“It’s the community joining together to help these kids heal”: Clinician experiences using trauma-informed assessment and treatment with unaccompanied migrant children in the United States

Objective: The United States has seen a significant increase in unaccompanied migrant children (UC) from Central America, who often experience a myriad of traumas throughout their migration journey. Although evidence-based, trauma-informed assessments and treatments exist, little is known about how community clinicians use and adapt these interventions to address the unique needs of UC. To enhance our understanding of mental health services for this vulnerable population, it is critical to characterize clinician experiences with intervention adaptation and delivery. Method: This qualitative study employs a socioecological model and descriptive phenomenology to thematically characterize the care needs of UC in the U.S. based on semi-structured interviews with 10 mental health clinicians. Results: Findings revealed several multi-level factors that warrant consideration in the assessment and treatment of UC across the individual, inter-personal, community, and societal spheres of a trauma-informed socioecological model. Results were grouped into seven themes that interact to affect assessment and treatment delivery: 1. Resilience (Individual-level); 2. Language (Individual-level); 3. Youth Needs and Values (Individual-level); 4. Clinician-Client Relationship (Interpersonal-level); 5. Caregiver Relationships (Interpersonal-level); 6. Acculturation to the United States (Community-level); and 7. Laws and Regulations (Society-level). Conclusions: Overall, findings highlight how all levels of nested ecological theory must be considered in the delivery of mental health services for UC.