> Deb Gould is a STARTTS Clinical Psychologist and clinical supervisor.

Children as young as 8 might be more adapted to life in Australia than their parents. The relative resilience of the child and/or vulnerability of the parents creates the possibility that the parents, perhaps needing support in order to hold the family, become cared for by a child. It worries us all and has been increasingly recognised as requiring active and proactive support rather than judgement and enforced change.

The formalisation/recognition of the ‘carer’ identity is new. Refugee children in particular would not identify themselves as such. Instead, they are son, daughter or others who have a particular relationship to the person needing care; this is an extension of that relationship.

The refugee children become carers when their parents, through disability or profound disorientation struggle with the parenting function. Their role sometimes extends beyond the instrumental tasks of household chores and shopping to the more complex task of emotional support. Refugee children are also reading to their parents, teaching them English, acting as interpreters. They stand ‘in loco parentis’. As such, they can alter their developmental pathway, usually sacrificing academic progress and social connection.

There are no particular ‘signs’ that a child is being a carer for another family member. Many young refugees are late for school, underachieve, are distractible, avoid activities and don't bring parents to school. Perhaps a clearer sign is the child who shows ‘false’ maturity. A more worrying presentation that we all have seen is the child with 'separation anxiety disorder’. Where the child is in a carer role, it is often the case that the adult is the one anxious about the separation and the child is anxious about what the adult would do in their absence.

Of course the child-as-carer is at risk for missing out on educational and social opportunities. However, they also gain new skills and we risk undermining this when we pathologise the process. An age appropriate sense of mastery (“I can do this”) and identity (“I am the oldest son”) is possible given the right support. When this role is inevitable and no alternatives seem available without breaking the family this reframe would be vital. However, they might need to give up any over-identification with the role. “I am not only carer; I can let someone else clean the house”.

In more practical ways we can organize some support specific to schools – an aide, mentor, academic support. Referral to case management services to organize a volunteer to help with time consuming tasks like shopping or information about interpreting services might be appropriate. This is not so simple and is frequently not acceptable to the family. Volunteers might not be aware of how much family roles are culturally defined and how these have been further distorted by life in war or a refugee camp. The child does. The volunteer isn’t always available. The child is. And the child is attached to their parents.

There is no doubt that the developmental needs of child are not being optimally met while they are in a caring role for their parents. However, it sometimes might be appropriate to assist the child rather than to rigidly force a change in roles. Support for young people should come from mental health and youth health services, linked with other relevant systems and informal resources (community groups and community leaders).

> Deb Gould

Deb is a Clinical Psychologist and clinical supervisor at STARTTS. She was trained in South Africa and has over 20 years experience as a clinician and supervisor in the psychotherapy field.

© 2010 STARTTS  Contact: hintsforhealing@startts.org.au