1. The Right to Rehabilitation Beirut, Lebanon 2013 Refugees and Asylum Seekers In the United States Karen Hanscom PhD Advocates for Survivors of Torture and Trauma (ASTT) www.astt.org

2. 1. Refugees & Asylum Seekers in the US 2. Refugee Benefits 3. Asylum Seekers in the US a) Detention b) no govt. services 4. Torture Rehabilitation in the U.S. Torture Victim Relief Act National Consortium 5. ASTT’s Treatment Program

4. Top 10 countries of Origin Bhutan (15,000) Burma (14,000) Cuba Iraq Somalia Democratic Republic of Congo Iran Eritrea Sudan Ethiopia

6. 1 - From outside the U.S. 2 – Special humanitarian concern to the U.S. 3 – Demonstrate persecution or fear of persecution (race, religion, political opinion, nationality, membership in a social gr.

7. Education (under 18 same free educ. - access to Univ. as US citizens Resettlement Services (1st 3 mo. Clothes, food etc.) Public Assistance (Cash and Medical Treatment Employment Benefits (work authorization

8. After 1 year: eligible to become permanent U.S. residents After 5 years: can petition for citizenship Spouse and any unmarried minors automatically receive refugee status

10. Have fled to the United States and enter the country. then apply for political asylum. After granted asylum, are called refugees

13. Some arrive with Visas. Others do not.

15. 429,000

24. Asylum Seeker Benefits

29.  Torture Victim Relief Act (TVRA)  National Consortium of Torture Treatment Programs (NCTTP) * Capacity to Serve 5-6,000 of the estimate 400,000 torture survivors in the U.S.

30. * 34 NCTTP Members in 15 States and Washington, DC * Of these - 24 comprehensive torture treatment programs * 5 legal or other programs * 1 torture survivor organization

31. * Torture Victim Relief Act Funds distributed by the Office of Refugee Resettlement * Other Federal Funding (very limited) * UNVFVT * State Grants * Foundations * Corporations * Individual Donations

32. * Case Management Referrals: Legal, Medical, Housing, Food, English Classes … * Psychosocial Groups & Activities * Psychological Treatment Individual and Group * Evaluations & Expert Court Testimony

33. Survey of National Consortium of Torture Treatment Programs Therapists about the Assessment, Diagnosis, and Treatment of the Psychological Sequelae of Torture Scott Vrana, Thomas Campbell & Russ Clay Traumatology 19(2) 144-153. 2013

34. * 17 therapists from 10 centers * 21 center directors * Therapist Survey (online) Semi-structured phone interview Note: During the study 2 centers closed due to lack of funding.

35. 1) Psychological Assessment: Most respondents used a combination of: interview (usually non-structured); and assessment tools - the most common being: Hopkins Symptom Checklist and the Harvard Trauma Questionnaire.

36. 2) Therapists clearly stated the need for more resources to conduct research to advance the field. 3) Therapists agreed that the psychological, social, legal, medical and economic aspects of a client’s functioning were intertwined and need to be considered together.