Psychosocial definition.
Community based psychosocial support. / Short presentation to set the frame and to define psychosocial support, and different levels of psychosocial intervention. What kind of indicators will allow us to assess the ability of children to be resilient?
Domain of psychosocial well being.
Activities to understand how communities have an influence on Children
and their psychosocial well-being.
2.
psychosocial support and protection aspects of child friendly spaces / Ask participants in small groups to draw an axis representing their life from childhood to adulthood, and let them think of an event that had a deep impact on the course of their lives. Then try to think about the different coping strategies they used: Individual Capacity. Societal Culture and Values, Family and Community.
Let some of the participants share their experience. Link the presentations to the PPT.
Psychosocial intervention planning. In small groups participants draw a pyramid divided into four (4) sections.
Imagine the pyramid represents a population affected by an emergency
participants receive four (4) strips of paper indicating levels of psychosocial support, then place the paper on the appropriate levels of the pyramid. Brainstorm on what type of focus for each level and who should be involved in each level.
In small groups ask participants to draw or create a map of your own community. Include the different services relevant to the children such as schools, clinics, public offices, sport facilities and places of worship. Discuss what risk factors and protective factors for children exist in the community.
Fill the table below on
Then discuss what activities the various services can use to support the community to support the psychosocial well being of children.
Circulate among the groups of trainees the chart paper below. Make them fill it and feedback in the end. / 15 min
10 min
30min
30 min
Total time / 90min,
Introduction
Psychosocial work is a component of child protection and overlaps with the term “social work”. It describes crosscutting activities which prevent and reduce negative impacts on well-being, such as advocating for improved access to basic services and security, and also community based activities which promote the ability of families and communities to support each other, resume everyday activities, and heal e.g. via parenting groups, children’s recreational and educational activities.
NEEDS OF THECHILDREN / AVAILABLE
RESOURCES / AVAILABLE
SKILLS / NON AVAILABLE RESOURCES
AND SKILLS
The activities to be done
PAY ATTENTION TO VULNERABLE GROUPS
Depending on the context, particular groups of people are at increased risk of experiencing
social and/or psychological problems.
Some groups (see also module 1) have often been found to be more vulnerable, i.e. children
and adolescents; older persons; persons with physical or mental disabilities and
people living with other health challenges; people living in poverty; those who are unemployed;
women and particular ethnic or linguistic minorities. Some groups may be at risk of more than one
issue. For example, an unemployed woman who is living with HIV and AIDS may be
particularly vulnerable. The more vulnerable a person is, the greater are the psychosocial
consequences of a crisis. However, no assumptions should be made. Some individuals
within an at-risk group may actually do fairly well in a crisis. Others may be marginalized and difficult to reach, such as older women, widows and those with poor mental health. In planning a response, it is vital to make an assessment, taking account of risk factors as well as the social, economic and religious resources
which are available and accessible to people. The IASC guidelines (page 5) list the
kind of resources that are helpful in supporting psychosocial well-being, for example:
• individual skills such as problem solving and negotiation
• having community leaders, local government officers, traditional healers
• having land, savings, crops and animals and livelihood
• having schools and teachers, health clinics and staff
• having religious leaders, practices of prayer and worship, burial rites
Where psychosocial support activities are planned, it is important to make sure that all relevant groups have access to and are included in them. This may require some advocacy work to ensure that community members are aware that a particular group is entitled to support.
A community-based approach involves the participation of community members. People working together in groups with helpers supporting the group’s values, needs and aspirations, are empowered and respected. It is best if the community is involved from the very beginning in identifying problems, discussing solutions and deciding on what concrete activities to carry out. Using the community’s knowledge, values and practices, psychosocial responses are more likely to be meaningful and effective. A greater level of accountability and ownership may also be achieved. Ownership gives people a stronger feeling of self-worth, importance and influence.
Support groups
Through community-based support groups, individuals who have been exposed to extreme stress find acknowledgement and respect. They participate in something bigger than themselves, creating meaning in a difficult world. By sharing personal stories, participants see that they have similar experiences and that their reactions to these difficult times are normal. Sometimes this is a painful process and a facilitator will support the group in this journey. Group members play their part, reinforcing self-esteem and self-worth.
Psycho-education
Psycho-education usually covers common reactions to difficult situations, as well as indicating coping mechanisms, skills and resources. The more people understand about themselves, the greater the possibility they have in addressing the difficulties they face.
Creative and physical activities
A wide range of activities can be helpful in promoting psychosocial well-being, including music, dance, drama, handicrafts, relaxation, yoga, physical exercises, sports and games. Traumatic experiences can affect a person physically and be felt as undefined pain, restlessness, hyperactivity or passivity. Physical exercises not only increase the participants’ consciousness of their body and its reactions, but also help participants let go of physical tension. Non-verbal activities give participants a break from the often painful realities of their lives. These activities help as a reminder that life can be joyful. They also help participants to sleep and relax, and thus make way for the recovery process. These activities should form an integral part of psychosocial programmes.
Play activities for children
As normal roles and daily routines can be lost after crisis events, establishing structure and daily routines becomes important. Community-based work with children can be used to improve children’s feeling of security, knowledge of health issues and their well-being. It promotes their participation in community life and builds collective skills. Children are just as active as adults in influencing and changing their everyday life and parents usually feel better if their children are well. School and pre-school settings play an important role in restoring security and trust after crises. Often, children find it even more difficult than adults to express their feelings verbally. Activities such as puppet theatres and games allow children to put their thoughts and feelings into words more easily.
Community mobilization
Community-based psychosocial activities specifically help people to work through issues that they bring about their situation. Community mobilization is usually on a broader scale. Community activities are organized with the community with a primary aim of strengthening social support. Projects such as building a house, cleaning a hospital compound, organising a soccer tournament, a music competition, puppet theatre, traditional dance, give the opportunity for a wide cross section of a community to be involved. People are able to contribute to their community and get a chance to appreciate the resources and value of others.
Psychosocial work therefore focuses on the aspects of an environment or situation which impact on both the social and psychological well-being of affected populations. This is achieved via working with the local community, sectors, and organizations to advocate for improved access to basic services and restore everyday recreational, social and vocational activities in order to promote psychosocial well-being.
From the field: Example of the problems with mental health terminology
“The problem is that technical words are often not used in a proper manner. People always talk about traumatized children. Because of that, the real difficulties of the children are not looked at and they are all put in the same category. When we speak of “a traumatized child”, it doesn’t say anything about him, about his life and his needs (.…). If we say that all children are traumatized because they are affected, we are wrong. Only some children are really traumatized and need help from a mental health specialist” (Source: Selvi, sSenior Protection Officer in Sri Lanka)
What is the difference between Psychosocial Support and Mental Health?
Psychosocial Support and Mental health. Although these terms are closely related, for many organisations and experts they have come to signal different, yet complementary, approaches. Agencies outside the health sector tend to speak of supporting psychosocial well-being. In contrast, agencies working in the health sector tend to speak of mental health but historically have also used the terms psychosocial rehabilitation and psychosocial treatment for non-biological interventions for people with mental disorders. Exact definitions of these terms vary between and within organizations. As this training is for Child Protection Officers, the term psychosocial support is used throughout for referring to this general area of programming. Mental health is used to refer to services provided to people suffering clinical mental health disorders such as depression, anxiety, post-traumatic stress disorder or psychosis.
Which articles of the Convention on the Rights of the Child (CRC) can I use to relate to the provision of psychosocial support?
Protection against abuse and neglect – Article 19 outlines the duty of governments to protect children from all forms of maltreatment by parents or others responsible for the care of the child and establish social programmes to prevent abuse and support psychosocial recovery:
Rehabilitative Care – Article 39 defines the duty of governments to make sure that a child affected by armed conflict, torture, neglect, maltreatment or exploitation, receives psychosocial support to restore well-being.
1. Basic services and security. The foundation for well-being is via the meeting of a person’s primary basic needs and rights for security, adequate governance, and essential services such as food, clean water, health care and shelter. While child protection workers usually cannot provide these directly, you can work with other sectors to make them aware of how they can deliver such services in a way that prevents psychosocial problems, and supports well-being e.g. by ensuring families are not separated or discriminated against in the way aid is distributed. (link to level 1)
2. Community and family supports. At the next layer community mobilisation is an essential primary activity to strengthen social support networks, and help people resume functioning. This may include funding educational and vocational projects, supporting community based children’s activities, or promoting social support networks. (link to level 2)
3. Focused, non-specialized supports. In the next layer, a smaller number of people will in addition require supports that are more directly focused on psychosocial well-being. These are for children or adults who having difficulty coping with their existing support network, but who are not suffering from a clinical mental disorder. They may include activities to help deal with the effects of particularly distressing events e.g. support groups for victims of rape or torture. These are typically carried out by trained social or community workers, or health care professionals. (link to level 3)
4. Specialised services . At the top of the pyramid is additional support for a small percentage of the population whose suffering, despite the aforementioned supports, is intolerable and/or who have great difficulties in basic daily functioning – that is, those who have severe clinical mental health disorders such as psychosis, drug abuse, severe depression, anxiety, or harmful to themselves of others etc.. This assistance could include psychological or psychiatric supports for people with mental disorders when their problems cannot be adequately managed within primary health services. (link to level 4)
Which professionals provide which levels of psychosocial support?
Professional / Level 1 / Level 2 / Level 3 / Level 4Animator/community worker / X / X
Child protection officer/social worker / X / X / X
Psychologist / X / X
Psychiatrist / mental health specialist / X
What are the basic principles of psychosocial work?
In all aspects of psychosocial work, including assessments, programming, monitoring and evaluation, there are basic principles that should be applied. These are as follows:
Best interests of the child.
The best interests of the child should be the primary consideration for all activities, taking into account what will be the impact for children, and avoiding doing harm. For example, groups for separated children may be designed to support them, but may also cause discrimination if these children are seen as different.
Child, family and community participation and empowerment.
The most effective and sustainable approach for promoting psychosocial well-being and recovery is to strengthen the ability of families and communities to support one another. Relief efforts can make matters worse if they reinforce a sense of powerlessness by treating those affected as helpless victims. Girls, boys, women and men should be active partners in decisions that affect their lives e.g. via involvement in relief efforts, older children working with younger children, parent committees. (Link to Foundation module: Child Participation)
Build capacities and strengthen resilience
Successful psychosocial programmes integrate into and build the capacity of community structures, civil society and governmental organisations. This means focusing activities on building strengths e.g. via training, awareness, community support groups, partnerships with local structures (Link to Section 1). Provision of direct support to community members by those not deeply familiar with the context, or stand-alone services or activities that deal with only one specific issue (such as post-traumatic stress disorder) should be avoided. (link to Co-ordination section)