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  • Subject Name : Mental health

Social Work

The social work practice aims to help the communities and the groups of people for improving their social status and works for their welfare (Coady & Lehman, 2016). This work aims to cover the social work practice for the refugee group of people. The refugees are a group of people who were forced to flee from their own country due to persecution, war or because of the violence.

The group of displaced people enters into another country where they face numerous issues because of different nationality, religion, ethnicity, language and others (Dustmann et al., 2019). The major risk is to their safety which requires the maximum attention by the social group. These ordinary people faces extraordinary conditions because they face most restrictive to most inclusive issues.

The refugees seeking to enter Australia faces their own share of issues due to temporary visa, legal and physical protection, lack of foreseeable alternative durable solutions and so on (Gleeson, 2019). The social workers have always worked for the benefit of these refugees who have entered Australia or who are seeking to enter Australia from fighting for their rights to giving them protection. The social workers have always been standing forefront to fight for refugees because providing them with physical protection is very important to save their lives.

They are the ones who have faced most traumatic life experiences due to facing war, violence and both internal and external conflicts (Hatton, 2017).

Trauma is the exposure to actual or threatened death, threatened or actual sexual violence, disaster or serious violence and this trauma is repeatedly faced by the refugee people. This repeated exposure to civilian war trauma affects their mental health badly. The traumatic war experiences faced by refugee people includes detention in concentration camps, witnessing violence, separation from family, physical torture and displacement (Morina et al., 2016).

These conflicts had such an impact that high volume of refugees have resettled throughout the world and this creates a major impact on their mental health. The mental health of the refugees are the most affected ones because of such traumatic events. The mental health outcomes of torture are worst in these people because of the extremity of trauma that they face in their lifetime.

The physical scars of torture are more apparent and the psychological consequences of torture go unseen and unaddressed most of the time. The most common mental health disorder diagnosed in most of the refugees is PTSD followed by depression and they have increased risk of suicide. The physical torture is related with PTSD and insomnia (Nose et al., 2017).

The evidence suggests that physical care takers do not even screen these people for their mental health. The affected mental health of refugees have some serious negative impacts in their life and they face hardship all throughout their lives.

In the host country, they face wide ranging of issues like discrimination, language related barriers, ethnic issues, medical issues and so on. All of these have a significant impact on their mental health. The social workers in this context aims to work on the mental health of the refugees who have significant affected metal health due to trauma they have faced in their lives. The social workers work for the common reactions that are produced post trauma in the refugees that includes anxiety, grief actions, eating disorders, insomnia, psycho- sexual problems, depression, panic attacks, dissociation and numbing, emotional stress and inability to plan future (Lindert & von Ehrenstein, 2018). The psychological consequences of the traumatic events is such that they lose hope of living in the host country. The social workers work for the benefit of these refugee people for the betterment of their mental health especially PTSD. The work by social workers is based on a trauma specific framework that will address the mental health issue PTSD in the refugee people.

The work of social workers begins with the identification of refugee people and also identification of the most affected people. The first step of the social worker is to diagnose refugees with mental illness so that appropriate measures can be taken (Shawyer et al., 2017). The determination of a client for their background is important for the assessment of their needs and for the identification of appropriate interventions.

The social worker must also have details of the client’s country of origin and their year of arrival. The social workers must also obtain their detailed data like their migration status, humanitarian, temporary protection visa holder and details of their family reunion. There are many survivors of torture and trauma that have no idea of their symptoms and signs thus all of them requires proper screening of their mental illness (Willaims & Amris, 2017). The work of social workers initiates with providing and ensuring privacy and confidentiality to the refugee people.

The personal framework used by the social workers for addressing the mental health of the refugee people will be based on their beliefs and assumptions. The common belief about the refugees for all is that they are highly disadvantaged people in the host country because of the discrimination and because they have no rights in another country. The personal framework that will be used while working with the refugee group of people will be trauma specific that is the trauma of war in the country that has led to the separation of family members. The social workers will prepare their clients for the interview where they will be welcomed and interviewed for the trauma that has led them to migrate into this country. The social worker will then make clear about their work and will introduce themselves appropriately because many refugees fear government officials and the government workers (Wall et al., 2017).

It is believed that the refugee people do not have a strong say in anything and they are believed to move after the advantages provided to them. The social workers will ask refugee to narrate their traumatic story so that the main reason for trauma can be identified.

In this case, the social workers are working for refugees so they will try and communicate with them in the language that they better understand. The language barrier is a common barrier that they face while talking to their clients. The personal framework will be trauma specific intervention so that this trauma of family separation due to war can be addressed in the refugee people (Bemak & Chung, 2017). The trauma specific interventions recognizes that the refugee’s needs to be respected, connected, informed and hopeful regarding their own recovery.

The personal framework is a trauma specific framework that will aim to address the symptoms and the conditions that have resulted from a traumatizing events. This personal framework aims to address all the aspects of these refugees that have an impact due to the trauma. The personal framework will address all the biopsychosocial aspects of the refugee in which all the biological, social and psychological factors will be addressed so that the better mental health outcome can be achieved (Wade & Halligan, 2017).

The first step will be to realize the widespread impact of this trauma (separation of family members due to war) and understand all the potential ways for the recovery. The second step will be recognition of the signs and symptoms of trauma in refugee people that needs to be addressed and the third step of this framework will be responding to the needs of mental health of refugees by fully integrating the knowledge about trauma and using trauma specific interventions like cognitive behavioral therapy (CBT) (Dobson & Dobson, 2018).

The personal framework will recognize the refugee’s requirements that needs to be respected so that their recovery can be considered. There is a strong interrelation between trauma and its symptoms thus trauma specific framework will address these symptoms such as depression, anxiety and social isolation that are the most common symptoms of PTSD in the refugees. The personal framework will also allow the workers to work in collaboration with the refugees, and other human service agencies so that the refugees can be empowered. The personal framework is also based on the social worker’s beliefs and assumption in which they will work towards making them screened for their mental health because it is believed that most of them do not get screened for their mental illness. It is also assumed that these people socially isolate themselves because they are highly insecure for their identity.

Thus, the personal framework is based on working for the betterment of mental health of the refugees so that they can be re integrated into the society. Another main aim of this personal framework is to make the young children go to school and have an easy access to education after addressing their mental health so that they can be educated. The personal framework will be based on few principles under which every individual will be respected for their ethnicity, originality and for their regional identity. There will be no room for discrimination based on religion, ethnicity, colour and education. All of these refugees will be given safety procedure under which all will be given physical and emotional safety. There will be transparency and every social worker working under this framework is required to ask the client before any intervention and they would be transparent of the procedure (Oral et al., 2016). This framework will also allow collaborative work and will aim to deliver person centered care to these people.

The culturally safe practices will be delivered and all of the refugees can report for any kind of discrimination or unacceptable behavior. The evidence based services and practices will be delivered and all of these people will be asked for feedback after the implementation of respective interventions. The social workers will aim to integrate refugee people into society and to empower them by providing educational opportunities also (Tecle et al., 2017).

The intervention that will be used under this personal framework for addressing the symptoms of PTSD is cognitive behavioral therapy.

The cognitive behavioral therapy is the therapy that is used by most of the mental health workers as this therapy focuses on the relationship among the thoughts, feelings and behaviors as it states that there is an interconnection (Zettle & Hayes, 2016).

The improvement in one domain have a potential to improve the functionality of another domain like if the thought process is improved using this therapy then the positive impact in behavior can be noted. This therapy is highly effective because it targets the current issues in an individual and then relate it to the present symptoms whose positive impact is then seen in behavior of the person under treatment.

This framework can be explained using various theories that approves the use of CBT for trauma in the refugees. The emotional processing theory is the theory that states the people who have experienced traumatic events in the past are more likely to develop association among objectively safe reminders of the meaning, events and the responses (Alpert, 2018). The core process of emotional processing is the change in these associations that results in unhealthy functioning of an affected individuals.

The second theory that approves the use of CBT among the patients having trauma is social cognitive theory. This theory suggests that the people who have experienced trauma and tries to incorporate the experience from the suffered trauma into their existing belief about their own selves, others or to the world then this leads to more unhelpful understanding of the self- efficacy (Jenkins & Raeside, 2018). This can be explained in simple terms as if a person who has experienced trauma in past feels that bad things such as a particular trauma only happens with bad people then they complicated their own feelings. This is then visible in their behavior which is usually negative for other people and for themselves.

These theories helps in better understanding the effectiveness of this therapy that will be applied for the refugees mental health.

The mental health therapists make use of various techniques to aid the patients in lowering down the symptoms and to improve the functionality of their behavioural process. The therapists that use CBT encourages the patients to re- evaluate their thinking process and its patterns and also re- evaluates their assumptions so that the unhelpful patterns can be identified. The refugees are exposed to their trauma narratives in a control way so that their behavior of avoidance and maladaptive associations with trauma can be addressed.

CBT is used in changing the behavioural patterns that are the result of specific thinking pattern that has developed due to the trauma that they have faced in their lifetime (Watkins, 2018). The consequences of this personal framework will be positive as the symptoms and signs of PTSD will be best addressed in refugees. This will also help integrating them into the society because of their changed behavior that will be acceptable by others in the community. This psychological therapy will formulate for the refugees in such a manner that their children will then be encouraged to join educational institutes for their better future in the country. This will all be done after going through legal process that is followed in the country but the mental health treatment under personalized framework will be given as soon as they will be identified having mental illness (Shou et al., 2017).

The conclusion drawn is that the personal framework that is used by the social workers for addressing the mental illness of refugee people due to traumatic events is an effective framework that is based on the traumatic specific intervention that is CBT. This framework aims to address all the biopsychosocial factors that have led to this condition of the refugee people with an aim to integrate them into the society. This will help refugee people in having better mental health and this will also be effective in facilitating interaction between social workers and the refugee people who are suffering from mental illness.

References for Social Work

Alpert, E. (2018). Measuring multimodal emotional processing in trauma-focused cognitive behavioral therapy: an integrative approach (Doctoral dissertation, University of Delaware).

Bemak, F., & Chung, R. C. Y. (2017). Refugee trauma: Culturally responsive counseling interventions. Journal of Counseling & Development95(3), 299-308.

Coady, N., & Lehmann, P. (Eds.). (2016). Theoretical perspectives for direct social work practice: A generalist-eclectic approach. Springer Publishing Company.

Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy. Guilford Publications.

Dustmann, C., Vasiljeva, K., & Piil Damm, A. (2019). Refugee migration and electoral outcomes. The Review of Economic Studies86(5), 2035-2091.

Gleeson, M. (2019). Protection Deficit: The Failure of Australia’s Offshore Processing Arrangements to Guarantee ‘Protection Elsewhere’in the Pacific. International Journal of Refugee Law.

Hatton, T. J. (2017). Refugees and asylum seekers, the crisis in Europe and the future of policy. Economic Policy32(91), 447-496.

Jenkins, L., Hall, H., & Raeside, R. (2018). Applications and applicability of social cognitive theory in information science research. Manuscript of paper submitted to Journal Librarianship and Information Science.

Lindert, J., & von Ehrenstein, O. (2018). 2.11-P20 Anxiety, depression and post-traumatic stress disorder among refugees-a systematic review. The European Journal of Public Health28(suppl_1), cky048-091.

Morina, N., Schnyder, U., Schick, M., Nickerson, A., & Bryant, R. A. (2016). Attachment style and interpersonal trauma in refugees. Australian & New Zealand Journal of Psychiatry50(12), 1161-1168.

Nosè, M., Ballette, F., Bighelli, I., Turrini, G., Purgato, M., Tol, W., ... & Barbui, C. (2017). Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis. PloS One12(2).

Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., ... & Peek-Asa, C. (2016). Adverse childhood experiences and trauma informed care: the future of health care. Pediatric Research79(1), 227-233.

Shawyer, F., Enticott, J. C., Block, A. A., Cheng, I. H., & Meadows, G. N. (2017). The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents. Bmc Psychiatry17(1), 76.

Shou, H., Yang, Z., Satterthwaite, T. D., Cook, P. A., Bruce, S. E., Shinohara, R. T., ... & Sheline, Y. I. (2017). Cognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD. NeuroImage: Clinical14, 464-470.

Tecle, A. S., Thi Ha, A., & Hunter, R. (2017). Creating a continuing education pathway for newly arrived immigrants and refugee communities. Journal of Teaching in Social Work37(2), 171-184.

Wade, D. T., & Halligan, P. W. (2017). The biopsychosocial model of illness: A model whose time has come.

Wall, M., Otis Campbell, M., & Janbek, D. (2017). Syrian refugees and information precarity. New Media & Society19(2), 240-254.

Watkins, E. R. (2018). Rumination-focused cognitive-behavioral therapy for depression. Guilford Publications.

Williams, A. C. D. C., & Amris, K. (2017). Treatment of persistent pain from torture: review and commentary. Medicine, Conflict and Survival33(1), 60-81.

Zettle, R. D., & Hayes, S. C. (2016). Rule-governed behavior: A potential theoretical framework for cognitive-behavioral therapy.

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