A Group Treatment for Displaced Survivors of Persecution: A Reflective Account Through a Psychosocial Lens

Authors

  • Nancy J Murakami New York University
  • HangYi Chen

DOI:

https://doi.org/10.1921/gpwk.v28i1.1109

Abstract

Millions of displaced survivors of persecution are navigating the impacts of both human rights violations and being forced to flee their homes, communities and nations. Their broad, pervasive, and complex psychosocial needs can develop into chronic and severe issues if they are not addressed. There is limited literature on clinical interventions and approaches that have a primary goal of promoting psychosocial health of displaced survivors of targeted persecution. The Orientation Group, developed by the Bellevue/NYU Program for Survivors of Torture in New York City, is one brief psychoeducational and skills-based group intervention aiming to support the psychosocial wellbeing of displaced survivors of torture, political oppression and other forms of persecution. Although not yet empirically studied, this group intervention has more than a decade of anecdotal support. This paper provides a reflective account of the Orientation Group and offers recommendations for enhancing the intervention.

References

Akinsulure-Smith, A.M. (2009) Brief psychoeducational group treatment with re-traumatized refugees and asylum seekers. The Journal for Specialists in Group Work, 34, 2, 137-150

Akinsulure-Smith, A.M., Ghiglione, J.B. and Wollmershauser, C. (2009) Healing in the midst of chaos: Nah We Yone’s African women’s wellness group. Women & Therapy, 32, 105-120

Alfadhli, K. and Drury, J. (2016) Psychosocial support among refugees of conflict in developing countries: A critical literature review. Intervention, 14, 2, 128-141

Amnesty International (2014) Torture in 2014: 30 Years of Broken Promises. [Accessed 10 November 2017 at https://www.amnestyusa.org/files/act400042014en.pdf]

Anonymous (2014) Evaluating the psychosocial components of a humanitarian project: Describing the effect of an intervention in relation to psychosocial problems. Intervention, 12, 3, 442-446

“Author” (2017)

Banach, M. and Couse, L.J. (2012) Interdisciplinary co-facilitation of support groups for parents of children with autism: An opportunity for professional preparation. Social Work with Groups, 35,4, 313-329

Bellevue/NYU Program for Survivors of Torture (PSOT) (2015) 2015 Impact report. New York: PSOT [Accessed 26 December 2017 at http://www.survivorsoftorture.org/our-impact]

Bemak, F. and Chung, R.C. (2017) Refugee trauma: Culturally responsive counseling interventions. Journal of Counseling & Development, 95, 3, 299-308, DOI: 10.1002/jcad.12144

Bernstein, D.A., Borkovec, T.D. and Hazlett-Stevens, H. (2000) New Directions in Progressive Relaxation Training: A guidebook for helping professionals. Westport, CT: Praeger/Greenwood

Başoğlu, M. (2006) Rehabilitation of traumatised refugees and survivors of torture: After almost two decades we are still not using evidence based treatments. British Medical Journal, 333, 1230-1231

Bunn, M., Goesel, C., Kinet, M. and Ray, F. (2016) Group treatment for survivors of torture and severe violence: A literature review. Torture Volume, 26, 1, 45-67

Cuijpers, P., van Straten, A. and Warmerdam, L. (2007) Behavioral activation treatments of depression: A meta-analysis. Clinical Psychology Review, 27, 318-326

Department of Homeland Security (2006) 2004 Yearbook of immigration statistics [Accessed 21 December 2017 at https://www.dhs.gov/sites/default/files/publications/Yearbook_Immigration_Statistics_2004.pdf]

Dombo, E.A. and Ahearn, F.L. (2017) The aftermath of humanitarian crises: A model for addressing social work interventions with individuals, groups and communities. Illness, Crisis & Loss, 25, 2, 107-126

Drožđek, B. and Bolwerk, N. (2010) Evaluation of group therapy with traumatized asylum seekers and refugees - The Den Bosch Model. Traumatology, 16, 4, 117-127

Drožđek, B., Kamperman, A.M., Tol, W.A., Knipscheer, J.W. and Kleber, R.J. (2014) Seven-year follow-up study of symptoms in asylum seekers and refugees with PTSD treated with trauma-focused groups. Journal of Clinical Psychology, 70, 4, 376-387, DOI: 10.1002/jclp.22035

Fallot, R.D. and Harris, M. (2008) Trauma-informed approaches to systems of care. Trauma Psychology Newsletter, 3, 1, 6-7 [Accessed 26 December 2017 at http://traumapsychnews.com/wp-content/uploads/2016/01/newsletter_2008_winter.pdf#page=6]

Foy, D.W., Glynn, S.M., Schnurr, P.P., Jankowski, M.K., Wattenberg, M.S., Weiss, D.S., Marmar, C. and Gusman, F. (2000) Group therapy. in E.B. Foa, T.M. Keane and M.J. Friedman (Eds.) Effective Treatments for PTSD. New York: The Guilford Press (pp.155-175)

Foy, D.W. and Larson, L.C. (2006) Group therapies for trauma using cognitive–behavioral therapy. in V.M. Follette and J.I. Ruzek (Eds.) Cognitive–Behavioral Therapies for Trauma. 2nd ed. New York: Guilford Press (pp.388-404)

George, M. (2012) Migration traumatic experiences and refugee distress: Implications for social work practice. Clinical Social Work Journal, 40, 429-437

Gonsalves, C.J., Torres, T.A., Fischman, Y., Ross, J. and Vargas, M.O. (1993) The theory of torture and the treatment of its survivors: An intervention model. Journal of Traumatic Stress, 6, 3, 351-365

Herman, J. L. (1997). Trauma and Recovery: The aftermath of violence - from domestic abuse to political terror. New York: Basic Books

Hinton, D.E., Pich, V., Hofmann, S.G. and Otto, M.W. (2013) Acceptance and mindfulness techniques as applied to refugee and ethnic minority populations with PTSD: Examples from "Culturally Adapted CBT". Cognitive and Behavioral Practice, 20, 1, 33-46

Hodges-Wu, J. and Zajicek-Farber, M. (2017) Addressing the needs of survivors of torture: A pilot test of the psychosocial well-being index. Journal of Immigrant & Refugee Studies, 15, 1, 71-89

Inter-Agency Standing Committee (IASC). (2007) IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva, Switzerland: IASC [Accessed 1 November 2017 at http://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf]

Jacobson, N.S., Dobson, K.S., Truax, P.A., Addis, M.E., Koerner, K., Gollan, J.K., Gortner, E. and Prince, S.E. (1996) A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 2, 295-304

Kim, D., Bae, H. and Park, Y.C. (2008) Validity of the subjective units of disturbance scale in EMDR. Journal of EMDR Practice and Research, 2, 1, 57-62. DOI: 10.1891/1933-3196.2.1.57

Kira, I.A., Ahmed, A., Wasim, F., Mahmoud, V., Colrain, J. and Rai, D. (2012) Group therapy for refugees and torture survivors: Treatment model innovations. International Journal of Group Psychotherapy, 62, 1, 69-88

Lacroix, M. and Sabbah, C. (2011) Posttraumatic psychological distress and resettlement: The need for a different practice in assisting refugee families. Journal of Family Social Work, 14, 43-53

Levi, O., Wald, I., Svetlitsky, V., Zusmanovitz, S., Parasha, E., Shoval-Zuckerman, Y., Afik, G., Haikin, G. and Fruchter, E. (2017) Combat-related multifaceted trauma-focused group therapy: A pilot study. The Journal of Nervous and Mental Disease, 205, 2, 133-139

Lewinsohn, P.M. and Libet, J. (1972) Pleasant events, activity schedules, and depressions. Journal of Abnormal Psychology, 79, 3, 291-295

Loewy, M.I., Williams, D.T. and Keleta, A. (2002) Group counseling with traumatized East African refugee women in the United States: Using the Kaffa ceremony intervention. Journal for Specialists in Group Work, 27, 2, 173-191

Neuner, F., Schauer, M., Klaschik, C., Karunakara, U. and Elbert, T (2004) A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72, 4, 579-87

McFarlane, C.A. and Kaplan, I. (2012) Evidence-based psychological interventions for adult survivors of torture and trauma: A 30-year review. Transcultural Psychiatry, 49, 3-4, 539-567

McKay, M., Davis, M. and Fanning, P. (2007) Thoughts and Feelings: Taking control of your moods and life. 3rd ed. Oakland, CA: New Harbinger

Mendelsohn, M., Zachary, R.S. and Harney, P.A. (2007) Group therapy as an ecological bridge to new community for trauma survivors. Journal of Aggression, Maltreatment & Trauma, 14, 1/2, 227-243

Meyer, S. (2013). Global Review: UNHCR’s Mental Health and Psychosocial Support for Persons of Concern. Geneva, Switzerland: United Nations High Commissioner for Refugees [Accessed 10 November 2012 at http://www.unhcr.org/51bec3359.pdf]

Migration Policy Institute (2017) Refugees and Asylees in the United States [Accessed 1 November 2017 at http://www.migrationpolicy.org/article/refugees-and-asylees-united-states]

National Capacity Building Project and Center for Victims of Torture (2005) Healing the Hurt: A Guide for Developing Services for Torture Survivors. Minneapolis, MN: CVT. [Access 11 November 2017 at: http://www.healtorture.org/sites/healtorture.org/files/Healing_the_Hurt_combined.pdf]

Nickerson, A., Bryant, R.A., Silove, D. and Steel, Z. (2011) A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clinical Psychology Review, 31, 3, 399-417

Office of Refugee Resettlement (ORR) (n.d.) ORR Benefits-At-A-Glance Fact Sheet. [Accessed 22 December 2017 at https://www.acf.hhs.gov/sites/default/files/orr/orr_fact_sheet_benefits_at_a_glance.pdf]

Padesky, C.A. and Mooney, K.A. (1990) Presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14 [Accessed 1 November 2017 at https://padesky.com/newpad/wp-content/uploads/2016/02/v6no_1_2_present_model_currentweb.pdf]

Paunovic, N. and Öst, L. (2001) Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy, 39, 1183-1197

Petri, L. (2010) Concept analysis of interdisciplinary collaboration. Nursing Forum, 45, 2, 73-82.

Porter, M. and Haslam, N. (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. JAMA, 294, 5, 602-612

Porterfield, K. (2004) Bellevue/NYU Program for Survivors of Torture Orientation Group: Group Therapy Manual for Clinicians. New York: PSOT

Pulvirenti, M. and Mason, G. (2011) Resilience and survival: Refugee women and violence. Current Issues in Criminal Justice, 23, 1, 37-52

Robertson, M.A.E., Blumberg, J.M., Gratton, J.L., Walsh, E.G. and Kayal, H. (2013) A group-based approach to stabilisation and symptom management in a phased treatment model for refugees and asylum seekers. European Journal of Psychotraumatology, 4, 1-8, DOI: 10.3402/ejpt.v4i0.21407

Salo, C.D. and Bray, E.M. (2016) Empirically tested interventions for torture survivors: A systematic review through an ecological lens. Translational Issues in Psychological Science, 2, 4, 449-463

Shapiro, E. (2009) Four elements exercise for stress management. in M. Luber (Ed.) Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and special situations. New York: Springer Publishing (pp.73-79)

Shapiro, E. (2012) 4-Element Exercises for Stress Reduction [Accessed 28 November 2017 at http://emdrresearchfoundation.org/toolkit/four-elements.pdf]

Siegel, D. (1999) The Developing Mind: How relationships and the brain interact to shape who we are. New York: Guilford.

Siriwardhana, C., Ali, S.S., Roberts, B. and Stewart, R. (2014) A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants. Conflict and Health, 8, 13 [Accessed 10 November 2017 at http://www.conflictandhealth.com/content/8/1/13]

Slobodin, O. and de Jong, J.T. (2015) Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy? International Journal of Social Psychiatry, 61, 1, 17-26

Smith, H. and Impalli, E. (2007) Supportive group treatment with survivors of torture and refugee trauma. in H.E. Smith, A.S. Keller and D.W. Lhewa (Eds.) “Like a Refugee Camp on First Ave”: Insights and experiences from the Bellevue/NYU Program for Survivors of Torture. New York: The Bellevue/ NYU Program for Survivors of Torture (pp.336-374)

Substance Abuse and Mental Health Services Administration (2014) Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration [Accessed 12 December 2017 at https://store.samhsa.gov/shin/content/SMA14-4816/SMA14-4816.pdf]

Tol, W.A., Song, S. and Jordans, M.D. (2013) Annual research review: Resilience and mental health in children and adolescents living in areas of armed conflict - a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry and Allied Disciplines, 54, 4, 445-460. DOI:10.1111/jcpp.12053

Turrini, G., Purgato, M., Ballette, F., Nosè, M., Ostuzzi, G. and Barbui, C. (2017) Common mental disorders in asylum seekers and refugees: Umbrella review of prevalence and intervention studies. International Journal of Mental Health Systems, 11, 51, 1-14, DOI: 10.1186/s13033-017-0156-0

United Nations High Commissioner for Refugees (UNHCR) (2017) Global Trends: Forced Displacement in 2016. UNHCR [Accessed 10 November 2017 at http://www.unhcr.org/5943e8a34.pdf]

Wilkinson, J. (2007) Immigration dynamics: processes, challenges, and benefits. in H.E. Smith, A.S. Keller and D.W. Lhewa (Eds.) “…Like a Refugee Camp on First Avenue”: Insights and experiences from the Bellevue/NYU Program for Survivors of Torture. New York: Bellevue/NYU Program for Survivors of Torture (pp.65-81)

World Health Organization (WHO) (2014) Basic Documents. 48th ed. [Accessed 7 December 2017 at http://apps.who.int/gb/bd/PDF/bd48/basic-documents-48th-edition-en.pdf#page=7]

Yalom, I.D. and Leszcz, M. (2005) The Theory and Practice of Group Psychotherapy. 5th ed. New York: Basic Books

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Published

2019-10-23

How to Cite

Murakami, N. J., & Chen, H. (2019). A Group Treatment for Displaced Survivors of Persecution: A Reflective Account Through a Psychosocial Lens. Groupwork, 28(1), 50-76. https://doi.org/10.1921/gpwk.v28i1.1109

Issue

Section

Groupwork with people who have experienced political exclusion