A psychotherapy model for treating child and adolescent refugees caught in the midst of catastrophic situations is proposed. Empirical studies of the peri-traumatic period, comprised between the moment of departure and up to the moment of arrival of the refugees to the sheltering country, are scarce and difficult to complete. A review of the literature reveals that negative, long term mental health outcomes in these populations are related to autonomic dysregulation and impaired narratives of the events, which result from exposure to overwhelming stress. The author combines case material from his own clinical experience treating Cuban children and adolescents inside refugee camps, with the available literature, in order to design the model. The role of the therapist is threefold and involves: (1) intervening to decrease hyperarousal and protect the refugee's neuroendocrine integrity, (2) helping the patient construct a cohesive narrative of the events during the peri-traumatic period and, (3) becoming an advocate for the refugee children and their families, helping to empower them so they can attain mastery and control over the forces that threaten to overwhelm their coping capacities. This model addresses a neglected area of refugee studies: treatment interventions during the peri-traumatic period. It attempts to bridge the empirical research gap that exists, due to the inherent difficulties of studying refugee populations “in the field.” This model could potentially be extrapolated to treat other similar populations.
Journal of the American Academy of Psychoanalysis & Dynamic Psychiatry – Guilford Press
Published: Dec 1, 2008