A Mixed Methods Study of Refugee Families Engaging in Multiple-Family Groups.

Abstract: This study investigated family factors and processes involved in Bosnian refugees engaging in multiple-family support and education groups in Chicago. Families that engaged experienced more transitions, more traumas, and more difficulties in adjustment. Engagement strategies for multiple-family groups should correspond with the underlying family processes by which refugee families manage transitions, traumas, and adjustment difficulties. Key Words: mental health intervention, multi-family groups, prevention, refugee families, trauma. In the past several decades, substantial numbers of refugees coming from global hot spots have resettled in the United States. Prior waves of refugees have included large populations from Vietnam, Cambodia, Laos, Cuba, and the former Soviet Union. With the destruction of the former Yugoslavia in the early 1990s, more than 200,000 refugees came to the United States from Bosnia-Herzegovina, including approximately 40,000 to Chicago, the site of this study (Refugee Reports, 2003). Each time a new refugee population arrives, local agencies struggle to provide adequate psychosocial services for adults and youth. Unfortunately, there is little existing theory or empirical research concerning refugee families' mental health to guide practitioners, policymakers, and scholars. The minimal family therapy literature on refugee families consists primarily of clinical reports and clinical theories that tend to focus upon problematic interpersonal aspects of the refugee experience such as family disruptions, traumatic remembrances, and gender and intergenerational conflicts (Chambon, 1989; DiNicola, 1997; Sluzki, 1979). The professional literature on immigrant families explicitly addresses issues such as youth, education, work, and family obligations (Portes & Rumbaut, 2001; Suarez-Orozco & Suarez-Orozco, 2001). However, refugee families may be distinct from immigrant families because of the extreme traumas and losses that refugees have endured (Danieli, 1998). Neither the immigrant nor refugee literatures present empirical research on family-focused mental health interventions or outreach with refugee families. Family Consequences of Refugee Trauma Family is at the center of Bosnian culture (Bringa, 1995). A common belief among Bosnians is that families have played a necessary and strong role in helping people to cope with massive social pressures in the former Yugoslavia (Weine, 1999). For those who became refugees and whose homes and communities were destroyed, the family was the most important remaining social institution. Thus, as an alternative to the clinical trauma mental health model, a Family Consequences of Refugee Trauma (FAMCORT) model was proposed (Weine et al., 2004). The FAMCORT model regards the family, more so than the individual, as the focal point. Such a framework emphasizes the multiple changes that war brings to the life of the family and its members, rather than concentrating upon discrete traumatic events and their mental health consequences. It recognizes that families regard a wide range of changes as part of refugee trauma, including changes related both to political violence and to the experience of displacement, and including both destructive and beneficial changes. Through the previous analysis of ethnographic data with Bosnian families, two subthemes of the model were identified: displaced families of war, representing family members' views of the adverse changes to the family caused by war and its consequences, and families rebuilding lives, referring to family members' thoughts about the helpful ways that families can manage those changes (Weine et al., 2004). The present study builds on this previous work by using this model to formulate initial research questions concerning how refugee families join a multiple-family group intervention. Multiple-Family Groups with Refugee Families This paper describes and analyzes an initiative that used multiple-family support and education groups to intervene with refugee families. …