Stanford experts have created four short videos to help lawyers at the U.S. border learn to sensitively interview migrant children and teens about traumatic experiences.
A team of Stanford experts has produced a series of videos aimed at benefiting children detained at the U.S. border. Intended for lawyers who work with detained migrants, the videos describe how to interview young people using techniques informed by scientific knowledge on trauma.
“Many of the attorneys working at the border have little experience interviewing children who have undergone serious emotional trauma, and it’s essential that those interviews — which are being done for kids’ benefit — don’t exacerbate the trauma they’ve experienced,” said Paul Wise, MD, professor of pediatrics and one of the project’s leaders. “In addition, having good, sensitive interviewing skills makes it far more likely that the lawyers will get the information they need to represent the best interests of children at the border.”
The project, which consists of four videos that were released today, is an example of how Stanford experts from a variety of disciplines can tackle a real-life problem with complex health, psychosocial, legal and political angles, according those involved in the work. The series of videos, each about 8 minutes long, can be viewed for free online. The full toolkit can be accessed here.
“We’re a medical school, dedicated to improving health and well-being in the real world,” Wise said. “This project came together quickly because of the transdisciplinary, collaborative environment at Stanford.”
“We all brought different expertise to the work, with the shared goals of underscoring our common humanity and the love we all have for our children,” said Maya Adam, MD, director of health education outreach for the Stanford Center for Health Education, which produced the videos.
Children detained near border
Over the last few years, tens of thousands of migrant children and teenagers — mostly from Central America — have been detained near the U.S. border while awaiting decisions on their immigration cases. Often, they are kept in jail-like facilities and do not know how long they will be detained. Many of these young migrants experienced significant trauma, such as witnessing violence or having family members die at the hands of gangs, before they arrived at the border. The hazards of the journey and the experience of being detained once they arrive can further traumatize them, Wise said.
Two groups of lawyers are working with children and teenagers in the U.S. immigration system: Some conduct interviews to help monitor the government’s treatment of detained children, while others offer legal representation to migrants who may qualify for asylum. But these lawyers, who work with nonprofit agencies or are volunteering their time pro bono, may lack information about the unique challenges of interviewing traumatized children, a need the Stanford team hopes to fill.
The videos are a collaboration between Stanford experts from several disciplines, including pediatrics, global health, psychology and psychiatry, as well as faculty at the University of Texas-Rio Grande Valley and medical and legal specialists who work regularly with children at the southern U.S. border. The series was produced by the Digital Medical Education International Collaborative, an initiative of the Stanford Center for Health Education.
The videos give advice about how to connect with children and teens to gain their trust. They explain basic information about the emotional needs of younger children and adolescents, especially in regard to their developmental understanding of traumatic experiences, and discuss how each age group may respond to talking about trauma. The videos also show vignettes, illustrated with simple animations, that provide examples of what detained children and their families may have experienced before arriving at the border and during their interactions with U.S. immigration officials.
‘Pretty scary questions’
“For children in need of defense, attorneys who may be taking their cases on will be asking very sensitive questions to see if they qualify for asylum,” said Marsha Griffin, MD, a clinical professor of pediatrics at the University of Texas-Rio Grande Valley, who participated in the videos because of her extensive experience treating detained children. “Attorneys may ask, for instance, if children were neglected, abused or abandoned by their parents, or if the child saw a local gang try to kill somebody. They’re pretty scary questions.”
To ask such questions in a sensitive way, the videos recommend giving children and teens as much control as possible: For example, attorneys are encouraged to explain that they want to help; familiarize themselves beforehand with what they need to say so that they can speak warmly instead of reading from a list; praise interviewees for their effort rather than the content of their answers; and tell kids they can take breaks or end the interview at any time, or skip answering questions if they wish.
“There’s an inherent power differential in interviewing, especially when an adult attorney is working with a child who is new to the country,” said Ryan Matlow, PhD, clinical assistant professor of psychiatry and behavioral sciences at Stanford, who contributed to the videos. “The adult needs to take care to give the child as much control and agency in the process as possible so that the interview is not retraumatizing for them.”
The videos offer advice about how to recognize when a young person needs additional mental-health support after an interview, such as when a teen who has been interviewed shows signs of being suicidal. They also recommend how lawyers working with migrants can seek emotional support for themselves and avoid burnout.
Shifting immigration policies mean that, in recent months, more migrants have been sent to Mexico to await the outcome of their U.S. immigration cases, the experts said, noting that the videos could act as a resource to lawyers working in Mexico or elsewhere. “The context and settings for interviews may vary based on changing government policies, but the general best-practice approaches for interviewing remain the same,” Matlow said.
Children’s and teens’ needs should be accounted for not just in the interview process but throughout their experiences as migrants arriving in the United States, he added. Children are not able to take on adult perspectives while detained and will likely feel much more traumatized than adults under similar circumstances.
“Adults may think if you keep kids in detention for a short time, it’s not a big deal, but kids are very in-the-moment,” Matlow said. “For them, it really matters ‘what’s happening to me now.’ A resolution in weeks is not as encouraging as for an adult who has a broader perspective on time.”
About the Stanford Center for Health Education
The Stanford Center for Health Education (SCHE) extends world-class health education to a global community of health professionals and to communities around the world, creating a more informed public and improving health outcomes in some of the world’s most vulnerable populations. SCHE designs and delivers online professional education and custom educational experiences to medical professionals around the world and shares open-access health education to the public. SCHE is a joint program of Stanford Medicine and the Office of the Vice Provost for Technology and Learning.