Serving the needs of immigrant families of children with autism

The growing influx of immigrant families into the USA necessitates an understanding of how these families manage mental health disorders. Few studies have documented the ways in which autism spectrum disorders (ASD) are understood across different immigrant groups. This lack of knowledge creates barriers for practitioners who are encountering immigrant families in their practice. The present paper provides a conceptual framework of how cultural values and beliefs shape the way diagnosis, etiology and treatment of ASD is perceived by both immigrant families and western practitioners and how differences in perspectives may create obstacles in treatment planning. A review of the literature describing practical and cultural barriers to mental health access and research among immigrant populations is also presented. Finally, recommendations are offered to practitioners, families and individuals with ASD to aid in increasing understanding and collaboration among these populations when designing and implementing treatment interventions.     

Health and the education of children from racial/ethnic minority and immigrant families

Building on a conceptual model of the transition to elementary school, this study explored the role of health in the early cognitive achievement of children from various racial/ethnic minority and immigrant families by applying multilevel modeling to data from a nationally representative sample of American kindergarteners. Whites tended to have the best physical health before transitioning to first grade. Children from immigrant Latino/a and Asian families had the worst physical health but the best mental health. Compared to white children from native families, these health differentials partially explained the lower math achievement and achievement growth of black children (whether from native or immigrant families) in first grade as well as the lower math achievement of children from Latino/a immigrant families and the lower achievement growth of children from Asian immigrant families during this period.     

Health Insurance,from a Child Language Broker's Perspective

In the midst of dramatic changes to American health care law there is need to understand the challenges that vulnerable populations encounter in obtaining and managing health insurance. Research has found that child language brokers, children who mediate language and culture for their immigrant families, assist with health‐related matters. We report on focus groups with 17 language brokers living in Central Los Angeles. In this article we detail their experiences language brokering for health insurance and their knowledge of health insurance and policies that apply to their immigrant families. We illuminate some barriers immigrant families face as well as how they navigate them. We conclude with policy implications, particularly in relation to making health insurance more accessible to non‐English speaking and immigrant populations.     

Stressors experienced by immigrant and other non-native English-speaking students in U.S. schools and their families

Abstract

This literature-based study of stressors experienced by recent immigrant families focuses on their impact on school-aged children. The author, a trainer of teachers of English as a second language and an education researcher specializing in issues affecting students with non-mainstream language backgrounds, identifies stressors resulting from (a) separation of families, (b) changes in familial roles, (c) social and legislative pressure that targets immigrant families, and (d) school bullying and harassment. Many immigrant students experience stressors in all four categories in addition to the stress of learning a new language and adapting to a new culture. To help mitigate the negative impact – which can include difficulty focusing on academics, developmental delays, or problem behavior – the author recommends that schools and communities embrace difference and support the struggles of immigrant students and their families and that schools, in particular, develop cultures and provide resources to help new Americans to thrive despite challenges.     

The academic achievement of socioeconomically disadvantaged immigrant adolescents: a social capital perspective

A sizable body of literature reports that social capital, derived from relational resources embedded in micro social contexts, is crucial for student achievement. This study aimed to examine whether this applies as well to socioeconomically disadvantaged immigrant adolescents in the US. In so doing, the study first identified the types of relational features that were strongly associated with immigrant adolescents’ academic achievement, before exploring how high- and low-achieving immigrant adolescents coming from similarly socioeconomically disadvantaged backgrounds differed in terms of these relational features. To this end, the study used the dataset of the Children of Immigrants Longitudinal Study (CILS). There was a significantly positive association found between academic achievement and a number of positive characteristics of social relationships with friends and teachers. In addition, a significant disparity in these relational features was found between high and low achievers among the socioeconomically disadvantaged. The findings illuminate the salience of peer contexts and of interpersonal trust in shaping immigrant adolescents’ educational outcomes in a way that transcends socioeconomic boundaries. It is pertinent for educators and policy-makers to empower immigrant youth as independent agents capable of generating academically relevant social capital on their own outside their families and ethnic communities.     

The Use of Sandtray Therapy With Adoptive Families

Providing mental health services to adoptive families is an increasing need, and research indicates that many mental health professionals are not proficient in issues commonly affecting adoptive families. Research shows that adopted children exhibit more emotional, behavioral, and social struggles than non-adopted children, often as the result of abuse and neglect in early life. Primarily, though, the needs in adoptive families are relational and identified as needing focus on family dynamics, attachment styles, and trauma exposure. This article suggests using sandtray therapy as a therapeutic method that is trauma-informed, attachment-friendly, and supportive of adoptive families.     

Examining psychotherapeutic and psychosocial factors in working with immigrant families

In spite of the fact that the United States has been historically associated with immigrants, little is still known about the process of assimilation that immigrant families go through, and a lack of sensitivity to the cultural diversity of immigrant families persists. Some mental health workers still suggest that the same techniques employed in working with American families can be applied to immigrant families. Through years of research, behavioral scientists have come to realize that a different approach to tutelage and psychotherapy is needed if immigrant families are to acculturate smoothly in American society. This paper addresses some problems associated with acculturation, the process of acculturation, immigrant families in transition and perspectives on the effectiveness of psychotherapeutic interventions. Some rudimentary guidelines are presented for understanding immigrant families via a comprehensive assessment battery which can assist in determining the stages of acculturation, the client's social and emotional functioning, as well as any cultural transitional conflicts the client may be experiencing as a result of migration. Moreover, a model for treating immigrant families is suggested.     

Examining Psychotherapeutic and Psychosocial Factors in Working with Immigrant Families

In spite of the fact that the United States has been historically associated with immigrants, little is still known about the process of assimilation that immigrant families go through, and a lack ofsensitivity to the cultural diversity of immigrant families persists. Some mental health workers still suggest that the same techniques employed in working with American families can be applied to immigrant families. Through years of research, behavioral scientists have come to realize that a different approach to tutelage and psychotherapy is needed if immigrant families are to acculturate smoothly in American society. This paper addresses some problems associated with acculturation, the process of acculturation, immigrant families in transition and perspectives on the effectiveness of psychotherapeutic interventions. Some rudimentary guidelines are presented for understanding immigrant families via a comprehensive assessment battery which can assist in detemzining the stages of acculturation, the client’s social and emotional functioning, as well as any cultural transitional conflicts the client may be experiencing as a result of migration. Moreover, a model for treating immigrant families is suggested.     

Understanding the Role of Immigrant Families' Cultural and Structural Mechanisms in Immigrant Children's Experiences beyond High School: Lessons for Social Work Practitioners

The destinies of the contemporary immigrant generation are challenged by the profound reshaping of the U.S. economy and the increasing diversity of new immigrant communities from the Latin American and Asian regions. Family represents a key link between immigrant children's social adjustment beyond high school and relationships with mainstream society. Placing an emphasis on culture and social structure, this article reviews contemporary literature and provides a framework for knowledge that helps social work practitioners and policy planners explore the distinguishing features of immigrant families that confer an advantage within their children's post-secondary education or labor market participation. Also considered is how culture and social structure overlap and interact to exert a significant influence on the future economic prospects of immigrant children.     

The Language of Learning: The Academic Engagement of Newcomer Immigrant Youth

The current study uses an accelerated longitudinal design to examine the role of three dimensions of academic engagement (behavioral, relational, and cognitive) in explaining the influence of English language proficiency on newcomer immigrant youths' academic performance across adolescence. The sample included 354 youth from Central America, China, the Dominican Republic, Haiti, and Mexico. As established with other populations, the behavioral, relational, and cognitive dimensions of academic engagement were closely associated to one another and significantly contributed to academic performance. Mediation analyses revealed that immigrant youth with limited English language proficiency were more likely to experience low levels of relational and behavioral engagement, which contributed to lower levels of academic performance over time.     

Revisiting Violence in New Destinations: Exploring the Drop in Latino Homicide Victimization in Emerging Immigrant Communities, 2000 to 2010

The turn of the twentieth century brought important demographic shifts among Latinos, including increasing settlement of both foreign-born and domestic Latinos into “new destination” regions and communities with little previous exposure to such populations. In turn, some scholars find higher rates of Latino victimization in these new destination communities, but there is little empirical research exploring whether and how these same locales fare today. Our goal is to address this gap in the literature by examining how lethal violence against Latinos in new immigrant destination communities has changed over the 2000 to 2010 decade. Using data from the National Vital Statistics System, we construct hybrid fixed- and random-effects models to examine the predictors of changes in Latino homicide victimization over time. Results suggest that (1) despite the turmoil of the Great Recession, new destinations experienced a sizable drop in Latino victimization, (2) this drop has resulted in new destinations now having lower levels of Latino victimization than other destination types, and (3) 70% of this change is attributable to changes in Latino family structure, including married and extended families, as well as changes in language use in new destinations. We conclude by discussing our findings and their implications for researchers and policymakers.     

“We don't want to talk about that”: Overcoming barriers to rural aging research and interventions on sensitive topics

Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach, describes the natural history of a project, the Mental Health and Aging Initiative (MHAI) to enhance awareness of mental health issues in rural Kentucky-Appalachian communities and overcome the reluctance of individuals in these communities to seek assistance. Funded by the United States Department of Agriculture (USDA), MHAI involved an educational intervention to improve knowledge about mental health and aging in rural Appalachian counties. The need to overcome significant community reluctance to engage in discussion of mental health resulted in significant modification of the protocol. The intervention was grounded in recognition of four key aspects of the local situation: (1) the need to understand the sensitivity of mental health as an element of rural culture; (2) the critical role of local community leaders as points of entry, acceptance, and action; (3) the need to overcome social stigma and reframe the topic of mental health in a more positive light; and (4) the need for methodological innovation in developing an empowering educational action plan oriented toward community-wide long-term impact. The intervention model that emerged from these considerations was based on engaging community leaders, providing educational and technical resources, and nurturing the acceptance by individual rural residents of responsibility for monitoring community mental health. This motif became a central theme in a strategy designed to facilitate culture change and acceptance of mental health as a community concern. It involved active engagement of community representatives in defining and implementing an intervention consistent with participatory action research as a means of empowering rural residents in monitoring and addressing sensitive health care issues. Given that many issues in rural health are difficult to address because of such sensitivity, the approach described is considered to have application in other contexts.     

MUSLIM FAMILIES AND FAMILY THERAPY

Muslim immigrant families living in the United States may well come to be attentiaon of mental health professionals. This article examines the applicability of the Anglo-American models of family therapy to Muslim immigrant families. The most significant difference in value systems between the Muslim and Anglo-American cultures is Muslim families' preference for greater connectedness, a less flexible and more hierarchial family structure, and an implicit communication style.
Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural difference. However, the preferred directions of change for Muslim families need to be integrated into the assessment and goals for family therapy.     

Access Barriers to Mental Health Services for Older Adults from Diverse Populations: Perspectives of Leaders in Mental Health and Aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

Spanning Borders,Cultures, and Generations: A Decade of Research on Immigrant Families

The authors review research conducted during the past decade on immigrant families, focusing primarily on the United States and the sending countries with close connections to the United States. They note several major advances. First, researchers have focused extensively on immigrant families that are physically separated but socially and economically linked across origin and destination communities and explored what these family arrangements mean for family structure and functions. Second, family scholars have explored how contexts of reception shape families and family relationships. Of special note is research that documented the experiences and risks associated with undocumented legal status for parents and children. Third, family researchers have explored how the acculturation and enculturation process operates as families settle in the destination setting and raise the next generation. Looking forward, they identify several possible directions for future research to better understand how immigrant families have responded to a changing world in which nations and economies are increasingly interconnected and diverse, populations are aging, and family roles are in flux and where these changes are often met with fear and resistance in immigrant-receiving destinations.     

Access barriers to mental health services for older adults from diverse populations: perspectives of leaders in mental health and aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

ATTENDING TO THE CONTEXT OF FAMILY TREATMENT: PITFALLS AND PROSPECTS

This paper argues that family therapy is failing to attend to the contexts in which family mental health services are provided and, therefore, is losing touch with the realities of family services in communities. We present a model for describing the institutional contexts of family mental health treatment in North America, and explore how these contexts influence family treatment. The model proposes that family mental health care can be categorized into three levels, analogous to the levels of the health care delivery system: (a) primary, (b) secondary, and (c) tertiary care. These levels represent systematically different contexts for family treatment; each has unique advantages and limitations. Translating treatment methods across levels can be hazardous because of differences in contexts. We argue that delineating the contextual levels of family mental health care can encourage more fruitful and respectful collaboration among the diverse professional groups working with families.     

Nursing care partnerships with women leaving jail. Effects on health and crime

Crime is a significant and complex social issue with profound health consequences for individuals, families, and communities. Conceptualizing criminal behaviors as health behaviors reflects the potential for innovative interdisciplinary approaches and alliances to interrupt cycles of crime as a way to improve health. Incarcerated populations have extremely high rates of undiagnosed and undertreated infectious diseases and mental illnesses. Nursing is uniquely positioned to develop prevention, intervention, and treatment strategies for individuals involved in criminal activities before, during, and after incarceration.     

Supporting the emotional and psychological well being of sexual minority youth: Youth ideas for action

Gay, lesbian, bisexual and transgender (GLBT) populations are susceptible to stress-related mental health disorders because of daily imposed stigma and prejudice. Yet minimal information exists from the perspective of sexual minority youth about how to support them in managing a challenging social environment during critical stages of development. Through the lens of youth from two geographic communities this study examined what is needed to support GLBT adolescent mental health. The study employed inductive secondary analysis of qualitative and quantitative data gathered through Concept Mapping needs assessments. Findings include 61 unduplicated ideas for support across the two groups of youth; 14 primary themes emerged with 22 stated needs common among both groups. Areas of need in multiple service systems are identified. The importance of the supports for meeting youths' emotional needs varied between the two communities. Ideas generated represent youth ideas for improving conditions which contribute to disparate community supports needed to develop positive emotional and psychological well being. The findings are conceptualized with regard to psychological and physical safety; community impact on emotional well being; schools and psychosocial supports; and access to relevant mental health and health care. Discussion includes implications for practice and policy.