Globally-Oriented Mental Health Care for Today’s World

Program Description

Partnerships for Trauma Recovery (PTR) offers a holistic, globally oriented approach to meeting the psychosocial needs of refugees, asylum seekers and other international survivors of human rights abuses. Of PTR’s clients, 96% have limited English proficiency, requiring linguistically accessible care; 100% are low-income; and at least 50% have post-traumatic stress disorder and 70% major depressive disorder. The level of trauma experienced by this population, and the diverse cultural contexts from which they originate, necessitate a tailored approach. PTR supports clients through our core mental health programming, which includes formal training for clinical interns in one of the few multidisciplinary clinical training programs in the nation with a focus on international survivors. Our program is led by a Clinical and Training Director who oversees a team of psychology, social work and psychiatry staff. Together, they serve clients and supervise and train 10 clinical interns (psychology and social work doctoral students). Additionally, PTR works with a network of 20+ cross-referral partners to offer housing, legal and employment assistance to this population. Our networked approach to care allows clients to find the resilience and wellness they need to build a solid socioeconomic foundation for the next chapter of their lives.

Creativity

PTR offers an original approach to addressing the mental health needs of international survivors of human rights abuses: we combine globally culturally aware, trauma-informed mental health care with services from a wide partner network to attend to the mental, physical, social and economic wellbeing of clients. Our clinical training program, which prepares the next generation of psychologists to serve this population, exemplifies our ingenuity. We not only address a pressing need for care, but by expanding clinical capacity to serve the mental health needs of this population, and creating a replicable training model, we set the stage to multiply the number of globally trauma-informed clinicians. Our resourcefulness is exhibited through our ability to leverage prior relationships and internal expertise to build a highly regarded clinical training program in just two years, assemble a partner network of 20+ organizations and leverage 14,000 hours of volunteer time just in 2017.

Leadership

At the core of PTR’s model is a clinical training program designed to prepare the next generation of mental health care leaders to meet the unique psychosocial needs of international survivors. Graduates from PTR’s clinical training program bring the expertise they gain into future clinical and supervisory roles, thus enabling other clinical trainees and organizations to emulate PTR’s approach. PTR also conducts training with front-line advocates to increase their capacity to provide trauma-informed services for clients, and to address their own secondary exposure to trauma. Attorneys representing asylum seekers, for example, may inadvertently exacerbate clients’ traumatic stress without an understanding of trauma. PTR disseminates information about our approach through events and strategic partnerships. PTR has shared our work through venues such as the World Affairs Council and California Immigrant Policy Center Refugee Policy Dialogue. These efforts have led to increased funding opportunities for African and Middle East clients.

Sustainability

In just two years, PTR has built a strong foundation for sustainability through our funding and implementation partners which include California Office of Emergency Services, Global Whole Being Fund, Kaiser Permanente, Zellerbach Family Foundation and many others. Additionally, PTR is establishing systems to bill through Medicaid for our refugee and asylum-seeking clients, all of whom are eligible for full health coverage in California. PTR also benefits from a widely supportive community. A 2010 Minnesota study found that 71% of agencies and 91% of immigrant-led mutual assistance associations identified mental health as the most significant unmet need of refugees. PTR has found a similar level of support among Bay Area organizations, such as members of the East Bay Refugee Forum. Our partners, from resettlement agencies to asylum attorneys to job training agencies, have expressed a vested interest in PTR’s continuation, as PTR meets an essential gap in services for their clients.

Replicability

Our Global Healing and Human Rights (GHHR) clinical training program has the potential to be replicated by academic institutions and community-based agencies nationally and even internationally through the creation of a Global Healing and Human Rights Training Center involving a Train-the-Trainer model. This model would train licensed clinicians in GHHR Level II, which would enable them to teach PTR’s GHHR Level I curriculum at community health agencies, hospitals and other institutions serving international survivors. This level of training would represent a training option above those already offered through PTR. PTR currently conducts short-term trainings with law students, attorneys, researchers, accompaniers for asylum seekers and other human rights defenders. These trainings build the capacity of participants to continue supporting their clients through a trauma-informed approach, while addressing their own response to secondary exposure to trauma. PTR has received requests for this training from a wide array of human rights partners.

Results/Outcomes

Since 2015, PTR has already served 170 clients from 30+ countries. PTR has graduated nine clinical interns from our Global Healing and Human Rights program with 10 more scheduled to graduate this coming spring. PTR’s leadership in the field has been recognized by the Alameda County Psychological Association, which selected PTR as the 2017 Community Organization of the Year. PTR also won the 2017 Diversity in Training Award from Palo Alto University’s Center for Excellence in Diversity. PTR is also committed to tracking client progress and uses the PTSD Checklist (PCL-5) and Hopkins Symptom Checklist (HSCL-25) to do so. Last year, clients with 10+ sessions improved an average of nine points on the PTSD checklist. These results are on par with national trends (Lambert et al., 2001). PTR is very proud of this success, especially given the unique histories of trauma found among our client population.