Working With the Encounter: A Descriptive Account and Case Analysis of School-Based Collaborative Mental Health Care for Refugee Children in Leuven, Belgium

Abstract

Scholars increasingly point toward schools as meaningful contexts in which to provide psychosocial care for refugee children. Collaborative mental health care in school forms a particular practice of school-based mental health care provision. Developed in Canada and inspired by systemic intervention approaches, collaborative mental health care in schools involves the formation of an interdisciplinary care network, in which mental health care providers and school partners collaborate with each other and the refugee family in a joint assessment of child development and mental health, as well as joint intervention planning and provision. It aims to move away from an individual perspective on refugee children’s development, toward an engagement with refugee families’ perspectives on their migration histories, cultural background and social condition in shaping assessment and intervention, as such fostering refugee empowerment, equality, and participation in the host society. Relating to the first stage of van Yperen’s four-stage model for establishing evidence-based youth care, this article aims to engage in an initial exploration of the effectiveness of a developing school-based collaborative mental health care practice in Leuven, Belgium. First, we propose a detailed description, co-developed through reflection on case documents, written process reflections, intervision, an initial identification of intervention themes, and articulating interconnections with scholarly literature on transcultural and systemic refugee trauma care. Second, we engage in an in-depth exploration of processes and working mechanisms, obtained through co-constructed clinical case analysis of case work collected through our practice in schools in Leuven, Belgium. Our descriptive analysis indicates the role of central processes that may operate as working mechanisms in school-based collaborative mental health care and points to how collaborative mental health care may mobilize the school and the family-school interaction as a vehicle of restoring safety and stability in the aftermath of cumulative traumatization. Our analysis furthermore forms an important starting point for reflections on future research opportunities, and central clinical dynamics touching upon power disparities and low-threshold access to mental health care for refugee families.

School-based Psychosocial Interventions’ Effectiveness in Strengthening Refugee and Migrant Adolescents’ Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study

“…It is possible that experiencing safety within the school and research context might have fostered in highly resilient participants a more open disclosure of difficult experiences between pre- and post-test assessment. Indeed, findings from focus group research with some of the participants suggest they mobilized school-based and research relations to address difficult experiences, such as discrimination, within the framework of the larger RWS study ( Spaas, Verelst, et al, 2022 ). In this case, the increased reporting of symptoms in the control group might not represent increased psychosocial suffering between pre- and post-test assessment, but rather form an indication of underreporting of symptoms at pre-test assessment.…”

“…Well-being was assessed using one item “How would you rate your overall well-being?”, with the following answer options and corresponding scoring: very bad = 1, bad = 2, normal = 3, good = 4, and very good = 5 (see also Spaas, Verelst, et al, 2022 ).…”

“…Positive relations with peers and teachers at school, for example, are related to better mental health outcomes in refugee and migrant adolescents and can even counteract postmigration stressors of social isolation, discrimination, and exclusion (e.g., Kia-Keating & Ellis, 2007;Schachner et al, 2018). Third, schools often form a bridge between refugee and migrant adolescents' family context and the host society (Fazel & O'Higgins, 2020;Rousseau et al, 2007;Spaas, Verbiest, et al, 2022). Here, scholars delineate the role of positive parent-school partnerships and collaborations in promoting adolescents' mental health and adaptation in resettlement (Georgis et al, 2014;Roubeni et al, 2015).…”

“…Here, scholars delineate the role of positive parent-school partnerships and collaborations in promoting adolescents' mental health and adaptation in resettlement (Georgis et al, 2014;Roubeni et al, 2015). Emerging studies also show that school-based interventions might improve family relationships and interactions between families and schools, known to play an important role in the well-being of refugee and migrant children (e.g., Nadeau et al, 2017;Spaas, Verbiest, et al, 2022).…”

Developing a Collaborative Approach to Support Access and Acceptability of Mental Health Care for Refugee Youth: An Exploratory Case Study with Young Afghan Refugees

“…Furthermore, studies on CMHC with URMs are lacking. It is important to note however that collaborative mental health care is a systemic approach that focuses on enabling a dialogue in which adolescents, parents and professionals have an equal voice [ 58 , 59 ]. The involvement of parents in the trajectory of URMs is of course significantly impeded by the still ongoing separation, potentially impacting the applicability of CMHC as an approach for the URM population.…”