Supporting families and children in adversity

“We need to take a person-centred approach, not a problem centred approach, because sometimes what we think of as a problem isn’t actually the problem.”

Cara Antonaccio

Cara Antonaccio was just a kid when she shared a hospital room with people that had moved their entire families to the United States to get access to cancer treatment. The inequities and the stressfulness she witnessed back then ignited her interest in global health and in psychosocial support. Now, she is determined to use her research skills to support families and children facing adversity.

“I saw how difficult it was for families who travelled thousands of miles for their child’s cancer care to not only manage having a child with cancer but also navigating the health system in the US, being in a new place, sometimes with five or six children they had to take care of at the same time”, the UNU Macau Researcher tells us.

So, she began questioning: “How do we support families when they’re experiencing extreme adversity? How can we make it easier for them just by making simple changes in their lives and helping them get the support they need?”

And she went on to look for answers. She pursued a double major in Health Policy and African Studies, a master’s in Public Health, a PhD in Social Work, and she still dreams of becoming a medical doctor one day.

In her PhD, she studied mental health and psychosocial well-being in conflict-affected communities and among youth who were formerly affiliated with armed forces and groups in Sierra Leone. Her work focused on understanding those former child soldiers’ reintegration experiences after they returned home after conflict, including who they lived with, what kind of physical and social disabilities they were experiencing, and on looking at how to ensure their reintegration in the communities was successful.

“They were just little kids, and they were forced to do just heinous things to their family members, to community members. And in conflict-affected communities, when you reintroduce former child soldiers back into the communities, there is a risk of them not reintegrating successfully, which can increase the risk of subsequent insecurity”, she explains. “So, it is really important that when formerly affiliated youth reintegrate, they do so in a way that is very sensitive to their needs and the community’s needs.”

Digital technologies may be of help. In this research, Cara Antonaccio and her colleagues at Boston College supported work on a mental health intervention that was delivered through what is known as “mHealth” (mobile health). “This was a cognitive behavioural therapy (CBT) intervention for youth affected by conflict, delivered through mobile technologies.”

Though there are challenges to be addressed – such as ensuring people have the digital literacies needed to use these technologies and subsidising their use –, this type of approach, she says, allows people to get access to mental health services that wouldn’t otherwise be available, “especially in communities that are sort of remote”. “They can use their phones to speak to clinicians or therapists. So, there is a lot of promise in channelling these technologies as tools to support people who have experienced adversity.”

One of the main take-aways from her research, she says, is that “we need to meet people where they are” and “go in with an open mind”, she says. “We need to take a person-centred approach, not a problem-centred approach, because sometimes what we think of as a problem isn’t actually the problem. So, we would go in with mental health interventions when families couldn’t even feed their children…” Sometimes, she adds, “what we think people need isn’t what they actually need”, and sometimes maybe certain interventions should come “after we address primary needs of survival”.

Curious by nature, and passionate about learning, one of the reasons Cara Antonaccio joined UNU Macau was that she wanted to get training in building digital platforms, while supporting experts in these fields in making decisions related to health and social issues.  She is motivated to conduct interdisciplinary research, as well as to design data-driven tools to support health in humanitarian crises and communities affected by conflict.

She is currently working on a programme that examines the conflict-related and contextual drivers of attacks against humanitarian assistance, as well as the geospatial diffusion dynamics of attacks against aid workers, globally.

“I’m really motivated to develop digital tools that we can use to help aid workers and community health workers keep themselves safe so that they can focus on the work that they’re meant to do”, she says. And that includes “programmes where we can send them warnings saying things like ‘this is the current situation at the place you are going, consider taking a different route’”.

The researcher notes “the motivation the UN has to use evidence to inform practice and policy” and, hence, sees in the work of UNU Macau a “great opportunity” to respond to that call.

An ocean away from her home country, she keeps her great great grandmother’s wedding ring close by. “To me, home is not really a place; it is sort of the people. And this makes me feel connected to my roots.”