"For Aboriginal peoples, country is much more than a place. Rock, tree, river, hill, animal, human – all were formed of the same substance by the Ancestors who continue to live in land, water, sky. Country is filled with relations speaking language and following Law, no matter whether the shape of that relation is human, rock, crow, wattle. Country is loved, needed, and cared for, and country loves, needs, and cares for her peoples in turn. Country is family, culture, identity. Country is self." -  Ambelin Kwaymullina (2005)

How should psychotherapists’ practice inform public health policies impacting the mental health of displaced couples and families as they relocate in the United States? How effective are the current public health policies and psychosocial interventions in supporting these populations? How do systems of oppression, marginalized and transnational identities impact these factors? As a systemically oriented clinician with interests in the mental health of refugee families, these are some of the questions driving my clinical practice and research endeavors.

Conceptual Framework:  A Humanitarian and Social Justice Approach

According to public discourses, refugee populations are guaranteed a legitimate protective status and easier access to resources in comparison to other immigrants. Which might come across as unfair advantages. This narrative is reinforced by governmental resettlement benefits (Morgan, 2021; Ludwig, 2013), other nongovernmental supports, and a steady increase in refugee populations. A recent report to the US Congress on proposed refugee admissions for fiscal year 2023, following the ongoing war in Ukraine, estimated an increase from 10,000 to 15,000 expected refugees from Europe and Central Asia, most directly related to the war (U.S. Department of State, 2022). As the US population is quickly shifting, its composition is becoming more culturally diverse. According to Pumariega et al. (2005), “first and second generation immigrants are the most rapidly growing segments of the American population,” (p. 258) with refugees comprising a crucial portion of that growth.

Research show that while adjusting to intrapsychic and interpersonal dynamics when settling in new environments with drastically different sociocultural values and norms, displaced populations must navigate additional challenges directly undermining the preservation of their identity. Despite arguments for the need to assimilate - to a certain degree - to be perceived as a ‘functional’ member of the host country/culture, available literature speaks to the limitations and dangers of the policies and approaches used to attain those aims, and furthermore, argues against their cultural insensitivity and ostracizing nature. Such methods can result in mental and emotional dissonance reinforced by feelings of systemic marginalization creating ongoing stress and trauma for these populations. While resettling in new environments can be lifechanging, the reality of refugee families can prove rather ambivalent and traumatizing. Available literature indicates that in many cases these populations are subjected to systematic and legal barriers while relocating (Salam et al., 2022). Esses et al. (2013) highlight some of these issues, stating that “immigration policies and the treatment of immigrants and refugees are contentious issues involving uncertainty and unease” (p. 518). This observation addresses a reality often overlooked in a population dealing with staggering multi-levels complex traumatic experiences. Refugee families are continually navigating intersecting nationalities, identities, and realities (Morgan, 2021; Frounfelker, Mishra et al., 2020; Frounfelker, Tahir et al., 2022). This includes “a wide array of nationalities, ethnicities and races, many of which are overlapping” (Pumariega et al., 2005, p. 582) that can be tainted by burdensome prejudices associated with their “refugee” status (Salam et al., 2022; Ludwig, 2013).

“Withness”: Marginalized Populations and Mental Health Risks

From a research, pedagogic and service perspective, my culturally responsible approach is to attempt to connect to the populations I research and serve by acknowledging my power and biases while adopting a ‘withness’ approach allowing me to take a step down position  to encourage safety and agency. It is my view that only through ongoing and engaging discourses can I assess these populations’ needs in a way that represents a balance between their lived experiences and the unfiltered essence of their values of origin.  Research shows that there are growing dire mental health concerns for refugees and that there are even more concerns for subgroups of refugee populations and those dealing with intersecting identities (East et al., 2017), which put them at higher risks of stress and complex mental health needs as marginalized/minority groups (Chao, 2019; Pumariega et al., 2005). These intersecting dynamics are often not taken into consideration by therapists. As clinicians and mental health providers, identifying and exploring the implications of these intersecting realities and identities can serve to better assess trauma responses and psychotherapy interventions for refugee families.

Guided by the framework of minority stress theory, family systems theory, and family science, my research interest aims to objectively test the effects of transnationality, intersecting identities, minority groups marginalization and colonizing practices on the mental health of refugee families, and the implications for psychosocial interventions, clinical practices, and resettlement processes. Our research intends to primarily utilize Community-Based Participatory Research to integrate practice, research, service, and policy implications.