Theoretical Understandings of Unaccompanied Young People Affected by War: Bridging Divides and Embracing Local Ways of Knowing

Theoretical Understandings of Unaccompanied Young People Affected by War: Bridging Divides and... Abstract This article explores the theoretical binary that has tended to encompass the majority of scholarship with unaccompanied refugee young people (URYP) affected by armed conflict. In this paper, we argue that URYP scholars often theorise this population via either a trauma/victimisation framework or resiliency lens, which creates a distinct binary. While these opposing theoretical perspectives provide important insight into understanding URYP’s experiences, this conceptual binary has tended to neglect the nexus of factors for URYP who are resourceful and determined in particular aspects of their lives, while simultaneously being vulnerable in others. We suggest that a more nuanced exploration of theoretical frameworks is necessary, specific to URYP’s experiences. Moreover, we call for greater analysis of theories that emerge from both the Global North and, particularly, the Global South in order to gain a more holistic appreciation of the complex lives and realities of URYP, whether during armed conflict or in its aftermath. By uniting trauma and resilience theories and integrating theories from the Global South, from where a majority of URYP originate, scholars may provide a richer account of URYP that is not only beneficial for global discourse, but may have greater significance for URYP who attempt to make meaning out of their experiences. Refugees, resilience, theory, trauma, young people Introduction Roughly half of the world’s fifty million refugees (UNHCR, 2015) are below the age of eighteen and approximately 2–5 per cent of all refugee young people are unaccompanied (Hartwell, 2011). An unaccompanied child refers to ‘… a person who is under the age of eighteen years, unless, under the law applicable to the child, majority is attained earlier and who is separated from both parents and is not being cared for by an adult who by law or custom has responsibility to do so’ (UNHCR, 1997, p. 5). While the concept of an unaccompanied child was officially defined in the 1990s, the reality of young people being left unaccompanied has been intrinsic to virtually every past war, refugee situation and natural disaster (Ressler et al., 1988). For unaccompanied young people, whose lives have been marred by armed conflict, their experiences are indeed shaped by intersecting factors such as gender, age, race, ethnicity, sexual orientation, mobility, socio-economic context and key developmental factors (Ressler et al., 1988). However, common themes are nonetheless present. In addition to being separated from their care-givers, a majority of unaccompanied refugee young people (URYP) may have directly experienced or witnessed the killings of loved ones, persecution, sexual violence and dangerous escapes (Hartwell, 2011). Moreover, the parents or primary care-givers of these children may have been killed or detained during conflict, gone missing, died during flight or were separated in the chaos of war and subsequent flight (Hartwell, 2011). A global and heightened awareness of the impact of armed conflict on URYP has garnered significant academic attention over the past fifteen to twenty years. However, drawing predominantly on theoretical ideas and understandings which emerged in the Global North, scholarly literature has tended to conceptualise the ways URYP navigate their socio-political terrains in war/post-war periods using two predominant conceptual lenses. On the one hand, the realities of URYP have been framed within the context of trauma and victimisation (Huemer et al., 2009). This focus on trauma and victimisation has provided important insights into the psycho-social well-being of this population. However, this scholarship may inadvertently reinforce popular discourses of URYP as inherently troubled, victimised and perpetually ‘at risk’ (Denov and Bryan, 2014). Moreover, while trauma and victimisation as a result of war invariably characterise the experiences of many young people, failing to also explore young people’s capacity to overcome adversity may provide a skewed picture of their reality. On the other hand, in response to trauma-based conceptualisations, an increasing focus on resilience among war-affected young people has emerged in the literature. This scholarship has emphasised children’s capacities, and their ability to ‘beat the odds’ and ‘cope well’ despite experiences of profound adversity and individual, familial and structural stressors (Fernando and Ferrari, 2013; Tol et al., 2013). Placing an emphasis on the resilience of URYP offers an important and dynamic perspective on the lives of this unique population. However, similarly to the trauma-based literature, a danger exists when researchers and practitioners over-emphasise resilience in children, assuming that all will or have the capacity to ‘bounce back’ (Denov and Akesson, 2017). Although social workers have explored the resilience/traumatisation binary framework with various populations (Fekete et al., 2014), the social work discipline has yet to substantially unpack this binary with URYP affected by war. We argue that a problematic dichotomy has formed within URYP discourse: a danger exists in either inappropriately pathologising URYP or—at the other extreme—conceptualising this population as inevitably able to ‘bounce back’ from adverse conditions. This conceptual binary has tended to neglect more blurred and fuzzy circumstances of URYP who are resourceful and strong in certain aspects of their lives, while simultaneously being ‘vulnerable’ in others (Wernesjö, 2014). Although recommendations suggest adopting a framework that incorporates both vulnerability and resiliency in Western contexts (Wernesjö, 2014), concrete efforts to bridge this conceptual divide need further attention. We suggest that a more nuanced exploration of theoretical frameworks is necessary. Moreover, we call for greater exploration of theories that emerge from both the Global North and, particularly, the Global South, in order to gain a more holistic appreciation of the complex lives and realities of URYP. The first segment of the paper details the scholarship drawn upon in our exploration of the literature on URYP. Second, we examine the Western-based trauma/resilience theoretical binary that has characterised the majority of URYP scholarship. It also considers the potential underpinnings of the recent shift from trauma-focused to resiliency-based literature, albeit with the former’s continued dominance (Jensen et al., 2014). The paper then explores theories emerging from the Global South, particularly northern Uganda and with Bhutanese refugees living in Nepal, which have been largely overlooked in URYP scholarship. While proposing an integration of both Western and non-Western conceptions of war/post-war experiences, we argue that both trauma and resilience theories should be viewed as intersecting and complementary entities, as opposed to a distinct binary. Moreover, non-Western theories of armed conflict should be drawn upon and explored to ensure a more nuanced and culturally relevant understanding of the lived realities and needs of URYP. Search strategy Although not a systematic review, we performed extensive literature reviews in PsycInfo, ERIC, PubMed, SOCIndex, Social Work Abstracts and Google Scholar. We applied key word searches to obtain scholarship related to: (i) unaccompanied refugee young people (‘minors’—generally up to eighteen years old), (ii) trauma and/or resilience as related to URYP and (iii) URYP affected by armed conflict. We excluded literature that did not focus on the mental health or overall well-being of this population. Finally, we searched the reference section of all studies and pursued those related to our criteria. URYP: unpacking theories of trauma and victimisation Theories of trauma and victimisation have long been used to describe and understand the experiences of URYP (Huemer et al., 2009). Herman asserts that psychological trauma composes: … an affiliation of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force … [which] overwhelms the ordinary system of care that gives people a sense of control, connection, and meaning. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence and death. They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe (Herman, 1992, p.33). When identifying URYP as ‘traumatised’, URYP scholars have frequently drawn upon the fourth edition of the Western-based Diagnostic and Statistical Manual of Mental Disorders (DSM) (Huemer et al., 2011; Vervliet et al., 2014b). The DSM-IV links behaviours of those experiencing trauma to specific mental health pathologies. Such pathologies include depression, anxiety and grief (Bronstein et al., 2013). Post-Traumatic Stress Disorder (PTSD) is the most notably acknowledged mental health pathology in URYP scholarship (Bronstein et al., 2013; Smid et al., 2011). As such, when referring to URYP as ‘traumatised’ or victims, we are drawing from ‘trauma’ associated with PTSD. DSM-IV identifies PTSD as re-experiencing a traumatic event in nightmares and flashbacks, avoiding thoughts that remind one of the event, feelings of guilt, self-destructive behaviour, diminished interest in activities, physiological arousal and an inability to remember key aspects of the traumatic event(s) (APA, 1994). Moreover, the DSM-IV contends that a candidate for PTSD must have directly experienced (or witnessed) a traumatic event, experienced repeated exposure to aversive details of the traumatic event or learned that a loved one experienced a traumatic event (APA, 1994). Due to the circumstances of armed conflict, URYP are frequently exposed to harsh circumstances that may engender a number of PTSD’s symptoms. By extracting PTSD symptomology from the DSM, a significant body of scholarship has argued that URYP are traumatised (Lambert and Alhassoon, 2015) and that direct exposure to war-related violence, or learning about injury/death to loved ones, will likely engender negative mental health effects, particularly psychopathology (Huemer et al., 2009). Although considerable scholarly debate exists which challenges the objectivity in measuring trauma exposure, academic scholarship commonly associates URYP with PTSD (Smid et al., 2011). Ubiquitous within such literature is that a separation from parents/care-givers may be the most egregious circumstance for URYP (Wernesjö, 2014). Trauma-focused scholars often identify URYP as a vulnerable population which may engender prolonged mental health impairments (Derluyn, 2005) and ‘internalise their problems’, resulting in depression and anxiety (Bronstein et al., 2013). In contrast, URYP may ‘externalise’ their feelings which often manifests in acting out behaviour (Bronstein et al., 2013). Additionally, URYP who have experienced multiple traumatic events, lower education levels and insufficient social supports are identified as being at risk for developing PTSD (Smid et al., 2011). It should also be noted that most trauma-focused scholars writing on URYP have tended to employ American-based, quantitative mental health checklists to ascertain their psychopathology. These included the Child PTSD Symptom Scale (Jensen et al., 2014), the Post-Traumatic Stress Disorder Checklist and the Hopkins Symptom Checklist (Bronstein et al., 2013). By privileging USA-based mental health instruments, scholars may apply mental health terminology that is potentially unfamiliar and culturally insignificant to URYP. Despite efforts to translate such instruments into the primary languages and cultures of unaccompanied young people (Betancourt et al., 2009), a majority of scholarship continues to employ the aforementioned checklists (Huemer et al., 2011). The significance of these trauma-centred theories is important, as they have influenced and shaped psycho-social interventions and policies for refugee youth, particularly with regard to their mental health (Marlowe, 2010). Many war-affected URYP do experience significant mental health challenges and these theories underscore the importance of recognising them and potentially alleviating some of URYP’s manifestations. However, despite attempts to culturally align Western-based trauma tools to fit with the values/beliefs of refugee youth (Betancourt et al., 2009), many interventions are ensconced within a Western, biomedical framework (Murray et al., 2010). For instance, while a number of interventions may propose utilising indigenous vernacular to identify distress in a particular culture, Western treatment modalities, namely Cognitive Behavioural Therapy (CBT) and individualised talk therapy, are primarily employed with URYP (Akello et al., 2006). As such, a general scholarly assumption presumes that an adaptation of Western-based therapeutic interventions may alleviate the negative manifestations of URYP. Similarly, cultural misalignments may occur when URYP are unfamiliar or uninterested in Western-based mental health treatment modalities as the primary intervention. Reflections and critiques of trauma-focused theories Trauma-focused theories with URYP have indeed highlighted the importance of understanding how URYP may have maladaptive responses to situations of harsh adversities. The danger with theories of trauma, however, lies in instances where it is employed with a lack of nuance. A substantial movement challenging the globalisation of PTSD emerged in the mid- to late 1990s. Led by Kleinman (1995), Summerfield (1999) and Bracken (1998), a group of scholars identified a number of limitations associated with the medicalisation of trauma and universalising trauma theory. Rooted in a postmodern lens, this scholarship has attested that trauma discourse has systematically sidelined the social and cultural dimensions of suffering (Bracken, 1998; Summerfield, 1999). These scholars have argued that trauma-focused literature often assumes an individualist approach whereby society privileges the individual and may overlook the important influences of the larger context and community. Moreover, this individualist approach insinuates that psychopathology, namely PTSD, must be primarily addressed with the individual experiencing it. As such, other relevant considerations of identity and history (social, political, cultural) may be easily lost or hidden (Marlowe, 2010). The above-mentioned scholars set the foundation for more contemporary critiques of cross-cultural applications of USA-based diagnoses. Current critics of trauma-based theories promote cultural idioms of distress, as opposed to the universalising of trauma. Cultural idioms of distress refer to culturally relevant terms related to mind–body functioning that express discomforting conditions in ways that are locally understood (Hassan et al., 2015). For example, in their work with Syrian refugees living in Canada, Pottie and colleagues (2016) warn against universalised and systematic screenings for PTSD, but instead explore how war-related manifestations are perceived locally. For instance, it has been noted that concepts such as ‘psychological state’, ‘psychological well-being’ and ‘mental health’ may be misunderstood and carry negative connotations and stigma, since suffering is commonly understood as a normal aspect of Syrian life (Hassan et al., 2015). Moreover, Syrian idioms of distress do not separate somatic experience and psychological symptoms, given that body and soul are viewed as interlaced within the context of overall well-being (Hassan et al., 2015). Specific idioms of distress common to Syrian refugees are tightness in the chest, pain in the heart, numbness of body parts or having the feeling of ants crawling over the skin in which bodily organs are perceived as unable to contain the distress (Hassan et al., 2015). Therefore, methodical inquiry into the personal and local cultural meanings of these expressions is always necessary. The implications of associating URYP within the confines of trauma-focused scholarship imply that URYP are vulnerable victims with minimal agency (Denov and Bryan, 2014; Wernesjö, 2014). It has been argued that such victimising constructs inevitably shape the landscape in which this population is perceived in global academic discourses (Denov and Bryan, 2014). Finally, a common critique of the universalisation of war-related trauma is its failure to acknowledge refugees as experts in their personal experiences (Wernesjö, 2014). Indeed, these important critiques have led to shifts in scholarly theorisations of URYP. One such shift is the focus on resilience-based theories. Resilience theory and URYP Theories of resiliency emerged in the 1970/80s when academics in Western contexts perceived an inconsistent and unpredictable number of young people from ‘at-risk’ populations presenting with remarkably ‘good’ mental and physical health despite various stressors (Tol et al., 2013; Ungar, 2005). Researchers began exploring the underpinnings associated with certain individuals ‘bouncing back’ from adverse experiences (Boyden and Mann, 2005; Ungar, 2005). Theories of resiliency piqued widespread curiosity and scholarly focus which continue to garner pervasive attention (Ungar, 2005). Ungar defines resilience as follows: In the context of exposure to significant adversity, whether psychological, environmental, or both, resilience is both the capacity of individuals to navigate their way to health-sustaining resources, including opportunities to experience feelings of well-being, and a condition of the individual’s family, community and culture to provide these health resources and experiences in culturally meaningful ways (Ungar, 2008, p. 225). With regard to young people affected by armed conflict, the concept of resiliency was initially described as an individual characteristic of ‘invulnerable’ youth who flourished despite experiencing extreme adversities of war (Betancourt and Khan, 2008). Contrarily, contemporary resilience-focused scholars have cautioned against resiliency as merely an individual trait, but instead one couched in resilient trajectories or a combination of individual and societal factors (Betancourt and Khan, 2008; Ungar, 2005). For instance, URYP may exemplify resiliency via attending school or religious activities (collectivity), innate personality traits (individual) or a combination of the two. The concept of resiliency has morphed into a theoretical framework which considers a strengths-based approach to understanding young people’s adaptive development, while informing appropriate intervention modalities (Zimmerman, 2013). As such, the concept of resiliency is described as the potential of, individually and/or communally, adapting and functioning effectively following an adverse situation (Brown and Kulig, 1996). This potential to positively adapt is both supported and inhibited by the social, political and environmental contexts in which URYP manage their lives (Brown and Kulig, 1996). Resiliency as a theoretical approach moves beyond conceptualising the potential for individuals or communities to ‘bounce back’, but instead attempts to identify factors or interventions that may concretely facilitate positive adaptation (Brown and Kulig, 1999). Resiliency scholarship is ostensibly divorced from the DSM. Instead, resilience theorists are far more concerned with an ecological framework that assesses for risk and protective factors. Risk refers to internal or external variables that increase an individuals’ likelihood of psychopathology in response to adversity (Boyden and Mann, 2005). For young people affected by armed conflict, risks constitute directly experiencing or witnessing the killing of loved ones, sexual violence, loss of parents, disrupted education and a lack of stable support systems (Carlson et al., 2012). Inherent to theories of resilience are protective factors. Protective factors are individual, familial and/or structural attributes which decrease the likelihood of negative outcomes following adverse experiences or risks (Betancourt and Khan, 2008). Internal protective factors for URYP constitute age, temperament, self-efficacy and self-esteem (Boyden and Mann, 2005; Zimmerman, 2013). External protective factors denote significant relationships with family/care-givers and community, enrolling in school, spirituality/religion and cultural beliefs (Betancourt and Khan, 2008). Without proper protective factors against these risks, those who experience risks may be ‘vulnerable’ to psychopathology (Carlson et al., 2012). As a result, a majority of resilience research with young people affected by armed conflict seeks to ascertain protective factors that lead to resiliency instead of psychopathology (Ní Raghallaigh and Gilligan, 2010). Although virtually all young people demonstrate negative effects from exposure to highly stressful and threatening environments, not all young people face prolonged discontent. Those young people who are able to ‘bounce back’ are deemed resilient (Boyden and Mann, 2005; Ungar, 2005). Resiliency theory includes several models that describe how protective factors may shelter young people against the maladaptive effects of risks (Zimmerman, 2013). The two most common are the compensatory model and the protective factor model (Zimmerman, 2013). In the compensatory model, protective factors neutralise risk exposure in a counteractive form (Zimmerman, 2013). For instance, parental support may compensate a young person’s risk of ever engaging in violent behaviour. Similarly, spiritual or religious activities may protect an URYP against maladaptive behaviours associated with armed conflict. This model suggests that protective factors modify the relationship between a risk and resiliency. Theories of resilience with URYP have gained significant attention in the past fifteen years. Perhaps the two most prominent protective factors associated with URYP resiliency are said to be education/enrolling in school (Carlson et al., 2012) and religion or religious affiliation (Fernando and Ferrari, 2013; Ní Raghallaigh and Gilligan, 2010). Other noteworthy protective factors that engender resiliency are said to include peer support (Boyden and Mann, 2005); strong familial relationships prior to displacement (Ressler et al., 1988); remaining silent about ‘traumatic experiences’/suppressing thoughts regarding pre-displacement lifestyles (Luster et al., 2009); future aspirations, including gaining employment (Carlson et al., 2012); collective connection to URYP’s culture and ethnic identity (Fernando and Ferrari, 2013); and helping those in need (Fernando and Ferrari, 2013). While theories of trauma have drawn primarily on quantitative methods with URYP, the use of qualitative methods to assess resiliency or coping strategies has dominated resilience literature on this population (Chase, 2013). Moreover, qualitative literature moves away from psychopathology by assessing the individual’s overall sense of well-being (Wernesjö, 2014) most commonly via individual interviews and focus-group discussions, as opposed to quantitative checklists. Such interviews and focus groups may enable URYP and scholars to better explore local idioms of distress. Critiquing resilience theory A key criticism of resiliency theories maintains that resilience-based literature is rooted within a Eurocentric worldview (Ungar, 2005). For instance, the meanings of social constructs such as ‘coping’ and ‘competence’ vary according to time and context, and most resilience-based research has been conducted by Western-trained psychological and social service communities (Ungar, 2005). Additionally, resiliency cannot be directly observed and measured; it is arbitrary and only inferred from observations based on related constructs such as ‘positive adaptation’ (Boyden and Mann, 2005). Furthermore, in a number URYP studies, resilience is tantamount to lack of psychopathology, as opposed to the idea that URYP’s personal resourcefulness may promote their own well-being (Boyden and Mann, 2005). Finally, the compensatory model of resiliency may not be ideally suited or applied to the complex realities of URYP. For instance, prior to armed conflict, URYP may have a number of protective factors that steer them away from maladaptive behaviour. Instead, risk factors—such as political violence—are beyond their control and may force them into situations of despair despite the protective influence of their parents, school or spiritual engagements. The emerging resiliency-based literature has indeed provided a valuable and nuanced understanding of young people’s realities and experiences, capturing and promoting URYP’s unique ability to contribute to their individual development, safety and well-being. However, similarly to the danger of over-emphasising traumatic experiences with regard to URYP, there may be a risk for researchers and practitioners to over-emphasise resilience in children, assuming that all will or have the capacity to ‘bounce back’ (Denov and Akesson, 2017). Bridging divides On a macro level, efforts to bridge the trauma/resilience binary have been examined. Whether via a neurobiological perspective or a greater interaction between researchers and policy makers (Fekete et al., 2014), scholarship has explored mechanisms to integrate this binary (Miller and Rasmussen, 2010). However, with regard to URYP, it appears researchers have yet to engage with the above-mentioned literature. Therefore, in both trauma and resilience-centred approaches, specific to URYP, key elements of nuance and complexity are missing. We suggest that exploring this ‘artificially’ separated binary (Miller and Rasmussen, 2010) is essential to holistically appreciating URYP experiences. As mentioned, the polarity between trauma and resilience has led to largely opposing camps whereby URYP are identified and constructed as being on one end of the spectrum or the other. This dichotomy fails to account for URYP who are resourceful, capable and strong in certain aspects of life and ‘vulnerable’ in others (Wernesjö, 2014). For instance, a female URYP may be considered ‘traumatised’ due to her experiences of surviving repeated acts of war-related sexual violence. Such acts may have engendered a number of trauma-specific maladaptive manifestations, including difficulty sleeping, flashbacks, nightmares, over-thinking or low self-esteem. On the other hand, however, this same female may have not only removed herself and her younger siblings from the imminent danger they faced by relocating to a refugee camp, but she also enrolled all of them in school. A number of her behaviours may align with trauma-focused theories (difficulty in sleeping, flashbacks, nightmares) while others exemplify acts of resiliency (enrolment in school). This example may illustrate a more genuine representation of the realities of many URYP whose experiences embody aspects of both trauma and resilience. When adhering to either approach in isolation, URYP’s ability to preserve and embrace a sense of agency despite facing symptoms of trauma when conceptualising one’s lived experiences during war is overlooked. Exploring this nuanced area begs further consideration in URYP scholarship. Other vital issues that are particularly relevant to URYP include the realities of victimisation, perpetration, guilt and moral responsibility. In some cases, URYP may have been implicated in armed conflict as victims, witnesses or participants and, in the case of former child soldiers, all three simultaneously (Denov, 2010). Such war-related experiences cannot easily be placed within the realm of either trauma or resilience, highlighting the importance of conceptualisations that recognise both victimisation and perpetration in violence, their implications for the individual and community in question, as well as appropriate interventions addressing justice and forgiveness. The acknowledgement of a problematic ‘trauma or resilience’ binary has been recognised in scholarship with URYP (Kohli, 2007; Wernesjö, 2014). However, while Wernesjö (2014) and Kohli (2007) recommend adopting a framework that incorporates both vulnerability and resiliency with URYP, neither theorises what this may realistically look like. Vervliet and colleagues (2014a) suggest the adoption of an intersectionality theoretical framework with URYP mothers. They argue that, in order to assess each constructed identity—‘refugee’, ‘unaccompanied’ and ‘young person’—expanding and adapting an intersectionality lens to various URYP populations may offer nuance to the multifaceted conceptual understandings of URYP while affording a more holistic analysis. Though the intersectionality framework is a valuable approach when commencing an analysis of URYP experiences, a more enhanced process may be warranted. Miller and Rasmussen (2010) suggest that a debate between advocates of trauma-focused and resilience theory is unnecessary and futile. Indeed, they offer an approach that attempts to bridge the trauma and resilience binary by arguing that pre- and post-migratory experiences cannot be viewed as distinct entities. Instead, they suggest that what is more realistic is an interaction between pre- and post-migratory experiences which often promotes both healthy and maladaptive environments (Miller and Rasmussen, 2010). Non-Western theories of URYP In order to holistically and ethically appreciate the experiences of war for URYP, we suggest that non-Western forms of knowing and being should be integrated more fully into Western mainstream theoretical pursuits. Creating space for non-Western theoretical and conceptual inquiries, based on communal forms of living, spirituality and forms of knowing that stray from common Western ideals, is vital for social science research (Chilisa, 2012) and especially with URYP. While locating scholarship on the non-Western manifestations of war-related experiences for URYP is a significant challenge, non-Western theories of war-related manifestations do exist for those affected by armed conflict. The importance of exploring non-Western theories is evident. As noted earlier, a majority of URYP originate from non-Western cultures and may have been reared in environments that adhere to unique ways of seeing and knowing that reflect local culture, contexts, understandings and idioms of distress (Hassan et al., 2015). A mainstream, Western idiom of distress would consider a war-related manifestation to either an internal or external cause (Fernando, 2014). In contrast, a predominant belief in most non-Western traditions is that an individual’s internal and external experience are not only related to each other, but they are one and the same; nothing is separate from anything else (Fernando, 2014). The following example illustrates localised manifestations of armed conflict in northern Uganda. Northern Uganda and the importance of cen Following armed conflict in a number of African countries, the manifestations of spirits affected substantial populations of combatants and civilians (Harlacher, 2009). This was the case in post-conflict northern Uganda. We selected northern Uganda as a case study due to: (i) the high number of young people left unaccompanied following the conflict, (ii) the extensive literature on the impacts of armed conflict on young people and (iii) a dearth of scholarship on non-Western manifestations of URYP’s war-related experiences. Decades of war in northern Uganda left many children (who were formerly abducted into the Lord’s Resistance Army (LRA)) as expressing trouble sleeping, experiencing nightmares and physical illness (Akello et al., 2006; Bilotta, 2016). Considering these were not identified prior to their involvement in armed conflict, believers of traditional Acholi culture equated such manifestations as ‘cen’ (Akello et al., 2006). Cen has been described as the revenging of spirits of those who were killed during the armed conflict and not given a proper burial (Harlacher, 2009). Indeed, the spirit of cen manifests by haunting the sufferer (usually the one who killed) and his/her family via nightmares, disturbing visuals, sickness and physical pain (Akello et al., 2006; Harlacher, 2009). If not explored via a locally specific contextual framework, scholars may identify symptoms of cen as those of PTSD. This may cause a misalignment in interventions for such symptoms, as cen and PTSD recommend varying treatment modalities (Bilotta, 2016). Cen requires specific cultural rituals and ceremonies (Bilotta, 2016), while PTSD is often treated by Western-based behavioural practices and possibly medication. In response to the armed conflict in northern Uganda, a number of studies were conducted that linked former young combatants as suffering from PTSD (Derluyn et al., 2004) and tended to employ checklists or questionnaires that assessed for PTSD. Other scholars and clinicians working in northern Uganda have raised cultural and ethical questions with regard to employing PTSD scales with this population (McKay and Wessells, 2004). McKay and Wessells (2004) called into question Derluyn and colleagues’ (2004) study on former child soldiers in northern Uganda, which utilised PTSD scales to assess trauma and asserted that former child soldiers showed a high rate of post-traumatic stress reactions. McKay and Wessells noted that the: Use of a diagnosis of PTSD as a starting point is problematic because it pathologises and stigmatises children, imposes categories formulated by westerners, and limits the conceptualisation of the kinds of support that are needed. We doubt that measurement of trauma by means of individualistic psychological tools is appropriate in the collectivist cultural context of northern Uganda (McKay and Wessells, 2004, p. 1646). The case of northern Uganda and the importance of recognising cen should not be seen as an anomaly. Research has identified non-Western manifestations of post-conflict experiences in a number of global contexts. For instance, Van Ommeren et al. (2001) explored a medically unexplained phenomenon in a Bhutanese refugee camp in south-eastern Nepal. Prior to the study, a significant number of young people in this camp experienced physical and mental ‘attacks’, primarily fainting and dizziness (Van Ommeren et al., 2001). A rumour existed that, years prior, two youth had committed suicide by hanging themselves on a tree near the camp and their spirits remained on Earth, since they had died an unnatural death (Van Ommeren et al., 2001). It was those spirits that were thought to inflict disease through possession of such attacks (Van Ommeren et al., 2001). The attacks consisted of fainting, dizziness and hyperventilation and each lasted roughly 105 minutes (Van Ommeren et al., 2001). In addition, common throughout such attacks were auditory and visual hallucinations. Despite physician and mental health intervention, no medical conclusions were drawn as to why this particular epidemic occurred at this refugee camp (Van Ommeren et al., 2001). The call for social work research, theory and practice to engage more substantially with culturally diverse theoretical and practice scholarship, particularly from the Global South, as well as the need to draw upon local knowledge and understandings in direct practice has been made elsewhere (see Bryan and Denov, 2011; see Denov and Akesson, 2017). Moreover, the profession has taken upon itself to improve its members’ ability to work with culturally and ethnically diverse clients (NASW, 2007). While these advancements should be commended, a recent literature review of social work scholarship on international immigration found a clear omission of cultural factors related to social work practice with migrants and refugees (Shier et al., 2011). Moreover, local approaches to practice emerging from the Global South have, for the most part, not yet entered into mainstream academic discourse, as well as social work curriculum (Felton and Harrison, 2017). Implications for social work Although theoretical in format, the arguments in this paper signify important implications for social work practice and research, specifically for social workers practising in post-conflict contexts. Advances in holistically assessing the impacts of armed conflict on URYP have increased in the recent past; however, further progress is warranted. Our arguments point to the need for advocacy and support of local capacities, indigenous to URYP, by including literature, stories, beliefs and helpers (Bryan and Denov, 2011) from URYP countries of origin. By challenging the Western-based binary, social workers will be better equipped to advocate for or facilitate culturally applicable healing strategies. By privileging social work paradigms from the Global North, social workers run the risk of perpetuating an imperial lens on what constitutes expertise. For instance, the commonly prescribed treatment modalities for Western-based, war-related psychopathology may conflict with URYP ways of knowing and systems of belief. And, by propagating such ‘healing strategies’, an inevitable hierarchical relationship forms whereby the social worker is unequivocally established as the sole expert, which may ultimately disempower URYPs who hold important cultural and contextual knowledge. With regard to future research and programming guidelines, greater research should explore indigenous forms of social work practice globally, particularly those related to post-conflict settings. Comprehensive research that analyses globally diverse nuances in armed conflict, violence, pain, suffering and healing will engender alternative theories that may assist social workers’ understandings of URYP’s experiences. Perhaps most importantly, research should include the voices of URYP and others affected by armed conflict. At this point, minimal scholarship has explored how trauma and resiliency are defined and understood by URYP. For instance, does being identified as ‘traumatised’ or ‘resilient’ impact how URYP are perceived in local or global discourse? How do URYP who believe in cen respond to the constructs of ‘trauma’ or ‘resilience’? How do URYP understand fainting, dizziness, and auditory and visual hallucinations? Who ultimately benefits from trauma and resilience label(s)? In order to accurately respond to such queries, a richer examination that unpacks the meanings of trauma and resilience for URYP is necessary. Conclusion URYP have myriad war-related experiences which may constitute both perilous and adaptive manifestations. Both trauma and resilience-based theories offer essential insight into the conceptualisation of URYP’s post-conflict realities. While valuable and unique in their individualised approaches, privileging trauma or resilience-based theories for URYP incorporates merely a fraction of the holistic context for this population. In this paper, we have argued that scholars should consider bridging the trauma and resilience binary in order to gain a nuanced perspective on the experiences and realities of URYP. The failure to intersect the two distinct approaches may perpetuate an ineffectual divide. Further exploration should consider whether URYP possess characteristics of trauma and resiliency either simultaneously or at differing periods of time during and following war-related experiences. In addition, having a general knowledge of non-Western theories would inevitably provide alternatives to Western-based trauma and resilience theories, which could potentially shift treatment modalities. The example of northern Uganda illustrates that PTSD treatment modalities may be less culturally relevant and meaningful to one who closely aligns with traditional Acholi culture (Bilotta, 2016). Moreover, the example from Nepal demonstrates the need for local expertise in understanding the complex realities and behaviours of youth affected by armed conflict. Perhaps a more culturally syntonic approach is to explore how URYP regard their own war-related experiences. Interviews or focus groups assessing what URYP organically understand about their experiences are critical. 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Theoretical Understandings of Unaccompanied Young People Affected by War: Bridging Divides and Embracing Local Ways of Knowing

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Oxford University Press
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0045-3102
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Abstract

Abstract This article explores the theoretical binary that has tended to encompass the majority of scholarship with unaccompanied refugee young people (URYP) affected by armed conflict. In this paper, we argue that URYP scholars often theorise this population via either a trauma/victimisation framework or resiliency lens, which creates a distinct binary. While these opposing theoretical perspectives provide important insight into understanding URYP’s experiences, this conceptual binary has tended to neglect the nexus of factors for URYP who are resourceful and determined in particular aspects of their lives, while simultaneously being vulnerable in others. We suggest that a more nuanced exploration of theoretical frameworks is necessary, specific to URYP’s experiences. Moreover, we call for greater analysis of theories that emerge from both the Global North and, particularly, the Global South in order to gain a more holistic appreciation of the complex lives and realities of URYP, whether during armed conflict or in its aftermath. By uniting trauma and resilience theories and integrating theories from the Global South, from where a majority of URYP originate, scholars may provide a richer account of URYP that is not only beneficial for global discourse, but may have greater significance for URYP who attempt to make meaning out of their experiences. Refugees, resilience, theory, trauma, young people Introduction Roughly half of the world’s fifty million refugees (UNHCR, 2015) are below the age of eighteen and approximately 2–5 per cent of all refugee young people are unaccompanied (Hartwell, 2011). An unaccompanied child refers to ‘… a person who is under the age of eighteen years, unless, under the law applicable to the child, majority is attained earlier and who is separated from both parents and is not being cared for by an adult who by law or custom has responsibility to do so’ (UNHCR, 1997, p. 5). While the concept of an unaccompanied child was officially defined in the 1990s, the reality of young people being left unaccompanied has been intrinsic to virtually every past war, refugee situation and natural disaster (Ressler et al., 1988). For unaccompanied young people, whose lives have been marred by armed conflict, their experiences are indeed shaped by intersecting factors such as gender, age, race, ethnicity, sexual orientation, mobility, socio-economic context and key developmental factors (Ressler et al., 1988). However, common themes are nonetheless present. In addition to being separated from their care-givers, a majority of unaccompanied refugee young people (URYP) may have directly experienced or witnessed the killings of loved ones, persecution, sexual violence and dangerous escapes (Hartwell, 2011). Moreover, the parents or primary care-givers of these children may have been killed or detained during conflict, gone missing, died during flight or were separated in the chaos of war and subsequent flight (Hartwell, 2011). A global and heightened awareness of the impact of armed conflict on URYP has garnered significant academic attention over the past fifteen to twenty years. However, drawing predominantly on theoretical ideas and understandings which emerged in the Global North, scholarly literature has tended to conceptualise the ways URYP navigate their socio-political terrains in war/post-war periods using two predominant conceptual lenses. On the one hand, the realities of URYP have been framed within the context of trauma and victimisation (Huemer et al., 2009). This focus on trauma and victimisation has provided important insights into the psycho-social well-being of this population. However, this scholarship may inadvertently reinforce popular discourses of URYP as inherently troubled, victimised and perpetually ‘at risk’ (Denov and Bryan, 2014). Moreover, while trauma and victimisation as a result of war invariably characterise the experiences of many young people, failing to also explore young people’s capacity to overcome adversity may provide a skewed picture of their reality. On the other hand, in response to trauma-based conceptualisations, an increasing focus on resilience among war-affected young people has emerged in the literature. This scholarship has emphasised children’s capacities, and their ability to ‘beat the odds’ and ‘cope well’ despite experiences of profound adversity and individual, familial and structural stressors (Fernando and Ferrari, 2013; Tol et al., 2013). Placing an emphasis on the resilience of URYP offers an important and dynamic perspective on the lives of this unique population. However, similarly to the trauma-based literature, a danger exists when researchers and practitioners over-emphasise resilience in children, assuming that all will or have the capacity to ‘bounce back’ (Denov and Akesson, 2017). Although social workers have explored the resilience/traumatisation binary framework with various populations (Fekete et al., 2014), the social work discipline has yet to substantially unpack this binary with URYP affected by war. We argue that a problematic dichotomy has formed within URYP discourse: a danger exists in either inappropriately pathologising URYP or—at the other extreme—conceptualising this population as inevitably able to ‘bounce back’ from adverse conditions. This conceptual binary has tended to neglect more blurred and fuzzy circumstances of URYP who are resourceful and strong in certain aspects of their lives, while simultaneously being ‘vulnerable’ in others (Wernesjö, 2014). Although recommendations suggest adopting a framework that incorporates both vulnerability and resiliency in Western contexts (Wernesjö, 2014), concrete efforts to bridge this conceptual divide need further attention. We suggest that a more nuanced exploration of theoretical frameworks is necessary. Moreover, we call for greater exploration of theories that emerge from both the Global North and, particularly, the Global South, in order to gain a more holistic appreciation of the complex lives and realities of URYP. The first segment of the paper details the scholarship drawn upon in our exploration of the literature on URYP. Second, we examine the Western-based trauma/resilience theoretical binary that has characterised the majority of URYP scholarship. It also considers the potential underpinnings of the recent shift from trauma-focused to resiliency-based literature, albeit with the former’s continued dominance (Jensen et al., 2014). The paper then explores theories emerging from the Global South, particularly northern Uganda and with Bhutanese refugees living in Nepal, which have been largely overlooked in URYP scholarship. While proposing an integration of both Western and non-Western conceptions of war/post-war experiences, we argue that both trauma and resilience theories should be viewed as intersecting and complementary entities, as opposed to a distinct binary. Moreover, non-Western theories of armed conflict should be drawn upon and explored to ensure a more nuanced and culturally relevant understanding of the lived realities and needs of URYP. Search strategy Although not a systematic review, we performed extensive literature reviews in PsycInfo, ERIC, PubMed, SOCIndex, Social Work Abstracts and Google Scholar. We applied key word searches to obtain scholarship related to: (i) unaccompanied refugee young people (‘minors’—generally up to eighteen years old), (ii) trauma and/or resilience as related to URYP and (iii) URYP affected by armed conflict. We excluded literature that did not focus on the mental health or overall well-being of this population. Finally, we searched the reference section of all studies and pursued those related to our criteria. URYP: unpacking theories of trauma and victimisation Theories of trauma and victimisation have long been used to describe and understand the experiences of URYP (Huemer et al., 2009). Herman asserts that psychological trauma composes: … an affiliation of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force … [which] overwhelms the ordinary system of care that gives people a sense of control, connection, and meaning. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence and death. They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe (Herman, 1992, p.33). When identifying URYP as ‘traumatised’, URYP scholars have frequently drawn upon the fourth edition of the Western-based Diagnostic and Statistical Manual of Mental Disorders (DSM) (Huemer et al., 2011; Vervliet et al., 2014b). The DSM-IV links behaviours of those experiencing trauma to specific mental health pathologies. Such pathologies include depression, anxiety and grief (Bronstein et al., 2013). Post-Traumatic Stress Disorder (PTSD) is the most notably acknowledged mental health pathology in URYP scholarship (Bronstein et al., 2013; Smid et al., 2011). As such, when referring to URYP as ‘traumatised’ or victims, we are drawing from ‘trauma’ associated with PTSD. DSM-IV identifies PTSD as re-experiencing a traumatic event in nightmares and flashbacks, avoiding thoughts that remind one of the event, feelings of guilt, self-destructive behaviour, diminished interest in activities, physiological arousal and an inability to remember key aspects of the traumatic event(s) (APA, 1994). Moreover, the DSM-IV contends that a candidate for PTSD must have directly experienced (or witnessed) a traumatic event, experienced repeated exposure to aversive details of the traumatic event or learned that a loved one experienced a traumatic event (APA, 1994). Due to the circumstances of armed conflict, URYP are frequently exposed to harsh circumstances that may engender a number of PTSD’s symptoms. By extracting PTSD symptomology from the DSM, a significant body of scholarship has argued that URYP are traumatised (Lambert and Alhassoon, 2015) and that direct exposure to war-related violence, or learning about injury/death to loved ones, will likely engender negative mental health effects, particularly psychopathology (Huemer et al., 2009). Although considerable scholarly debate exists which challenges the objectivity in measuring trauma exposure, academic scholarship commonly associates URYP with PTSD (Smid et al., 2011). Ubiquitous within such literature is that a separation from parents/care-givers may be the most egregious circumstance for URYP (Wernesjö, 2014). Trauma-focused scholars often identify URYP as a vulnerable population which may engender prolonged mental health impairments (Derluyn, 2005) and ‘internalise their problems’, resulting in depression and anxiety (Bronstein et al., 2013). In contrast, URYP may ‘externalise’ their feelings which often manifests in acting out behaviour (Bronstein et al., 2013). Additionally, URYP who have experienced multiple traumatic events, lower education levels and insufficient social supports are identified as being at risk for developing PTSD (Smid et al., 2011). It should also be noted that most trauma-focused scholars writing on URYP have tended to employ American-based, quantitative mental health checklists to ascertain their psychopathology. These included the Child PTSD Symptom Scale (Jensen et al., 2014), the Post-Traumatic Stress Disorder Checklist and the Hopkins Symptom Checklist (Bronstein et al., 2013). By privileging USA-based mental health instruments, scholars may apply mental health terminology that is potentially unfamiliar and culturally insignificant to URYP. Despite efforts to translate such instruments into the primary languages and cultures of unaccompanied young people (Betancourt et al., 2009), a majority of scholarship continues to employ the aforementioned checklists (Huemer et al., 2011). The significance of these trauma-centred theories is important, as they have influenced and shaped psycho-social interventions and policies for refugee youth, particularly with regard to their mental health (Marlowe, 2010). Many war-affected URYP do experience significant mental health challenges and these theories underscore the importance of recognising them and potentially alleviating some of URYP’s manifestations. However, despite attempts to culturally align Western-based trauma tools to fit with the values/beliefs of refugee youth (Betancourt et al., 2009), many interventions are ensconced within a Western, biomedical framework (Murray et al., 2010). For instance, while a number of interventions may propose utilising indigenous vernacular to identify distress in a particular culture, Western treatment modalities, namely Cognitive Behavioural Therapy (CBT) and individualised talk therapy, are primarily employed with URYP (Akello et al., 2006). As such, a general scholarly assumption presumes that an adaptation of Western-based therapeutic interventions may alleviate the negative manifestations of URYP. Similarly, cultural misalignments may occur when URYP are unfamiliar or uninterested in Western-based mental health treatment modalities as the primary intervention. Reflections and critiques of trauma-focused theories Trauma-focused theories with URYP have indeed highlighted the importance of understanding how URYP may have maladaptive responses to situations of harsh adversities. The danger with theories of trauma, however, lies in instances where it is employed with a lack of nuance. A substantial movement challenging the globalisation of PTSD emerged in the mid- to late 1990s. Led by Kleinman (1995), Summerfield (1999) and Bracken (1998), a group of scholars identified a number of limitations associated with the medicalisation of trauma and universalising trauma theory. Rooted in a postmodern lens, this scholarship has attested that trauma discourse has systematically sidelined the social and cultural dimensions of suffering (Bracken, 1998; Summerfield, 1999). These scholars have argued that trauma-focused literature often assumes an individualist approach whereby society privileges the individual and may overlook the important influences of the larger context and community. Moreover, this individualist approach insinuates that psychopathology, namely PTSD, must be primarily addressed with the individual experiencing it. As such, other relevant considerations of identity and history (social, political, cultural) may be easily lost or hidden (Marlowe, 2010). The above-mentioned scholars set the foundation for more contemporary critiques of cross-cultural applications of USA-based diagnoses. Current critics of trauma-based theories promote cultural idioms of distress, as opposed to the universalising of trauma. Cultural idioms of distress refer to culturally relevant terms related to mind–body functioning that express discomforting conditions in ways that are locally understood (Hassan et al., 2015). For example, in their work with Syrian refugees living in Canada, Pottie and colleagues (2016) warn against universalised and systematic screenings for PTSD, but instead explore how war-related manifestations are perceived locally. For instance, it has been noted that concepts such as ‘psychological state’, ‘psychological well-being’ and ‘mental health’ may be misunderstood and carry negative connotations and stigma, since suffering is commonly understood as a normal aspect of Syrian life (Hassan et al., 2015). Moreover, Syrian idioms of distress do not separate somatic experience and psychological symptoms, given that body and soul are viewed as interlaced within the context of overall well-being (Hassan et al., 2015). Specific idioms of distress common to Syrian refugees are tightness in the chest, pain in the heart, numbness of body parts or having the feeling of ants crawling over the skin in which bodily organs are perceived as unable to contain the distress (Hassan et al., 2015). Therefore, methodical inquiry into the personal and local cultural meanings of these expressions is always necessary. The implications of associating URYP within the confines of trauma-focused scholarship imply that URYP are vulnerable victims with minimal agency (Denov and Bryan, 2014; Wernesjö, 2014). It has been argued that such victimising constructs inevitably shape the landscape in which this population is perceived in global academic discourses (Denov and Bryan, 2014). Finally, a common critique of the universalisation of war-related trauma is its failure to acknowledge refugees as experts in their personal experiences (Wernesjö, 2014). Indeed, these important critiques have led to shifts in scholarly theorisations of URYP. One such shift is the focus on resilience-based theories. Resilience theory and URYP Theories of resiliency emerged in the 1970/80s when academics in Western contexts perceived an inconsistent and unpredictable number of young people from ‘at-risk’ populations presenting with remarkably ‘good’ mental and physical health despite various stressors (Tol et al., 2013; Ungar, 2005). Researchers began exploring the underpinnings associated with certain individuals ‘bouncing back’ from adverse experiences (Boyden and Mann, 2005; Ungar, 2005). Theories of resiliency piqued widespread curiosity and scholarly focus which continue to garner pervasive attention (Ungar, 2005). Ungar defines resilience as follows: In the context of exposure to significant adversity, whether psychological, environmental, or both, resilience is both the capacity of individuals to navigate their way to health-sustaining resources, including opportunities to experience feelings of well-being, and a condition of the individual’s family, community and culture to provide these health resources and experiences in culturally meaningful ways (Ungar, 2008, p. 225). With regard to young people affected by armed conflict, the concept of resiliency was initially described as an individual characteristic of ‘invulnerable’ youth who flourished despite experiencing extreme adversities of war (Betancourt and Khan, 2008). Contrarily, contemporary resilience-focused scholars have cautioned against resiliency as merely an individual trait, but instead one couched in resilient trajectories or a combination of individual and societal factors (Betancourt and Khan, 2008; Ungar, 2005). For instance, URYP may exemplify resiliency via attending school or religious activities (collectivity), innate personality traits (individual) or a combination of the two. The concept of resiliency has morphed into a theoretical framework which considers a strengths-based approach to understanding young people’s adaptive development, while informing appropriate intervention modalities (Zimmerman, 2013). As such, the concept of resiliency is described as the potential of, individually and/or communally, adapting and functioning effectively following an adverse situation (Brown and Kulig, 1996). This potential to positively adapt is both supported and inhibited by the social, political and environmental contexts in which URYP manage their lives (Brown and Kulig, 1996). Resiliency as a theoretical approach moves beyond conceptualising the potential for individuals or communities to ‘bounce back’, but instead attempts to identify factors or interventions that may concretely facilitate positive adaptation (Brown and Kulig, 1999). Resiliency scholarship is ostensibly divorced from the DSM. Instead, resilience theorists are far more concerned with an ecological framework that assesses for risk and protective factors. Risk refers to internal or external variables that increase an individuals’ likelihood of psychopathology in response to adversity (Boyden and Mann, 2005). For young people affected by armed conflict, risks constitute directly experiencing or witnessing the killing of loved ones, sexual violence, loss of parents, disrupted education and a lack of stable support systems (Carlson et al., 2012). Inherent to theories of resilience are protective factors. Protective factors are individual, familial and/or structural attributes which decrease the likelihood of negative outcomes following adverse experiences or risks (Betancourt and Khan, 2008). Internal protective factors for URYP constitute age, temperament, self-efficacy and self-esteem (Boyden and Mann, 2005; Zimmerman, 2013). External protective factors denote significant relationships with family/care-givers and community, enrolling in school, spirituality/religion and cultural beliefs (Betancourt and Khan, 2008). Without proper protective factors against these risks, those who experience risks may be ‘vulnerable’ to psychopathology (Carlson et al., 2012). As a result, a majority of resilience research with young people affected by armed conflict seeks to ascertain protective factors that lead to resiliency instead of psychopathology (Ní Raghallaigh and Gilligan, 2010). Although virtually all young people demonstrate negative effects from exposure to highly stressful and threatening environments, not all young people face prolonged discontent. Those young people who are able to ‘bounce back’ are deemed resilient (Boyden and Mann, 2005; Ungar, 2005). Resiliency theory includes several models that describe how protective factors may shelter young people against the maladaptive effects of risks (Zimmerman, 2013). The two most common are the compensatory model and the protective factor model (Zimmerman, 2013). In the compensatory model, protective factors neutralise risk exposure in a counteractive form (Zimmerman, 2013). For instance, parental support may compensate a young person’s risk of ever engaging in violent behaviour. Similarly, spiritual or religious activities may protect an URYP against maladaptive behaviours associated with armed conflict. This model suggests that protective factors modify the relationship between a risk and resiliency. Theories of resilience with URYP have gained significant attention in the past fifteen years. Perhaps the two most prominent protective factors associated with URYP resiliency are said to be education/enrolling in school (Carlson et al., 2012) and religion or religious affiliation (Fernando and Ferrari, 2013; Ní Raghallaigh and Gilligan, 2010). Other noteworthy protective factors that engender resiliency are said to include peer support (Boyden and Mann, 2005); strong familial relationships prior to displacement (Ressler et al., 1988); remaining silent about ‘traumatic experiences’/suppressing thoughts regarding pre-displacement lifestyles (Luster et al., 2009); future aspirations, including gaining employment (Carlson et al., 2012); collective connection to URYP’s culture and ethnic identity (Fernando and Ferrari, 2013); and helping those in need (Fernando and Ferrari, 2013). While theories of trauma have drawn primarily on quantitative methods with URYP, the use of qualitative methods to assess resiliency or coping strategies has dominated resilience literature on this population (Chase, 2013). Moreover, qualitative literature moves away from psychopathology by assessing the individual’s overall sense of well-being (Wernesjö, 2014) most commonly via individual interviews and focus-group discussions, as opposed to quantitative checklists. Such interviews and focus groups may enable URYP and scholars to better explore local idioms of distress. Critiquing resilience theory A key criticism of resiliency theories maintains that resilience-based literature is rooted within a Eurocentric worldview (Ungar, 2005). For instance, the meanings of social constructs such as ‘coping’ and ‘competence’ vary according to time and context, and most resilience-based research has been conducted by Western-trained psychological and social service communities (Ungar, 2005). Additionally, resiliency cannot be directly observed and measured; it is arbitrary and only inferred from observations based on related constructs such as ‘positive adaptation’ (Boyden and Mann, 2005). Furthermore, in a number URYP studies, resilience is tantamount to lack of psychopathology, as opposed to the idea that URYP’s personal resourcefulness may promote their own well-being (Boyden and Mann, 2005). Finally, the compensatory model of resiliency may not be ideally suited or applied to the complex realities of URYP. For instance, prior to armed conflict, URYP may have a number of protective factors that steer them away from maladaptive behaviour. Instead, risk factors—such as political violence—are beyond their control and may force them into situations of despair despite the protective influence of their parents, school or spiritual engagements. The emerging resiliency-based literature has indeed provided a valuable and nuanced understanding of young people’s realities and experiences, capturing and promoting URYP’s unique ability to contribute to their individual development, safety and well-being. However, similarly to the danger of over-emphasising traumatic experiences with regard to URYP, there may be a risk for researchers and practitioners to over-emphasise resilience in children, assuming that all will or have the capacity to ‘bounce back’ (Denov and Akesson, 2017). Bridging divides On a macro level, efforts to bridge the trauma/resilience binary have been examined. Whether via a neurobiological perspective or a greater interaction between researchers and policy makers (Fekete et al., 2014), scholarship has explored mechanisms to integrate this binary (Miller and Rasmussen, 2010). However, with regard to URYP, it appears researchers have yet to engage with the above-mentioned literature. Therefore, in both trauma and resilience-centred approaches, specific to URYP, key elements of nuance and complexity are missing. We suggest that exploring this ‘artificially’ separated binary (Miller and Rasmussen, 2010) is essential to holistically appreciating URYP experiences. As mentioned, the polarity between trauma and resilience has led to largely opposing camps whereby URYP are identified and constructed as being on one end of the spectrum or the other. This dichotomy fails to account for URYP who are resourceful, capable and strong in certain aspects of life and ‘vulnerable’ in others (Wernesjö, 2014). For instance, a female URYP may be considered ‘traumatised’ due to her experiences of surviving repeated acts of war-related sexual violence. Such acts may have engendered a number of trauma-specific maladaptive manifestations, including difficulty sleeping, flashbacks, nightmares, over-thinking or low self-esteem. On the other hand, however, this same female may have not only removed herself and her younger siblings from the imminent danger they faced by relocating to a refugee camp, but she also enrolled all of them in school. A number of her behaviours may align with trauma-focused theories (difficulty in sleeping, flashbacks, nightmares) while others exemplify acts of resiliency (enrolment in school). This example may illustrate a more genuine representation of the realities of many URYP whose experiences embody aspects of both trauma and resilience. When adhering to either approach in isolation, URYP’s ability to preserve and embrace a sense of agency despite facing symptoms of trauma when conceptualising one’s lived experiences during war is overlooked. Exploring this nuanced area begs further consideration in URYP scholarship. Other vital issues that are particularly relevant to URYP include the realities of victimisation, perpetration, guilt and moral responsibility. In some cases, URYP may have been implicated in armed conflict as victims, witnesses or participants and, in the case of former child soldiers, all three simultaneously (Denov, 2010). Such war-related experiences cannot easily be placed within the realm of either trauma or resilience, highlighting the importance of conceptualisations that recognise both victimisation and perpetration in violence, their implications for the individual and community in question, as well as appropriate interventions addressing justice and forgiveness. The acknowledgement of a problematic ‘trauma or resilience’ binary has been recognised in scholarship with URYP (Kohli, 2007; Wernesjö, 2014). However, while Wernesjö (2014) and Kohli (2007) recommend adopting a framework that incorporates both vulnerability and resiliency with URYP, neither theorises what this may realistically look like. Vervliet and colleagues (2014a) suggest the adoption of an intersectionality theoretical framework with URYP mothers. They argue that, in order to assess each constructed identity—‘refugee’, ‘unaccompanied’ and ‘young person’—expanding and adapting an intersectionality lens to various URYP populations may offer nuance to the multifaceted conceptual understandings of URYP while affording a more holistic analysis. Though the intersectionality framework is a valuable approach when commencing an analysis of URYP experiences, a more enhanced process may be warranted. Miller and Rasmussen (2010) suggest that a debate between advocates of trauma-focused and resilience theory is unnecessary and futile. Indeed, they offer an approach that attempts to bridge the trauma and resilience binary by arguing that pre- and post-migratory experiences cannot be viewed as distinct entities. Instead, they suggest that what is more realistic is an interaction between pre- and post-migratory experiences which often promotes both healthy and maladaptive environments (Miller and Rasmussen, 2010). Non-Western theories of URYP In order to holistically and ethically appreciate the experiences of war for URYP, we suggest that non-Western forms of knowing and being should be integrated more fully into Western mainstream theoretical pursuits. Creating space for non-Western theoretical and conceptual inquiries, based on communal forms of living, spirituality and forms of knowing that stray from common Western ideals, is vital for social science research (Chilisa, 2012) and especially with URYP. While locating scholarship on the non-Western manifestations of war-related experiences for URYP is a significant challenge, non-Western theories of war-related manifestations do exist for those affected by armed conflict. The importance of exploring non-Western theories is evident. As noted earlier, a majority of URYP originate from non-Western cultures and may have been reared in environments that adhere to unique ways of seeing and knowing that reflect local culture, contexts, understandings and idioms of distress (Hassan et al., 2015). A mainstream, Western idiom of distress would consider a war-related manifestation to either an internal or external cause (Fernando, 2014). In contrast, a predominant belief in most non-Western traditions is that an individual’s internal and external experience are not only related to each other, but they are one and the same; nothing is separate from anything else (Fernando, 2014). The following example illustrates localised manifestations of armed conflict in northern Uganda. Northern Uganda and the importance of cen Following armed conflict in a number of African countries, the manifestations of spirits affected substantial populations of combatants and civilians (Harlacher, 2009). This was the case in post-conflict northern Uganda. We selected northern Uganda as a case study due to: (i) the high number of young people left unaccompanied following the conflict, (ii) the extensive literature on the impacts of armed conflict on young people and (iii) a dearth of scholarship on non-Western manifestations of URYP’s war-related experiences. Decades of war in northern Uganda left many children (who were formerly abducted into the Lord’s Resistance Army (LRA)) as expressing trouble sleeping, experiencing nightmares and physical illness (Akello et al., 2006; Bilotta, 2016). Considering these were not identified prior to their involvement in armed conflict, believers of traditional Acholi culture equated such manifestations as ‘cen’ (Akello et al., 2006). Cen has been described as the revenging of spirits of those who were killed during the armed conflict and not given a proper burial (Harlacher, 2009). Indeed, the spirit of cen manifests by haunting the sufferer (usually the one who killed) and his/her family via nightmares, disturbing visuals, sickness and physical pain (Akello et al., 2006; Harlacher, 2009). If not explored via a locally specific contextual framework, scholars may identify symptoms of cen as those of PTSD. This may cause a misalignment in interventions for such symptoms, as cen and PTSD recommend varying treatment modalities (Bilotta, 2016). Cen requires specific cultural rituals and ceremonies (Bilotta, 2016), while PTSD is often treated by Western-based behavioural practices and possibly medication. In response to the armed conflict in northern Uganda, a number of studies were conducted that linked former young combatants as suffering from PTSD (Derluyn et al., 2004) and tended to employ checklists or questionnaires that assessed for PTSD. Other scholars and clinicians working in northern Uganda have raised cultural and ethical questions with regard to employing PTSD scales with this population (McKay and Wessells, 2004). McKay and Wessells (2004) called into question Derluyn and colleagues’ (2004) study on former child soldiers in northern Uganda, which utilised PTSD scales to assess trauma and asserted that former child soldiers showed a high rate of post-traumatic stress reactions. McKay and Wessells noted that the: Use of a diagnosis of PTSD as a starting point is problematic because it pathologises and stigmatises children, imposes categories formulated by westerners, and limits the conceptualisation of the kinds of support that are needed. We doubt that measurement of trauma by means of individualistic psychological tools is appropriate in the collectivist cultural context of northern Uganda (McKay and Wessells, 2004, p. 1646). The case of northern Uganda and the importance of recognising cen should not be seen as an anomaly. Research has identified non-Western manifestations of post-conflict experiences in a number of global contexts. For instance, Van Ommeren et al. (2001) explored a medically unexplained phenomenon in a Bhutanese refugee camp in south-eastern Nepal. Prior to the study, a significant number of young people in this camp experienced physical and mental ‘attacks’, primarily fainting and dizziness (Van Ommeren et al., 2001). A rumour existed that, years prior, two youth had committed suicide by hanging themselves on a tree near the camp and their spirits remained on Earth, since they had died an unnatural death (Van Ommeren et al., 2001). It was those spirits that were thought to inflict disease through possession of such attacks (Van Ommeren et al., 2001). The attacks consisted of fainting, dizziness and hyperventilation and each lasted roughly 105 minutes (Van Ommeren et al., 2001). In addition, common throughout such attacks were auditory and visual hallucinations. Despite physician and mental health intervention, no medical conclusions were drawn as to why this particular epidemic occurred at this refugee camp (Van Ommeren et al., 2001). The call for social work research, theory and practice to engage more substantially with culturally diverse theoretical and practice scholarship, particularly from the Global South, as well as the need to draw upon local knowledge and understandings in direct practice has been made elsewhere (see Bryan and Denov, 2011; see Denov and Akesson, 2017). Moreover, the profession has taken upon itself to improve its members’ ability to work with culturally and ethnically diverse clients (NASW, 2007). While these advancements should be commended, a recent literature review of social work scholarship on international immigration found a clear omission of cultural factors related to social work practice with migrants and refugees (Shier et al., 2011). Moreover, local approaches to practice emerging from the Global South have, for the most part, not yet entered into mainstream academic discourse, as well as social work curriculum (Felton and Harrison, 2017). Implications for social work Although theoretical in format, the arguments in this paper signify important implications for social work practice and research, specifically for social workers practising in post-conflict contexts. Advances in holistically assessing the impacts of armed conflict on URYP have increased in the recent past; however, further progress is warranted. Our arguments point to the need for advocacy and support of local capacities, indigenous to URYP, by including literature, stories, beliefs and helpers (Bryan and Denov, 2011) from URYP countries of origin. By challenging the Western-based binary, social workers will be better equipped to advocate for or facilitate culturally applicable healing strategies. By privileging social work paradigms from the Global North, social workers run the risk of perpetuating an imperial lens on what constitutes expertise. For instance, the commonly prescribed treatment modalities for Western-based, war-related psychopathology may conflict with URYP ways of knowing and systems of belief. And, by propagating such ‘healing strategies’, an inevitable hierarchical relationship forms whereby the social worker is unequivocally established as the sole expert, which may ultimately disempower URYPs who hold important cultural and contextual knowledge. With regard to future research and programming guidelines, greater research should explore indigenous forms of social work practice globally, particularly those related to post-conflict settings. Comprehensive research that analyses globally diverse nuances in armed conflict, violence, pain, suffering and healing will engender alternative theories that may assist social workers’ understandings of URYP’s experiences. Perhaps most importantly, research should include the voices of URYP and others affected by armed conflict. At this point, minimal scholarship has explored how trauma and resiliency are defined and understood by URYP. For instance, does being identified as ‘traumatised’ or ‘resilient’ impact how URYP are perceived in local or global discourse? How do URYP who believe in cen respond to the constructs of ‘trauma’ or ‘resilience’? How do URYP understand fainting, dizziness, and auditory and visual hallucinations? Who ultimately benefits from trauma and resilience label(s)? In order to accurately respond to such queries, a richer examination that unpacks the meanings of trauma and resilience for URYP is necessary. Conclusion URYP have myriad war-related experiences which may constitute both perilous and adaptive manifestations. Both trauma and resilience-based theories offer essential insight into the conceptualisation of URYP’s post-conflict realities. While valuable and unique in their individualised approaches, privileging trauma or resilience-based theories for URYP incorporates merely a fraction of the holistic context for this population. In this paper, we have argued that scholars should consider bridging the trauma and resilience binary in order to gain a nuanced perspective on the experiences and realities of URYP. The failure to intersect the two distinct approaches may perpetuate an ineffectual divide. Further exploration should consider whether URYP possess characteristics of trauma and resiliency either simultaneously or at differing periods of time during and following war-related experiences. In addition, having a general knowledge of non-Western theories would inevitably provide alternatives to Western-based trauma and resilience theories, which could potentially shift treatment modalities. The example of northern Uganda illustrates that PTSD treatment modalities may be less culturally relevant and meaningful to one who closely aligns with traditional Acholi culture (Bilotta, 2016). Moreover, the example from Nepal demonstrates the need for local expertise in understanding the complex realities and behaviours of youth affected by armed conflict. Perhaps a more culturally syntonic approach is to explore how URYP regard their own war-related experiences. Interviews or focus groups assessing what URYP organically understand about their experiences are critical. 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