2. What Is Trauma-Informed Care?
3. Ten Clinical Pearls for Applying a Trauma-Informed Approach to Care for Refugee and Immigrant Youth
3.1. Practice a Strengths-Based Approach to Care
3.2. Create an Immigrant-Friendly Healthcare Environment
3.3. Promote Trusting Relationships Within the Health Care Environment
3.4. Ask for Permission to Discuss Potentially Difficult Subjects
3.5. Recognize the Impact of Trauma on the Developing Brain, Various Manifestations of Trauma, and Screen for Trauma and Associated Mental Health Conditions
- Anxiety about the possibility of parental deportation or safety of family members in the country or origin;
- Family separation, either planned separation due to immigration logistics or separation as a result of immigration policy or detention;
- Bullying or victimization at school;
- Physical or sexual abuse;
- Dangerous conditions during migration;
- Family conflict or intrafamilial violence;
- Unsafe neighborhoods or gun violence (in country of origin and after relocation);
- Racism and microaggressions (both in country of origin and after relocation).
3.6. Treat Trauma-Related Disorders Appropriately
3.7. Utilize a Two-Generational Approach to Care
3.8. Know Your Own Local Resources and Make Sure They Are Trustworthy
3.9. Recognize that Trauma May Not End after Migration
3.10. Advocate for Your Patients Both in and outside the Clinic: For Your Patients and for Yourself
Ten Clinical Pearls of Trauma Informed Care for Refugee and Immigrant Youth
- Practice a strengths-based approach to care;
- Create an immigrant-friendly healthcare environment;
- Promote trusting relationships within the healthcare environment;
- Ask for permission to discuss potentially difficult subjects;
- Recognize the impact of trauma on the developing brain and various manifestations of trauma and screen for trauma and associated mental health conditions;
- Treat trauma and its associated symptoms appropriately;
- Utilize a two-generational approach to care;
- Know your own local resources and make sure they are trustworthy;
- Recognize that trauma may not end after migration;
- Advocate for your patients both in and outside the clinic: for your patients and for yourself.
Conflicts of Interest
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|Lead the social history or psychosocial assessment with questions about family and patient strengths||“Tell me a little bit about yourself. What are some things that you’re really proud of?”|
“What is something you’re good at?”
|Gather information about family supports, and strengthen those relationships when possible||“If something difficult were to happen, who would be available to help?”|
“If something really good were to happen, who would be cheering for you?”
|Congratulate patients and families on progress or accomplishments||“I’m so glad to hear that you are smoking fewer cigarettes—that’s wonderful! That’s a really challenging task. I can tell that you really care about your kids and are motivated to get their asthma under control. You should be really proud of your hard work.”|
|Acknowledge specific strengths, without stereotyping or making assumptions about religious, ethnic, or cultural groups||“That’s pretty great that you speak both English and Spanish. It’s a huge advantage when looking for jobs or applying to college—make sure to put that on all your applications.”|
“It sounds like your extended family is very close. I’m glad you have so much support available—it’s really important when taking care of your children and yourself. You should be proud of all the effort you’ve put into keeping those relationships strong.”
|Help patients and families build on past success to continue to build resilience||“It sounds like it was really challenging to cut out soda for the whole family, but you’ve done it for a whole month now! That is really going to set a healthy example for your kids. What would be another step that you could take as a family to help Dad manage his diabetes?”|
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