Any parent who’s ever struggled with bedtimes, carpool schedules, child care, naps, tantrums, and more knows that parenting can be stressful.
However, the amount and intensity of parental stress has reached a public health crisis, affecting one-third of parents. In late August, U.S. Surgeon General Dr. Vivek Murthy, who is also the father, issued a recommendation that parents’ mental health was at risk. This is the same kind of statement that public health officials used to publicly warn the public about the dangers of smoking decades ago.
Immigrant parents face even higher risks. Jamie Ballard, a researcher at the University of Minnesota who focuses on mental health, parenting, and immigrant families, said the Surgeon General’s report found common causes of stress such as basic needs, screen time, loneliness, and busy schedules. He stated that the causes were outlined.
“Immigrant parents face all of this and more,” she said.
A new program in Minnesota works with immigrant parents to help them deal with their children’s challenging behaviors. The support program, called Empowered Generations, is designed for parents of children ages 3 to 8. After last year’s pilot program showed promising results, including a 20% reduction in problem behavior in children after eight weeks, researchers are seeking additional funding from the National Institutes of Health to expand the program this summer. I received an offer.
Ballard and Christopher J. Mehas, another researcher at the University of Minnesota who focuses on high-stress families, are working to address both the stressors common to all parents and the unique concerns of immigrant parents. We developed this program as a method based on scientific evidence. They started the pilot with 16 therapists, half of whom had expertise with immigrants or immigrant families.
“We found that it led to parents feeling more confident and reporting less stress,” Ballard said.
Veronica Rivera Arteaga understands these challenges both personally and professionally. Arteaga works as a therapist for Empowered Generations. She is also a mother who came to the United States from Mexico in 2007.
“You add in the barriers of arriving in a new state or a new country: not being able to read street signs, not knowing how to ride a bus or rent an apartment,” Arteaga said. . “Immigrant parents are almost always outside the tolerance range…The stress levels of immigrants are high, impacting their ability to make good decisions and relax.”
Arteaga and other therapists in the program pointed out that logistics aren’t the only common stressors for immigrant parents. Although challenges vary depending on the country of origin, there are many similarities, including:
I come from a culture where we don’t talk about stress and depression. Acculturation Gap: While parents and grandparents are influenced by their home country’s culture, children are often more accustomed to American culture. Discrimination and racism in the United States Stigma against mental health conditions in the home country. PTSD from actual travel/migration experiences. living in poverty.
Parental stress can also affect children. Children of parents with mental health conditions are more likely to develop mental health conditions themselves, such as depression and anxiety.
This intergenerational trauma must be broken, said Chansofal Mak, one of the newly hired therapists. However, parental stress has been ignored. For example, when Cambodians came to the United States in the 1980s, they underwent mental health testing, but there was no follow-up of the testing.
“They’re still living with PTSD, and it shows in their parenting,” she says.
structure
Mehhus was searching around for the best way to reach parents in need. He found his primary care physician as an entry point into the program.
“Primary care physicians are reliable sources of information in non-judgmental situations,” he says.
It’s also a good way to connect with parents since the majority of parents take their young children to the doctor.
In the pilot project, doctors participated in training to identify parents who might benefit from the program. This usually refers to parents who express moderate concerns about their child’s behavior, such as a 3-year-old’s frequent tantrums or sending an older child to school. The doctor will talk to the family about language preferences and cultural expectations for the session. The therapist who best meets the parents’ wishes will contact the family. If the family agrees that the program might be helpful, we set up six online or in-person sessions.
The sessions are based on simple, easy-to-teach interventions that are proven to make a difference, Ballard said.
In the first session, the therapist invites parents to talk about their strengths and their child’s strengths.
“We focus on building relationships,” says Maria Angelica Keller Flores, one of the therapists. “Parents are often surprised when they talk about their child’s strengths because they talk about misbehavior. And when you talk about their strengths as a parent, they feel validated.”
Subsequent sessions will focus on effective ways to provide instructions to young children.
Oftentimes, the parent may be doing something else and giving the child a command like, “Hey, pick up something,” and “the parent gets angry when the child doesn’t do that,” Flores said. he says.
Instead, parents can look their child in the eye and say, “Can you do this for me?” she said. “Just clearly communicating that direction when your child is listening can make a big difference.”
Parents may find it hard to believe at first, but very simple changes can have a big impact, therapists say. And parents often notice results from the first session.
“The moment we slowed down and got to the kids’ level and did the actions she told us to do, our collaboration with our two girls literally skyrocketed at that point. ” said one parent in a focus group after the program. “We were really blown away by the little things in the first week, just this simple thing, how much it helped us.”
Therapists also conduct role-playing exercises with parents.
“It’s usually a very important moment for parents,” Arteaga said. “Kids suddenly realize that they’ve been busy working or cleaning and haven’t been able to stop and engage with them. That’s where I get the most feedback. They say, ‘Right now. , I remembered my childhood.
After six weeks, Arteaga is usually surprised at how much her parents have changed. They changed the tone and method of communication and the way they disciplined their children.
Her parents were often just as surprised, she said. “It works!!!” they would tell her. They report smoother bedtimes, more efficient transitions, and a willingness to follow safety protocols. “They’re very happy. Seeing their parents relaxed, the kids are happy too,” Arteaga said.
why it works
Research and anecdotal evidence show that this intervention is effective for all parents. For example, Ms. Flores reported positive results from working with parents of a different race than her own.
But researchers and therapists believe that when immigrant parents are paired with a therapist from the same or similar home country, their chances of success increase.
Arteaga said just removing the language barrier can go a long way. It’s too difficult to express the nuances of parenting through an interpreter, she says.
“It’s my tone, it’s the way I move, it’s the way we communicate, it’s the way we connect,” she said.
Many families don’t feel comfortable talking to a therapist who they perceive to be an authority figure, Mack said. “They’re superficial and friendly because they don’t feel safe talking about issues… They like to tell stories of migration – they’re storytellers – and if they don’t feel comfortable, they don’t tell anyone He doesn’t even want to talk.”
An essential understanding between parents and therapists who share the same cultural background can be critical, Flores said. For example, traditional punishment in most Latinx countries differs from American practice, she says. And people who come from countries with violence are often focused on survival.
“In Cambodia, traditional parenting is based on fear and is harsh,” Mak says. “We’ve gone through a lot of civil wars and genocides, so parents want to make sure their children are alive. … They don’t have time to reflect on how they parent.”
A therapist from the same culture can also alleviate concerns about bias. In many cultures, the term “mental health” has very negative connotations, Mack said. “They don’t want to be identified as crazy. They know that mental health is emotional health, and that family relationships can be affected by an individual’s mental health. No.”
In addition to reducing stress for parents, the pilot program found a 10% reduction in children’s sadness and anxiety.
Over the next four years, Empowered Generations plans to train 60 therapists and 200 physicians in Minnesota. Eventually, they hope the program will become a national model.
“That’s the driving force behind this effort,” Ballard said, adding, “If this model works and connects families with supports that help their children thrive, we hope other states will follow suit. I hope so.”
Help for parents:
If you are a parent, therapist, or physician who would like to learn more about Empowered Generations, please contact the Knowledge for Parents team at kfp@umn.edu.
