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Working with refugee children and their families presents formidable challenges to therapists as children who are fleeing the atrocities of war or the perils of a traumatizing and persecuting environment present with a host of emotional and somatic reactions including panic attacks, flashbacks and dissociation (Trowell, 2008). The violence these children have witnessed or been subjected to and the losses they have sustained have obliterated their sense of safety in the world.
Adding to the trauma they experienced in their home countries that led to them fleeing from home are the traumas many of them experience during the relocation. These traumas can include witnessing the death of family members or of other individuals who are fleeing with them, being subjected to sexual violence and kidnapping, being forced to perform free or low-cost labor, recruitment for sex trafficking and enlistment in gangs (DeHoff et al., 2017; Kaplin et al., 2019). Other dangers include lack of food, being exposed to the elements, traveling long distances under highly unsafe conditions and facing health risks (Clauss-Ehlers, 2019).
Trauma can also occur in the dangerous, unsanitary and overcrowded refugee camps where the children have to wait for months for their cases to be processed. As Montgomery (1998) reported in a large study with refugees from the Middle East, the most frequent incidents of violence occurred when children lived in refugee camps outside the home country.
Many children continue to be traumatized even after being admitted to the host country, as they find themselves having to adjust to a very different and hostile culture with limited support. All this occurs while they are experiencing what Papadopoulos (2008) calls the “inexplicable gap” (p. 18), which is the loss of a sense of continuity and belonging they were not aware they had.
In her paper, Dr. Franco gives a painful account of the case of Maria, a seventeen-year-old adolescent who experienced emotional neglect and