1 “The Traumatic Experiences of Children and Families Living on the U.S.-Mexico Border Luis E. Flores, M.A., LPC, LCDC, RPT-S Executive Vice President

1

““The Traumatic Experiences of The Traumatic Experiences of Children and Families Living Children and Families Living

on the U.S.-Mexico Borderon the U.S.-Mexico Border

Luis E. Flores, M.A., LPC, LCDC, RPT-SLuis E. Flores, M.A., LPC, LCDC, RPT-SExecutive Vice PresidentExecutive Vice President

Serving Children and Adolescents in Need Serving Children and Adolescents in Need Inc. Inc.

Question? Email: [email protected] 2

The Case of VeronicaThe Case of Veronica Referred to OPT Substance Referred to OPT Substance

Abuse TreatmentAbuse Treatment 14 years14 years Father is U.S. citizen and Father is U.S. citizen and

mother is legal immigrantmother is legal immigrant Veronica is U.S. citizenVeronica is U.S. citizen Sexual AssaultSexual Assault Anger (Arranques)Anger (Arranques) Risky behaviorsRisky behaviors Conflict at homeConflict at home Supporting ParentsSupporting Parents Not the focus of treatmentNot the focus of treatmentMother: “Yo quiero que lo Mother: “Yo quiero que lo

saque…”“No lo ha superado saque…”“No lo ha superado todavia”todavia”


The United States-Mexico The United States-Mexico BorderBorder

Distant NeighborsDistant Neighbors Triumph/DefeatTriumph/Defeat

Border between two cultures: Border between two cultures: Protestant Anglo-Saxon/Ibero-Indian Catholic Protestant Anglo-Saxon/Ibero-Indian Catholic

Developed/Third WorldDeveloped/Third World Language Language

Precision/ImprovisationPrecision/Improvisation


Views on the Views on the United States Mexico United States Mexico

BorderBorderLa FronteraLa Frontera


Dynamic Transnational InteractionDynamic Transnational InteractionDaily CrossingsDaily Crossings

21,917 pedestrians -- 35,468 vehicles -- 21,917 pedestrians -- 35,468 vehicles -- 8,216 trucks8,216 trucks

(Texas Center for Economic and Enterprise Development, 2005)(Texas Center for Economic and Enterprise Development, 2005)


One AreaOne Area


The BorderThe Border

““physical isolation, frontier conditions, physical isolation, frontier conditions, transnational frictions, ethnic rivalries and transnational frictions, ethnic rivalries and a sense of separation from heartland areas a sense of separation from heartland areas have contributed… to the identity of people have contributed… to the identity of people from the…borderlands” (Oscar J. Martinez)from the…borderlands” (Oscar J. Martinez)


What affects one What affects one side affects the side affects the

other. We’re other. We’re literally one literally one

region with a region with a fence down the fence down the

middle.”middle.”(San Diego Mayor Jerry Sanders, (San Diego Mayor Jerry Sanders,

USA Today Feb.6, 2007, USA Today Feb.6, 2007, referring to the violence in referring to the violence in

Tijuana)Tijuana)


Views of the Border: Views of the Border: Mexico looks at their Mexico looks at their

BorderBorder Succumbing to Succumbing to

“Agringamiento”“Agringamiento” Permissive moral Permissive moral

climateclimate Image of the Image of the

“Pocho”“Pocho” Lost cultural identifyLost cultural identify ViolenceViolence Disconnected from Disconnected from

MexicoMexico


Views of the Border: Views of the Border: U.S. looks at their BorderU.S. looks at their Border

Undocumented Undocumented migrationmigration

Drug SmugglingDrug Smuggling ViolenceViolence PovertyPoverty TerrorismTerrorism Belonging more to Belonging more to

Mexico than the Mexico than the U.S.U.S.

SpringbreakersSpringbreakers


Living in the PeripheryLiving in the Periphery Border, inner cities, Indian reservations and the Border, inner cities, Indian reservations and the

failure to assimilatefailure to assimilate Both centers of power focus on problems, differences, Both centers of power focus on problems, differences,

contradictions: Borderlanders/fronterizos focus on contradictions: Borderlanders/fronterizos focus on livingliving

Devising homemade approaches to problemsDevising homemade approaches to problems What appears problematic (mainstream irritation) is What appears problematic (mainstream irritation) is

normal to Borderlanders/fronterizosnormal to Borderlanders/fronterizos Own identity: learning to adapt in an alien cultural Own identity: learning to adapt in an alien cultural

environmentenvironment Physical proximity with Mexico: Physical proximity with Mexico: Choque, Herida Choque, Herida

AbiertaAbierta Disparity of power between the two countriesDisparity of power between the two countries Feelings of superiority and contemptFeelings of superiority and contempt Creation of a fenceCreation of a fence


The South Also ExistsThe South Also Exists

NAFTA and migrationNAFTA and migration MaquiladorasMaquiladoras Immigrants repeat poverty experiences in Immigrants repeat poverty experiences in

the U.S., but with racism and discriminationthe U.S., but with racism and discrimination Having hope makes possible enduring Having hope makes possible enduring

povertypoverty To locals the border is concrete, not a To locals the border is concrete, not a

metaphormetaphor Border also as a comfort zone for people Border also as a comfort zone for people

from the borderlands from the borderlands


U.S. Stereotypes About U.S. Stereotypes About Mexicans: Internalization and Mexicans: Internalization and

Over-identificationOver-identification Frontier ThreatsFrontier Threats LazyLazy Taking jobs Welfare Taking jobs Welfare

and Healthcare and Healthcare LeechesLeeches

Not trustworthyNot trustworthy ImmatureImmature AggressiveAggressive OversexedOversexed ImmoralImmoral Above all: Mexicans Above all: Mexicans

are Dirtyare Dirty

•Ingrained in mainstream psycheIngrained in mainstream psyche•InternalizationInternalization•Over-identification or Over-identification or •Ethnic self-hateEthnic self-hate


Mexican Stereotypes about Mexican Stereotypes about U.S. citizensU.S. citizens

Blond, blue eyedBlond, blue eyed GullibleGullible Easily AmusedEasily Amused TouristTourist Does not care what Does not care what

others think of him/herothers think of him/her IntelligentIntelligent Business savvyBusiness savvy ColdCold EducatedEducated DryDry


Understanding the Understanding the Experiences of Border FamiliesExperiences of Border Families

Importance of understanding the context of the Importance of understanding the context of the border and how it affects borderlanders/fronterizosborder and how it affects borderlanders/fronterizos

Fluidity Fluidity Economic interdependenceEconomic interdependence Diversity within borderlanders: Americanos, Diversity within borderlanders: Americanos,

Mexico-Americanos, border crossers & invisible Mexico-Americanos, border crossers & invisible populationspopulations

The effects of acculturationThe effects of acculturation Confounding experiences about identifyConfounding experiences about identify Assimilation is not the end of discriminationAssimilation is not the end of discrimination Nowhere to go: Border only identity?Nowhere to go: Border only identity? Safety of the borderSafety of the border


Understanding The Understanding The Experiences of Border Experiences of Border

FamiliesFamilies Disconnection from mainlandDisconnection from mainland Borderlanders/fronterizos adapting to an alien Borderlanders/fronterizos adapting to an alien

cultural environmentcultural environment MigrationMigration Separation from loved onesSeparation from loved ones Lack of understanding of systems and institutionsLack of understanding of systems and institutions Grieving the loss of homeGrieving the loss of home Uprooting of meaning in physical, social and Uprooting of meaning in physical, social and

cultural domainscultural domains ColoniasColonias


Understanding The Understanding The Experiences of Border Experiences of Border

FamiliesFamilies Getting stuck between Getting stuck between

the two culturesthe two cultures Mainstream Mainstream

institutionsinstitutions Pressure to Pressure to

Acculturate or retain Acculturate or retain valuesvalues

Poverty and RacismPoverty and Racism Guilt over becoming Guilt over becoming

too Americantoo American Constant connection Constant connection

with Mexicowith Mexico

Change and Change and adapt/ lose adapt/ lose

identityidentity

Stay the same Stay the same and resist and resist

retain identityretain identity


Can we transform an Can we transform an enchiladaenchilada

into a hamburger?into a hamburger?


SCAN’s Border SCAN’s Border Traumatic Stress Traumatic Stress Response CenterResponse CenterWebb CountyWebb County

Webb- LaredoWebb- Laredo Estimated Estimated

Population: Population: 224,695*224,695**U.S. Census Bureau (2004). *U.S. Census Bureau (2004). Annual Estimates of the Annual Estimates of the Population for Counties of Texas: Population for Counties of Texas: April 1, 2000 to July 1, 2003 (CO-April 1, 2000 to July 1, 2003 (CO-EST2003-01-48). EST2003-01-48). : Population : Population Division, U.S. Census Bureau. Division, U.S. Census Bureau. Release Date: April 9, 2004Release Date: April 9, 2004


Targeted CommunityTargeted Community 94% people of 94% people of

Mexican descentMexican descent Primarily Spanish Primarily Spanish

speaking or bilingualspeaking or bilingual Own language: Own language:

(Spanglish) Code (Spanglish) Code SwitchingSwitching

Low acculturatedLow acculturated Close ties with MexicoClose ties with Mexico Recent ImmigrantsRecent Immigrants Primarily Medically Primarily Medically

IndigentIndigent


CharacteristicsCharacteristics

Poverty Rate 26.8% Compared to the Poverty Rate 26.8% Compared to the state’s 16.2%state’s 16.2%

Child Poverty rate is 36.1% Child Poverty rate is 36.1% Compared to state’s 22.7%Compared to state’s 22.7%

Laredo Lowest Per Capita Income in Laredo Lowest Per Capita Income in US (54.2%)US (54.2%)

48.2% HS Diploma (75.3%)48.2% HS Diploma (75.3%) 9.6% bachelor’s degree (23.2%) 9.6% bachelor’s degree (23.2%)


Community NeedsCommunity Needs

Medically Underserved Area and Medically Underserved Area and PopulationPopulation

Medical Self-Treatment Medical Self-Treatment Health Personnel Shortage AreaHealth Personnel Shortage Area Extremely Limited Publicly Funded Extremely Limited Publicly Funded

Mental Health Services for Children Mental Health Services for Children and Adultsand Adults

Dearth of Mental Health Dearth of Mental Health ProfessionalsProfessionals



Environmental Safety in Neighborhood Environmental Safety in Neighborhood Higher substance use problems in Higher substance use problems in

youth and adultsyouth and adults Border violence: Drug Traffic WarsBorder violence: Drug Traffic Wars HIDTA since 1990HIDTA since 1990 Great availability of drugsGreat availability of drugs Availability of psychotropic Availability of psychotropic

medications in Mexicomedications in Mexico



Higher rates of youth alcohol useHigher rates of youth alcohol use Slightly higher rates of life use of Slightly higher rates of life use of

inhalants in Elementary Schools, with inhalants in Elementary Schools, with greater differences in 5greater differences in 5thth and 6 and 6thth grades grades

More likely to report being offered More likely to report being offered Marijuana Marijuana

Higher rates of use of tobacco, Higher rates of use of tobacco, Inhalants, Cocaine, Crack and Rohypnol Inhalants, Cocaine, Crack and Rohypnol

Border Communities may not fit the Border Communities may not fit the “Latino Paradox”“Latino Paradox”


JuanJuan Juan is 16 years of ageJuan is 16 years of age Multiple unsuccessful treatment episodesMultiple unsuccessful treatment episodes Second generation Mexican American: Second generation Mexican American:

Parents are bilingualParents are bilingual Difficulties controlling aggression Difficulties controlling aggression Long history of substance abuseLong history of substance abuse Long history of witnessing domestic Long history of witnessing domestic

violenceviolence Diagnosed with ADHD and Depression, Diagnosed with ADHD and Depression,

currently taking medicationcurrently taking medication Parental substance abuseParental substance abuse Community violenceCommunity violence


Juan’s storyJuan’s story


Infrastructure GapsInfrastructure Gaps Scarcity of Master level Scarcity of Master level

therapiststherapists No counseling services No counseling services

for children with no for children with no coveragecoverage

No trauma specific No trauma specific services before grantservices before grant

Surveyed Private Surveyed Private Providers before grant : Providers before grant : No trauma specific No trauma specific servicesservices

No therapy services for No therapy services for medically indigent adultsmedically indigent adults

Laredo MSA with highest Laredo MSA with highest rate of uninsured (36%) in rate of uninsured (36%) in TexasTexas


Data from Three Data from Three Projects Projects operated by operated by SCANSCAN Juvenile Drug Juvenile Drug

CourtCourt Motivational Motivational

Enhancement Enhancement ProgramProgram

Youth Recovery Youth Recovery HomeHome

Youth Substance Abuse and Youth Substance Abuse and Trauma Trauma


Comparison Between Comparison Between Three ProgramsThree Programs

0

20

40

60

80

MEPDrug CourtYRH

MEP 39 61 34

Drug Court 33.6 52.3 27.3

YRH 52 66.7 42.9

Internal External Both


Victimization MEPVictimization MEP

55

58

45

35

19

22

0 20 40 60 80

HX.Vic

Hx.worry

Acute.Vict

Past Year

90 Days

Curr.worry


Victimization Drug CourtVictimization Drug Court

44.5

21.9

46.1

64.1

0

10

20

30

40

50

60

70

Past Yr Past 90 Acute Any Hx.CW


Victimization Drug Court Victimization Drug Court and MEPand MEP

0

10

20

30

40

50

60

70

Drug Court 44.5 21.9 46.1 64.1

MEP 35 19 45 58

Past Yr Past 90 Acute Any Hx.CW


Border Traumatic Stress Border Traumatic Stress Response CenterResponse Center

Cover wide range of age Cover wide range of age and traumatic stress and traumatic stress experiencesexperiences

Adoption, Adaptation and Adoption, Adaptation and Diffusion of Evidence Diffusion of Evidence Based-PracticesBased-Practices

EBT’s and Best Practices EBT’s and Best Practices taking root in the taking root in the communitycommunity

EBT’s work with border EBT’s work with border populations.populations.

Systems Change: Impact Systems Change: Impact as Many Systems as as Many Systems as PossiblePossible

Becoming a Trauma Becoming a Trauma Informed OrganizationInformed Organization

Public AwarenessPublic Awareness


Border Traumatic Stress Border Traumatic Stress Response Center Response Center

Children 2 to 18Children 2 to 18 All types of traumatic experiencesAll types of traumatic experiences Adding new services rather than only Adding new services rather than only

strengthening our existing programsstrengthening our existing programs TF-CBT/CM-TFTTF-CBT/CM-TFT PCIT PCIT TST-SATST-SA TAPTAP


49% Male49% Male 51% Female51% Female 100% Mexican

American 94% born in US 6% were born in

Mexico 62% prefer to

speak Spanish at home

Gender Ethnicity & Gender Ethnicity & LanguageLanguage

Gender of Clients

51%49%Male

Female

Preferred Language

38%

62%

English

Spanish


11.6

27.224.5

37.8

0.90

5

10

15

20

25

30

35

40

2 to 5 6 to 9 10 to 12 10 to 17 19

Children's Ages


Trauma Types (N=116)Trauma Types (N=116)

15.713.9

21.3

10.2

32.4

15.7

63.9

5.69.3

21.3

1.93.7

54.6

38.9

11.114.815.7

10.5

0

10

20

30

40

50

60

70Sex Abuse

Sex. As.

Phys.ab.

Assault

Emoti. Ab.

Neglect

Domestic V

Terrorism

Medical

Accident

Disaster

Kidnap.

Tr. Loss

Imp.Careg.

Ext. Int.V.

Com.Viol.

Sch. Viol.

Other


Serving Border CommunitiesServing Border Communities Service Barriers: scheduling, border fluidity, treatment Service Barriers: scheduling, border fluidity, treatment

adherence, instability, lack of transportation, fear of adherence, instability, lack of transportation, fear of CPS, waiting listsCPS, waiting lists

Service model that target several areas of need, Service model that target several areas of need, address common barriers and are integrated in address common barriers and are integrated in community.community.

Challenges in treatment adherenceChallenges in treatment adherence Process of culture informationProcess of culture information Impact as many systems as possibleImpact as many systems as possible Utilize evidence-based approaches that can be adapted Utilize evidence-based approaches that can be adapted

to meet the cultural and linguistic needs of the to meet the cultural and linguistic needs of the populationpopulation

Foster the Development of culturally sensitive Foster the Development of culturally sensitive interventions: awareness, acquisition, distinguish and interventions: awareness, acquisition, distinguish and integrateintegrate


Serving Border Serving Border CommunitiesCommunities

Language values and the Language values and the potential for misdiagnosispotential for misdiagnosis

Hire Bilingual, bicultural staff Hire Bilingual, bicultural staff and staff who are open to and staff who are open to embrace other culturesembrace other cultures

Process of self-discoveryProcess of self-discovery Non-evaluative introspectionNon-evaluative introspection From the specific to the From the specific to the

universaluniversal Support staff’s attempts to Support staff’s attempts to

Find other cultures’ Find other cultures’ worldviews and translating worldviews and translating them into therapeutic values: them into therapeutic values: create bridges of meaningcreate bridges of meaning



Assess level of acculturation Assess level of acculturation and stress related to and stress related to acculturation pressuresacculturation pressures

Ecological context: poverty, Ecological context: poverty, race, class subordination, race, class subordination, class exploitation and social class exploitation and social injusticeinjustice

Distinguish between culture Distinguish between culture and effects of isolation and effects of isolation poverty and discrimination; poverty and discrimination;

Racism and discrimination Racism and discrimination within Mexican Americanswithin Mexican Americans

Undocumented or medically Undocumented or medically indigent immigrants do not indigent immigrants do not have access to MH services: have access to MH services: how do they cope with stress/ how do they cope with stress/ uprooting? uprooting?

No pensar, aguantar, No pensar, aguantar, sobreponerse, controlarsesobreponerse, controlarse


Serving Border CommunitiesServing Border Communities Parents are focused on the Parents are focused on the

futurefuture Become aware of the changes Become aware of the changes

in Traditional Family Values in Traditional Family Values and the Costs of “Getting and the Costs of “Getting Ahead” of Hispanic familiesAhead” of Hispanic families

Individual responsibility and Individual responsibility and the idea of the leveled playing the idea of the leveled playing fieldfield

Understand that families may Understand that families may be having problems be having problems maintaining family maintaining family connectionsconnections

Families may have increased Families may have increased job pressures with less job pressures with less external support and less external support and less time to devote to one anothertime to devote to one another

Conflict between their own Conflict between their own set of values and the set of values and the adjustments they need to adjustments they need to make.make.


Serving Border CommunitiesServing Border Communities Therapist’s personal values Therapist’s personal values

and level of acculturation and level of acculturation Staff become aware of their Staff become aware of their

stereotypes and cultural stereotypes and cultural biasesbiases

Staff receive ongoing Staff receive ongoing guidance and training on guidance and training on recognizing cultural values: recognizing cultural values: value multiculturalismvalue multiculturalism

Be aware of acculturation can Be aware of acculturation can impact family impact family communication: parents may communication: parents may be figuring out how to be figuring out how to function in a new culturefunction in a new culture

Consequences of not paying Consequences of not paying attention to cultural values: attention to cultural values: Personalismo Personalismo andand Fatalismo Fatalismo: : (Señora Maria).(Señora Maria).



Culture is DynamicCulture is Dynamic Great diversity among Hispanic Great diversity among Hispanic

Populations and among Populations and among Mexican American populations/ Mexican American populations/ Border CommunitiesBorder Communities

Mexican cultural values: are Mexican cultural values: are metaphors to guide you in your metaphors to guide you in your discovery of new cultures.discovery of new cultures.

Do not reduce cultural values Do not reduce cultural values to basic concepts: become to basic concepts: become more aware of the affective more aware of the affective componentscomponents

Make an effort to understand Make an effort to understand and discover these values in and discover these values in your interaction with your interaction with individualsindividuals


Serving Border Serving Border Communities Communities

Gather information Gather information about past and present about past and present separations from loved separations from loved ones and family: ones and family: Become aware that Become aware that separations as well as separations as well as reunions can be tense reunions can be tense and painfuland painful

Obtain information Obtain information about significant about significant others left in native others left in native country and assess for country and assess for guilt, shame or worryguilt, shame or worry



Loss of languageLoss of language Uprooting of meaning: Uprooting of meaning:

physical, social and physical, social and culturalcultural

MH gender differences MH gender differences in immigrantsin immigrants

History of possible History of possible traumatic experiences in traumatic experiences in journey to cross the U.S. journey to cross the U.S. (exploitation, extreme (exploitation, extreme physical hardships, physical hardships, abuse, violence, abuse, violence, witnessing violence or witnessing violence or accidents)accidents)

Buried Where?Buried Where?



Drug Trafficking and its impact on Border Drug Trafficking and its impact on Border Traumatic Stress: Dealing with Traumatic Stress: Dealing with kidnappings, violence and reaction to kidnappings, violence and reaction to perceived environmental dangerperceived environmental danger

Be aware of how to help families integrate Be aware of how to help families integrate cultural values, especially when affecting cultural values, especially when affecting family relationsfamily relations

Be aware of the impact of disadvantaged Be aware of the impact of disadvantaged neighborhoods on collective efficacy and neighborhoods on collective efficacy and emotional bonds with family members.emotional bonds with family members.


Serving Border Serving Border Communities Communities

Orientation to treatment: Accept that Orientation to treatment: Accept that low acculturated Hispanics/recent low acculturated Hispanics/recent immigrants may not understand immigrants may not understand “therapy” and may lack sophistication “therapy” and may lack sophistication interacting with U.S. services systemsinteracting with U.S. services systems

Understand that views towards Understand that views towards children is sometimes to placate them, children is sometimes to placate them, not push them towards developmental not push them towards developmental and achievement milestonesand achievement milestones



Decrease stigma about counseling Decrease stigma about counseling Assess (cultural) beliefs regarding Assess (cultural) beliefs regarding

mental health treatmentmental health treatment Assess client’s expectations of treatmentAssess client’s expectations of treatment Assess client’s expectations of the Assess client’s expectations of the

therapisttherapist Engage clients from the first contactEngage clients from the first contact Place close attention to engaging father Place close attention to engaging father

whenever possiblewhenever possible



Foster Biculturalism: retaining language, Foster Biculturalism: retaining language, cultural ties and rituals while learning the cultural ties and rituals while learning the new language and customsnew language and customs

Longer resident and acculturation, the Longer resident and acculturation, the greater risk for negative health outcomesgreater risk for negative health outcomes

Strengthen protective factorsStrengthen protective factors It is ok to have two perspectives, It is ok to have two perspectives,

languages and cultures languages and cultures Acculturation oriented therapists may Acculturation oriented therapists may

create more emotional distress by create more emotional distress by stripping the family too quickly of the stripping the family too quickly of the protection of the old cultureprotection of the old culture


Serving Border Serving Border CommunitiesCommunities Cultural Imperialism or Isolation: Focus on the Cultural Imperialism or Isolation: Focus on the

development of coping skills that can help families development of coping skills that can help families increase their proficiency regarding intercultural and increase their proficiency regarding intercultural and intracultural issues: Build their abilities to achieve intracultural issues: Build their abilities to achieve bifocality.bifocality.

Examining how Hispanics use cultural adaptation skillsExamining how Hispanics use cultural adaptation skills Facilitate basic and practical information about developing Facilitate basic and practical information about developing

and achieving goals for adaptationand achieving goals for adaptation



FATALISMO: FATALISMO: Accepting: Taking what life gives youAccepting: Taking what life gives you

PERSONALISMO:PERSONALISMO:Importance and significance on personal interactions: Importance and significance on personal interactions:

warmth and importance of connections. The need to warmth and importance of connections. The need to develop trust. Interpersonal conflict is discouraged. develop trust. Interpersonal conflict is discouraged.

Personal relationships must be based on simpatía and Personal relationships must be based on simpatía and respeto.respeto.

FAMILISMO:FAMILISMO:Family is more important than the Individual: It is the Family is more important than the Individual: It is the

center for social support: harmony, solidarity, center for social support: harmony, solidarity, cooperation, strong emotional ties and reciprocal cooperation, strong emotional ties and reciprocal

kinship obligationskinship obligations


PersonalismoPersonalismo The glue that maintains The glue that maintains

relationships: striving for relationships: striving for meaning and connection in meaning and connection in relationshipsrelationships

““The degree of reality The degree of reality an in interpersonal relationship an in interpersonal relationship is dependent on the frequency, is dependent on the frequency, quality and warmth of the quality and warmth of the interpersonal relationship that interpersonal relationship that can be lived in a determined can be lived in a determined period of time” (Diaz-Guerrero)period of time” (Diaz-Guerrero)

Interpersonal conflict is Interpersonal conflict is discouraged: Disagreement is discouraged: Disagreement is not expectednot expected

Pleasantry in interactions “para Pleasantry in interactions “para servirle,” “ a sus ordenes,” “en servirle,” “ a sus ordenes,” “en su casa,” Sin agraviar a los su casa,” Sin agraviar a los presentes,” mande?presentes,” mande?

No expressions of anger or No expressions of anger or irritationirritation


Serving Border Serving Border CommunitiesCommunities Assess readiness for cultural informationAssess readiness for cultural information

Make it a point to immerse your staff in the Make it a point to immerse your staff in the cultureculture

Assessment, Clinical Supervision and training Assessment, Clinical Supervision and training includes issues related to culture, acculturation, includes issues related to culture, acculturation, environment and immigration experiencesenvironment and immigration experiences

Being aware of cultural borderlandsBeing aware of cultural borderlands Recognizing how cultural values guide/influence Recognizing how cultural values guide/influence

interventionsinterventions Building bridges between cultural meaningsBuilding bridges between cultural meanings Immersed in the culture: process of Immersed in the culture: process of

introspectionintrospection Staff at different levels of acculturationStaff at different levels of acculturation


Familismo: The healing and Familismo: The healing and protection provided by family networksprotection provided by family networks

Valuing families Valuing families over individualityover individuality

Supremacy of the Supremacy of the father and father and abnegation of the abnegation of the mothermother

Complete Complete responsibility of responsibility of raising children goes raising children goes to the mother: she to the mother: she transmits the valuestransmits the values

Loyalty to the familyLoyalty to the family


Building Bridges of Building Bridges of Cultural MeaningCultural Meaning

Respeto Respeto (obeyed or (obeyed or loved?)loved?)

Simpatía Simpatía MachismoMachismo MarianismoMarianismo


Acculturation and the Acculturation and the breakdown of valuesbreakdown of values

A comment on A comment on familismo familismo andand personalismo personalismo Poverty and Acculturation have an Poverty and Acculturation have an

impact on traditional family valuesimpact on traditional family values Family Conflict is often a result of Family Conflict is often a result of

uprooting and disconnectednessuprooting and disconnectedness Area may reflect who you are but the Area may reflect who you are but the

institutions and the values are institutions and the values are mainstreammainstream

What are the consequences of having What are the consequences of having values that you cannot honor anymore? values that you cannot honor anymore?


Building Bridges of Building Bridges of Cultural MeaningCultural Meaning

Pay Attention to DifferencesPay Attention to Differences Contextualize DifferencesContextualize Differences Reframe the Problems/needs as Reframe the Problems/needs as

a dilemma of co-existing valuesa dilemma of co-existing values Preview future family patterns Preview future family patterns

and cultural blendsand cultural blends


The Case of MarioThe Case of Mario 10 years of age10 years of age Second generationSecond generation Family Spanish-Family Spanish-

speakingspeaking Father was from Father was from

Mexico, died in car Mexico, died in car accidentaccident

Sister was sexually Sister was sexually abusedabused

Cousin Disappeared in Cousin Disappeared in Nuevo LaredoNuevo Laredo

Symptoms of PTSDSymptoms of PTSD CM-TFTCM-TFT


Meeting the Needs of Meeting the Needs of Communities along the U.S.-Communities along the U.S.-

Mexico BorderMexico Border

Documents

1 “The Traumatic Experiences of Children and Families Living on the U.S.-Mexico Border Luis E. Flores, M.A., LPC, LCDC, RPT-S Executive Vice President