Bridging Community and Culture

A conversation with Dr. Saida Abdi about the newly launched CIRCLE Project in Minneapolis: Collaboration for Immigrant & Refugee Leadership & Excellence

Refugee and immigrant children in the United States often face trauma and systemic barriers that include a lack of linguistically and culturally appropriate services, affordability, mistrust, and stigma. These compounding factors decrease the likelihood of seeking support and services. The CIRCLE Project aims to change that by providing trauma-responsive, culturally, and linguistically relevant mental health support to East African and Latinx children, youth, and their families in Minneapolis. CIRCLE is a partnership, launching in the 2022-2023 school-year, and is a collaboration between the University of Minnesota, Watercourse Counseling Center, Somali American Parents Association (SAPA), Comunidades Latinas Unidas En Servicio (CLUES), Minneapolis Public Schools (MPS), and Boston Children’s Hospital’s Trauma and Community Resilience Center.

To learn more about the CIRCLE Project and how it came to Minneapolis, we spoke to Dr. Saida Abdi, PhD, MSW, LICSW, a Clinical Social Worker and Assistant Professor at the University of Minnesota School of Social Work.

Dr. Abdi serves as the Director of the CIRCLE Project in Minneapolis. She has worked at Massachusetts General Hospital and Children’s Hospital in Boston, developing interventions for refugee and immigrant children across the world. Dr. Abdi, originally from Somalia, has personal understanding of the refugee experience and has worked for more than 20 years with refugee youth and families in the diaspora.

This interview has been edited for clarity and length.

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Q: Tell us about you and your role in this project?

Dr. Saida Abdi: My name is Dr Saida Adbi. I am myself originally from Somalia and a refugee. I worked for many years developing interventions for refugee/immigrant kids across the world. I worked with colleagues in Boston developing the model we’re using here and implementing learning groups. Then I worked with others across the country implementing the model. I am now the director for this project and I actually moved to Minnesota to do this work. I had a great job in implementing this in other states and I thought, “How do we do this in Minnesota because it’s so needed?”

Q: What is the CIRCLE Project?

Dr. Abdi: The CIRCLE (Collaborative for Immigrant & Refugee Children’s Leadership & Excellence) Project is based on an intervention that we developed at Boston Children’s Hospital. We were a research center looking at what refugee children and immigrant children need. If you are a refugee or even if you’re an immigrant child who’s coming through our borders, we know you are experiencing trauma. We know that you are afraid. We know that your family is afraid. We know that what drives you out of Somalia, Syria, Afghanistan, Ecuador, or Honduras, is danger and lack of safety. And that those children are coming to us having been exposed to or their parents have been exposed to traumatic experiences. But when they come here there is additional trauma. There is the trauma of being afraid of systems. Discrimination is hugely traumatic. Lack of security and safety – that’s what trauma is all about. It’s a lack of safety and security. So those children often need support. It doesn’t mean there’s anything wrong with those children. It means, given their experiences, they need support, they need safety. They need language and cultural access.

So we asked the communities, if your child needed help – if your child is struggling – where would you go for help? The only outside system that they identified was the schools. They said, “The only place I will go and actually trust is the schools because I’m already sending my kids there.” So we have to be in a school.

This is what we call addressing the social-ecological needs of a family. So don’t look at a child that is struggling, look at what’s around the child. Who is this child interacting with? What resources, what capacities, what knowledge do these people and these systems have access to? Support the family, support the teachers, support the community, support the neighborhood, because that child lives in that ecology. The model is helping the child to learn to self-regulate, so I want to give that child, through groups, the ability to calm themselves because there is always going to be things that are going to trigger or bother them.

But I also want everyone around that child to do the work of supporting that child to calm themself, to stay present in their schoolwork, and in their community work. I want that child to have a choice, so we do group activities where it’s not about something being wrong with you. We bring groups of children together and we do a lot of activities that are fun. We eat food together. We have someone from their culture, like a Cultural Broker who is part of those groups. We work with families, so we’re helping with acculturation.

The CIRCLE Project uses a tiered model, Tier 1 to Tier 4. So Tier 1 is community engagement, we focus on community outreach. That means someone like a Culture Broker might be out in the community talking to families about the services we provide, and more importantly, the kind of support that children may benefit from to do well in school. Tier 2 is group work in schools. Tier 3 is traditional, clinical services. Children can receive individual therapy with school-based clinicians and other supports as they need it. Tier 4 is acculturation and home-based services. It is the most intensive care. We have a Cultural Broker and clinician working together on this service, going into homes.

Q: Why Minneapolis?

Dr. Abdi: We came to Minneapolis for this reason: the large number of Somali and East African immigrant and refugee kids here. And now we’re actually getting more Latino/Latinx kids. The model is built on this idea of it’s not like a university or a clinic that has a lot of power coming into communities and making them do things. It’s really strengths-based, building on what already exists in the communities. So it was really important for us that we were partnering with community agencies that are providing services that are already embedded in those communities, and we already had some relationships with Minneapolis agencies. Through the Boston Children’s Hospital work, the collaborative with Watercourse and myself had a long-existing relationship, but how we expanded to follow the model expanded the partnership. We are very fortunate to find CLUES as a partner and also SAPA. So it just made sense to us. It’s just such a great opportunity because we also have a partnership with MPS.

Q: We know that the program was implemented in Boston as well as Canada, do you think that the same level of success can be replicated in Minnesota?

Dr. Abdi: One of the things that we integrate into this project is a very rigorous evaluation to see what are the things that work. The model that we’re doing now is much more comprehensive, in the sense that the ownership lies with many agencies. And we want to have an equal partnership with the community, with the clinical provider, with the university – so that we’re all working together.

Sustainability is so important. So how do we continue doing this work? How do we expand it to other communities? How do we also distill what the most important thing is? What are the things that really work, like groups? Groups are the most amazing thing and they give access to support kids fast so that many of those kids don’t actually need to come back for one-to-one therapy because they did the groups and they have connected. Groups do all of this and the kids are showing improvement. So the work we do is about emotional wellness and social belonging. So two things that we measure and we look at is how well is the child doing in school and in the environment, but also, a child can’t actually learn well unless they are doing well in their social environment. We’re measuring how they were doing when they came in when they got out and we’re seeing that, in every place we did the project, there is evidence that the groups are very helpful to kids, that the kids do much better once they started with the groups.

I am looking at success as sustainability through partnerships between the community, clinical provider, and the university and an outcome that shows that we are actually delivering what we promised to families and kids.

Q: Can you explain the partnerships and what are the roles of those partners in the project?

Dr. Abdi: Boston Children’s Hospital, where I used to work before I came here, holds the model. They are what’s called a model development site, so they do all of the training for us in partnership with our project. SAPA is the Somali American Parent Association. They do a lot of outreach and work with Somali American families and parents and have been in the schools for a long time. So they do a lot of the cultural brokering, parenting work, and outreach to Somali and East African families. And then CLUES – we are so amazingly blessed to have them as a partner. They are actually one of the biggest mental providers in the Twin Cities to Latino/Latinx, families and communities. They were able to contribute a Cultural Broker to the project.

This model and this approach is an intentional partnership with the community. It’s not us coming to communities and telling them what to do. We’re building capacity, ensuring that if we were to leave – that whatever we’re doing is going to stay with the communities. And so we’re leaving a better system behind.

Q: How would you define the role of a Cultural Broker? How do you see them interacting with a community looks like?

Dr. Abdi: Cultural brokering is a model that is being developed all the time. Our team and our model have stepped into it because we love it. We realized you cannot do this work if you cannot have a cultural bridge to the communities we’re working with. I think about the Cultural Broker as a bridge between service systems and communities.

For example, the culture broker is someone who not only translates what the patient said but adds to it and provides context. They act as a buffer as well. So specifically around mental health, we want the clinicians to have a bigger – contextual understanding – of not only what the mental health symptoms are, but also how people make meaning of those mental health symptoms. Always when we do training for Cultural Brokers and clinicians, we say “Come as a learner before you become a helper.”

The Cultural Broker is going to be your supporter, your bridge. So a Cultural Broker’s job is to expand how we think about services, specifically about mental health services, and to provide the lens of the community into the services we’re providing. We always think about this integration of clinical and cultural understanding of symptoms of help-seeking behaviors. One of the things we say is, when the client comes to us, “Where else have they been?” The clinician may be the last person they come to. In my culture, I will go to my religious faith healer. I will go to my family. I will go to my community. Then, if all of them can’t solve my problem, then I may be seeking outside help. This is one of the reasons we do a lot of work in the community because we want the faith healer, the family, the community leaders, to know about mental health and to know what they can solve and what they need more help with.

Q: What are some of the anticipated outcomes – or impacts – of the program?

Dr. Abdi: Every child matters and every child is important and so when I think about long-term change and system change, I first want – really to think of each child in school that is struggling because of a situation, because of trauma, because of discrimination, because of all the things we talked about that we try to address here so fundamentally. Really the first thing – when we start work supporting children – is being there. Having someone right there – who looks like you, who speaks your language, who knows your culture – to support you.

And then the second thing is actually changing the school environment, changing how we serve kids. Being in front of it, not waiting for kids to get in trouble, but supporting them before they need a referral. We want to get to that child when they are not yet at the point where they are “in trouble.” The work is to give them resilience, but also to do the work in the system in which they live to make sure that they get support. So teaching them skills, then you are improving the system.

And finally, my dream is to have trauma-informed, culturally relevant care in every school, and every community. Many of the children will come to us with trauma because they live in a neighborhood here in Minneapolis, not because they came from a war. Some of the cases in our research had more trauma here in the US than they did in the war. So really it is about creating safety, about caring, about connectivity, about relationships. Every child needs an environment that is safe, that is connected, that has their own relationships where they feel nurtured and cared for.

Q: How will this project help engage families living in the community?

Dr. Abdi: This project’s motto is that you cannot just teach a child. When I am asked to help with children who have behavior problems, I will not ask the 13-year-old to do what you do not ask a 30-year-old to do. I will not ask a child to calm themself and behave when the teacher is yelling or the parent is yelling. So the fundamental thing is that we train the parents and the schools so that everyone who is in the child’s social environment can support the child.

A child might be struggling, but the social environment that they’re staying in – home, school, neighborhood – is failing to help the child. In our project, we have an assessment tool that asks, “How is the child doing? And how is the social environment? How is the parent doing? How is this school doing?” And then we determine how to take care of that child.

We found that if the family is struggling, then we engage the whole community in services to help the child. Then we actually help them improve the social environment. We teach them how to communicate across cultures. I am very committed to the idea that it’s not enough to work with children.  We need to work in the community with families and in systems.

Q: How do we bridge the gap between communities?

Dr. Abdi: I’m hoping in the future, we stay ahead of the divide by leveraging our Cultural Broker. This is really how you walk the walk – by having Cultural Brokers standing together, being in the community. The work that we have to do is not impossible. It might be challenging, but we can do it by continuing to have partnerships, to build those relationships, to be in the community, to listen to the community.

The other aspect of being ahead of the divide is the focus on youth because they are a part of the community and they will be the people that the model will be handed off to as they begin to engage more and take an active role. One of the things I’m looking at is how we get youth from the community to become clinicians so that we’re not always thinking about engaging interpreters, but instead we are actually building the capacity in the community.

We have to have youth as leaders. I wanted them to take off with this project. Social ecology doesn’t demand a child to do better. It asks everyone around the child to be better and, if you do, then the child will do better.

Q: What do you need for this work to be successful? How can people be involved or help?

Dr. Abdi: The grant is a community-based grant. It is really the idea that the clinician sees some things and then the Cultural Broker sees something different, and it’s by bringing those two together that we do a good job of taking care of families and children. So what I need is just to have the grace of being supported by each other, working together, and never taking our eyes off the goal, which is taking care of kids and families. So that would be my greatest wish: just being collaborative. All hands on deck, open dialogue, and acceptance.

Then the final thing is that we all become ambassadors and champions of children and families, providing the support and socio-cultural development services that they need and expanding to more families and children. This is not a one-person, one-company, one-organization job. It is work that has to be done in partnership with families, communities, schools, and with providers. It’s where we need to put our resources because, again, we’re talking and thinking about children. We are here to support and partner with you, to work with you, and to do whatever is needed to get this done.

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The CIRCLE Project is a community-based program that is intentionally partnering with local organizations that are already established in our community. It would not be possible without the clinical providers, the Cultural Broker, schools, and most importantly, the families and their children.

A special thank you to Dr. Saida Abdi for spending time with us to thoughtfully answer our questions about the CIRCLE Project and for all her work supporting refugee and immigrant children and families. Thank you for being a systems change-maker and for continuing to advocate for community, family, and individual resiliency for refugee and immigrant communities.

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Watercourse Counseling Center is a nonprofit agency that strengthens our community by supporting people in the journey toward emotional well-being. We strive to improve community wellness by creating equitable access to mental health services, bringing services into the community, building partnerships to address community issues impacted by mental health, and mentoring mental health trainees in a community mental health model. 

We are a group of a diverse, multilingual team of dedicated clinicians that currently provide mental health services in an outpatient setting and manage school-based clinics at 16 schools in Minneapolis.