recovery can take place only within the context of relationships; it cannot occur in isolation. In her renewed connections with other people, the survivor re-creates the psychological faculties that were damaged or deformed by the traumatic experience. Judith Herman 1992 P133 Trauma and Recovery (from domestic abuse to political terror)pandora, London, 1994
Dealing with Disclosure of Traumatic Material Listen to and respond to whatever the young person presents with acknowledgment. Indicate that their response is usual after what they have been through. Say that you know other young people who have felt the same way. Affirm that it is all right to have felt helpless, afraid, sad or angry. Acknowledge the reaction, whatever it is and state that you anticipate that they may well feel sad, angry, etc again Indicate that they can come to you when they are especially worried, troubled, sad or cannot concentrate. Acknowledge the young person s bravery in talking about his or her feelings. Let young person know that you may need to refer them to another service that can support them. Emphasise that you will support the young person through this process.
QPASTT Contact Details 28 Dibley Street, Woolloongabba, QLD Phone: 07 33916677 Email: admin@qpastt.org.au Website: www.qpastt.org.au
References APS Submission to the National Inquiry into Children in Immigration Detention Dudley, M., Steel, Z., Mares, S., & Newman, L. (2012). Children and Young People in Immigration Detention. In Journal of Child and Adolescent Psychiatry. Gladwell, C. & Elwyn, H. (2012). Broken futures: Young Afghan Asylum Seekers in the UK and on Return to Their Country of Origin. (http://www.refugeesupportnetwork.org/sites/default/files/files/broken%20futures%20final%20version.pdf) Herman, J. (1997). Trauma and Recovery (The aftermath of violence from domestic abuse to political terror). Basic Books, New York. Hodas, GR. (2006). Responding to Childhood Trauma: The Promise and Practice of Trauma Informed Care. Martin, G., Richardson, A.S., Bergen H.A., Roger, L., Allison, S. (2005). Perceived academic performance, self esteem and locus of control as indicators of need for assessment of adolescent suicide risk: implications for teachers (Journal of Adolescence 28, pp 75 87) Montgomery, E. (Ed) (2011). Trauma, Exile and Mental Health in Young Refugees. In Acta Psychiatrica Scandinavica. Multicultural Youth Advocacy Network (Australia). (2012). Unaccompanied Humanitarian Minors in Australia An overview of national support arrangements and key emerging issues. (http://www.myan.org.au/file/file/myan%20uhm%20policy%20paper%20sept%202012.pdf) Row, C.A., Walker, K.L., Button, P.L., Hirsch, J.K. (2013). The relationship between negative life events and suicidal behaviour. Moderating role of basic psychological needs (Crisis 34 (4), pp233 241) Additional training resources from FASSTT, specifically VFST (Foundation House)