somalilProject SHIFA: Supporting the Health of Immigrant Families and Adolescents
School-based Trauma Systems Therapy for Somali Adolescent Refugees
Children’s Hospital Boston, Massachusetts

About Our Project

Somalis are one of the largest groups of refugees resettled in Massachusetts and across the United States.  Many Somali youth experienced war and violence prior to resettlement, and continue to face ongoing acculturative and resettlement stress.  Many Somali youth experience mental health problems related to trauma and stress; however, cultural and practical barriers have led to very few of them receiving mental health services.  In response to this high level of unmet need, Project SHIFA was developed to provide culturally appropriate mental health care for Somali youth and their families.  Project SHIFA grows out of a partnership between the Somali community, and education and mental health systems in the Boston area.  Based out of the Lilla G. Frederick Pilot Middle School in Boston, Project SHIFA provides services along a continuum of care—from prevention to full intervention.  We currently serve Somali families throughout Boston Public Schools. For more information, view our poster.

Demographic Data

Massachusetts: http://migrationinformation.org/datahub/state.cfm?ID=MA
http://quickfacts.census.gov/qfd/states/25/2507000.html

Our Work

Project SHIFA consists of three components of prevention and intervention: 1) parent outreach focused on anti-stigma and psycho-education, 2) school-based groups for students and trainings for teachers and 3) direct intervention for youth using an empirically-supported model of treatment, Trauma Systems Therapy. Parent outreach, under the leadership of our partner the Refugee and Immigrant Assistance Center, reduces stigma of mental health within the Somali community through providing education about how stress and mental health problems effect children’s functioning and ability to learn. Within the school, early intervention groups are conducted to help Somali students with acculturation and socialization. These groups also serve to help identify youth who are in need of more intensive mental health services.  Teacher trainings and consultation further minimize acculturative stress within the school setting and help teachers understand how learning and behavior may be affected by trauma and stress.  Finally, those students who demonstrate significant mental health needs receive school- and community-based care under the Trauma Systems Therapy (TST) model.  TST is a phase-based model of care that builds a child’s emotional regulation skills while simultaneously targeting and reducing social environmental stressors that contribute to a child’s emotional dysregulation.  TST incorporates home-based care, school-based therapy, and legal advocacy to achieve these goals.

Within Project SHIFA, we believe that care is best provided by, or in partnership with, members of the Somali community.  Boston University School of Social Work has facilitated the training and professional development of two Somali social work students who provide mental health services under Project SHIFA, and who partner with additional social work trainees to build cultural understanding among providers.

Project SHIFA is currently in its second year of implementation, and is expanding to serve students at English High School.  Community-wide acceptance of the program has led to active parent involvement and 100% engagement in treatment among youth referred for services.  Preliminary results show that the program is highly successful in increasing access, reducing mental health symptoms, and supporting academic success.

The Partners

• Children’s Hospital Boston
• Lilla G. Frederick Middle School
• English High School
• Refugee and Immigrant Assistance Center
• Somali Development Center
• Boston University School of Social Work
• Alliance for Inclusion and Prevention

What Are We Learning

• Building mental health service capacity within the Somali community
• Role of discrimination and resettlement stressors in understanding mental health of refugee youth
• Powerpoint presentation conducted at the American Psychological Association in 2008 entitled “Adapting Interventions for Refugee Youth:  Trauma Systems Therapy for Somali Adolescent Refugees”

Success Stories

Mustafa’s Miracle

Moving to a new community, attending a new school, and making new friends can be daunting and stressful for any child. But when that child has already experienced significant trauma; when the move to a community means traveling halfway around the world; when new friends and teachers speak a different language, then the challenge of adapting can be overwhelming…
From Fear To Understanding: A Journey Toward Good Mental Health

When Dalmar and his family arrived in Boston from Somalia, they hoped the stress and trauma of living in a war-torn country was left far behind. But something followed them…

New Resource Available

A new article, New Directions in Refugee Youth Mental Health Services: Overcoming Barriers to Engagement, outlines reasons why refugee communities rarely access mental health services even when in need and ways to overcome these barriers.

For more information about this project, contact Heidi Ellis at Heidi.Ellis@childrens.harvard.edu