Creating through covid: Virtual art therapy for youth resettled as refugees

Art therapy reduces trauma-related psychopathology in refugee youth. Given the added stress of COVID-19 on traumatized refugee populations, we adapted art therapy for refugee youth and their families in the virtual space. We describe program development, implementation and experientials, and clinical recommendations illustrated through two cases. Observations and feedback support art therapy as a tool to address socioemotional functioning in families who resettle as refugees and foster positive emotions, sense of self and community, confer stress coping skills, and enhance resilience. In light of the persistence of the pandemic, the unprecedented number of global refugees, and their unique needs for mental health services, virtual art therapy can expand accessibility and reach of beneficial methods to address trauma in refugee groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Photovoice techniques and art therapy approaches with refugee and immigrant adolescents.

This paper describes a program informed by art therapy and Photovoice approaches and techniques aimed at helping new immigrant and refugee teens to navigate personal and cultural identities by reflecting on their experiences as new residents in the US. Photovoice is a photography and social action method that encourages participants to photograph aspects of their daily lives, reflect on their meaning and significance and galvanize necessary changes. The program began in February 2020 at the Arab-American National Museum (AANM), but was adapted for an online format and re-framed towards a reflection on the COVID-19 pandemic. Broad questions teens explored included: What is good? What is challenging? What is sustaining during challenging times? What needs to change? and What about your culture and background are you proud of and wish to share with other US residents? Highlights of the sessions demonstrate how art therapy interventions paralleled photography-assigned themes of self, home, and community and encouraged group interaction and mutual support. A virtual museum exhibition culminated the program and reached community leaders. Self-reports from select participants highlight changes in posttraumatic stress, anxiety, and somatic symptoms over the course of programming.

Perceived Stress among Iranians during COVID-19 Pandemic; Stressors and Coping Mechanisms: A Mixed-methods Approach.

OBJECTIVE: New coronavirus (COVID-19) pandemic socioeconomically affected the world. In this study, we measured the perceived stress in response to the COVID-19 pandemic among Iranians to determine the groups at both extremes of the spectrum followed by identifying the stressors and coping mechanisms. METHODS: This study was a mixed-methods study. We distributed a web-based 10-item perceived stress scale (PSS-10), to measure perceived stress score (PSS), through social networks from March 12 to 23, 2020. Then, we interviewed 42 students, 31 homemakers, 27 healthcare providers, and 21 male participants to identify the sources of stress and coping mechanisms. RESULTS: Finally, 13,454 participants completed the questionnaires. The median and interquartile range (IQR) of the participants' PSS was 21 (15-25). Students, homemakers, and healthcare workers (HCWs) showed a higher median (IQR) of PSS compared to other groups (23 [18 to 27], 22 [16 to 26], and 19 [14 to 24], respectively). Male participants showed a lower median (IQR) PSS (17 [12 to 23]). Content analysis of 121 participants' answers showed that the most common stressors were school-related issues mentioned by students, family-related issues mentioned by homemakers, and COVID-19-related issues mentioned by healthcare providers. Male participants' coping mechanisms were mostly related to the perception of their abilities to cope with the current crisis. CONCLUSION: Our participants clinically showed a moderate level of PSS. The main stressors among students, homemakers, and HCWs were related to their principal role in this period, and male participants' coping mechanisms were inspired by the self-image retrieved from the social perspectives.

Rapid assessment of mental health of Detroit-area health care workers during the COVID-19 pandemic

Background: The COVID-19 pandemic may adversely impact the mental health of health care workers (HCWs). To address this issue, it is essential to determine levels of anxiety, depression, and traumatic stress, and sources of stress, and to identify subgroups of HCWs at a higher risk of adverse mental health outcomes during the COVID-19 pandemic. Methods: We conducted a cross-sectional study of symptoms of mental illness in HCWs in the area surrounding Detroit, Michigan. The online survey included questions about demographics, health and clinical factors, and sources of stress. Several tools were used to assess psychiatric symptoms among HCWs, including the Perceived Stress Scale, the Patient Health Questionnaire depression scale, the Generalized Anxiety Disorder 7-item assessment, and the Posttraumatic Stress Disorder Checklist for DSM-5. The adequacy of personal protective equipment, patient resources, and training for highly contagious diseases were rated. Results: The sample (N = 129) was predominantly female (51.2%) and White (65.9%), with 30.2% screening positive for clinical follow-up to assess anxiety, 20.9% for moderate to severe depression, and 16.3% for elevated traumatic stress. Differences were found by self-reported psychiatric diagnosis and chronic conditions, and role on treatment teams. Conclusions: Frontline HCWs demonstrate high levels of stress and trauma symptoms. Timely screening and accommodations may be needed during health care crises, such as the COVID-19 pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Research With Refugees and Vulnerable Populations in a Post-COVID World: Challenges and Opportunities.

At the Stress, Trauma and Anxiety Research Clinic (STARC) at Wayne State University in Detroit, we are currently amid data collection for a longitudinal prospective study of Syrian refugee children and their parents. Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, our goal is to understand the impact of exposure to war trauma and the stress of migration on symptoms of posttraumatic stress disorder, anxiety, and depression, as well as the neurobiological, epigenetic, and environmental correlates of risk and resilience. Like many research groups around the world, the COVID-19 pandemic brought our work to a screeching halt. Researchers who, like us, were engaged in human subjects research were left grappling with the question of how to continue their work while ensuring the safety of both research staff and participants, and while maintaining scientific integrity. In March 2020, our institution halted all in-person human subjects research that did not have direct benefits to participants, which continued until October, when research activity was resumed subject to implementation of modified procedures. Over the past 2 years, we have pivoted, adapted, and flexed, ultimately making changes that have allowed us to continue successful data collection throughout the pandemic. This article will discuss the specific challenges of working with ethnically minoritized and immigrant populations during the pandemic, the adaptations that we implemented to enable safe and effective data collection, as well as the new knowledge that we can apply to future research protocols.

Virtual Arts and Movement Therapies for Youth in the Era of COVID-19.

The COVID-19 pandemic has had a significant impact on youth, including through increased isolation, the transition to online schooling, decreased access to arts and sports programming, exposure to illness, and anxiety. The pandemic has also affected the delivery of therapeutic services at a time when youth have needed more help building coping skills and reducing stress. Creative arts and movement therapies promote creativity and adaptability to better develop cognitive flexibility1 while enhancing self-regulation and self-direction, adaptive skills that are protective in the face of stress.2 Creative arts and movement-based group therapies delivered through community settings-such as resettlement agencies, schools, and community recreation centers-are feasible, cost-effective, and increase accessibility, especially for populations often underrepresented in the therapeutic space.3 Offering such interventions at the group level benefits both those who are experiencing significant stress and anxiety4,5 and those who are not experiencing such symptoms, as they still reap the long-term benefits of building stress-relaxation and emotion regulation skills. Having previously demonstrated the efficacy of art therapy (AT) and dance/movement therapy (DMT) in improving posttraumatic stress and anxiety symptoms for youth,4,5 our laboratory-the Stress, Trauma, and Anxiety Research Clinic-shifted programming to virtual formats, in partnerships with local resettlement agencies and schools.

The Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare Workers with Pre-Existing Psychiatric Conditions.

Both healthcare workers (HCWs) and psychiatric patients during the COVID-19 pandemic appear to have elevated prevalence of psychiatric symptoms, but little is known about HCWs with psychiatric diagnoses. To examine their response to the pandemic, we analyzed their perspective, and association with psychiatric symptoms and stress among HCW with psychiatric diagnosis. Using an online survey of HCW, we analyzed demographics, work information, health factors, open-ended question, sources of stress and standardized mental health scales (Perceived Stress Scale (PSS), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), and Posttraumatic Stress Disorder Checklist (PCL)). Sixteen out of 129 HCWs reported a pre-existing psychiatric diagnosis (median age 32 years, 8 were females, 8 work in the emergency department). Their perception of the impact severity on symptoms was significantly correlated with all the mental health scales and with stress from avoiding physical contact. In multivariate analysis, PSS score and PCL score were associated with self-rated impact of the COVID-19 pandemic on symptoms (standardized beta = .51 for PCL and standardized beta = .55 for PSS). GAD-7 score was significantly related to both impact (standardized beta = .44) and stress from avoiding physical contact (standardized beta = .53). HCWs with psychiatric diagnoses reported a range of perception of the impact of the pandemic on their symptoms with increased severity associated with worse psychiatric outcomes and more stress from avoiding physical contact with others. There is a growing importance to protect HCWs mental health, including those with pre-existing psychiatric diagnosis, and proactively counter psychosocial consequences of healthcare crises.