Review questions
True or false?
Creating an environment that acknowledges the effect of trauma and tries to create a sense of physical and emotional safety can be done without requiring a person to disclose their experience of trauma.
True
It is important to not require refugees or immigrants to discuss trauma.
True
Promoting resilience
While there are many definitions of resilience, researchers generally agree that resilience refers to “patterns of desirable behaviour in situations where adaptive functioning or development have been significantly threatened by adverse experiences” (Masten et al., 1995, p.283).
In the past, resilience has been described as an individual attribute, but emerging literature emphasizes the importance of contextual and cultural factors (Simich et al., 2012). This is coined the “social-ecological” definition of resilience, whereby resilience is dependent on the ability of the individual and their environments to interact in ways that optimize outcomes (Ungar, 2013). Thus, resilience is not only the outcome of individual psychological processes, but also involves the “social process that reside in relationships among people, systems and institutions at the level of families, neighborhoods, communities, and organizations, governments and transitional networks” (Kirmayer, 2014, p.vii).
Preliminary research has identified formal and informal methods for promoting resilience. Informally, personal networks have been identified as the key contributors to successful resettlement and integration. Formally, it is recognized that there is needs to be more service delivery options to promote resilience. Specific to the health services sector, the nature of service delivery is of utmost importance, characterized by ongoing outreach and cultural competence (Simich et al., 2012).
Video: A community approach to resilience
With Dr. Michael Ungar (Director, Resilience Research Centre)
What I've been trying to say of course is that resilience is something that is facilitated and what we are actually understanding from our work is that that is an effort that has to be a group effort. It's not that personal positive thinking, mindfulness practices, self-regulation, these are good skills, these are important. But, in every case, what you often see is that when you increase the stress on a population, especially of kids, what you begin to understand is that more of the change, more of what's going to get them through, is going to be external to them. So good program design, good governance, good schools, good policing, good safety, good family support, these things become a community of concern around individuals. And just to get this very clearly, if risk is relatively low and you are exposing someone to relatively few disadvantages, then if they simply flip the switch, change their thinking, take a different attitude, then chances are that will be sufficient to buffer them against the stress. But if you increase and you compound that with trauma, migration, war, racism, and language problems, you begin to get a situation where you have to think more systemically. You have to think about more elements of their life which is going to actually influence the resilience or the outputs that you want.
A social-ecological perspective of resilience emphasizes cultural sensitivity – the importance of culture in understanding resilience. Certain actions that immigrants or refugees display may differ from what North American culture may define as necessary or typical of resilient behaviour. Service providers should recognize that methods for fostering the resilience of an immigrant or refugee client must be congruent with that client's culture and context (Ungar, 2008).
Resilience represents a shift away from vulnerability and pathology, and instead focuses on the strengths and solutions that migrants bring with them (Simich, 2014).Service providersare encouraged to “move away from diagnosing and treating traumatic wounds and losses to fostering individual and collective adaptation and flourishing” (Kirmayer, 2014, p.vii).
Video: How to foster resilience
With Dr. Michael Ungar (Director, Resilience Research Centre)
If we want to foster resilience, what we have to do is think about it as a set of resources that we can actually facilitate, we can actually help people to access. In the work that my team and I, at the Resilience Research Centre, have been doing all around the world, we keep seeing recurring patterns in what is actually predictive of the likelihood that people who are under stress, especially children and youth, are going to experience the capacity to withstand those stressors. And there are certain things that appear, such as, of course, relationships. We know that those are important, but we do have to think broader than just the primary caregiver often because, to be truthful, those caregivers are often under a lot of stress. And then, of course, we might want to also consider thinking about things like a really powerful identity, which again isn't something just inside of us, it's given to us: opportunities to show our talents, to use our talents. We also see consistently a theme of control or efficacy. And that can be personal efficacy in our relationships, making decisions that affect us, as well as political efficacy—that notion of being able to change or have a say over institutions around us. We've also been seeing a lot of focus on social justice. Again that tends to be given to us, the idea that we're treated fairly by our communities as well as getting the basic material resources that we need, everything from housing safety, clothing, these kinds of things. We're also seeing a theme in our work of belonging or social cohesion that could be represented by spirituality or a sense of attachment to a religion or institution, some sort of identity related to being part of a group. And, finally, we also see around the world a real sense of continuity or culture, that we have a sense of where we're coming from and the heritage that we've inherited. So if I got those seven things: relationships, identity, power control, social justice, basic material resources, a sense of cohesion or belonging, and finally culture, if you can imagine those seven things being juggled up in the air and then interacting with each other, what we're concretely understanding is that people who get those seven things or help to find those seven things in ways that are meaningful, navigation and negotiation, are actually more likely to be able to withstand stress when stress occurs in the future.
Trauma-informed services
Organizations that provide services to newcomers should be aware of trauma-informed services. Service providers should be sensitive to the effects of organized violence and plan programs in a way that recognizes there are many paths to recovery.
- When service providers are trauma-informed, they do not automatically assume, for example, that every client seeking services has a biological mental illness or needs psychiatric services.
- When programs are trauma-informed, clients are not inadvertently re-traumatized by policies or procedures that recreate or resemble previous traumatic events. As such, all clients can benefit from services, whether or not they choose to identify themselves as trauma survivors (Blanch, 2008).
Featured resource
The Trauma-Informed Toolkit outlines recommended practices that will help service providers and organizations increase their capacity to deliver trauma-informed services.
Read the Trauma-Informed Toolkit