THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER:
SOWO 709-001W
COURSE TITLE:
Working with Refugee and Immigrant Survivors of Torture and
Trauma
SEMESTER & YEAR:
Spring 2016
INSTRUCTOR:
Josh Hinson, MSW, LCSW
School of Social Work
Tate-Turner-Kuralt Building, Campus Box 3550
Phone: (919) 962-6434
E-mail: QHinson@email.unc.edu
OFFICE HOURS:
TBD
COURSE DESCRIPTION: A combination of webinars, on-line instruction, teleconference
consultations and required reading assignments focused on individual, family, and group skills
for working with refugee and immigrant survivors of torture and trauma.
COURSE OBJECTIVES: The student who successfully completes this course will be able to:
1. Understand the impact of war, violence, and immigration trauma on the physical, social,
and emotional development of children, adolescents, adults, and families using the
“Triple Trauma Paradigm.”
2. Select and administer appropriate evidence-based instruments for assessing the impact of
torture and trauma on individuals.
3. Identify and strengthen sources of multi-layered social resilience among survivors of
torture and trauma.
4. Evidence awareness of the need for social support among survivors of torture and trauma
by articulating plans for and advocating for implementation of supportive treatment
groups.
5. Integrate evidence-based treatment of mental health disorders into a holistic program for
refugee and immigrant health promotion and wellness.
6. Develop plans for evaluating effectiveness of refugee and immigrant trauma treatment at
the individual, family, and community levels.
EXPANDED COURSE DESCRIPTION: Refugees and immigrants suffer from chronic physical
illnesses, mental illnesses, and substance abuse at rates much higher than the general population.
Research indicates a correlation between torture/trauma and negative health outcomes, yet
routine mental health screening and assessment does not occur in the refugee reception and
placement (R&P) process, and culturally appropriate mental health and behavioral treatment
services are not readily available to refugees and immigrants in many communities. Stigma
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surrounding mental health prevents many refugees and immigrants from actively seeking mental
health care, and lack of screening by service providers limits opportunities to identify distress in
refugees and immigrants who do not come forward.
Given the impact that torture, trauma, and immigration/acculturation stress have on refugees’ and
immigrants’ health, the first part of this course will focus on research that supports these
findings. Next, students will explore screening and assessment instruments that have been (or are
being) studied for reliability and validity in measuring the effects of torture and trauma on the
health and mental health of these populations. Students will then review literature that outlines
supportive group treatment as a culturally appropriate and effective intervention for enhancing
refugees’ and immigrants’ social support networks and multi-layered social resilience. Finally,
students will adapt current models for refugee and immigrant health promotion to fit the needs of
specific populations, and will explore plans for evaluating their effectiveness.
This course is offered in partnership with Gulf Coast Jewish Family & Community
Services. The e-curriculum was developed through funding from the Department of Health
and Human Services, Office of Refugee Resettlement.
CERTIFICATE IN GLOBAL TRANSMIGRATION: This course will count towards the Graduate
Certificate in Global Transmigration. Students pursuing the certificate will be required to:
1) Earn a passing grade in 9 credit hours listed as meeting the requirements of the certificate
(only 3 credit hours can count towards the degree).
2) Participate in a year-long seminar series, culminating in presentation of new research on a
specific population or area of study in a conference-like setting.
3) Complete an approved field practicum or volunteer experience with an
immigrant/transmigrant population, or in an area of practice specific to transmigrants.
CLASS ASSIGNMENTS:
Case Summary: Being careful to maintain clients’ confidentiality, students will post on the
discussion forum a case summary for a client with whom they are currently working (or a
population with whom they plan to work) using the social ecological framework to describe
variables, risk and protective factors. Students will read all posts and choose one to respond to.
Group Social Resilience Presentations: Students will work in small groups to identify the
sources of social resilience that are common among the populations/individuals with whom they
work. Groups will then present a summary of their findings and recommendations for enhancing
protective-enabling factors in a live web session.
Health and Mental Health Needs Assessment: Students will post on the discussion forum a brief
description of the most common health and mental health needs identified in their population,
citing at least two scholarly sources and their own practice experience when applicable. Students
will discuss current barriers to mental health services and possible strategies to overcome them.
Students will view all posts and select one to comment on.
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Program Proposal: Students will write a brief proposal for establishing a program to assess
mental health needs of individuals in the practice setting or population they are working with.
Students will compare and contrast the assessment tools discussed in this module, providing
rationale for their decision to use a particular instrument. Students will post their proposals on
the discussion forum, allowing all students to see which instruments are being used by whom.
Students will view all posts and select one to comment on.
Support Group Concept Paper: Students will identify an organization that currently serves (or
has the capacity to serve) immigrant or refugee survivors of torture and trauma. Students will
write a 1-page concept paper that 1) identifies their target population; 2) explains and documents
the need for support groups; 3) describes how groups could be implemented in a specific agency
(where, when, and by whom); and 4) proposes next steps for the organization to consider in
developing support groups for it clients.
Final Presentations: In small groups, students will develop a final program proposal that
includes plans for assessment, strategies for enhancing resiliency, supportive groups and/or other
EBT, and evaluation. Program proposals will be submitted using a narrated PowerPoint
presentation. Students will view all proposals and will select one to respond to. In this final
response, students will summarize the learning from this course by discussing steps necessary to
adapt and implement treatment models covered in the course.
GRADING:
1. Case summary (Module 1)
2. Group social resilience presentations (Module 2)
3. Health and mental health needs assessment (Module 3)
4. Program proposal (Module 4)
5. Support group concept paper (Module 5)
6. Final presentations (Module 7)
7. Responses to other students’ posts (Modules 1, 3, 4, 6, 7)
15%
10%
15%
10%
15%
15%
20%
GRADING SYSTEM:
The School of Social Work operates on an evaluation system of Honors (H), Pass (P), Low Pass
(L), and Fail (F). The numerical values of these grades are:
H: 94-100
P: 80-93
L: 70-79
F: 69 and lower
A grade of P is considered entirely satisfactory. The grade of Honors (“H”) — which only a
limited number of students attain – signifies that the work is clearly excellent in all respects.
POLICY ON INCOMPLETES AND LATE ASSIGNMENTS
An assignments is considered late if it is uploaded any later than the time it is due. The
grade for late assignments will be reduced 10% per day, including weekends. Therefore, an
assignment that would merit a grade of 100 on Friday will receive a grade of 70 if submitted on
Monday. Similarly, an assignment due at midnight on Thursday uploaded at 1am will be
considered one day late.
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A grade of “Incomplete” is given only in exceptional and rare circumstances, such as family
crisis or serious illness. It is the student’s responsibility to request and explain the reasons for an
incomplete. The instructor has no responsibility to give an incomplete without such a request.
POLICY ON ACADEMIC DISHONESTY
It is the responsibility of every student to obey and to support the enforcement of the Honor
Code, which prohibits lying, cheating, or stealing in actions involving the academic processes of
this class. Students will properly attribute sources used in preparing written work and will sign a
pledge on all graded coursework certifying that no unauthorized assistance has been received or
given in the completion of the work. All written assignments should contain a signed pledge
stating: “I have not given or received unauthorized aid in preparing this written work.”
Credit will not be awarded for unpledged work. Please refer to the APA Style Guide, The SSW
Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism
(including self-plagiarism, or submitting work that has been previously submitted in another
course) and appropriate use of assistance in preparing assignments. In keeping with the UNC
Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be
made to the Office of the Student Attorney General for investigation and further action as
required.
POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES
Students with disabilities that affect their participation in the course and who wish to have
special accommodations should contact the University’s Disabilities Services
(http://disabilityservices.unc.edu) and provide documentation of their disability. Disabilities
Services will notify the instructor that the student has a documented disability and may require
accommodations. Students should discuss the specific accommodations they require (e.g.
changes in instructional format, examination format) directly with the instructor.
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Class 1: Torture, Trauma and the Experiences of Refugees and Immigrants
TOPICS TO BE ADDRESSED:
 Impacts of war, violence, torture and other trauma
 A social ecological model for immigrants and refugees
READINGS:
American Psychological Association. (2010). Resilience and recovery after war: Refugee
children and families in the United States. Washington, DC: Author.
Ehntholt, K. A., & Yule, W. (2006). Practitioner review: Assessment and treatment of refugee
children and adolescents who have experienced war‐related trauma. Journal of Child
Psychology and Psychiatry, 47(12), 1197-1210. doi: 10.1111/j.1469-7610.2006.01638.x
WEBINAR:
Working Clinically with Traumatized Refugee Children and Families
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2013/04/15/kateporterfields-webinar-working-clinically-with-traumatized-refugee-children-and-families/
Class 2: Resilience & Recovery
TOPICS TO BE ADDRESSED:
 Protective-enabling factors and multi-layered social resilience
 Resiliency in children, families, communities, and case management
READINGS:
Doron, E. (2005). Working with Lebanese refugees in a community resilience model.
Community Development Journal, 40(2), 182-191. doi: 10.1093/cdj/bsi026
Montgomery, E. (2010). Trauma and resilience in young refugees: A 9-year follow-up study.
Development and Psychopathology, 22(2), 477-489. doi: 10.1017/S0954579410000180
Henley, R. (2010). Resilience enhancing psychosocial programmes for youth in different cultural
contexts: Evaluation and research. Progress in Development Studies, 10(4), 295-307. doi:
10.1177/146499340901000403
WEBINAR:
Identifying and Reinforcing Resiliency in Torture Survivors
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2010/07/12/webinar-onidentifying-and-reinforcing-resiliency-in-torture-survivors/
Live class session on BlueJeans: Date and time TBD
Class 3: Health Promotion and Wellness
TOPICS TO BE ADDRESSED:
 Conceptual model: trauma, PTSD, depression and physical health
 The importance of a holistic approach
 The importance of a primary care physician to the resettlement plan
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READINGS:
Mollica, R.F. (2011). Introduction and Global Mental Health Action Plan. In Mollica, R. (Ed.),
Textbook of global mental health: Trauma and recovery (pp. 13-59). Harvard Program in
Refugee Trauma.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . .
Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many
of the leading causes of death in adults. The Adverse Childhood Experiences (ACE)
study. American Journal of Preventive Medicine, 14(4), 245-258.
WEBINARS (view at least one):
Integrated Health and Mental Health Approach to the Care of Torture Survivors
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2012/02/29/dr-richardmollicas-webinar-on-the-integrated-health-and-mental-approach-to-the-care-of-torturesurvivors/
Health Promotion for Torture and Trauma Survivors
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2012/05/16/register-forthe-npct-webinar-on-health-promotion-on-92811/
The Trauma Story: An Empathic and Therapeutic Conversation with the Survivor
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2013/06/01/dr-richardmollica%e2%80%99s-webinar/
Class 4: Measuring Trauma and Mental Health
TOPICS TO BE ADDRESSED:
 Existing instruments for screening
 Measuring trauma in a primary care setting
 Development and use of the Refugee Health Screener – 15 (RHS-15)
READINGS:
Lavelle, J. (2011). Measuring trauma, measuring torture. In Mollica, R. (Ed.), Textbook of global
mental health: Trauma and recovery (pp. 506-537). Harvard Program in Refugee
Trauma.
Pathways to Wellness. (2011). Integrating refugee health and well-being: Creating pathways for
refugee survivors to heal. Retrieved from
http://www.lcsnw.org/pathways/pdf/RefugeeHealthScreener.pdf
WEBINARS:
Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15
http://refugeehealthta.org/webinars/mental-health-screening-and-care/tools-andstrategies-for-refugee-mental-health-screening-introducing-the-rhs-15-2/
Operationalizing the RHS-15
http://refugeehealthta.org/webinars/mental-health-screening-and-care/refugee-mentalhealth-screening-operationalizing-the-rhs-15/
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Class 5: Supportive Group Treatment
TOPICS TO BE ADDRESSED:
 Social isolation and social support networks
 Resiliency in group treatment
READINGS:
Akinsulure-Smith, A. M. (2012). Using group work to rebuild family and community ties among
displaced African men. Journal for Specialists in Group Work, 37(2), 95-112.
Akinsulure-Smith, A., Ghiglione, J., & Wollmershauser, C. (2009). Healing in the midst of
chaos: Nah We Yone's African women's wellness group. Women & Therapy, 32(1), 105120. doi: 10.1080/02703140802384602
Smith, H., & Impalli, E. (2007). Supportive treatment with survivors of torture and refugee
trauma. In Smith, H., Keller, A., & Lhewa, D. (Eds.), “Like a refugee camp on First
Avenue” Insights and experiences from the Bellevue/NYU program for survivors of
torture: Program manual (pp 336-374). Retrieved from
http://refugeehealthta.jsi.com/files/2011/07/intro_like_a_refugee_camp_on_first_avenue.
pdf
Live class session guest Dr. Hawthorne Smith on BlueJeans: Date and time TBD
WEBINARS (optional):
Group Treatment at the Bellevue/NYU Program for Survivors of Torture: Rationale, Processes
and Development
http://gulfcoastjewishfamilyandcommunityservices.org/refugee/2013/06/18/drhawthorne-smiths-webinar-on-group-treatment-at-the-bellevuenyu-program-forsurvivors-of-torture-rationale-processes-and-development/
Promoting Wellness Through Refugee Adjustment Support Groups
https://hhs.adobeconnect.com/_a1020204752/p1ft0wf8wgx/?launcher=false&fcsContent
=true&pbMode=normal
Class 6: Evaluation
TOPICS TO BE ADDRESSED:
 Ethical obligations to evaluate outcomes in conflict and post-conflict situations, and
ethical differences between clinical care and clinical research
 Developing research questions with the community or its diaspora
READINGS:
Grodin, M., & Piwowarczyk, L. (2011). Research ethics. In Mollica, R. (Ed.), Textbook of global
mental health: Trauma and recovery (pp. 538-558). Harvard Program in Refugee
Trauma.
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Class 7: Adaptation of Models to Specific Populations, Communities and
Cases
TOPICS TO BE ADDRESSED:
 Students present individual, community or organizational case studies and discuss steps
necessary to adapt and implement treatment models covered in the course
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