Jesuit Social Services
Working Cross-Culturally

Refugees - Trauma, Grief and Loss


Refugees arriving in Australia come from countries where there has been war, ethnic, political or religious persecution, famine and poverty. Many of these refugees, including children and young people, have witnessed violence and may also have been direct victims of torture and/or abuse.

Ideas from this Help Sheet
  1. Even when the immediate physical impact of war or persecution is gone, the psychological impact of these events on a young person's life may go on for many years.
  2. Help for refugee young people needs to be co-ordinated and many support systems involved.
  3. Giving young refugees information about the effects of trauma and naming their experiences 'post traumatic stress disorder' can assist them to understand that others have experienced these symptoms too.

Refugee Minors

Some refugee children and young people have been separated from their parents and come to Australia as unaccompanied refugee minors. These young people are granted permanent residency on humanitarian grounds or are placed on a Temporary Protection Visa and may live with a distant relative or a carer when they first arrive.

Until the age of 18 or until their circumstances change, such as being re-united with their parents or taking out Australian citizenship, these young people are eligible for support services.1 However, they face extraordinary challenges in adapting to their new environment without parental support at a time in life when developmental changes can often be challenging enough.

Trauma experiences

The trauma experiences of refugee young people may have included:

  • constant exposure to physical and emotional danger;
  • loss of home and family;
  • displacement in refugee camps;
  • injury and abuse;
  • exploitation - sometimes forced as child soldiers into acts of violence, abuse, torture and rape or watching others commit these abuses;
  • sexual assault.

The trauma of camp experiences

Many refugees experienced terrible conditions in camps: witnessing death; experience sickness and hunger; lack of safety, exposure to further abuse and STD's; lack of food, education and medical care; lack of secure housing or hope for a future. In camps, young people may not have adults to protect them, or may have adult guardians who are themselves traumatised, grieving and unable to provide for basic needs.

These experiences can have deep and long-lasting effects on a young person's self esteem and confidence as well as their sense of hope and control over their lives. These young people are likely to anticipate the worst outcomes for their future.

Arrival in a safe country

Even when the immediate physical impact of war or persecution is gone, the psychological impact on a young person's life of war and forced migration may go on for many years. While the world on the outside now seems more safe and secure, it is possible the world inside a young person's head still feels dangerous and scary. Effects are likely to last longer if the person was exposed to trauma at a young age, or for an extended period of time.

Impact of trauma

Young people may have high levels of anxiety, grief and loss, a shattered world view and depression as a result of their experiences and are likely to be suffering post - traumatic stress.

Post-traumatic stress disorder (PTSD) may show as:

  • Persistent memories and nightmares, disturbed sleep
  • Difficulty thinking, concentrating, remembering
  • Distrust and fear of strangers
  • Emotional distancing or numbing, lack of trust
  • Fear of being alone or of dark places
  • Being constantly 'on guard' for danger
  • Overreacting to situations
  • Inability to manage anger or stress
  • Lack of control over violent or impulsive behaviour, tantrums
  • Physical symptoms such as headaches, loss of appetite
  • Emptiness, apathy, despair
  • Increased anxiety about relationships
  • Fierce self-sufficiency or clinging dependency
  • Over-protectiveness and suspicion of danger
  • Self-harm, self-degradation, self-blame, hopelessness, suicidal thoughts

Giving help

  • Help for refugee young people needs to be co-ordinated and many support systems involved. If the young person's school, family case worker, health service and church or mosque can all work together to support the young person, then the outcomes are likely to be better.

  • Respond to the young person's and family's practical needs first. Stable housing and engagement in a supportive school will help to reduce day-to-day stress levels and establish routine.

  • Post-traumatic stress disorder is not easy to treat. Get expert help from people who are skilled in this work. Consult agencies experienced specifically in working with refugees such as Foundation House (see: Resources).

Helping young people make friends

It is normal for young people who have experienced trauma to have trouble trusting others and making friends. The young person might feel anxious in social situations and need time to build confidence in large groups. At the same time, a small group of trusted friends can support the young person and reduce their isolation.

Try to keep social contact limited to people the young person feels comfortable to be around. Building relationships with adults other than family members can provide stability and a safety net away from family patterns. Trust in a counsellor or case worker is an important stepping stone, but should not be relied upon solely.

The young person might resist making friends for fear of losing them. Feelings of shame, anger or distrust can also get in the way of making friends, especially if the child has experienced sexual abuse. Friendships need to be built slowly to allow time for trust to be tested and develop in its own time.

Provide Information about PTSD

Young people who have come to Australia from experiences of war and displacement need to know that these experiences are not easy to leave behind.

When young people don't know what to expect they can think they are going crazy.

Giving young refugees information about the effects of trauma and naming their experiences 'post traumatic stress disorder' can help. They can then see that others too have experienced the symptoms they are struggling with. Once the experiences are identified and named they can start to be treated.

No young person should have to carry the knowledge of the horror of war on their own. In telling their secrets, the burden of shame and guilt may be lifted.

Confidentiality

When young people have been subjected to violence or have witnessed violence against others in their family they may feel a strong sense of shame. It will be hard for that person to tell their story.

It is most important that the person listening can be trusted to keep their secrets. The young person may feel that their shame is visible to others. If they have been sexually assaulted they may feel they are ruined for life and will never find a partner, that they somehow invited the attention.

Their stories must be treated with great gentleness and understanding.

Letting go of grief and loss

Alongside trauma some young people will be experiencing feelings of deep grief and loss for family and friends who are no longer living and for a whole way of life.

  • It might be helpful to support the young person in saying goodbye in a formal ritual.
  • A symbolic burial of the dead can make more mental space for the living.
  • Letting go might need to happen each day. Some people make a small shrine in their house where they can 'speak' each day to a lost loved one. Some plant a tree, or release a bird, or throw poems into the sea...
  • Religious leaders can suggest ways to let go that are culturally appropriate.

Grief and Loss Practice Skills:

As a worker helping a young person to deal with grief and loss, try to practice the following skills:

  • Listen carefully and openly and hear their experience.
  • Be truthful, honest and aware of your limitations: acknowledge if you don't understand or know how to react to what they are going through.
  • Say the name of the person who has died and talk about them if this is culturally appropriate (ask the young person if this is ok). Not saying the name of the deceased person/s can leave some bereaved people feeling as though the one who died is forgotten or dismissed.
  • Be aware of those who are grieving who may be forgotten, for example, children, grandparents, friends.
  • Ask "How are you getting along?" and then really listen to the response. Stay and hear and try to understand. Allow the person to say whatever they need to, however difficult and complex it may be.
  • Refer to a specialist grief counsellor if necessary. But if you have successfully engaged the young person don't underestimate the value of your relationship with them. They may need to share their grief with you rather than another worker.

Name strengths

Many refugee people have extraordinary survival skills and a tough inner character. This can be built on to construct a picture of a future full of hope rather than one of despair.


1 Mercy Family Services (2005) Unaccompanied Humanitarian Refugee Minors, Queensland. (Accessed 26th August 2009)

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"I wasn't comfortable with the way their Dad treated the kids but I can't seem to get it right either. How do I get the balance right?."
Related Help Sheets
 Worker Help Sheets
Impact of Migration
Other Cultures
 Parents Help Sheets
Settling into a New Country
Resources
 Victoria
Foundation House
provides counselling and support services to people who are from refugee backgrounds and have survived torture or war related trauma.

www.foundationhouse.org.au
Tel: (03) 9388 0022
 New South Wales
STARTTS - NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors.

www.startts.org.au/
Tel: 02 9794 1900
Suggested Reading

Victorian Foundation for Survivors of Torture Inc., (2000) A Guide to Working with Young People who are Refugees, Strategies for Providing Individual Counselling and Group Work, Victoria.

Australian Human Rights Commission, (2008) Face the Facts Questions and Answers about Asylum Seekers and Refugees, Australia.

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