Pediatric Perspectives and Tools for Attorneys Representing Immigrant Children: Conducting Trauma-Informed Interviews of Children from Mexico and Central America
2. Immigrant Children Seeking Protection in the United States
2.1. The Migration Paradigm: Stages of Migration and Associated Experiences of Adversity and Trauma
2.1.2. Migration and Border Crossing
2.1.3. Apprehension and Detention
2.1.4. Post-Detention Community Release
- Reunification and integration with family/sponsor
- Family/household conflict after “honeymoon”
- Exacerbated social stressors in sponsoring household (e.g., financial, housing, food)
- Carried over trauma—re-victimization
- Legal system—fear of deportation, stress in providing testimony
- Acculturation—identity shift, language barriers
- School system—unable to navigate
- Isolation—lack of community
- Discrimination, lack of sense of belonging
- Survivor’s guilt—“carriers of hope”
- Repayment of family debt
3. Trauma and Toxic Stress
- Direct or indirect exposure to intense and overwhelming experiences that involve threat or harm to a person’s physical and/or emotional integrity
- Overwhelms the person’s coping resources
- Often leads to coping mechanisms that help survive/adapt in the short run but may cause serious harm in the long run
4. The Effects of Traumatic Stress on Immigrant Children’s Presentations and Functioning in Legal Interviews
- Difficulty with attachment—negotiating and developing trusting relationships
- Difficulty with attention, concentration, and memory
- Challenges in providing narrative
- Little or no elaboration—avoidance and/or recall difficulty
- Disorganized, non-linear, incoherent, perseverative
- Difficulties with emotion identification, expression, and regulation
- Behavior and affect that are incongruent with events described
- Behavioral indicators of distress—fidgety, restless, no eye contact, rapid breathing, fast talk, tangential
5. Conducting Trauma-Informed Interviews with Children in Migration
5.1. Guiding Principles for Trauma-Informed Interviewing
- ensure that children feel physically and psychologically safe during the interview, and that any perceived risks are addressed (safety);
- develop a clearly defined and trustworthy relationship and rapport, where interviewers provide clear and accurate information to children (trust and transparency);
- develop plans and efforts for obtaining support from peers, family, and community (peer support);
- align efforts and priorities so that the child and interviewer are working together towards a shared goal (collaboration and mutuality);
- provide children with maximal control over the interview process and highlight children’s (and their family’s) strength and resilience (empowerment, voice, and choice); and,
- acknowledge and integrate information about children’s developmental stage, trauma history, and cultural identity into the interview process (attention to cultural, historical, and gender issues).
5.2. Interview Practice Recommendations
5.2.1. Obtain Background Knowledge
- child developmental processes and the impact of development on children’s cognitive, emotional, and interpersonal functioning;
- impact of compounded trauma and adversity exposure on children and child development;
- information about children’s primary language, culture(s) and community of origin, including the history of their communities;
- level of education and literacy (within the community of origin and specific to the child);
- migration experience and trajectory (e.g., accompanied, unaccompanied, separated);
- current legal status and related risks;
- current living placement/situation and related risks (given that children’s presentation and level of disclosure may be impacted by how safe they feel in their current situation).
5.2.2. Build Rapport and Engagement
- using a friendly, genuine tone and avoid an overly professional or rigid approach;
- using humor, warmth, and personal connection;
- showing interest in children’s interests and experiences (asking about their day, their current well-being, their hobbies, their family, etc.);
- building engagement around non-threatening (i.e., not trauma-related) topics with easy-to-answer questions;
- providing multiple opportunities for meeting and connecting to gradually build the relationship and demonstrate consistent presence over time;
- identifying and connecting around commonalities, interests, experiences shared between the child and interviewer (as appropriate—always consider the risk/benefit tradeoffs of personal disclosures);
- considering and addressing power imbalances in the child-interviewer dynamic (e.g., due to ethnicity, gender, physical stature, disability; for example, seating at equal heights so not to intimidate children);
- continuously working to explore and identify child priorities and core goals and values (e.g., what are they most concerned about/what do they need most in this moment?).
5.2.3. Maintain Respect for Children, Their Family, and Community
- body language that demonstrates attunement with the child’s mood and experience (e.g., relaxed and open posture, gradually increasing physical proximity as a demonstration of support and interest, appropriately mirroring a child’s affect and presentation);
- open reflection and identification of children’s observed mood and emotions;
- offering summarizing statements that reflect content and affect;
- checking for understanding and confirmation of children’s statements and feelings, also offering opportunities for children to provide correction, clarification, and elaboration;
- inviting children to pose their own questions;
- following and mirroring children’s pacing and tone (more often than not, this means slowing down);
- validating children’s experiences of reported and/or observed emotional distress or cognitive challenge (e.g., attention or memory difficulty) as common, normal, and often protective responses to trauma and adversity;
- responding sensitively and appropriately to children’s expression of distress (while interviewers also regulate their own secondary affect);
- allowing or creating time and space for silence and reflection;
- acknowledging and reflecting (instead of avoiding or minimizing) experiences of feeling stuck or hopeless (even if it requires the interviewer to acknowledge that they themselves “don’t have the answers”).
5.2.4. Maximize Agency and Predictability
5.2.5. Provide Closure to the Interview and Engagement Process
5.2.6. Maintain Professional Balance and Engage in Self-Care
6. Applying Trauma-Informed Practice in a Medical—Mental Health—Legal Partnership Approach
- Important role of the medical home in which children and their caretakers build a trusting long-term relationship.
- A trauma-sensitive setting that understands the developmental and psychological needs of children becomes a safer setting in which to reveal complex histories of trauma.
- Understand that children may not be comfortable in a law office setting and that may interfere with a child’s sense of safety. Legal teams should develop strong networks or partnerships with medical and mental health experts to facilitate timely referrals.
- Legal provider should try to identify healthcare facilities that have integrated co-located mental health services to minimize need for client to go to different offices and to allow for a warm “handoff” that can improve adherence to mental health services.
- Collaborating with medical and mental health experts can mitigate or prevent re-traumatization by having to repeat traumatic histories repeatedly to different professionals.
- Medical–mental health–legal partnerships can help prepare youth for court and mitigate the need to repeat their histories to judges by providing written and oral professional testimony.
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Bodily Functions||Behavior||Development and Learning|
Children and families seeking refuge and asylum in the United States pursue an official, authorized legal status as a means of ensuring their safety and protection. Here, we use the term “durable legal status” to convey the need and benefit of securing long-term protections, in recognition of the fact that many legal status classifications are temporary or short-term in nature (e.g., temporary protected status, protection against deportation during an appeal), thereby failing to protect the best interests and well-being of children. There are multiple routes or processes for securing durable legal status (e.g., before an immigration judge in an asylum hearing, or before a USCIS officer in an affirmative process); our article aims to broadly cover the principles and practices of trauma-informed intervewing that are generally relevant to legal professionals interacting with immigrant children, however, we acknowledge that strategies may vary depending on children’s specific circumstances and context within the U.S. immigration system.
For further information on differential reactions to traumatic stress based on age and developmental stage, readers are referred to resources available through the Substance Use and Mental Health Services Administrations (https://www.samhsa.gov/child-trauma; accessed on 30 December 2022) and the National Child Traumatic Stress Network (https://www.nctsn.org; accessed on 30 December 2022).
Here we are broadening Falicov’s definition of cultural humility within therapeutic contexts, to be applied within general service provision, including interviewing for legal/advocacy purposes.
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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Matlow, R.B.; Shapiro, A.; Wang, N.E. Pediatric Perspectives and Tools for Attorneys Representing Immigrant Children: Conducting Trauma-Informed Interviews of Children from Mexico and Central America. Laws 2023, 12, 7. https://doi.org/10.3390/laws12010007
Matlow RB, Shapiro A, Wang NE. Pediatric Perspectives and Tools for Attorneys Representing Immigrant Children: Conducting Trauma-Informed Interviews of Children from Mexico and Central America. Laws. 2023; 12(1):7. https://doi.org/10.3390/laws12010007Chicago/Turabian Style
Matlow, Ryan B., Alan Shapiro, and N. Ewen Wang. 2023. "Pediatric Perspectives and Tools for Attorneys Representing Immigrant Children: Conducting Trauma-Informed Interviews of Children from Mexico and Central America" Laws 12, no. 1: 7. https://doi.org/10.3390/laws12010007