Research
Terra Firma's team of medical, mental health and legal professionals conducts and publishes research to further expand on best practices in the care of unaccompanied immigrant children and families seeking asylum.
Co-authored by Terra Firma National Network Advisor, Dr. Minal Giri, this article explores ethical tensions in child immigration evaluations, offering guidance for clinicians balancing advocacy, objectivity, and trauma-informed care in complex asylum cases.
February 2026
Advocacy and Assessment: Ethical Dilemmas and Practice Considerationsin Pediatric Asylum Evaluations
"Terra Firma’s work with asylum-seeking children and families provides evidence in support of the establishment of MH-medical-legal partnerships and highlights the importance of the MH component in addressing asylum-seekers’ legal needs."
July 2022
Mental Health as the Cornerstone of Effective Medical-Legal Partnerships for Asylum-Seekers: The Terra Firma Model
“Migrants of all ages and from all three Northern Triangle countries
cite violence, forced gang recruitment, extortion, poverty, abuse,
and abandonment among their reasons for leaving.”
2018
Vulnerable But Not Broken: Psychosocial Challenges and Resilience Pathways Among Unaccompanied Children from Central America
"As one of its signature priorities, the Trump administration implemented substantial changes to immigration policy, which profoundly affected the health and welfare of immigrant children and families. Actions by the Biden administration to end these policies are critically important, but policy reversals aren’t enough to address the harm that has been done."
When Undoing is Not Enough — Repairing Harms Inflicted on Immigrant Children
2021
“Research suggests that initial traumatic experiences and resulting emotional dysregulation may lead to subsequent heightened trauma exposure (e.g., physical and sexual abuse). In order to properly treat and advocate for unaccompanied children, it is imperative to consider the complexity of these trauma responses.”
Terra Firma: Medical-Legal Care for Unaccompanied Immigrant Garifuna Children
2017
“In accordance with internationally accepted rights of the child, immigrant and refugee children should be treated with dignity and respect and should not be exposed to conditions that may harm or traumatize them. The Department of Homeland Security facilities do not meet the basic standards for the care of children in residential settings.”
Detention of Immigrant Children
2017
“Adding to the traumatic experiences that motivate refugee and migrant families to flee, it is the exposure of continued stress following the migration process what appears to predict negative mental health outcomes. Immigration detention itself is a traumatic experience with inherent toxic stress."
Working with Parents and Children Separated at the Border: Examining the Impact of the Zero Tolerance Policy and Beyond
2019
“When immigrant parents are forcibly separated from their children pursuant to a policy of family separation, the manifold harms are not only medical and psychological, but legal and ethical. Family separation adversely affects the health of immigrant families in addition to posing potential ethical ramifications that remain to be fully ascertained.”
The Ethical and Public Health Implications of Family Separation
2019
“By understanding the four unique phases of the immigration journey: pre-migration, migration, detention, and post-release, social service providers caring for newly arrived unaccompanied children can offer a trauma-informed approach that considers children's complex medical, psychosocial, educational, and legal needs.”
Unaccompanied Children Seeking Safe Haven: Providing Care and Supporting Well-Being of a Vulnerable Population
2018