Short Term Psycho-educational Groups
In reviewing the publications about different studies or pilot interventions attempted in working with the Latino immigrant parents and their youngsters coming to join them after a long separation, one finds initiatives being tried in both clinical and school settings to address their psycho-educational needs through short term groups for parents and for the adolescents. The best initiatives, of course, are those that insert these psycho-educational group sessions as part of a longer term, on going family therapy and/or individual therapy or group therapy, which will continue to work with the families that present with problems that cannot be resolved with a short term intervention such as this. One such group is the family therapists at El Centro, from the University of Miami, under supervision by Drs. Daniel Santisteban and Maite P. Mena (Santisteban and Mena, 2009). They have been working with Hispanic adolescents from separated families as a subgroup of their work with Latino youth with behavioral and substance abuse problems. However, they underscore both the importance and limitations of the insertion of these psycho-educational materials in their larger program:
… “That is not to imply that one or two sessions spent discussing separation-related material, no matter how “corrective” the experience, can magically create a bond where none has existed. However, we have witnessed that these sessions do have a powerful positive effect on the responsiveness of the family to treatment as new frameworks for understanding their problems are opened”.
These researchers/clinicians have been developing a program called Culturally Informed and Flexible Family-Based Treatment for Adolescents for Hispanic families with children that have substance abuse problems as their presenting issue. CIFFTA includes several different components, besides family sessions, in order to better adapt their interventions to the great diversity that is the Hispanic population and its varied needs. Based on their research in a separate study, focused on investigating the links between immigration and acculturation-related factors, clinical processes, and adolescent behavior. they have come up with a flexible manual for the therapists involved with Hispanic adolescents who are abusing substances, or in other ways putting themselves at risk with their behaviors, and for their parents. The program also incorporates individual sessions for the adolescent that favor Motivational Interviewing strategies (Miller and Rollnick, 2002), which avoid the resistance usually triggered by direct confrontation in adolescents by therapy or authority figures. It also integrates, communication skills and crises management, as well as coping and education on acculturation and discrimination stress. When working with recent immigrants, psycho-educational interventions in a group mode are specifically intended to educate both parents and adolescents on the impact of their separation on the parent-child attachment to create a needed framework for their family sessions. The interventions add components that include parenting guidelines and education on adolescent risk behaviors for the parents i.e. drug/ sex education, as through their research they discovered that an important factor of the lack of communication with the adolescents on this area was the parent’s lack of confidence on their own knowledge about this topics. The CIFFTA program has a length of 16 weeks with 2 sessions per week. The authors have created a manual whose many different modules guide the therapist in choosing the best combination of interventions for each family according to their needs, while presenting problems in a culturally competent way and based on evidence sustaining their application to this population, as researched by the authors. Their hope is that the ability of the therapist to choose among a milieu of different modules of themes will help avoid the valid complain from therapists against manuals suppressing the flexible creativity needed in therapy, as well as the optimal building of rapport with the family.
Another such pilot program, utilizing a group format manual- based intervention, created with the collaboration of school and mental health clinicians in Los Angeles, California, is a school based mental health program for traumatized Latino immigrant children by Dr. Sheryl Kataoka et als (2003). This study was done with 198 students from third to eighth grade exhibiting symptoms of depression and PTSD as a result of exposure to community violence. During eight sessions, the youngsters received a manual-based cognitive-behavioral therapy, delivered in Spanish by bicultural/bilingual school social workers. Parents and teachers were also eligible to receive psycho-education on trauma and related interventions and support services. The students in the intervention group had significantly greater improvement of their symptoms of PTSD (trauma symptoms) and depressive symptoms, as compared with the students in the waiting list, though the gains were described as modest.
Other short term psycho-educational interventions that are manual-based, and directed more specifically at immigrant families separated for an extended time, are currently being developed using the information available on the most important issues identified by the literature as affecting these families. They are currently under way as pilots in different parts of the country, as for example in some secondary schools in Fairfax County Public Schools in Virginia. Hopefully the results of such initiatives will be published, in the near future. School based programs to aid in the acculturation/adaptation stress of refugee children and families have emerged as well, as described by Rousseau and Guzder (2008), as also preventive programs directed towards immigrant and refugee families and children, also mainly in school settings, whose function is to help with adaptive family support and community support (Morse, 2005)
In addition, the workshops for the parents and the youngsters developed by this author and coming up in the next chapters can be easily translated into a format of short-term psycho-educational modules for both parents and students, as it will be discussed as they are introduced to the reader. Hopefully though, they will be utilized in conjunction with other forms of therapeutic intervention secured for the youngster and the parents, as those needs are identified for each family, either by school or mental health professionals. The workshop materials may be used as an introduction to the issues usually affecting the parents and young immigrants, as they struggle with their difficulties in developing trust. And, as an important opening to their dialogue about the impact of the separation in their current relational distance: a powerful underlying fuel that aggravates possibly all of their current emotional distress in the family and behavioral problems in the adolescent or younger child, because it blocks a conflict free communication between parent and child.