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It is estimated that at least 33 million people around the world
have been displaced from their homes by war or persecution.
Numerous studies have documented high rates of psychological
distress among these survivors of extreme violence and forced
migration, yet very few have access to clinic-based mental health
care. In any case, clinic-based services cannot adequately address
the constellation of displacement-related stressors that affect
refugees daily, whether in a new region of their homeland or a new
country--stressors such as social isolation, the loss of previously
valued social roles, poverty and a lack of employment
opportunities, and difficulties obtaining education and medical
care. Additionally, many refugees from non-western societies find
western methods of psychiatric and psychological healing culturally
alien or stigmatizing, and therefore underutilize such services.
This book brings together an international group of experts on the
mental health of refugees who have pioneered a new approach to
healing the psychological wounds of war and forced migration. Their
work is guided by an ecological model, which, in contrast to the
prevailing medical model of psychiatry and clinical psychology,
emphasizes the development of culturally grounded mental health
interventions in non-stigmatized community settings. The ecological
model also prioritizes synergy with natural community resources to
promote adaptation, prevention over treatment, the active
involvement of community members in all phases of the intervention
process, and the empowerment of marginalized communities to address
their own mental health needs. Drawing on their expertise in
community psychology, prevention science, anthropology, social
psychology, social psychiatry, public health and child development,
the authors present a variety of highly innovative, culturally
grounded interventions designed to improve the mental health and
psychosocial well-being of communities that have survived the
nightmares of political repression, civil war, and genocide. They
discuss the various conceptions of well-being and distress that
have informed their projects, their own integrations of western and
indigenous approaches to understanding and relieving psychological
distress, and in several instances their creative use of
well-trained paraprofessionals. They examine with remarkable candor
the challenges they have faced in carrying out their work in
extraordinarily demanding conditions. An extended introductory
chapter reviews and analyzes what we know about the impact of
political violence and exile on mental health, and lays out the
ecological model in rich theoretical and empirical context. The
first of two concluding chapters addresses the critical and
often-neglected issue of the evaluation of community-based
interventions in conflict and post-conflict settings; the second
sums up the implications of the achievements and limitations of the
programs described, poses questions that must be answered, such as
"How adequate is the PTSD construct in capturing the nature of
refugee trauma?", and suggests numerous directions for future
research and practice. The Mental Health of Refugees: Ecological
Approaches to Healing and Adaptation is an essential reference for
all professionals who seek to serve members of this vulnerable
population, for those who train and supervise them, and for program
administrators and policymakers concerned with refugee well-being.
It is also an excellent resource for graduate courses in public
mental health, community psychology and psychiatry, refugee and
immigrant studies, psychological trauma, medical anthropology, and
ethnopolitical violence.
It is estimated that at least 33 million people around the world
have been displaced from their homes by war or persecution.
Numerous studies have documented high rates of psychological
distress among these survivors of extreme violence and forced
migration, yet very few have access to clinic-based mental health
care. In any case, clinic-based services cannot adequately address
the constellation of displacement-related stressors that affect
refugees daily, whether in a new region of their homeland or a new
country--stressors such as social isolation, the loss of previously
valued social roles, poverty and a lack of employment
opportunities, and difficulties obtaining education and medical
care. Additionally, many refugees from non-western societies find
western methods of psychiatric and psychological healing culturally
alien or stigmatizing, and therefore underutilize such services.
This book brings together an international group of experts on the
mental health of refugees who have pioneered a new approach to
healing the psychological wounds of war and forced migration. Their
work is guided by an ecological model, which, in contrast to the
prevailing medical model of psychiatry and clinical psychology,
emphasizes the development of culturally grounded mental health
interventions in non-stigmatized community settings. The ecological
model also prioritizes synergy with natural community resources to
promote adaptation, prevention over treatment, the active
involvement of community members in all phases of the intervention
process, and the empowerment of marginalized communities to address
their own mental health needs. Drawing on their expertise in
community psychology, prevention science, anthropology, social
psychology, social psychiatry, public health and child development,
the authors present a variety of highly innovative, culturally
grounded interventions designed to improve the mental health and
psychosocial well-being of communities that have survived the
nightmares of political repression, civil war, and genocide. They
discuss the various conceptions of well-being and distress that
have informed their projects, their own integrations of western and
indigenous approaches to understanding and relieving psychological
distress, and in several instances their creative use of
well-trained paraprofessionals. They examine with remarkable candor
the challenges they have faced in carrying out their work in
extraordinarily demanding conditions. An extended introductory
chapter reviews and analyzes what we know about the impact of
political violence and exile on mental health, and lays out the
ecological model in rich theoretical and empirical context. The
first of two concluding chapters addresses the critical and
often-neglected issue of the evaluation of community-based
interventions in conflict and post-conflict settings; the second
sums up the implications of the achievements and limitations of the
programs described, poses questions that must be answered, such as
"How adequate is the PTSD construct in capturing the nature of
refugee trauma?", and suggests numerous directions for future
research and practice. The Mental Health of Refugees: Ecological
Approaches to Healing and Adaptation is an essential reference for
all professionals who seek to serve members of this vulnerable
population, for those who train and supervise them, and for program
administrators and policymakers concerned with refugee well-being.
It is also an excellent resource for graduate courses in public
mental health, community psychology and psychiatry, refugee and
immigrant studies, psychological trauma, medical anthropology, and
ethnopolitical violence.
This book is intended as a contribution to the study of the
relation of political ideas and governmental policies. It seeks to
examine and evaluate the British Labour Party's early efforts to
apply socialist theories to foreign policy actions. Since I have
focused on these ideas and events, I have not attempted to take
into account happenings on the British domestic front that, though
important to the Labour Party and the trade unions, did not
directly affect foreign policy. Nor are matters of imperial or
Commonwealth policy considered, except as they relate to the
development of socialist theories and interpretations or as they
influenced Great Britain's relations with other independent states.
I must express my appreciation for their assistance to Drs. Malcolm
Moos, Thomas 1. Cook, and Carl B. "Swisher, under whose direction
this project first began at the Johns Hopkins University; to Mrs.
E. Rickman of the Labour Party's Library and to Mrs. Gladys D.
Cremer of the Fabian Society, for access to various Labour and
socialist ma terials; to the Rutgers University Research Council
for grants in support of some of the research; and to Mrs. Edward
Teifeld and Mrs. Boris Pritsky for the wearisome efforts of typing
various versions of the manuscript. The responsibility for errors
is, of course, mine. The book is dedicated to my wife Marilyn, who
aided so greatly in its preparation, not least by a tactful and
appropriate balance of patience and impatience."
A native Pennsylvanian, born in Meadville in 1867 and a graduate
of Allegheny College, Frederic Howe dedicated his life early on to
the cause of improving society and played a major role in many
movements for progressive change from the early 1890s to the Second
World War--the period that Richard Hofstadter famously dubbed the
"age of reform." Howe was a fighter against corruption and
political bosses in Cleveland; a leader in Progressive politics in
New York City; a spokesman for reform through numerous books and
articles and as director of the Cooper Union's People's Institute;
an ardent campaigner for "Fighting Bob" La Follette, Woodrow
Wilson, Al Smith, and Franklin D. Roosevelt; a defender of
immigrants and civil liberties as commissioner of immigration for
the Port of New York during the First World War; and an advocate
for consumers as the first consumers counsel in the New Deal.
Kenneth Miller's biography takes the reader behind the scenes and
shows how "the great game of politics" was played in the age of
reform.
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