“There is a Mental Resistance” : Experiences of Involving Refugee Parents in a Youth Trauma Recovery Program from the Perspective of Participating Youth, Parents and Facilitators

Scalable light-touch programs that align with the Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) approach is becoming an established intervention model for refugee youth with symptoms of post-traumatic stress. Teaching Recovery Techniques (TRT) is one example and, as TF-CBT guidelines state, parent sessions are included as the model relies on parents to provide support and instigate the techniques. In addition to traumatic stress, refugee families are often subjected to acculturative, isolation and resettlement stress.

This study sought to understand how refugee parental involvement in TRT functions in practice and how it is perceived by participating youth, parents, and facilitators in Sweden. Thirty semi-structured interviews (11 youth, 8 parents, and 11 TRT facilitators) were conducted by phone or videoconference, transcribed, and analyzed using Thematic Network Analysis. A global theme ‘Parental engagement in trauma recovery requires dedicated attention’ emerged. Three organizing themes sat within this global theme: (i) Shifting roles when adapting differently to a new context; (ii) Tendency to keep parents at a distance; and (iii) Parent sessions don’t just happen.

Whilst the potential for refugee parent involvement was recognized, a number of factors preventing their participation were identified. Cultural adaptations within TRT facilitators’ training are recommended, including: raising awareness about contextual factors and changes in family dynamics with regard to trauma and migration; adopting culturally responsive ways to present parental involvement to youth and parents; adding positive parenting skills; addressing parental mental health and readiness; and preparing facilitators to redirect parents to adequate services, when needed.

Highlights

• In order to successfully engage refugee parents in trauma recovery intervention, the facilitators need to strive for cultural humility, be aware of stressors in the refugee context, changes in family dynamics and support the youth in disclosing participation to parents in a culturally responsive way.
• Enhancing parental sessions with positive parenting skills in addition to psychoeducation and trauma recovery techniques, may increase youths’ motivation to involve parents.
• Facilitators need to be aware of and direct parents to other services in order to support parents to be ready to participate.
• Time and resources to establish relationships and trust are important for successful involvement.