Tracing a Path from the TSS Group to Interdisciplinary Advocacy

by Ryan Matlow, Ph.D., ’13

When I was member of the Traumatic Stress Studies Group and a clinical psychology graduate student within the Developmental Cognitive Neuroscience specialization, I had the special opportunity to learn the foundational science that informs our understanding of children’s reactions to stress, adversity, and trauma exposure. In particular, I developed a knowledge base and clinical awareness of the mechanisms, processes, and contextual factors that underlie the vastly varied reactions that children may have to traumatic life experiences.  At the time, I knew that this learning would inform my future clinical and research efforts; what I did not know was how this foundation would lead to opportunities for advocacy and social action.

Clinical experiences across my early career stages emphasized clinical evaluation and trauma-focused psychotherapy with immigrant children and families. Coupled with my own childhood experiences growing up alongside a largely immigrant farmworker community, my clinical activities deepened my engagement and commitment with the immigrant population, as I gained greater awareness of the current and historical traumas connected with the systemic oppression of peoples arriving at the US border primarily from Central and South American countries. 

Headshot of Ryan Matlow
Dr. Ryan Matlow

With knowledge of the short- and long- term consequences of child trauma exposure, I was deeply concerned and disturbed by the rise of harsh border policies surfacing in 2018 under the Trump administration, which included practices of forcibly separating children from their families at the border, as well as subsequent prolonged detention of unaccompanied children in restrictive, congregate care settings.  As with many others, I wanted to get involved, but was unsure exactly how. 

When I saw calls for health professionals to serve as volunteers in monitoring the conditions of care for children (including those separated from family) in US government custody, I was interested, but still early in my career, thought why me?, figuring there are many other seasoned mental health professionals who should be first in line for such an effort. 

“I was interested, but, still early in my career, thought why me?

Upon further reflection, I realized that my past training had me well-prepared.  Did I meet the criteria for involvement?  Knowledge about trauma and trauma-informed care? Well, yes.  Experience working with children? Sure.  Knowledge of best practices in mental health service delivery?  Nearly a decade of training in this.  Speak Spanish? Yes.  Furthermore, my reflection led to the realization and reminder that this opportunity aligned with my personal, professional, and social values.  I had to throw my hat in the ring. 

From Volunteering to Interdisciplinary Advocacy

I didn’t realize at the time that this first step in signing up to volunteer for a site visit at a shelter facility for immigrant children would open up a realm of new opportunities for service, advocacy, and career development.  I joined attorneys, who under federal agreement, had unique access to care facilities and to the recently-arrived children being held in restrictive care by our government. 

Applying my past training and experience, my role was to help facilitate a child-friendly, trauma-informed interview process, as children shared their stories of adversity, distress, anxiety, and sadness while in government custody.  It was my role in particular to highlight the psychological impacts of children’s experience during immigration processing and custody.  While full of pain and desperation, the children’s experiences served as testimony and evidence to be submitted in court in order to inform the ongoing class-action litigation that set the standards of care for children across the country (i.e., the Flores Settlement Agreement). Furthermore, children often expressed gratitude for the chance to be seen and heard in their experience, and many were motivated by the knowledge that sharing their pain might prevent another child from having to endure a similar experience in the future.  It was a moving experience, to say the least.

Through the partnerships and relationships developed with attorneys and other health professionals in this first site visit, I have now had the opportunity to be present with dozens of children held amongst thousands of others in converted WalMarts, tent cities in the middle of the Texas desert, military bases, as well as in shelters and camp settings in Mexico (due to Remain in Mexico and Title 42 asylum bans) as they’ve shared their stories and experiences.  Along with colleagues, I have been working to elevate these stories – backed by the established literature on the psychology and neuroscience of developmental trauma – to the forefront of our social and political awareness. 

We have submitted expert reports and testimony in federal class-action litigation, testified in congressional and legislative briefings, produced reports with renowned international human rights organizations, published opinions in leading medical journals, submitted recommendations for policy and standards of care, and sought to educate the public through the media.  Furthermore, I have discovered opportunities for an instrumental interdisciplinary exchange, as I have learned immensely about immigration law and advocacy, while also offering training and professional development for legal professionals on approaches for providing social-emotional support within the context of a trauma-focused interview with children (training that is often standard in psychology, but uncommon in legal education).  

Ongoing Collaboration for Policy Change

While the challenges and concerns are ongoing, and many needed changes to immigration policy and systems are yet to be realized, I believe we have had impact in our efforts, both in individual cases and at the systems-level.  When I signed up for that first volunteer visit, I had not expected to find my way into what has been the most rewarding and fulfilling work of my career, work that has changed my professional trajectory.  This work would not have been possible without the foundational knowledge and experience I gained in my graduate training.  The work was also made possible by battling a tinge of ‘impostor syndrome’ and by stepping out of the silo of traditional psychology practice and into the realm of interdisciplinary collaboration and advocacy. 

Finally, and most importantly, the work and professional growth I have encountered is solely due to the courage and strength of the children and families who have shared their experiences and vulnerabilities with my colleagues and I.  While I often brace myself for stories of pain, trauma, and suffering, I walk away with lasting impressions of resilience, altruism, and inspiration from the children and families I have been honored to speak with.  I am grateful – and indebted – to these families, and I carry their stories with me as we seek to improve systems of care – and broader society – in effort to uphold justice, humanity, and child health.

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Dr. Matlow was a graduate student on the TSS Group team from 2008 to 2013. He is currently a Clinical Associate Professor in Psychiatry and Behavioral Sciences at Stanford University. He serves as Director of Community Programs for Stanford’s Early Life Stress and Resilience Program, and is a faculty member in Stanford’s Human Rights and Trauma Mental Health Program.