Transcription of the episode “Stephanie Carnes on post-traumatic growth and resilience: Cultural competence and creating safe environments for Central American immigrant children in today’s U.S.”

Amy H-L: 00:15 I’m Amy Halpern-Laff.

Jon M: 00:17 And I’m Jon Moscow. This is Ethical Schools podcast, where we talk about how to create equitable and inclusive learning environments that support students becoming capable of and committed to creating a more ethical world.

Amy H-L: 00:29 Our guest today is Stephanie Carnes. Stephanie is a bilingual clinical social worker in a large public school in New York’s Hudson Valley. A trauma-focused clinician, she has spent the majority of her career working with Central American immigrant children and is currently developing a short term model of trauma treatment for specific use with this population. She’s also the founder of Create Cultural Competence, a New York based consultancy. As a consultant. Stephanie helps school districts and community agencies to develop a more nuanced understanding of the populations they serve and to create culturally responsive micro communities. Stephanie regularly presents on topics related to trauma treatment and culturally competent practice at national and international conferences. She holds master’s degrees in both international human rights law and clinical social work and is fluent in Spanish. To learn more about her work, please visit createculturalcompetence.com. Welcome, Stephanie Carnes.

Stephanie C: 01:45 Thanks so much. Amy.

Amy H-L: 01:46 How did you get into working with the immigrant population?

Stephanie C: 01:51 So as true for so many of us in education, we don’t really purposely walk into our life’s work. It just sort of happens to us and that’s certainly what happened to me. I was working in a clinical mental health in residential foster care and I was working with pregnant and parenting teenagers in Poughkeepsie, New York. And my director approached me sort of out of the blue in 2014 and this was about the same time that the surge of children were arriving at our borders from Central America. And he said, you know, I recall on your resume that you speak Spanish and we’ve decided to open up a federally funded shelter program to temporarily care for these children who are crossing the border unaccompanied. And you know, we all sort of exaggerate on our resumes and I wasn’t particularly fluent in Spanish. I had taken the odd class in high school, but somehow I found myself the clinical director of this unaccompanied minors program. And it really sort of shifted my focus as a clinician, you know. In residential mental health care, you see trauma and you see trauma saturation. But what I saw in the population of unaccompanied minors in terms of trauma exposure was something I almost couldn’t comprehend in that they had been exposed to layer upon layer upon layer of trauma. But there was also a really unique and powerful resilience that I saw pretty much globally in this population, and that sort of shifted the way I view trauma treatment. And then the federal government ceased funding those programs, sort of unceremoniously, as the federal government is wont to do, and I found myself working with the same population but in a different setting, in a large public school.

Jon M: 03:36 So you talk about layers of trauma experienced by Central American immigrant children. Can you tell us more about that?

Stephanie C: 03:43 Absolutely. So the situation in Central America is so dire at present, you know, exacerbated by U S policies towards Central America over the past 50 plus years, that exposure to violence, and I mean really sort of grim graphic in your face community violence, has become a normalized sort of rite of passage for Central American children. It’s part of life to see bodies chopped up in the street. It’s part of life to be unable to go to school because of the fear of shootings en route to school. I also see profound effects related to the trauma of poverty. You know, we’re starting to learn that to a great extent migration from Guatemala doesn’t have as much to do with violence as it does from poverty caused by the effects of climate change. And when children are forced to subsist on grass soup and that’s real, that’s profoundly traumatizing in and of itself in that it denies children the typical experiences that we think of as characterizing childhood. We also want to think about the layer of trauma related to you know, everyone in Central America knows the risks of the journey northward. They know the risks of what happens in Mexico, the incredible vulnerability that children face, kidnappings, hunger, drownings. One in three females during the journey through Mexico is sexually assaulted. Everyone knows of those risks, but still they undertake the journey, which really has to be a tip off to us as to how bad everyday conditions are in Central America. For my students, you know, in the past, when they crossed the U S border, they were home free in terms of the level of vulnerability and sort of threat that they faced. That’s no longer the case. You know, we hear now on an almost weekly basis about children drowning in the Rio Grande. We hear about children dying in the custody of Border Patrol. Just last week, a 16-year-old boy died in Border Patrol custody of the flu. So whereas in the past when children would cross the border, they knew that they were pretty close to reaching their destination, that’s no longer the case.

Jon M: 06:05 Now, you talked about the continued trauma when they’re sort of in the hands of the Border Patrol, but when the students get up to, for example, the New York metropolitan area in the current political climate, is there continued trauma on a daily basis?

Stephanie C: 06:21 Absolutely. You know, I think the layers continue. I’ve worked with so many children who’ve said to me, “When I crossed the border, my heart exploded with joy because I would finally be with that long lost mother or father,” the person from whom they had experienced this prolonged separation. And what ends up happening is it’s sort of what I like to call the challenge of the Insta-family in that this child is suddenly back with that primary caregiver, but it doesn’t feel like the primary caregiver mom or dad is really the person that they left behind, the person who raised them in their country of origin. And now here they are forced with the prospect of making a family with someone who’s actually a stranger to them, so they’re confronted with this sort of profound sense of grief and this idea that their heart will never be whole again because it will always be in two countries. And Jon, you mentioned the political climate. You know, this is something that I kind of refer to as Trump trauma because it truly has profound implications for my students. There’s a new type of fear for them in that they’re out of the in your face violence of community, you know, gang warfare in the street, machete attacks on their way to school, but they’re living with this constant and pervasive fear of what will happen if they are deported. They’ve told me so many times, they feel like now they have to live como fantasmas, which means I have to live like a ghost, you know, constantly looking over their shoulders. I’m sure that Spanish speakers have heard this term, “por uno pagan todos” and this is a mentality that Central American immigrants really feel right now, that they have to sort of change the majority perception of Central Americans. There are continuous speeches, televised, in which our president references bad hombres, references the rapists from Central America, the drug dealers, the people who are going to kill our children. And my students feel an incredible pressure to prove that they’re not, that, that they are something different. And I think that that sort of collective vilification of the Central American identity has really significant effects for anyone’s psyche, but particularly a teenager’s psyche and sense of identity and sense of heritage, and cultural pride in who they are.

Amy H-L: 08:49 How do you see schools as the institutions best situated to work with these children and perhaps with their families as well?

Stephanie C: 09:01 So the rhetoric that us trauma therapists have always been told is that schools are not the appropriate setting to do trauma based work. And to a degree that makes sense. You know, trauma disclosures don’t always come at opportune moments. And in schools you can’t really control when the bell rings. So I’ve had many situations in which a traumatic disclosure is made, the bell rings and I’m trying to figure out, do I put this child on the bus? Do we try and figure out a way to close Pandora’s box so that they can leave the school and go about their daily life? But what, what I think we’ve started to see in schools is that once these Central American immigrant children are able to step outside of survival mode, that’s when we really start to see trauma bound symptoms related to what they’ve been exposed to. And I think what some of my colleagues and I, some of my teaching professional colleagues and I, have realized is that healing has to come before learning. We simply cannot expect a child to learn to conjugate an English verb if they’re experiencing intrusive images of a shooting in a street in Tegucigalpa, Honduras. So what we’ve really been trying to look at is how do we bring together learning, because obviously we have mandates that are a priority since we are educational institutions, with this profound need for clinical services. You know, as a trauma focused therapist, what I really should be doing is referring out to community clinics, where they might be able to receive what we consider to be the gold standard of trauma treatment, which is trauma focused cognitive behavioral therapy. That’s simply not realistic with this population. Clinics have spectacularly long wait times, even in a well-connected, well-served area like New York’s Hudson Valley. Most clinics have very few Spanish speaking providers. Often clinics do not have sliding scales. Often they want to take insurance. My students don’t have access to insurance. My students can’t pay 50 or 70 dollars per session, which would be on the very, very low end here in Westchester County and, quite honestly, for my students, survival is a priority. And I know I mentioned that survival has shifted. It is no longer physical safety related survival, but it’s economic survival. Most of my students work between 40 and 70 hours a week, and that’s on top of attending high school full time. So for me to make a clinic appointment for them that’s smack dab in the middle of their work hours would show just a cultural blind spot as an upper middle class, white, educated female mental health provider. So my feeling is an intervention needs to take place in a way and in a place that the students can receive it. That’s school. So that’s really why I believe an intervention should be delivered in a school setting.

Jon M: 12:05 What is the desahogarse model of trauma treatment?

Stephanie C: 12:09 So I’ve been doing this work with Central American immigrant students for about seven years now. And I’m not a particularly magical clinician. I don’t have clinical superpowers. But I did begin to notice that my students from this population and my clients before I was in a school setting were getting better much faster. We’re experiencing a mitigation and a reduction in their trauma based symptomatology in a way that I didn’t see when I worked with the domestic trauma exposed population and I decided to ask my students why that was, what it was about our work that was working and I kept hearing the same response over and over again from them and that was “porque me desahogue’ ” In our sessions, “I unburdened.” And that was an incredibly powerful watershed moment for me because I realized these students aren’t mentally ill, these students do not meet full PTSD criteria. What these students need is the opportunity to unburden and to have someone bear witness, to have someone go with them to that painful place, to relive their suffering and to validate and honor and celebrate the strength and resilience that they used to survive it. So the desahogarse model comes directly from the words of my students with desahogarse meaning to unburden. And it is a short term model of trauma treatment for specific use with this population that focuses on the trauma narrative. And the reason why we focused on the trauma narrative is by doing so, students are able to make meaning and gain a sense of mastery for the seemingly inexplicable dehumanizing experiences that they’ve been through in their home countries, in their journeys, after crossing the border. And then the second part of that theoretical approach is that the mental health provider or the person engaging in this emotional space with them celebrates their resilience. The reason why there’s this focus on resilience is throughout my work with this population, I heard another phrase all the time, and that was “no he logrado nada,” and that means “I haven’t achieved anything.” And the reason why this would come up is I would say to my students, you know, I think if I were in your shoes, I would probably be curled up in the fetal position somewhere in the Sonoran desert in Mexico because I just don’t think that I have the resilience to survive what you’ve survived. And my students would tell me over and over again, but I haven’t achieved anything, but I haven’t achieved anything. And an important piece of the model is that it teaches students about the effects of trauma. There’s a huge psychoeducation piece because I want students and clients to understand that even Superman would need some support if he faced the seemingly insurmountable obstacles that you faced and overcame. So it’s really about celebrating and then fine tuning resilience. And what I mean by that is I want to help students change the mindset of what constitutes an achievement. All of these student capabilities that we’re looking for now, you know, with our SEL buzzwords of resilience and adaptability, these students have those capabilities already. SEL is social emotional learning. That’s the big buzzword right now in mental health and in school based mental health particularly is looking at the whole child and making sure that the whole student is well rounded and that they’ve got these sort of social emotional survival instincts that they’ll need to flourish in adulthood. These Central American immigrant students already have those capabilities. We don’t need to teach them how to be resilient. We don’t need to teach them how to be adaptable, but we do need to teach them how to use those capabilities in new settings. So I have students who don’t think twice about the fact that they clung onto a life raft to get across the Rio Grande with alligators snapping at their heels when they didn’t know how to swim. But when they have to take a math readiness test in preparation for their TASC or formerly, GED exam, that is spectacularly anxiety and doubt provoking. So the final step of this model is helping them figure out how to use that very same innate resilience to tackle the new challenges related to life and school in the United States.

Amy H-L: 16:50 Wow. That’s amazing stuff. I mean, that sounds like a terrific and innovative model to use. How do these students do with regard to their relationships with other students and even among themselves? I mean, trust must be a really difficult thing for them.

Stephanie C: 17:09 So, you know, you would think it would be, and coming from a domestic foster care population, I had that same expectation. And I have to be completely honest that these students are incredible. The sense of community that they forge in schools, their willingness to share their stories, their willingness to accept feedback, their bravery is, you know, I really talk about how the desahogarse model is not mine, it’s theirs. And I truly dedicate it to them because I’ve never met a group of students or a population that is so focused on improving their lives and the lives of those around them. So a phrase I hear all the time that really inspires me is “Tengo que seguir adelante.” “I have to keep moving forward.” And I even call it the adelante mentality because these students are able to tap into the supports that they have. Some of them, the meager supports that they have, they’re able to connect to some higher purpose that allows them to not only heal but to thrive. You know, there’s this, there’s this burgeoning field related to trauma that’s called post traumatic growth and it’s taking resilience one step further. So resilience is you’re able to get up one more time than the number of times you fall down. Post traumatic growth takes it further and posits that people who’ve been through trauma are actually better human beings for having gone through that trauma. They’re more relationally connected. They are more motivated academically. They may have stronger spiritual connections than people who’ve not been through the trauma. And all of this makes the assumption that some healing has been done, but I can’t think of a population with whom I’ve worked that illustrates this idea of post traumatic growth more than these Central American immigrant children.

Jon M: 19:11 So, I have a question, which is that obviously many of the schools, for example, in the Lower Hudson Valley, have had a large influx of immigrant students with the trauma that you’re talking about. And in many cases, my sense is, the schools and the communities weren’t prepared. So what are the things that schools and thinking even outside of schools, communities, what can they be doing? I mean, obviously the kind of work you’re doing, is absolutely essential. I suspect also that there aren’t a whole lot of people like you doing that work in each of the schools just because there aren’t. So what would you say to a superintendent or principal or a guidance counselor or somebody who wants to be effective and feeling like, what do I do?

Stephanie C: 20:00 You know, I think there are a lot of people who really do want to do this work. And you know, I’ve done a good deal of trainings in schools and community agencies and there really is a sense of duty that I think is phenomenal to act as a bridge and to figure out how to build those connections. And there’s some really easy, tangible, concrete ways that schools and community agencies can sort of package themselves as safe and as willing to be culturally competent. You know, when I talk about cultural competence, we have to consider that that’s sort of a triangular approach in that you’ve got the population that you serve and their unique needs and resiliencies and challenges. But we also bring our perspective, an organization or as a school and our own values. So being culturally competent means being willing to look not only outward at the population you serve, but also inward and really scan your own values and your own past experiences and your own identity, both as an individual provider and as a community. I think some really easy, cost-effective steps toward cultural competence are speak some Spanish or whatever language is most relevant to your population. I always tell the story about how when I first started working with this population, I was desperate to connect with the students and my Spanish wasn’t as fluent as it is today, but I was determined to do it. So I went into the classroom and the kids were talking in Spanish about how much they hated the food in our cafeteria, how it was gringo food and it was just terrible. Um, so I thought this is it. This is my opportunity to connect. And I decided to jump in and you know, sort of echo their woes about being hungry. And I wanted to say to them, I’m hungry all the time, too. I know how you feel. Well, unfortunately instead of saying “hambre,” I said “hombre,” which means I have a man all the time. You can imagine how that went over. But I knew in that moment that I had a choice. I could either remain this stoic authority figure that immigrant kids tend to see school professionals as being, or I could laugh and I decided to laugh. And in that moment, the connection that I was really trying to force and trying so desperately to, to forge happened organically. And I tell that story to say, speak some Spanish. It doesn’t have to be beautiful. It doesn’t have to be grammatically correct, but it will go miles in demonstrating that you are not only willing to learn, but you’re also safe. I think it’s important for us, you know, as educators, we want still a sense of curiosity and in them, you know, for the world around them and as providers, as educators, we want to demonstrate a respectful cultural curiosity, even if that’s something as simple as, hmm, I can’t imagine what Chiquimula, Guatemala was like growing up. Can we sit down and look at Google Earth and you can walk me through your village? I think we also want to build a net of resources. If you’re that one person in your school or your community that knows the really good non-corrupt immigration attorneys, you’ll become popular very quickly because students come to learn who has the trustworthy information, where are the resources, who’s made the connections that will allow us to integrate into this community? And then, you know, I think my final push for how a school can create cultural competence is normalizing mental health care and giving permission for suffering. The downside to the adelante mentality is that students from Central America feel that they have to be Superman. In their cultures, mental health is often not a “thing,” and I’m putting that in air quotes. Many have the perception that any mental health symptom is a sign of locora or madness. So they’re very, very hesitant from asking for help when, like I said, Superman would need some mental health support if he went through the similar, things that they’ve been through. We can also help students develop a lexicon through which to express their feelings because if mental health is not a “thing,”students aren’t taught how to express those feelings. So giving them a safe, supportive environment in which they can practice that vocabulary, as basic as it sounds, is incredibly important and healing. And in the end, transformative.

Amy H-L: 24:38 Stephanie, how do you work in your consultancy, when you’re a consultant to a school as opposed to being part of the faculty?

Stephanie C: 24:47 So that’s a great question. You know, I’m very cognizant of my role as a respectful observer when I go out and do trainings in districts and community agencies. You know, I’m not the expert. And I think trauma work in and of itself is a humbling experience, and being a clinician is as well because you are continuously reminded that you are not the expert on your clients’ subjective realities. And that’s certainly true when I am in a new district, you know, training. I think my first job is always listening and understanding and getting a sense of how people feel about this influx of Central American children. You know, at the end of the day, our job is to educate and that’s, something that’s upheld by the Supreme Court in Plyler versus Doe. So this is our job and we have to do it. But that doesn’t mean that it should be necessarily rammed down people’s throats. So I think, you know, I think part of my work is really listening and hearing, but also humanizing kids who, due to the current political rhetoric, have been dehumanized. And what I’ve found, I’ve trained in districts where the majority of educators are sort of on the liberal spectrum. And I’ve trained in districts that are more rural, with a very different, perhaps less diverse demographic. And I find that the shift in how the members of the audience interact with the material is almost palpable when I start to tell the individual stories, the story of the Guatemalan boys who were shoved out of the way as the bullets flew at their father in his murder, the girl who was kidnapped and held in a safe house in Mexico for two weeks. And I always ask the question of my audiences, if we were parents, and many of us are, myself included, how bad would it have to be in the Hudson Valley, in Florida, in Sacramento, for us to make the decision to entrust our precious child to a human smuggler to cross 3,000 miles of delinquency, of banditry, of organized crime, to cross a river, to end up in Border Patrol. How bad would it have to be to make that decision? And it’s so interesting because when I say that, nine times out of 10, I watch and feel the energy in the room change. Because in that moment, these students, this population, stops being a tattooed gang member on Fox News and starts being a child. And that’s what they are when they come through our home, our halls, they’re members of our community, they’re children. So my work really is about humanizing. My work is about meeting districts where they are and giving them strategies that are realistic and able to be implemented for where they are.

Amy H-L: 27:42 When you work with educators as a consultant, do you have strategies to help them with the secondary trauma that they must be experiencing?

Stephanie C: 27:52 Absolutely. And that’s a wonderful question. And it’s a timely question because the World Health Organization just classified burnout related to work as a medical condition in their classification of medical issues last week. So absolutely, this population in particular is so trauma saturated, and typically educators, teachers, don’t have to be as well versed in self care as maybe clinicians do. But with this population, because the trauma disclosures will come flying out to any person that the student trusts, I work a lot with teachers on so what do you do with that story. So how do you fight back against the system in which you might feel powerless to help these students, particularly given the current political landscape? I talk a lot about writing. I talk a lot about the importance of desahogarse, of unburdening, for the people who are receiving the traumatic disclosures as well. I think creating a school climate in which colleagues feel that they can turn to people and unburden and receive support in a nonjudgmental way is absolutely critical. Because if we don’t give educators the tools to stay in it, to keep doing this challenging work, they will burn out and then we won’t have anyone to care for the kids. So I think that’s extremely important to find self care strategies that are individualized and that really work for you. You know, as a clinician we’re always told to preach deep breathing and tell people working with trauma how important deep breathing is. And you know, I’ve learned deep breathing does not work at all. For me, deep breathing exacerbates things for me. I’ve learned that for myself. I cannot watch the news. I cannot read the comments underneath articles related to Central American immigration when I read the Washington Post or the New York Times because I do get so emotionally dysregulated. So I think it’s so important for people who are bearing witness to students’ suffering to figure out what their unique triggers are and then to implement coping skills that are specific to their experience.

Jon M: 30:00 Is there anything else that you’d like to add, anything that we haven’t asked about or that you’ve been thinking about that you haven’t had a chance to say?

Stephanie C: 30:08 You know, the one thing I’d like to add, and this piggybacks off the idea that I’m not a clinical magician and that anybody could do this work, I worked with a girl all last year who made spectacular progress related to her trauma related symptoms. And at the end of the year, I said to her, you know, you’re a changed person. You had these layers upon layers upon layers of trauma, gang violence, separation from primary care giver. How is it that you’re doing so well now? What was the moment that really made the difference for you? And she looks at me with tears in her eyes and she said it was the moment that you told me I was strong. Nobody ever told me that before. Now, telling a student that they’re strong is not a particularly sophisticated clinical intervention. This is something we all can do, but the moral of the story is that’s the resilience that’s innate in this population, but they don’t realize it because survivalism is just a normalized part of life. So I think what I want to emphasize is this is doable work. This is not reinventing the wheel type of work and the positive effects and impact are profound and have ripple effects.

Amy H-L: 31:16 Thank you so much for coming on the podcast today. This has been a tremendous learning experience, for me at least.

Stephanie C: 31:24 Thank you so much for having me. I’m so grateful to have had the opportunity to speak with you both.

Jon M: 31:29 And thank you, our listeners. You can learn more about Stephanie’s work, as Amy mentioned at the beginning, by visiting her website, www.createculturalcompetence.com, and you can visit our website, ethicalschools.org, where you can check out our articles and podcast episodes. And please subscribe so that you automatically get notified of the next podcast and the next newsletter, and we’re on Twitter @ethicalschools. Thanks again. See you next week.

Listen to the episode: https://ethicalschools.org/2019/06/stephanie-carnes-on-post-traumatic-growth-and-resilience-cultural-competence-and-creating-safe-environments-for-central-american-immigrant-children-in-todays-u-s/