Interview with Dr. Robert Henley

Biography:

Dr. Robert Henley is a clinical psychologist who has researched child protection and psychosocial support. He has extensive experience in the field abroad and lived in Switzerland for several years, working at two renowned universities where he focused on the benefits of post-disaster sports competitions for traumatized youth. Currently, he resides in San Diego, CA, working for the San Diego American Indian Health Center which provides resources about suicide prevention and drug and alcohol abuse treatment to native peoples, as well as offering individual and community sessions for psychological support. Joining him in this interview was Melisa Aleman, Youth Services program Manager at SDAIHC.

What factors do you think are most important in psychosocial interventions for youth? In addition, how can these factors be applied to the COVID-19 crisis?

Our focus at the youth center is for interventions concerning alcohol and drug prevention in a non-Western way. A lot of our programming is tailored to the native culture. We have contractors come in and talk to our youth about suicide prevention, tobacco use and drug and alcohol abuse. Since we haven’t been meeting with them in person, everything is virtual. Our main concern right now is to transition from being with them in-house, to working with them virtually. We’re also able to implement resources at this time for the parents and the families through our Facebook account. We have a resource table that is available Monday-Friday where they can pick up arts and crafts, recipes, food, whatever they need at the moment. We also do a Facebook live cooking class, which attracts a lot of kids which is cool. We also have beading classes, storytelling, and meeting with the elders once a week. They talk about what they’ve gone through and their knowledge of higher education, gardening, and what being native was like in their time.

Mental health is often seen as a very Westernized, medical topic. How do you adapt your interventions towards different cultural communities and what particular changes do you make in your programs to help introduce these topics?

When I worked in Switzerland, I worked with three different organizations and two of them were universities. We worked with kids during or immediately after disasters, like the Iran earthquake and the Thailand tsunami. We also worked with kids who lived on the streets because their families died from HIV/AIDS. There are really so many different circumstances for interventions, so we really needed to talk with the people of the community to figure out what they needed and what would work for them.

A lot of times, people just want to be heard, so creating spaces where people can talk and helping them figure out what they need is important.

Younger people typically need more guidance while older people like to work together.

In different cultural communities you have to consider a community approach. For example, in the Iran earthquake, an entire town was leveled, so emphasis was placed on creating fields for the kids to play soccer. However, it was soon realized that the kids were traumatized and didn’t know how to play, and because they were traumatized it was difficult for them to avoid conflict with each other.

So, the various sports programs couldn’t be solely focused on winning and losing, but also about participating cooperatively, having fun and getting along with each other. This is a big difference between “psychosocial sports approaches” and regularly competitive sports, which are about competition and winning.

After disasters the UN has typically tried to address the children’s needs by setting up schools, churches or temples, and playgrounds in an attempt to begin normalizing the situation even amidst the chaos. This is an important and successful strategy, but you have to work with the culture and community. In many cultures, communities don’t want women involved or young girls to participate in sports. This needs to be taken into account. In cases like these, such as in Iran, the UN has created enclosed or walled spaces where the girls could play privately. We need to listen to the community’s specific needs, and the same logic applies to native communities here in San Diego.

Would you say that understanding the local culture and adapting your response to that culture is the most challenging a response? 

When we at SDAIHC do community events with Native peoples, everyone’s involved. No one is left out. We always have a family dynamic. Since our natives come from different areas, we have to be one group and embrace that in order to be productive and learn from each other. However, mental health is individualized, even though there may be groups.

When I worked with the Apache in Arizona, I quickly realized that I was on their land, I was in their nation, I was in their community, and I needed to stop talking and listen to how they experienced things in their culture. I came with a mindset of wanting to help, but it is about how they want help and what works for them.

The Native American culture is much more family and community oriented than the typical way that white communities approach things, which is very individualized. They do things together as a community and have strong support for each other. As soon as I realized that, I was being more helpful in my work.

Over my years of working I have also come to realize that resilience is the underlying glue that helps people keep going, but each community’s resilience is dependent on their social structure and community structure, so this is something we need to understand before we can emphasize it (see attached article for more information about Dr. Henley' resilience research).

How do you go about implementation of an intervention virtually? What are some of the biggest challenges?

(Melisa) Here at the San Diego American Indian Center the first step is to get everyone on board. The changes happen in our work, but they also happen with staff members and other members of the community. We need to make sure that they have access to the internet and that they can see the resources we put out there.

Another challenge is getting consent forms to our youth because parents need to be okay with their children meeting one-one-one with us virtually. This is a problem we’ve only had recently because typically parents are used to coming into the youth center and picking up any pertinent paperwork, but now we need email addresses, we need to call people, and it’s an extra step. We need to make sure they have access to a fax machine, or that they can mail it in or send a picture to us. We’re working on getting the form online, having the parents be able to sign it right there and send it back to us on the same platform. Any interaction we have with the children needs to be approved, including one-on-one tutoring and getting resources. Now we have definitely started to get the hang of things and we have settled into a “new norm.”

We also have problems with young people not being able to understand how the technology works or how to use the links that we send them, so we have to teach them how to do that.

(Dr Henley): In a more international setting, oftentimes money comes in from a foreign government or an NGO with a demand that services be applied to everyone, both men and women, boys and girls, which can contradict the local culture and end up creating cultural and societal changes that are uncomfortable and can cause conflict. Another example is when a friend of mine who worked in the Ivory Coast and was implementing sports programs as a means of peacekeeping during a civil war. He quickly realized that you have to be very careful about how you create the teams: You can’t create the two teams from the two conflicting sides; instead, you have to mix them. There are many examples of this need for awareness.

How do you think that public policy responses can better support psychosocial interventions during crises for youth in developing countries or in general?

In the COVID situation, having money from the government is really helpful. It really helped our organization (SDAIHC) continue to function. Additionally, they changed the regulations so that we can get paid the same amount for telemedicine. We’re a little nervous now because they’re talking about going back to seeing people in person, but we haven’t even finished the first wave yet. The danger is that there are politics involved in public policy, and there are a lot of differences of opinions about how and where money should be used.

When working with children, involving children in decisions with program evaluation or even creating programs is very important, as well as involving women too, because they are mothers. This is a good idea, but it can also create tension in the community because it may not have been so open to involving women and children in the past.

And new efforts evolve out of initial efforts to help communities: I knew a woman who created a program for street kids in Tanzania that involved providing school classes on the streets so that the kids could be educated, and some kids successfully went off to college without even having a home. In the process, she realized that children don’t have rights there, and she has now moved forward with new initiatives for child protection. Even here in the US, there is a lot of debate about what comprises children’s rights and women’s rights, and more so in other countries. A big part of public policy is “rights”, and in some places, the rights of children aren’t even considered, and NGOs have to be created to protect women’s and children’s rights.

We are lucky that in the United States, despite our current issues with social justice, we can make a real impact, whereas in other places, interventions are not as easy or successful.