FEATURED PROGRAM FOR
JULY 2003

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The Home Program

Program Objectives and Unique Needs Addressed
This community-based action program seeks to alleviate the negative psychosocial effects of war trauma in adolescents resettled with their families to St. Louis, and supports their adjustment to U.S. culture. The program includes counseling with individuals and groups,
case management with youths and parents, psychosocial support in adjustment to U.S. culture, connection with legal and other services, psychotherapy, and psychological assessment of trauma training for other professionals.

American/Western and non-American, non-Western models of approach and intervention often represent different, competing worldviews. Many refugee and new immigrant families in the United States come from countries with a collectivistic life style, different from the typically individualistic and competitive American style. They bring diverse needs, interests, and customs, and they are developing new linguistic, cultural, political, economic, and social patterns, and new modes of intergroup interaction.

In the Home Program’s view, service providers can best address youths’ and children’s needs by considering this multicultural context, and directing the refugee children they serve toward an understanding of self and identity, of families, social groups, health practices, and rituals—in other words, all elements of their specific cultures.

In the program staff’s experience, many service providers would benefit greatly by improving their own knowledge of cultural competence and perceptions of cross-cultural issues, as well as developing a greater sense of cultural sensitivity and responsiveness.

The Home Program seeks to take culturally specific and ethnically sensitive approaches in their intervention, based on specific beliefs, customs, and practices typical for refugee and new immigrants’ cultures and ethnicities. Rather than focusing primarily on a conversational, intellectual, individualistic approach, the program uses mostly community-oriented practices. Refugees become their own resource, stimulating empowerment and self-reliance. The Home Program works on refugees’ capacity to re-establish sociocultural networks and a sense of community, and to enhance their capacity to be in charge of their own lives.

Program Description
The Home Program reaches all area refugee youth, their parents and teachers, organizations for youth educational needs and employment, and other organizations working with children and youth generally.

The program includes
• counseling with individuals and groups
• case management with youths and parents
• psychosocial support in adjustment to U.S. culture
• connection with legal and other services
• psychotherapy and psychological assessment of trauma
• training for other professionals

Refugees involved in the Home Program receive
• psychological support with trauma, anger management, conflict resolution
• workshops for strengthening self-esteem, self-confidence and communication skills
• connections and support with GED and job skills programs
• excursions, discussions, group visits, artistic activities
• gift certificates and other rewards

Refugees in this program have multiple issues: war trauma, educational neglect during the war, consequences of bad nutrition or health neglect during the war, and lack of English proficiency, among others. Some of them are not able to meet the requirements of the regular school system. After assessing their skills by psycho-social assessment, the Home Program helps them connect with appropriate alternative schools or training programs available in the area to gain job skills.

The family and household situation is usually considered a significant element of intervention screening, so for individual counseling, the program provides home visits. For example, if the program assesses a mother as highly dysfunctional, in addition to providing counseling to her, the program conducts a psychological evaluation and submits a request for disability pension.
In addition to individual and family counseling, the program has regular workshops and activities on topics such as strengthening communicational skills (with use of videos); Emotional Bingo; TEMAS (Tell Me A Story), anger management (with video). The staff use psychological creative games as instruments.

Groups of youth meet monthly to discuss questions and problems. The groups also address strengthening personality characteristics and developing life and job skills. Non-refugee youth join activities such as visits to the Science Center, the Botanical Garden, the zoo, or museums. Frequently non-refugee youth are from another ethnic group with whom there is expressed conflict at school. Other youth are invited to make contacts with youth in the Home Program, which can result in concrete positive action.

Often, program staff transport the children. For workshops and activities, youths with driver’s licenses may pick up younger children.

All activities and transportation are free of charge.

To the Home Program’s knowledge there is no other program of this type in the area.

Resource Materials Used in Program
The program offices are located in the area where these refugees reside. For some of them the office is within walking distance.

Program staff use psychological instruments for youth available to licensed psychologists. All workshop materials and some psychological instruments (BASC, TSI, TCCC) have been translated into Serbo-Croatian for the program. The Home Program staff attends a 15-hour Multicultural Training program, which uses a training manual developed specifically for it.

Groups Served by Program
This community intervention program originally served Bosnian/former-Yugoslavian refugee youth resettled in the St. Louis area, including secondary migrants who moved to the area after being initially resettled elsewhere. They now accept clients from all refugee groups.
Initial referral age for clients is between 12 and 17, but any family member with needs is served. The problem/issue with the child is considered a reflection of whatever is happening within the family.

Most of the cases are referred to the Home Program by family courts. Others come to the program referred by word-of-mouth.

Program Funding
The Home Program is funded through September 2003 by the Missouri Department of Public Safety, through the helpful efforts of the St. Louis Mental Health Board. The MDPS does not offer continuation funding; other funds are being sought to continue the program.

Program Staffing and Required Staff Training
The Program Director is a licensed psychologist. From five to seven Community Support Workers act as cultural brokers, mediating for client families as they adjust to the administrative and social requirements of living in the United States. Volunteer mentors work with no more than five children each. Meeting the children twice a week, they seek to help them adjust to school and social life, and address the many other transitions the children face.

Staff are trained by the licensed psychologist in multicultural issues, cross-cultural sensitivity, culturally responsive mental health services, war trauma and post-traumatic stress disorder (PTSD), acculturation, and cultural adjustment. Community Support Workers have some academic or professional background in social work, as well as detailed if not native familiarity with the refugees’ culture. Volunteers are typically students in social work programs.

A new immigrant and victim of war herself, Dr. Todorova Moreno is a licensed psychologist, therapist, and university professor trained both in the United States and in Europe. She teaches cross-cultural psychology at St. Louis University, and directs a multicultural training program funded by the Missouri Department of Public Safety.

Defining Program Success
Success is defined using process and outcome measurements. Process measurements used include the number of students who participate in the program or attend workshops, the number of parents involved in the program or attending workshops, and the number of referrals by family courts. Outcome measurements used include a reduction in youth crime and violence (long-term), the number of conflicts and fights at school, truancy records, academic success, problems at home, family dynamics, and significant differences between test-retest application of the same psychological instruments.

Program Outcomes
During its first two years the program served about fifty families. Twelve families are in the program as of 2003; this is the program’s full capacity.

About half or more of the students enrolled have shown improved behavior and academic success. Most of the others continue to struggle in high-risk situations, apparently enmeshed in dysfunctional family situations, but do still participate in the program. The program has helped refugee mothers qualify for Supplemental Security Income benefits.

Program Contact
Program Director Ilina Todorova Moreno, Ph.D.
5629 Gravois Avenue
St. Louis, MO 63116
Phone 314-351-0835

Program Dates
The program began in October 2001; it is currently operating.

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