How do families “cope” with inter-generational trauma?
· Minority Stress and Trauma-Informed Approaches. Presented by the National Health Care for the Homeless Council and The Fenway Institute Tuesday, April 17, 2018 | 2-3 p.m. CT. Marginalized groups experience daily stressors related to their minority status through stigma, discrimination, and oppression. This form of chronic stress is traumatic ...
How can I cope with racial trauma?
booklet,Psychological Treatment of Ethnic Minority Populations. Its purpose is to (a) produce a highly readable brochure summarizing in broad terms the mental health issues of greatest concern to the four ethnic minority psychological associations,(b) increase awareness regarding the need for balance between culturally universal modes of ...
What is the best treatment for trauma-related symptoms in refugees?
• Ethnic minorities are exposed to higher rates of trauma and are less likely to receive adequate mental health treatment due to service barriers and the lack of culturally informed treatment providers (Turner et al., 2016). • Recent research has found positive associations between trauma and the following symptomology in ethnic minorities:
How can we improve trauma-informed care?
Exposure to Traumatic Events and Level of PTSD Symptoms. Table 2 presents TEI data and indicates high levels of trauma exposure in this sample. Using the PTSD categorical variable, 22% of participants had current PTSD. Of these 45 participants meeting criteria for PTSD, 95% were at one time consumers of mental health services, having prior diagnoses and treatment for …
What is the model minority?
The promulgation of the “model minority” myth, thatAsian Americans and Pacific Islanders are the most similar toEuropean Americans, and, thus, are viewed as “models” forand/or “better than” other ethnic minority groups, hascreated many problems for Asian Americans/Pacific Islanders.The result has been (a) a lack of attention to AsianAmerican/Pacific Islander issues in mental health research andclinical practice, (b) the creation of antagonisms with otherminority groups who may view Asian Americans/PacificIslanders as co-conspirators with European Americans, and (c)interference with the development of collaborative effortsand coalition building among racial/ethnic minority groups.
What is the role of a healer in mental health?
The role of the mental healthprofessional or healer is to identify the targetof therapeutic intervention and restorebalance to the holistic system.
What is culturally competent therapist?
Culturally competent therapists seek out educational,consultative, and multicultural training experiences .Because traditional training of mental healthprofessionals is often limited to knowledge of a Whitemiddle class population, the potential provider mustactively educate himself or herself about a diversepopulation.
What is Indian health service?
Indian Health Service is the largest single provider ofmental health services to American Indian people. In 2001,IHS employed 194 mental health workers, 54% of thembeing American Indian. Native people were seeking servicesfor alcohol and substance abuse problems, anxiety, panic,depression and grief, cultural conflict, and suicide attempts.Adequate funding is an ongoing problem for IHS andfrequently the only services that can be provided are crisisintervention and emergency care. It should be noted,however, that IHS does not serve many Native people, sothis information relates only to those Native people whohave access to IHS services.The state of the art in theassessment and diagnosis of psychological disorders oftraditional Native people is a work in progress.The use ofpsychological tests that have a normative sample from themajority population, even with statistically appropriatenumbers of minority participants, does not reflect thepsychological make up of an American Indian. Also, becauseof the diversity among tribes, caution must be exercised if atest uses data from one tribe in the development of thenormative sample. It cannot be generalized to other Nativetribes.While DSM-IV-TR includes cultural concerns andencourages practitioners to consider culture for diagnosingpersons from different cultures, no guidelines or criteria areoffered for specific minority groups.
Why does trauma continue throughout generations?
Sadly, the trauma continues throughout generations because those who needed help, never received it.
What is intergenerational trauma?
Inter-generational trauma is a concept developed to help explain years of generational challenges within families. It is the transmission (or sending down to younger generations) of the oppressive or traumatic effects of a historical event. For example, a great grandmother who was placed in a concentration camp in Germany may have learned ...
How does trauma affect grandchildren?
The transmission of the historical trauma may begin to negatively affect her grandchildren and her grandchildren’s children, etc., leading to generations of emotional distance, defensive behaviors around expression of emotions, and denial.
Can a grandparent ignore trauma?
For example, a grandparent who refused to examine the impact of her trauma may be teaching her grandchildren (intentionally or unintentionally) to ignore the impact of their trauma. Sooner or later the trauma is likely to be triggered by something. Trauma is not something you can hide from, no matter how hard you try.
Can trauma be hidden?
Trauma is not something you can hide from, no matter how hard you try. As a result, I have learned over time, by treating multiple clients with trauma histories, that there are a few ways inter-generational trauma negatively impacts families:
Is intergenerational trauma discussed?
The consequences of inter-generational trauma are rarely if ever discussed unless a therapist or other mental health professional mentions it. While it is a very important topic, it’s a topic that many mental health professionals are either uninformed about or simply disinterested in.
How can trauma informed care be beneficial?
The prevalence and impact of trauma constitute a public health crisis that is complicated by the cultural heterogeneity of contemporary society and a higher rate of trauma among individuals from minoritized communities. A trauma-informed care approach can facilitate improved treatment of those who have experienced trauma, and trauma-informed care is increasingly viewed as potentially beneficial for all patients. This article outlines general principles of trauma-informed care and ways to enact it. Because the situations in which trauma arises, the ways in which it is conceptualized, and how patients respond to it are influenced by both culture and individual factors, a cultural humility approach is also described and recommended. Psychiatrists can navigate the complex terrain of cultures and social backgrounds in the clinical encounter and can promote healing when treating patients who have experienced trauma by adopting a trauma-informed care approach and an attitude of cultural humility.
What is the Western approach to trauma?
The modern Western approach favors an individualizing attitude toward trauma, based on assumptions that individuals conceive of themselves as independent beings. This is a tasking endeavor for most patients who present from collectivist high-context cultures in which a sense of and belief in community and interdependence is promoted, rather than independence, and who hence have more relational self-constructs (40, 41).
What is trauma informed care?
Trauma-informed care is a strength-based approach to caring for individuals mindfully, with compassion and clarity regarding boundaries and expectations, to avoid unintentionally triggering a trauma or stress response. Trauma-informed care acknowledges that many people have experienced potentially traumatic events and that the health consequences of such events are significant. It recognizes that unique individual and previous life experience, including physical, social, and cultural environments, may influence how people respond to potentially traumatic events and how they receive, experience, and interact with their health care. Trauma-informed care is being adopted within and across health care, educational, legal, governmental, and agency settings in an acknowledgment that trauma is a societal issue (15, 21). In the clinical setting, trauma-informed care requires structuring each patient encounter in such a way as to facilitate healing and foster resilience.
How does cultural context affect trauma?
Cultural context and conceptualization of self, whether individualistic or collectivist, shape how a person experiences, perceives, makes meaning of, and eventually heals from trauma. These contexts also affect how one’s condition is diagnosed and treated in the health care system. For example, one study looked at a sample of 20 Salvadoran women exposed to trauma and found that 19 did not meet DSMcriteria for PTSD despite their impairment and suffering (42). In this respect, their cases were similar to Sara’s. In a study that explored variables for resilience and vulnerability after a 1999 earthquake in Turkey, researchers found that participants struggling with trauma did not fit the classical DSMcriteria triad but rather presented with reexperiencing, cognitive impairment, and numbing (43).
What is trauma in psychology?
Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically and emotionally harmful or threatening and that has lasting adverse effects on the individual’s physical, social, emotional, or spiritual well-being. (15)
How does culture affect mental health?
Although some patient populations may be more susceptible to trauma exposure on the basis of sociodemographic circumstances, culture is one of the mitigating factors that play a role in the variability of individual response to potentially traumatic events (10–12) . One example of how cultural context can affect a patient’s experience of mental health care is the perception among some African Americans that the health care system as a whole is a white, racist institution (28). This attitude is sometimes based on personal experiences or family memories, and certainly there is a history of harmful racism in health care in the United States, such as the infamous Tuskegee syphilis experiment. The case of Henrietta Lacks also highlights ways in which standards of patient consent and privacy have been ignored for African Americans (36). One study found that some African-American patients with posttraumatic stress disorder (PTSD) did not seek treatment because they feared family or cultural disapproval (37). The myth of the strong black woman might also lead African-American women to avoid seeking care for mental health issues, including trauma (28).
What to ask a patient about comfort?
Ask about the patient’s comfort regarding handshake, eye contact, or personal space.
What percentage of mental health professionals are black?
Because less than 2 percent of American Psychological Association members are Black or African American, some may worry that mental health care practitioners are not culturally competent enough to treat their specific issues.
What are the factors that could potentially change beliefs about symptoms of mental illness?
Cohort effects, exposure to mental illness, and increased knowledge of mental illness are factors that could potentially change beliefs about symptoms of mental illness. Participants appeared apprehensive about seeking professional help for mental health issues, which is consistent with previous research.
How does racism affect mental health?
Despite progress made over the years, racism continues to have an impact on the mental health of Black and African American people. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences.
Which group is more likely to have feelings of sadness, hopelessness, and worthlessness than adult whites?
Adult Blacks and African Americans are more likely to have feelings of sadness, hopelessness, and worthlessness than adult whites. [7]
Do black people have mental health issues?
Overall, mental health conditions occur in Black and African American (B/AA) people in America at about the same or less frequency than in White Americans. However, the historical Black and African American experience in America has and continues to be characterized by trauma and violence more often than for their White counterparts and impacts emotional and mental health of both youth and adults. (See prevalence statistics below).
Do black people seek help for depression?
However, MHA screening data shows that Black and African American people who screen positive for depression self-identify as planning to seek help at higher rates than the general population says they will seek help.
Why do people seek inferior care in high risk areas?
In high-risk areas, those who choose to seek treatment often receive inferior care because there tends to be little diversity among mental health providers and decreased understanding about the different mental health needs across minority groups.
What is unmet need?
Unmet need was defined as “feeling the need for services, but not using them” or “receiving inadequate care.” Respondents could indicate more than one reason as a barrier to pursuit of care, illustrating that barriers are not mutually exclusive.
What are quality improvement efforts?
Quality improvement efforts include screening, cultural sensitivity training and language-appropriate treatment and educational materials. At the federal level, policies would assist in training a diverse workforce to adequately meet America’s mental health needs.
What is primary care provider?
Primary care providers, including family nurse practitioners, are integral to ensuring all patients receive comprehensive care, and they serve as a key resource for those most vulnerable to the negative health effects resulting from discrimination.
Is there stigma associated with mental illness?
Education and awareness: Despite progress in recent years, there is still a stigma associated with mental illness. Embarrassment can be lessened by helping people in at-risk communities understand that mental health is an essential part of well-being — just like a healthy diet, sleep and exercise.
What is the best treatment for PTSD?
Evidence-based exposure therapies include Prolonged Exposure (PE), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Narrative Exposure Therapy (NET; KIDNET for children). NET (Schauer, Neuner, & Elbert, 2011) is the only model specifically developed for treating immigrant and refugee populations in post-conflict, low-income contexts and has been extensively researched with refugee populations (Robjant & Fazel, 2010; Crumlish & O’Rourke, 2010). NET integrates elements of cognitive behavior therapy and testimony therapy and is specially targeted for individuals who have been exposed to multiple traumatic events in their lifetime (see Schauer, Neuner, & Elbert, 2011 for a full description of the treatment model). A recent study conducted by Slobodin and de Jong (2015a) reviewed the literature on the efficacy of treatments for asylum seekers and refugees, including trauma focused interventions, group therapies, multidisciplinary interventions and pharmacological treatments. They reported that the majority of studies had positive outcomes for reducing trauma-related symptoms. However, the evidence mostly supports NET and CBT as the recommended treatment modalities for refugees.
Why are immigrants and refugees not getting mental health care?
This can be for a variety of reasons including the stigma associated with mental health in many cultures, the inability to properly diagnose because of cultural and linguistic barriers, less access to health insurance, lack of financial resources, and the propensity to seek help from traditional healers or providers before seeking Western mental health services (Betancourt et al., 2015; Kandula et al., 2004).
How does traumatic stress affect children?
Persistent intergenerational transmission of family violence accompanied by harsh parenting practices and low positive involvement between parents and children is one dimension of a complex set of consequences related to traumatic stress that affect family and community functioning. Although resilience is readily seen in displaced communities, the lasting negative effects of traumatic stress on individual and family health is ubiquitous across multiple generations. The sequelae of maladaptive coping that often includes mental health disturbances, substance abuse and intimate partner violence, are further exacerbated by poverty and social disparities that place these families on a delicate faultline. There are currently no evidence-based parent or family-level treatments for traumatic stress. A review of the literature on family-based interventions for traumatized immigrants and refugees conducted by Slobodin and de Jong (2015b) found only six experimental studies, four school-based and two multifamily support groups. They validated that the shortage of research in this area currently does not allow for effectiveness claims to be made about family-based interventions with these populations.
Is it ethical to use westernized treatments?
Using westernized treatments without proper cultural tailoring and testing may not be ideal or even ethical for those who come from other countries. Many immigrants and refugees come from collectivistic cultures that prioritize interpersonal relationships and social networks above the needs of the individual.
Is there evidence for traumatic stress?
There are currently no evidence-based parent or family-level treatments for traumatic stress. A review of the literature on family-based interventions for traumatized immigrants and refugees conducted by Slobodin and de Jong (2015b) found only six experimental studies, four school-based and two multifamily support groups.