A systematic review of naturalistic interventions in refugee populations

Naturalistic interventions with refugee populations examine outcomes following mental health interventions in existing refugee service organisations. The current review aimed to examine outcomes of naturalistic interventions and quality of the naturalistic intervention literature in refugee populations with the view to highlight the strengths and limitations of naturalistic intervention studies. Database search was conducted using the search terms ‘refugee’, ‘asylum seeker’, ‘treatment’, ‘therapy’ and ‘intervention. No date limitations were applied, but searches were limited to articles written in English. Seven studies were identified that assessed the outcome of naturalistic interventions on adult refugees or asylum seekers in a country of resettlement using quantitative outcome measures. Results showed significant variation in the outcomes of naturalistic intervention studies, with a trend towards showing decreased symptomatology at post-intervention. However, conclusions are limited by methodological problems of the studies reviewed, particularly poor documentation of intervention methods and lack of control in the design of naturalistic intervention studies. Further examination of outcomes following naturalistic interventions is needed with studies which focus on increasing the rigour of the outcome assessment process.

Peer journeys : building graduate capabilities for life long learning

Students experience university as peers. Peer-to-peer interaction offers unique opportunities for fostering the academic, social and emotional wellbeing of students (Kuh, 2008). Peer programs provide a formalisation of this relationship enabling students to partake both as peer leaders and program participants. The success of such programs is reliant on the university having a reserve of motivated and trained peer leaders. From their initial experience of peer programs as participants in first year and their ongoing involvement as peer leaders, students grow their graduate capabilities and employability skills through scaffolded peer leadership and training opportunities. Universities aspire to produce graduates who are inspirational leaders, effective collaborators and competent professionals ready to participate in the global community (DEEWR, 2012; Shook & Keup, 2012). This poster describes a model which scaffolds the development of peer leaders’ graduate capabilities using a university-wide supporting framework to grow a range of peer-to-peer initiatives across a variety of coordinated peer programs underpinned by a social justice framework (Gidley, Hampson, Wheller & Bereded-Samuel, 2010; Nelson & Creagh, 2012).

Utilisation of hospital emergency departments among immigrants from refugee source-countries in Queensland

Despite the increasing number of immigrants, there is a limited body of literature describing the use of hospital emergency department (ED) care by immigrants in Australia. This study aims to describe how immigrants from refugee source countries (IRSC) utilise ED care, compared to immigrants from the main English speaking countries (MESC), immigrants from other countries (IOC) and the local population in Queensland. A retrospective analysis of a Queensland state-wide hospital ED dataset (ED Information System) from 1-1-2008 to 31-12-2010 was conducted. Our study showed that immigrants are not a homogenous group. We found that immigrants from IRSC are more likely to use interpreters (8.9%) in the ED compared to IOC. Furthermore, IRSC have a higher rate of ambulance use (odds ratio 1.2, 95% confidence interval (CI) 1.2–1.3), are less likely to be admitted to the hospital from the ED (odds ratio 0.7 (95% CI 0.7–0.8), and have a longer length of stay (LOS; mean differences 33.0, 95% CI 28.8–37.2), in minutes, in the ED compared to the Australian born population. Our findings highlight the need to develop policies and educational interventions to ensure the equitable use of health services among vulnerable immigrant populations.

Longitudinal Evidence on Educational and Occupational Outcomes Amongst South Sudanese Men from Refugee Backgrounds Living in Urban and Regional Southeast Queensland

Australia has continued to benefit from the human, social and economic capital contributed by immigrant resettlement over many years. Humanitarian entrants have also made significant economic, social and civic contributions to the Australian society. Since 2000, approximately 160,000 people have entered Australia under the refugee and humanitarian resettlement program; around 15% have come from South Sudan and one third of these are adult males. In response to the 2003 evaluation of the Integrated Humanitarian Settlement Strategy (IHSS), which recommended to seek further opportunities to settle humanitarian entrants in regional Australia, the Department of Immigration and Citizenship (DIAC) has since encouraged regional settlement to “address the demand for less skilled labour in regional economies and to assist humanitarian entrants to achieve early employment”. There is evidence, however, of the many challenges faced by humanitarian arrivals living in regional areas. This chapter focuses on the educational and occupational outcomes among 117 South Sudanese adult men from refugee backgrounds. In particular, the chapter uses both cross-sectional (at first interview) and longitudinal data (four interviews with each participant at six-month intervals) to compares outcomes between men living in Brisbane and those living in the Toowoomba–Gatton region in Southeast Queensland.

SettleMEN-2: Displaced twice? Impact of the Queensland floods on men from refugee backgrounds living in Brisbane and Toowoomba. Broadsheet No. 1: Exposure to and impact of the floods

Between 2008 and 2010, the SettleMEN study followed a group of 233 recently arrived men from refugee backgrounds living in urban and regional Southeast Queensland with the aim of documenting their health and settlement experiences. The study found that overall, these men bring important resources that may help them to cope better with the challenges of settlement: good levels of subjective health status, mental health and wellbeing; good family and social support; and good levels of engagement in tertiary/trade education in Australia. Over time, however, their levels of wellbeing decreased as they experienced barriers to social participation and inclusion within their host community, including: unemployment and difficulties securing good jobs (even for those with tertiary/trade qualifications obtained in Australia), financial stress, difficulties accessing housing, limited interactions with neighbours, and experiences of racism and discrimination. Importantly, although men living in the Toowoomba acknowledged some of the benefits of regional settlement, they faced greater barriers to participation in the labour market, reported lower job satisfaction, and were more likely to experience social exclusion overall. In 2012 method approach and a peer interviewer model, we were able to conduct a follow 141 (61%) of the original 233 SettleMEN participants to document the impact of the January 2011 Queensland floods on their health and settlement. This broadsheet focuses on participants’ degree of exposure to and impact of the floods, their perceptions of safety and security, and their vulnerability and adaptive capacity to extreme weather events.

Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic : narratives from an Australian setting

Problem: In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010. Question: Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved? Methods: The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants. Findings: The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations. Conclusions: Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.

Review essay -- Weber L and Pickering S (2011) Globalization and borders : death at the global frontier

The pertinence of this book cannot be overemphasised. The world’s refugee crisis has reached a two‐decade high with the United Nations recently announcing that ‘displacement is the new 21st century challenge’ (UNHCR 2013). The transnational movement of dislocated peoples fleeing conflict, persecution and poverty is a global responsibility requiring nation states to collaborate for humanitarian resolutions embedded in human rights. However, in times of human rights expansionism, and the relaxation of borders for maximising free‐trade and fiscal prosperity, the movement of people experiencing immense abuse and deprivation has witnessed an increase in draconian regulation within discourses of intolerance and deterrence. Weber and Pickering cogently and emphatically emphasise the human cost of inhumane and populist government immigration and border‐entry polices underpinned by ideologies of retribution, suspicion, and demonisation. It is a moving and engaging narrative: a book that exposes state prejudice and abuse, whilst advocating for the victims who undertake perilous journeys in search of safety from lives of violence and persecution. Moreover, it is a book that pushes ideological boundaries and seeks new criminological horizons, for which the authors must be sincerely congratulated. It is a text of innovation, inspired thinking and long lasting criminological value.

“Would you; could you; on a boat?” Wait-time and travel-time activities during river ferry journeys and their relationship to overall satisfaction in Brisbane Queensland

This study investigates travel behaviour and wait-time activities as a component of passenger satisfaction with public transport in Brisbane, Australia. Australian transport planners recognise a variety of benefits to encouraging a mode shift away from automobile travel in favour of active and public transport use. Efforts to increase public transport ridership have included introducing state of the art passenger information systems, improving physical station access, and integrating system pricing, routes and scheduling for train, bus and ferry. Previous research regarding satisfaction with public transport emphasizes technical dimensions of service quality, including the timing and reliability of service. Those factors might be especially significant for frequent (commuting) travellers who look to balance the cost and efficiency of their travel options. In contrast, infrequent (leisure) passengers may be more concerned with way finding and the sensory experience of the journey. Perhaps due to the small relative proportion of trips made by river ferry compared to bus and rail, this mode of public transport has not received as much attention in travel-behaviour research. This case study of Brisbane’s river ferry system examines ferry passengers at selected terminals during peak and off-peak travel times to find out how travel behaviours and activities correlate to satisfaction with ferry travel. Data include 416 questionnaires completed by passengers intercepted during wait times at seven CityCat terminals in Brisbane. Descriptive statistical analysis revealed associations between specific wait time activities and satisfaction levels that could inform planners seeking to increase ridership and quality of life through ferry-oriented development.

Digital storytelling as a social work tool : learning from ethnographic research with women from refugee backgrounds

This paper reflects on the wider potential of digital narratives as a useful tool for social work practitioners. Despite the multiple points of connection between narrative approaches and social work, the influence of narratives on practice remains limited. A case study of a digital storytelling (DST) process employed in a research project with a small group of lone mothers from refugee backgrounds is used to trigger discussion of broader applications of DST as part of everyday social work practice. The use of DST acknowledged women’s capacities for self-representation and agency, in line with participatory and strengths-based approaches inherent in contemporary social work. The benefits of using DST with lone mothers from refugee backgrounds illustrate how this method can act as a pathway to produce counter-narratives, both at the individual and broader community levels. Documenting life stories digitally provides the opportunity to construct narratives about experiences of relocation and settlement as tools for social advocacy, which can assist social workers to ensure meaningful outcomes for service-users. These propositions can serve to inform social work practices with people from refugee backgrounds and address some of the intricacies of working in diverse and challenging contexts.

Placement Trajectory : mapping the journeys of children and young people in out-of-home care

Significant problems confront our child protection out-of-home care system including: high costs; increasing numbers of children and young people entering and remaining in care longer; high frequency of placement movement; and, negative whole-of-life outcomes for children and young people who have exited care. National policy and research agendas recognise the importance of enhancing the evidence base in out-of-home care to inform the development of policy, programs and practice, and improve longitudinal outcomes of children and young people. The authors discuss the concept of placement trajectory as a framework for research and systems analysis in the out-of-home context. While not without limitations, the concept of placement trajectory is particularly useful in understanding the factors influencing placement movement and stability. Increasing the evidence base in this area can serve to enhance improved outcomes across the lifespan for children and young people in the out-of-home care system.

Narratives of healing: a case study of a young Liberian refugee settled in Australia

The Tree of Life group program is a narrative-based expressive arts intervention, designed to target the psychological difficulties faced by young people from refugee backgrounds. This study utilised a case study methodology to investigate the experience of a single adolescent from a Liberian background resettled in Australia, who participated in a manualised version of the Tree of Life program. The case study aimed to identify the underlying therapeutic processes that enabled the participant to adopt a preferred self-narrative. The participant was observed to demonstrate positive gains as a result of program participation. Five therapeutic factors were identified as particularly salient to the program’s success: the exploration of alternative stories of self; the fostering of group cohesion; the provision of corrective emotional experiences; the experience of outsider witnesses; and the instillation of hope. These factors were discussed in relation to working with young people from refugee backgrounds. Recommendations for future implementation of the Tree of Life program are provided.

Levels of social trust among men from refugee backgrounds after the 2011 Queensland floods

Purpose This paper examines the relationship between flood exposure and levels of social trust among a cohort of adult men from refugee backgrounds who were affected by the 2011 Queensland floods in Australia. Design/methodology/approach A quantitative questionnaire was administered to 141 men from refugee backgrounds almost two years after the 2011 Queensland floods. The survey was administered in person by trained peer in-terviewers, and included a number of standardised instruments assessing respondents’ so-cio-demographic characteristics, levels of social trust towards and from neighbours, the police, the wider Australian community, and the media, and exposure to and impact of the floods. Multiple logistic regression analyses were used to assess the relationship between flood exposure and social trust adjusting for pre-disaster levels of trust and other potentially confounding variables. Findings Participants with higher levels of flood exposure were significantly more likely to report greater levels of trust both towards and from their neighbours, the wider Australian community, and the media, and they were also more likely to believe that most people can be trusted. Research limitations/implications Although the study reports on data collected two years after the floods, the analysis has adjusted for pre-disaster measures of social trust and other socio-demographic variables. Originality/value Our paper has highlighted the important place of social trust and social capital for refugee communities in a post-disaster setting. Disaster responses that support social capital among marginalised populations are critical to increasing community resilience and supporting recovery.

SettleMEN : health and settlement among men from refugee backgrounds living in South East Queensland

Between 2008 and 2010, the SettleMEN study followed a cohort of 233 recently arrived men from refugee backgrounds living in urban and regional areas of South East Queensland with the aim of documenting their health and settlement experiences. This report presents the key findings of the study.

Good Starts for refugee youth

Good Starts Study for Refugee Youth is a Melbourne-based longitudinal study of 120 young refugee people. The study sought evidence about their experiences, attitudes and social supports, to inform efforts to support their well-being in Australia. The Good Starts study was a collaboration between the La Trobe Refugee Research Centre, La Trobe University (LARRC) and The Victorian Foundation for Survivors of Torture (Foundation House). The study was funded by VicHealth.

Good Starts for recently arrived youth with refugee backgrounds : promoting wellbeing in the first three years of settlement in Melbourne, Australia

This report describes the key findings of a longitudinal study (2004—2008) investigating the experiences of settlement among a group of 120 recently arrived young people with refugee backgrounds settling in Melbourne, Australia. Each year, less than one per cent of the world’s refugees are offered resettlement in one of 18 countries participating in The Office of the United Nations High Commissioner for Refugees (UNHCR) resettlement programme. Australia offers places to around 13,500 people per year, of whom about 26 per cent are between the ages of 10 and 19. What are the experiences of these young people in their early settlement years? How do they negotiate the transition from childhood to adulthood given the traumas of their past and the challenges of their present and future in Australia? What are the key social determinants of wellbeing and good settlement and what can we learn from these young people about what social policies and services will most effectively support them to make successful lives in their new home? This study explores these questions, the overall aim being to identify the key social determinants of wellbeing and settlement and to describe the lived experiences of these young people as they shape their lives in Australia.