BRiTA FuturesA response to the issues of culturally

and linguistically diverse (CALD ) school children and young people.

Rita Prasad-Ildes & Elvia RamirezQueensland

Transcultural Mental Health Centre

What is BRiTA Futures?• A group intervention

program that aims to build healthy bicultural identities by addressing issues of cultural identity and acculturation stress.

• Builds on strengths of culture of origin.

• Supports the development of life skills using relevant cultural frameworks.

Overview of presentation• Rita: a brief overview of the key mental

health issues experienced by CALD children and young people with a particular focus on risk and protective factors – provide the context to which we developed BRiTA Futures.

• Elvia: overview of the BRiTA Futuresprogram, how it works and outcomes achieved & future directions.

CALD children and young people

• MH issues for CALD children and young people has generally not received much attention as underrepresented in services which is due to a complex dynamic between beliefs about MI and help seeking & access barriers.

• MHP&P an important strategy to redress inequalities in the health system.

• Harnessing the inherent cultural strengths & protective factors of CALD families for optimal development of CALD children and young people.

Key conceptsCALD• Culturally and

linguistically diverse• Diversity in terms of

race, religion and ethnicity from NESC

• Reflects intergenerational & contextual issues

Acculturation• Adaptation to a

different culture• Continuous contact

and change• Subsequent changes

to original cultural patterns

Context of multicultural MH promotion & prevention

3 conclusions:• Stress factors relating

to migration• Minority status• Cultural background

factors

VS “healthy migrant effect”

“Healthy Migrant Effect”• 1st generation health benefit vanishes over

generations. • When drilling down: 1st generation girls and 2nd

generation boys more at risk• By 3rd generation ethnic minority youth appear

to have more mental health problems and risk behaviours than native born. (Oppedal et al, 2005)

Child development across cultures

• The goals of development do not differ greatly, but there are many different ways to reach them (Keats, 1997)

• Eg parenting is constructed by culture: autonomy vsinterdependence.

Acculturation the main adaptive task following migration

• Formation of identity

• Coping with changes and stressors in families

• Schooling BRiTA Futures participants, 2008

Acculturation development

• Developing a healthy bicultural identity for optimal mental health

Biculturalism- the most important protective factor

• Biculturalism = competency in both cultures & sense of belonging to both cultures

• Biculturalism = great deal of personal assets.

Drawings from children participating in BRiTA Futures, 2008

Family & PeersFamily• Changes in family

structure & dynamics• Transmission of

stressors between family members

• Intergenerational issues

• Parental expectations(Bevan, 2000)

Peers• Western culture: peer

support is rated higher than family

• Non Western cultures: family support is rated higher than peer support(Oppedal, 2004)

Importance of Schooling

• School is the most important arena where CALD children learn the norms and values of the mainstream society

Overview of BRiTA Futures

• How was BRiTA Futures developed• Who is BRiTA Futures for• What is in BRiTA Futures• How BRiTA Futures is delivered

– Training group facilitators– Running group programs

• Effectiveness of BRiTA Futures• Future Directions

BRiTA Futures

• B uilding• R esilience• i n• T ranscultural• A ustralians

How was BRiTA Futuresdeveloped

• Began in 2002 in response to study “Coping in a new world”.

• Identified the need to develop a group program that promoted resilience within a framework that acknowledged risk and protective factors related to cultural diversity and the experience of acculturation and bicultural identity development.

• Informed by national and international research on resiliency & mental health promotion programs.

• Developed in consultation with a reference group of young people with a CALD background and a reference group of experts.

• Piloted in Canberra and 3 Qld locations.

How was BRiTA Futuresdeveloped

• The primary school version was developed integrating components from the Qld education syllabus for Upper Primary School.

• Teachers reviewed the program content.• Piloted in four primary schools.• Adolescent program was later adapted for use

with young people from a recent refugee background.

• Assumes that the setting in which BRiTAFutures has been delivered can support the sustainability of personal skills acquired.

Who is BRiTA Futures for

• Those who have migrated to Australia from a non-English background country, regardless of type of visa:– proficiency in English language– length of stay in Australia

• Second and further generations of Australians with CALD backgrounds.

• Those who come in regular contact with the above.

Who is BRiTA Futures for

• Multicultural and ethno-specific groups. • School and community settings.• Primary School Program. For children

in grades 5 to 7 or aged between 9 to 12 years.

• Adolescents Program. For young people aged 12 to 18 years of age.

Manual resources

BRiTA Futures contentPrimary School Program

• Session 1. Resilience in Our Multicultural Classroom

• Session 2. Cultural Identity: Making Me Who I Am

• Session 3. Building Empowerment: Self talk and Self-esteem

• Session 4. Building Social Competences: Understanding Cross Cultural Communication

BRiTA Futures contentPrimary School Program

• Session 5. Social Competencies: Resolving Conflict & Coping with Challenges

• Session 6. Making Life Fun: Beat Stress & Build Optimism

• Session 7. Family & Friends: Staying Strong with Positive Relationships

• Session 8. Bouncing Back After Hard Knocks: How to Stay Resilient Throughout Life

BRiTA Futures contentAdolescents

• Session 1. Getting to Know Me, Getting to Know You, Trusting Each Other

• Session 2. Cultural identity & Life Experience: Making Me Who I Am

• Session 3. Habits of Thinking: Self-talk and Self esteem

• Session 4. Habits & Feeling: Understanding Our Emotions

• Session 5. Communications Strategies for Calming Conflict

BRiTA Futures content (continues)Adolescents

• Session 6. Sticks and Stones: Challenging Social and Cultural Stereotypes

• Session 7. Staying in Balance: Humour, Values and Spirituality

• Session 8. Building Positive Relationships: Family, Peer & Community Networks

• Session 9. Getting to Know the Support Services

• Session 10. Life Goals and Future Planning

Training Group Facilitators• Potential Group Facilitators are selected to

attend training using an application form:– has access to target group– has the support of school or setting– has capacity to deliver and evaluate program– has some group facilitation skills– has been cleared to work with target group

• Length of GF training: PS (1 day), Adol (2 days)

• Format of GF training: hands on, competency based

• Support: manual, resources, mentoring.• GF trainers include experienced facilitators.

Group Facilitators• Class teachers, Teacher

Aids, ESL Teachers• School Counsellors,

Guidance Officers, School Chaplains,

• Child & Youth Mental Health Workers

• Youth Workers• Community mental health

workers• Community leaders and

volunteers

Delivery

• Classroom settings: English as an Additional Language students, whole class, whole school, combined with arts programs or with other initiatives.

• Community settings: youth camps, weekly sessions, weekend sessions, school holiday sessions, combination of these.

• Using cultural consultants. • Using language assistants.

Delivery

• Brita Futures is often delivered by two facilitators.

• Partnerships have been established and strengthened in this process.

Key issues

• Pre and post quantitative evaluation tools still being refined and validated

• Multicultural Children Resilience Survey• Multicultural Youth Resilience Questionnaire

• Group Facilitators dealing with own acculturation issues.

• Class teachers shifting to facilitator’s role.• Sustainability

Key Outcomes

• Group facilitators trained in Qld since June 2008: 86

Key Outcomes• Since Nov 2007,

number of children and young people who:

• have completed BRiTA Futures: 299

• are undergoing BRiTA Futures: 160

• A total of 459!

Key Outcomes

• Schools that are regularly delivering BRiTAFutures: 3

• Settings attracting funding to enhance it.

Effectiveness of BRiTA Futures• A comprehensive evaluation strategy from the

perspective of participants, group facilitators, school staff and parents/guardians. Feedback:

• “I can be more open about my culture, express myself, and not be so scared about things.” (CALD student)

• “I thought kids from other countries were weird and different and so they should be left out, now they can join in and make friends with us.” (non-CALD student)

• The students had to “step out of their comfort zones to understand how other children felt.” (class teacher)

Feedback from class teachers

CALD students• more proud of their culture now, more confident• realise that all families are the same in general• they are not so embarrassed by their culture• they feel more comfortable accepting their

differences• feel that the class environment is safer• some found difficult to understand some of the

concepts

Feedback from parents• “He is not coming home upset and refusing to

go to school. He is quite happy being who he is and what he wants to do.” (CALD parent)

• “Schools should have a “buddy” system for the newly arrived families in order to provide more support for these families…. They could be better represented at Parents and Friends Meetings.” (non-CALD parent)

0 2 4 6 8 10 12 14 16

Mean Score

Autonomy

Self-esteem

Empathy

Self-awareness

Communication

Goals & Aspirations

Help-seeking

Res

ilien

ce In

dica

tors

POSTPRE

Resilience Indicators:

Means for the variables Goals and Aspirations,

and Help-seeking, were both statistically

significantly higher at post-program evaluation (GS: t =-2.17, p = 0.04; HS: t =-2.05, p = 0.05.

All other variables increased but

differences were not statistically significant.

41.2

41.4

41.6

41.8

42

42.2

42.4

PRE (42.31) POST (41.68)

Acculturation Stress:The mean for acculturation stress was slightly lower but not

significant (t =-.23, df = 45, p =.82).

Future Directions• Roll out to other States• Training delivered either in Qld or other

States• Direct training to Group Facilitators: $385

per person• Group Facilitator Train-the-trainer training:

cost to be determined• If setting supplies evaluation data,

QTMHC would provide evaluation reports

Future Directions

• BRiTA Futures for Adults in Families• Conceptual framework has been

completed.• Project Officer that will develop content is

being recruited.• Piloting is planned to commence first

quarter 2010.

For more information

• Visit:www.health.qld.gov.au/pahospital/qtmhc/default.asp

• Email: QTMHC@health.qld.gov.au• Phone: (07) 3167 8333

• Elvia Ramirez or Farah Suleman