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After a Border Crossing, a Joyous Haven in the South Bronx - New York Times

Joy boomed from the speaker on the reception desk, the irrepressible rhythm of reggaeton transforming the waiting room of a South Bronx medical clinic
into a late-afternoon Zumba class.

Teenagers from Honduras and Guatemala were shimmying to the beat, their workout part of an unusual form of therapy for many who had endured nunimaginable trauma not so long ago. About the same time, in the quiet of Exam Room 10, a lawyer was preparing immigration documents for his client to sign.

Here, at this outpost of Montefiore Medical Center, exists what is believed to be the only legal-medical partnership in the country designed specifically for children who crossed the Mexicanborder illegally and are trying to settle into their new communities. Known as Terra Firma, the program began in October 2013, months before the surge of unaccompanied minors entering the
United States.

While immigrants’ advocates have consistently deplored the dearth of lawyers to meet the needs of the new arrivals, their focus is now shifting: It has become clear to lawyers and advocates alike that mental health services with Spanish-speaking therapists are also desperately lacking. Terra Firma is still limited in scope, having served about 200 children in
three years, but it has defined a holistic model that other legal service groups in New York say they would like to adopt.

“There’s a lot of needs the kids have outside the legal ones,” said Brett Stark, 30, a lawyer for Catholic Charities New York and one of the three founders of Terra Firma. “For them to participate meaningfully in their own case, they have to be empowered and enabled by doctors and psychologists.” Mr. Stark recalled an asylum case last year in which he sensed that his
young client was holding back details of why he had fled Guatemala. Mr. Stark alerted the other founders of Terra Firma, Dr. Alan Shapiro, a pediatrician and the group’s chief medical director, and Cristina Muñiz de la Peña, a pediatric psychologist, both of whom are affiliated with the Children’s Hospital at Montefiore.

Over a period of several weeks of group therapy and individual sessions, the client eventually felt safe to tell of his horror: His best friend had been
beheaded next to him by gang members. At the boy’s asylum hearing, Dr. Muñiz testified that it had taken nine months for her patient to tell this story because in blacking out the incident, he had suffered post-traumatic stress disorder. The judge granted the boy asylum. In three years, Dr. Shapiro has written affidavits for 26 clients who showed signs of trauma ranging from broken bones and bullet wounds to schizophrenia; all 26 cases, he said, resulted in approval to stay in the United States.

“We are trying,” Dr. Shapiro said, “to give the kids the life that they deserve.” There are other legal agencies in New York that provide mental health services for immigrant youth, including the Door and the Safe Passage Project, but none with a distinct legal-medical partnership for unaccompanied minors. “Everybody recognizes the Terra Firma model, which is geared towards
children and trauma, seems to be the way to go,” said Jojo Annobil, director of the Immigration Law unit for the Legal Aid Society.

Because Terra Firma is the only place offering such services, groups are considering opening similar programs in Queens or Brooklyn. “At least we have started the conversation,” Mr. Annobil said.

Although Terra Firma offers individual counseling and medical appointments for children and their guardians, the heart of the program is its 10-month group therapy unit. To foster closeness,it is restricted to 12 girls and 12 boys, who meet on alternate Wednesdays. The participants come for dinner first, and then take part in the Zumba class taught by Deborah Snider, the associate director of community pediatric programs for Montefiore Medical Center.

“When people walk into the clinic and see a meal prepared and Zumba, they think, ‘Wow, they treat us like human beings, like people,’ ” Dr. Shapiro,
56, said.

After Zumba, the teenagers gather in a conference room. Dr. Muñiz, 34, and a social worker use games and guest speakers to stimulate group discussion on trauma, from sexual assault to gang violence, and help the children cope with their emotions. The night concludes with a meditation and mindfulness exercise called “la balanza.”

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