Giving yourself a "brain freeze"- reducing self-harming behaviour in refugee children and young people with complex trauma presentations

Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) counsellors have observed relatively high rates of self-harming behaviour in children and young people from refugee backgrounds. These vulnerable... [ view full abstract ]

Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) counsellors have observed relatively high rates of self-harming behaviour in children and young people from refugee backgrounds. These vulnerable clients describe self-harm as a way to manage dissociative symptoms or cope with intense emotional distress.

Concurrently, Dialectal Behavioural Therapy (DBT) has emerged as an evidence-based intervention for clients with complex trauma presentations and self harming behaviours (Granato et al, 2015; Landes et al, 2016). However, the use of DBT strategies with refugee background young people requires flexibility and cultural sensitivity. An adapted version of DBT has been applied to a small cohort of refugee children and young people with the aim of reducing self-harming behaviours. These children and young people are from a variety of cultural and religious backgrounds, ages and genders; however they all presented with complex trauma history, severe PTSD symptoms, regular self-harming behaviours and/or high risk behaviours. These complex trauma symptoms were exacerbated by experiences of intergenerational conflict, domestic and family violence and experiences of neglect.

This paper will outline and explore the effectiveness of adapted DBT strategies with this vulnerable client group, including inclusion in safety planning. Case studies will be provided to illustrate the cultural and systemic complexities facing at risk refugee children and young people who self-harm. While our work has seen a reduction of self-harming behaviours, increased distress tolerance and improved emotion regulation there are also some cases where recovery has been limited so far.

We will look at the inclusion of stakeholders, parents and carers to assist the children and young people in their recovery, and the importance of advocacy in reducing shame.