This year marks the 65th anniversary of the Convention Relating to the Status of Refugees, which was adopted by the United Nations in the aftermath of the Holocaust. The Convention was built upon the Universal Declaration of Human Rights — itself a direct repudiation of the atrocities of the Holocaust — particularly Article 14, which recognizes the right to asylum in other countries from persecution. Initially, the Convention was limited to protecting those European refugees, and it was anticipated that the refugee problem would abate with time. Yet today, the world faces the largest refugee crisis since World War II, with 65 million persons forcibly displaced, including 21 million refugees.
Refugees have become so pervasive in human consciousness that the Oxford Dictionaries for Children identified “refugee” as the 2016 Oxford Children’s Word of the Year, based on findings from the 500 Words global children’s writing competition sponsored by BBC Radio 2. According to the BBC, “refugee” was selected “due to a significant increase in usage by entrants writing in this year’s competition combined with the sophisticated context that children were using it in and the rise in emotive and descriptive language around it.”
It is in this setting of massive global displacement that the UN General Assembly has decided to hold a high-level Summit for Refugees and Migrants on 19 September, with the aim of coordinating the world’s humanitarian response to these victimized and vulnerable populations. Ahead of the Summit, the UN Member States have developed a Draft Political Declaration for adoption at the Summit. Included in the broad scope of this statement are commitments to treat all refugees and migrants in a “people-centred, sensitive, humane, [and] dignified manner;” to “take measures to enable refugees … to make the best use of their skills and capacities, recognising that empowered refugees are better able to contribute to their own and their communities’ well-being;” and to “commit to share best practices [and] provide refugees with sufficient information to make informed decisions.”
During the past two years, colleagues and I have been undertaking research and training that addresses these very objectives. Project MIRACLE (Motivational Interviewing for Refugee Adaptation, Coping, and Life Empowerment) is an innovative approach to casework with refugees. Motivational Interviewing (MI) is an evidence-based, person-centered counseling style that aims to help clients explore and resolve ambivalence about behavior change. This is particularly relevant for refugees because they must adapt to their new lives in many ways – from language, to customs, to foods, to learning new work skills, new transportation systems, sometimes even things such as learning to operate a stove. However, although refugees may see the necessity for adaptation, they are sometimes reluctant to change, given that they have not freely chosen to do so, but have been forced into making a move that requires such change. This adaptation process creates what is known as acculturative stress.
Today, the world faces the largest refugee crisis since World War II, with 65 million persons forcibly displaced, including 21 million refugees.
MI entails client collaboration, evocation, and autonomy. The method was originally developed in the field of substance abuse treatment; however, it has since been expanded to numerous areas of health, mental health, and social work. Although refugee service providers have used MI on an ad-hoc basis, Project MIRACLE is the first time that MI has been applied in a conceptual and systematic manner specifically to this population.
A cornerstone of MI is empathy. To this end, the first phase of Project MIRACLE was the development and validation of the Helpful Responses to Refugees Questionnaire (HRRQ), which measures refugee caseworkers’ empathetic responses to hypothetical refugee statements. Subsequently, 34 US caseworkers were trained in MI in a three-hour webinar format using a randomized controlled trial; outcome was measured using the HRRQ. Training group participants’ responses significantly improved from before to after training compared to the control group which received no training; these results were replicated in the control group after those participants received training. These initial studies were supported by the Lois and Samuel Silberman Grant Fund in The New York Community Trust and conducted with colleague Kristen L. Guskovict. Manuscripts are currently under submission to peer-reviewed journals.
In a case of serendipitous synergy, recently I was contacted by the Client Support Services Program (CSS), which provides intensive case management to Government-Assisted Refugees throughout six cities in Ontario, and is coordinated by of the YMCA of Greater Toronto. The CSS program has been actively involved in implementing client empowerment approaches since the program’s inception several years ago, and had likewise identified MI as having significant potential for application with refugees. We are now collaborating to provide a live MI training to CSS staff, and to solicit staff feedback in a debriefing session. This will add to our knowledge base about the utility of MI not only for caseworkers and the refugee clients they work with, but across countries that have differing resettlement policies and programs as well as sociopolitical contexts. Further, the CSS program has developed a comprehensive client outcome assessment system that may allow for a pilot impact evaluation of the training on client outcomes.
Project MIRACLE is also expanding beyond resettlement countries to host countries. Currently Kristen is in Greece with the Danish Refugee Council, training protection workers in refugee camps on basic underpinnings of MI such as empathy and active listening, within the context of a larger training on refugee trauma. These protection workers are also completing the HRRQ, which will allow us to assess its relevance to camp settings.
MI clearly is not a panacea for all the tremendous challenges facing the UN Summit. However, it is a potentially powerful tool for advancing the person-centered empowerment aims formulated in the draft declaration. And MI’s focus on empathy certainly promotes the commitment to treat refugees with sensitivity, humanity, and dignity. In the words of Henry David Thoreau, “Could a greater miracle take place than for us to look through each other’s eyes for an instant?”
Featured image credit: united nations world flag by Etereuti. Public domain via Pixabay.
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