ARC Foundation Module 7 Psychosocial Support

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Foundationmodule7Psychosocialsupport
Contents
Introduction
Definitionsofterms
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Section1 Whatispsychosocialsupportandwhyisit importantinemergencies?

Keylearningpoints Whatdoespsychosocialmean?andwhatispsychosocialwellbeing? Definitionsofpsychosocialsupportandpsychosocialinterventions Whypsychosocialsupportisimportant Trainingmaterialforthissection
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Section2 Arightsbasedapproach: principlesandapproaches

Keylearningpoints Psychosocialsupportandchildrights Thechilddevelopmentandthechildrightsapproachestochildrenaffectedby humanitarianemergencies Trainingmaterialforthissection
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Section3 Principlesofpsychosocialprogramming
Keylearningpoints Childrensrighttolife,survival,anddevelopment(CRCArticle6) Donoharm Nonviolenceinallitsforms Participation Workingwithfamiliesandcommunities Accesstoavailableresourcesandcapacities Contextualapproach Multilayered,integratedpsychosocialsupport Trainingmaterialforthissection
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Section4 Implementationstrategies
Keylearningpoints Level1Basicservicesandsecurity Level2Communityandfamilysupports Psychosocialsupportactivitieswithchildren Psychosocialsupportactivitieswithfamiliesandothercaregivers Level3Focusednonspecialisedsupports
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Foundationmodule7Psychosocialsupport Contents
Level4Specialisedservices
21 Whatshouldbeavoidedinpsychosocialprogrammesinemergencies
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Section5 Monitoringandlearningin psychosocialprogrammes

Keylearningpoints Psychosocialinterventionswithintheprogrammecycle Childfriendlymethodsfordesign,monitoringandevaluation Levelsofparticipation Methodsusedfordesigning,monitoringandevaluatingpsychosocialprogrammes Theaimandlogicofpsychosocialprogrammes Keyevaluationcriteriaforpsychosocialprogrammes
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Endnotes Furtherreading
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Trainingmaterialforthismodule
Exercisesandhandoutsarealsolistedattheendofeachsection. Whenreferredtointhetext,exercisesandhandoutsarealwaysfromthelistof trainingmaterialattheendofthesectionwherethereferenceappears,unlessthe referencespecificallypointstoothersections.
Section1 Whatispsychosocialsupportandwhyisit importantinemergencies?

Exercise1 Exercise2 Handout1 Handout2 Handout3 Handout4 Effectsoffrighteningexperiencesandseparation Theimportanceofsocioculturalunderstanding Casestudy Reactionsandfactorsalteringoutcomes Scenario Socioculturalnorms
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Section2 Arightsbasedapproach: principlesandapproaches

Exercise1 Exercise2 Childrightsandpsychosocialsupport CRCarticleslinkedtopsychosocialsupport
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Exercise1 Exercise2 Exercise3 Handout1 Handout2 Handout3 Handout4 Handout5 Psychosocialwellbeing:everybodysresponsibility Psychosocialinterventionpyramid Communityandfamilysupport Scenario Roleplayidentities Scenario TheIASCpsychosocialsupportpyramidmodel Scenario
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Section4 Implementationstrategies Section5 Monitoringandlearningin psychosocialprogrammes
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ThismoduleisoneofthefollowingseriesofARCresourcepackmodules. Foundationmodules 1 Understandingchildhoods 2 Childrightsbasedapproaches 3 Programmedesign 4 Participationandinclusion 5 Advocacy 6 Communitymobilisation 7 Psychosocialsupport Criticalissuemodules 1 Abuseandexploitation 2 Education 3 Childrenwithdisabilities 4 Sexualandreproductivehealth 5 Landmineawareness 6 Separatedchildren 7 Childrenassociatedwitharmedforcesorarmedgroups Allmodulesinclude:
studymaterialgivingdetailedinformationonthemodulessubjectandalistof furtherreading slidesgivingkeylearningpointsandextractsfromthestudymaterial,offeringa usefulresourcewhenintroducingtrainingeventsandexercises trainingmaterialforparticipatoryworkshopsthatcomprises exercisesgivingpracticalguidanceforfacilitatorsandhandoutsforparticipants.
ThefollowingdocumentsarealsoincludedintheARCresourcepackCDROMto ensureyoucanmakethemostofthesemodules.
Userguide AnintroductiontotheARCresourcepackandtherelationshipsbetweenmodules. Trainingmanual AdviceandideasfortrainingwithARCresourcepackmaterials. Facilitatorstoolkit Generalguidanceonhowtobeaneffectivefacilitator,withstepbystep introductionstoawiderangeoftrainingmethods. Definitionsofterms Acronyms
Acknowledgements Thefollowingindividualsandorganisationscontributedtothedevelopmentofthe materialinthismodule.
ViviStavrou UNICEF
TerredesHommes
Coverphotograph UNICEFNYHQ20070797/NicoleToutounji.Barrachit,Lebanon.
Introduction
Thismoduleprovidespracticalinformation,guidelines,examplesandtoolstosupport organisationsandkeyactorstoundertakepsychosocialsupporttobringaboutpositive changeforchildreninhumanitariancontexts.Usefulguidanceisprovidedtoanalyse whattypeofsupportbestsuitsaparticularcontextaswellasidentifyingtargetsand appropriatemessagesanddevelopingsupportstrategies. Psychosocialsupportinemergencieshasspecificchallengesandrisks,butalsohasthe potentialtodrawattentiontoneglectedemergenciesandmakearealchangeinthe fulfilmentofchildrensrights.Itcanleadtoshorttermchangesbutcanalsoaddress underlyingcauses,makingitanessentialpartofarightsbasedapproach. Thisfoundationmoduleisorganisedintofivesections,followingthelogicthatcouldbe usedinaworkshoptointroducetraineestoarightsbasedapproachtoARC.The materialinthismoduleiscomplementedbymoredetailedapplicationinother methodologyorCriticalissuemodulesandsoaimatestablishingbaseprinciplesand conceptsthroughgenericexercises. Section1Whatispsychosocialsupportandwhyisitimportantin emergencies? Explainstheconceptofpsychosocialsupportandhowitcanincrease theresiliencyofchildrenwhilecreatinganintegrateddevelopmentalapproachto promotingpsychosocialwellbeing. Section2Arightsbasedapproach:principlesandapproaches Illustrateswhy childrightsareessentialtopsychosocialsupportandtheneedtoaddresspsychosocial issuesnotjustonanindividuallevel,butalsoholisticallywithincommunities. Section3Principlesofpsychosocialprogramming Explainswhypsychosocial supportshouldberightsbased,childfriendly,genderandageresponsive,and culturallysensitiveandsustainable,andhowthismaybeaccomplished. Section4Implementationstrategies Outlinesdifferenttypesofsupportthatmay berequiredfollowingemergencies. Section5Monitoringandlearninginpsychosocialprogrammes Tellsofthe importanceofclearandmeasurableobjectivesandindicatorsthatareestablishedat theinitialstagesoftheintervention,aswellasseekingtheparticipationofchildren, familyandcommunitymembersindevelopingsupportprogrammes. Definitionsofterms
Psychosocial referstothecloseconnectionbetweenpsychologicalaspectsofhuman experienceandthewidersocialexperience. Psychosocialsupport isascaleofcareandsupportwhichinfluencesboththe individualandthesocialenvironmentinwhichpeopleliveandrangesfromcareand supportofferedbycaregivers,familymembers,friends,neighbours,teachers,health workers,andcommunitymembersonadailybasisbutalsoextendstocareand supportofferedbyspecialisedpsychologicalandsocialservices.Toreflectthisbroad rangeoftypesofsupport,theInterAgencyStandingCommittee(IASC)Guidelines usethecompositetermMentalHealthandPsychosocialSupport(MHPSS).Thismodule willmakeusofthetermpsychosocial.
Foundationmodule7Psychosocialsupport Introduction
Cognitive pertainstothementalprocessesofperception,memory,judgment,and reasoning. Affective referstoexpressingemotionorfeelingemotional. Socialeffects concernrelationships,familyandcommunitynetworks,cultural traditionsandeconomicstatus,includinglifetaskssuchasschoolorwork. Mainstreaming ensureschildrenspsychosocialwellbeingisapriorityinallaspects ofprogramming,policydevelopmentandorganisationaldevelopment.
Section1 Whatispsychosocialsupportandwhyisitimportantin emergencies?

Keylearningpoints
Psychosocialreferstothechildsinnerworldandtherelationshipwithhisorher environment. Psychosocialsupportisimportantinordertomaintainacontinuumoffamilyand communitybasedcareandsupportduringandafterhumanitariancrisesandto preventimmediateorlongtermmentalhealthdisorders. Accesstohumanitarianassistanceandsafetyandsecurityforthepopulationisthe cornerstoneofpsychosocialsupportduringhumanitarianemergencies. Animportantshifthastakenplaceinpsychosocialinterventionsfromanindividualised approachtoacommunitybasedapproachfocusedonenhancingtheresiliencyof childrenandfamilies. Theaimofpsychosocialinterventionsistoaddresschildrensissuesandneedsina holisticmannerandtoplacepsychosocialinterventionsinsidewiderdevelopmental contextssuchaseducationorhealthcare.Thiswillcreateanintegrateddevelopmental approachtopromotingpsychosocialwellbeing. Whatdoespsychosocialmean?andwhatispsychosocialwellbeing? Thetermpsychosocialisusedtoemphasisethecloseconnectionbetween psychologicalaspectsofthehumanexperienceandthewidersocialexperience. Psychologicaleffectsarethosethataffectdifferentlevelsoffunctioningincluding cognitive(perceptionandmemoryasabasisforthoughtsandlearning),affective (emotions),andbehavioural.Socialeffectsconcernrelationships,familyand communitynetworks,culturaltraditionsandeconomicstatus,includinglifetaskssuch 1 asschoolorwork. Theuseofthetermpsychosocialisbasedontheideathatacombinationoffactorsare responsibleforthepsychosocialwellbeingofpeople,andthatthesebiological, emotional,spiritual,cultural,social,mentalandmaterialaspectsofexperiencecannot necessarilybeseparatedfromoneanother.Thetermdirectsattentiontowardsthe totalityofpeoplesexperienceratherthanfocusingexclusivelyonthephysicalor psychologicalaspectsofhealthandwellbeing,andemphasisestheneedtoviewthese issueswithintheinterpersonalcontextsofwiderfamilyandcommunitynetworksin whichtheyarelocated(seediagramDefinitionofpsychosocial). Thesetwoaspectsarecloselyintertwinedinthecontextofcomplexemergencies wherebytheprovisionofpsychosocialsupportispartofthehumanitarianreliefand earlyrecoveryefforts.Oneofthefoundationsofpsychosocialwellbeingisaccessto basicneeds(food,shelter,livelihood,healthcare,educationservices)togetherwitha senseofsecuritythatcomesfromlivinginasafeandsupportiveenvironment.The benefitsofpsychosocialsupportinterventionsshouldresultinapositiveimpacton childrenswellbeing,andaddressthebasicpsychologicalneedsofcompetenceand relatedness.
Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?
Definitionofpsychosocial
Definitionsofpsychosocialsupportandpsychosocialinterventions Psychosocialsupport:
isabouthelpingchildren,familiesandcommunitiestoimprovetheirpsychosocial 3 wellbeing isaboutencouragingbetterconnectionsbetweenpeople,andbuildingabettersense ofselfandcommunity isexpressedthroughcaringandrespectfulrelationshipsthatcommunicate understanding,toleranceandacceptance isaboutpromotingeverydayconsistentcareandsupportinthefamilyandcommunity. Psychosocialsupportisacontinuumofcareandsupportwhichinfluencesboththe individualandthesocialenvironmentinwhichpeoplelive.Thiscontinuumrangesfrom careandsupportofferedbycaregivers,familymembers,friends,neighbours, teachers,healthworkers,andcommunitymembersonadailybasis,ie.ongoing nurturingrelationshipsthatcommunicateunderstanding,unconditionallove,tolerance andacceptance,andextendstocareandsupportofferedbyspecialisedpsychological andsocialservices.Experiencehasshownthatemergencydriveninterventionsare bestaccomplishedviagroupexperiencesincommunitysettings,wherethemost individualscanbehelpedinthequickestmannerthroughcollectivesupportofthe group.Inthelongertermaftermathofacrisis,inadditiontocontinuedpsychosocial support,asmallminorityofchildrenmayrequireprofessionalpsychological interventions.Thislevelofcareisbeyondthescopeofpsychosocialsupport,although thereisalotofcrossoverwithcommunitybasedmentalhealthcare,especiallywhen familymembersengagewithmentalhealthworkerstoprovidesupport(seediagram TheIASCpsychosocialsupportpyramidmodel). Undernormalconditions,forhealthydevelopment,mostchildrendonotrequire additionalpsychosocialsupportaboveandbeyondthecareandsupportofferedby theirfamiliesandhouseholds.Wherethisfirstcircleofsupportisrupturedorbroken, othercommunitymembersmighthavetostepin.Itiswhereandwhenthissecond circleofsupportisbrokenorrupturedthatexternalagencieshavearoletoplayby 4 offeringprogrammaticpsychosocialsupportorinterventionsaimedat:
strengtheningthecapacityofcaregivers,friends,teacherstoprovideeveryday psychosocialcareandsupporttoallchildren strengtheningthecapacityofspeciallypositionedcommunitymembersand paraprofessionalstoprovidespecialisedpsychosocialsupporttosubgroupsofchildren atriskand/orchildrendirectlyaffectedbyHIVandAIDS,povertyandconflictwho haveexperiencedseverelossesortrauma. Complexemergenciestendtoweakenthetraditionalsocialandsecuritysafetynetsfor children.Organisedcareandsupporthasbeenrelativelyquickinrespondingtothe material,physicalandeducationalneedswhichhavemoretangibleoutputs.However, beyondthis,holisticchilddevelopmentdemandsmore.Thekeyunderlyingideato psychosocialinterventionsaddressingposthumanitarianemergencyrecoveryis thatparticipationinsuchactivitiesassistschildrenandtheirfamilieswhohave experiencedseverestresstorestoretheirsocialandpsychologicalhealthandprevent morelongtermsocialandmentalhealthproblems.Theprimaryfocusofsuch psychosocialinterventionsisonsupportingthenaturalhealingandrecoveryprocess byrestoringasquicklyaspossibleresilienceinthefaceofchallengingcircumstances 5 andthestabilityofanentireaffectedcommunity. Whypsychosocialsupportisimportant Experiencingdifficultordisturbingeventscansignificantlyimpactthesocialand emotionalwellbeingofachild.Exposuretoviolenceordisaster,lossof,orseparation fromfamilymembersandfriends,deteriorationinlivingconditionsandlackofaccess toservicescanallhaveimmediate,aswellaslongtermconsequencesforchildren, familiesandcommunitiesbalance,developmentandfulfilment. Recentyearshaveseenadramaticgrowthinprogrammesdesignedtoprovide psychologicalandcommunitybasedsupporttochildrenandfamiliesrecoveringfrom distressingevents.Throughoutthe80sand90smanyagenciesappliedwestern, individualisedapproachestocounsellingandtherapytoculturesinwhichtheydonot readilyapply.Anumberofstudieshaveshownthattheconsequencescanbenotonly wastefulbutalsopotentiallydamagingtochildrenastheymaynotrecogniseand valuewhatalreadyexistswithintheculture,withinfamiliesandwithineachchild, potentiallyunderminingexistingpracticesandtraditionswhichmaybeofgreat importanceinfacilitatingchildrensrecovery. Thetermpsychosocialinterventionaroseintheearly1990sasareactionagainstthe overlymedicalandoftendecontextualisedposttraumaticstressdisorder(PTSD) modelofresponsetochildrenaffectedbyconflict.Thepsychosocialapproachshiftsthe emphasisfromchildrensvulnerabilitiestoaviewofchildrenasactiveagentsinthe faceofadversityandadoptsamodelofservicedeliverywhichrecognisesand 6 strengthensresilienceandlocalcapacities. Thisresiliencebuildingapproachto psychosocialwellbeingandchildprotectionwasdevelopedinanattempttoadvancea moresustainableandholisticapproachtoworkingwithchildrenaffectedbyconflict, HIVandAIDS,naturaldisastersandotherverydifficultanddangeroussituations. Psychosocialinterventionsdonotarisefromaninitialpremiseofneed,illnessor deficiencyofindividualchildren,butbuilduponachildsnaturalresilienceandfamily andcommunitysupportmechanisms,examinepossibleriskandprotectivefactorsand attempttoprovideadditionalexperiencesthatwillpromotecopingandpositive
development,despitetheadversitiesexperienced.Anunderstandingofthecultureis offundamentalimportanceinplanningprogrammes. Psychosocialinterventionsplanforpositivechangeforchildrenwithinthethreecore 7 psychosocialdomains (skillsandknowledge,emotionalandsocialwellbeing),aswell asthebroaderdomainsimpactinguponthewellbeingofchildren,theirfamiliesand communities(seediagramPsychosocialdomains).Inaddition,thespiritualand physicalhealthandwellbeingofchildrenareimportantindicatorsoftheiroverall 8 wellbeingandneedtobeconsideredwithinthecorepsychosocialdomains.
Psychosocialdomains
Psychosocialindicatorsfromaparticipatoryevaluationstudyofsports,play andstructuredrecreationactivitiesdoneincampsforinternallydisplaced people,northernUganda Thequalitativeresultsindicatethatalthoughthereviewcannotclaimadirectcausal relationshipbetweentheperceivedchangesandthesportsanddevelopment,right toplayprogrammes,theoverallbenefitsindicateapositiveimpactonchildrens wellbeingandaddressthebasicpsychologicalneedsofcompetenceandrelatedness. Emotionalwellbeing Themostcommonlycitedchangeinthisdomainbythechildrenwasanincreased senseofsecurityandconfidenceasindicatedbyreachingoutandmaking friends,oratleastparticipatinginsocialactivities(prosocialbehaviour).Thisis anespeciallyimportantstepforformerlyabductedchildren. Themostcommonlycitedchangeinthisdomainbytheadultswasincreasedself controlandprosocialbehaviour(reducedaggression,reducedratesofconflict andfightingamongstthechildrenandincreasedcooperation).Citedinfluences beingpositivepeerpressure,principlesoffairplay,positivecoachingand facilitationexperiences,improvedselfcontrolandproblemsolvingfrom participationinregular,organisedactivity. Parentsreportthattheirchildrensandtheirownparticipationintheactivitieshas broughtaboutachangeinthemasparents,resultinginagreaterawarenessof thespecificneedsofdifferentagegroups(unlikeinthepastwhenparentsjust didwhatevertheylikedfortheirchildren)agreaterawarenessoftheirown childrensindividualstrengthsandneeds,andmoreintergenerationaldialogue. Thehappierthechildren,thehappierandmoreproudweare.Alsoacquisitionof skillsandknowledgeareanotherpositivesideeffect. Socialwellbeing Themainchangehereisrelatedtotheimprovedabilitytoassumesocially appropriateroles,whichappearstobelinkedtoagreatersenseofthechild beingappreciatedbythefamilyandbelongingtotheircommunity.Thechilds participationintheresumptionofculturalactivitiesandtraditionsisakey indicatorinthisdomain. Bothadultsandchildrenplacedthegreatestvalueonsocialskill,socialresponsibility andsocialconformityasevidencedbypositivesocialfunctioningbehaviour. Socialcompetenceisprimarilyindicatedthroughimprovedgoodvaluesasshown bythewillingandrespectfulparticipationinappropriatehousehold responsibilities,livelihoodsupportandfilialobligations.Fulfillingchildrelated developmentaltasks,suchasschoolworkandplay,issecondarytotraditional obligationsandtasksthatsupportfamilycohesionandsurvival.Contributingto thefamilyandlivinguptofamilyexpectationsaremajorindicatorstofamily membersthattheyouthisdoingwell.Similarfindingsfromresearchdonein northernUgandashowsthatfamilyconnectednessandsocialsupportappearto bethemainprotectivefactorsforthepsychosocialwellbeingofchildren. Thereis,however,lessevidenceonthebenefitsrelatedtogreaterandsustained socialinclusion,ofimprovednetworkingandsocialcohesionbetweenthe
participatingchildrenandchildrenoutsideoftheproject. Skillsandknowledge Themainchangesinthisdomainarerelatedtotheacquisitionofskillsand knowledgerelatedtoprojectactivitieslikefootballandnetball,dances,games, playingmusicandsongs,drama,debates,discussionsandtrainingsrelatedto childrights,healthinformation,safebehaviour,sessionsonthequalitiesof friendlybehaviour,conflictresolution,peaceandforgiveness. Thereappearstobeaboostingofchildrenscognitivedevelopmentrelatedto learningandcreativity. Parentsreportanincreaseintheirchildrensknowledgeasevidencedbythechildren returningandinformingthefamilymembersofhealth,hygieneandchildrights messagesteachingsiblingsandneighbouringchildrenthegamestheylearnt participatingintheprogramme. Parents,teachers,coachesandfacilitatorsreportthatchildrenwhogothroughthe structuredgrouporsportsprogrammesbecomemorecreativeandexploremore. Teachersreportthattheparticipatingchildrendrawmorepicturesandtheir drawingsaremoreskilledthanbefore.Theparticipatingchildrenplaymore,and theyplaybetterorganisedgamesintheplayground.Theyhaveintroducednew activitiesanddomoreactivitiesthantheotherchildren. Physicalwellbeing Therelevanceofphysicalhealthandwellbeingtothechildrenisanimportant indicatoroftheiroverallwellbeing.Thechildrenemphasisetheimportanceof physicalhealthandcleanlinesstotheirphysicalandpsychologicalwellbeingmore thantheadultsdo.Beinghealthy,cleanandstrongandhavingenoughfoodto eatisoneofthemainthingsthatmakethechildrenfeelhappyandproud. StayingaliveisahugeachievementintheIDPcampsofnorthernUganda.The abilitytokeepthemselvesclean,wellgroomedandhealthyisasignofself efficacyaswellasindicatingeconomicsecurityandfamilyconcern.Being hungry,gettingsickand/orlosingtheirparentsfromillnessisoneofthemost commonlycitedworriesandfearsthatthechildrenreport. ReviewofUNICEFsupportedRighttoplayinterventionsinrespondingtothe psychosocialneedsofchildrenaffectedbyconflictinnorthernandeasternUganda StavrouV,UNICEF,UgandaSeptember2007
Trainingmaterialforthissection Exercise1 Exercise2 Handout1 Handout2 Handout3 Handout4 Effectsoffrighteningexperiencesandseparation Theimportanceofsocioculturalunderstanding Casestudy Reactionsandfactorsalteringoutcomes Scenario Socioculturalnorms
Section2 Arightsbasedapproach:principlesandapproaches
Keylearningpoints
Therightsbasedapproachisfocussedonstrengtheningfamilies,communitiesand othersocialinstitutionsasresponsiveandprotectivespacesforchildren. Therightsbasedapproachadvocatesforuniversalaccesstoessentialservicesand Stateprotectionforchildren. Workthatseekschangesinthepsychosocialwellbeingofchildrenmeansthat:
familyandcommunityaswellasindividualissuesareaddressed thereisadeliberateandexplicitfocusonbringingtogetherpsychologicalfactors andsocialinclusion,andnotfocussingonmaterial,psychological,spiritualor welfaresupport.
Guidingprincipleswhenprovidingpsychosocialsupporthelptoreducetheriskofharm andpromotecommunitybasedintervention. Psychosocialsupportandchildrights Psychosocialsupportanddevelopmentprogrammesareacriticalelementinthe protectionofchildrensrights.TheinterventionsshouldbebasedupontheUN Conventionontherightsofthechild(CRC),ensuringthatallgroupsaregiventhe opportunitytoparticipateandallinterventionsareculturallyrelevant.Inlinewiththe CRC,childrenshouldhaveanactiveroleindesigningandimplementingprogrammes. BelowaresomeoftherelevantstandardsfromtheCRCthatapplytopsychosocial supportandchildren'srighttoit.
1 Article29.1.a Psychosocialsupportcanprovidetheopportunityforchildrento bedevelopedtotheirfullestpotential. 2 Article5andArticles12to17 Psychosocialsupportempowerschildrenand youthbyprovidingopportunitiestoparticipateinsociallife,beselfreliant,develop selfconfidenceandempowermentwithdueregardtothematurityandevolving capacityofthechild,andrespectingtherightsandresponsibilitiesofadults. 3 Article2 Psychosocialsupportcombatsdiscriminationbyfacilitatingthe integrationofgroupssufferingfromdiscrimination,suchasgirls,childrenbelonging tominoritygroups,childrenlivinginpovertyandchildrenwithdisabilities. 4 Articles20,22,23and31 Psychosocialsupportadvocatesforandprovidesan opportunityforallgroupsofchildreninneedofspecialprotection tobeprovidedequalaccesstodifferenttypesofsupport(includingeducation,social protection,sports,play,music,danceanddrama),suchaschildrenwithdisabilities, childrenlivinginsocialandotherinstitutions,childrenlivingindetentioncentres,child refugees,childreninrehabilitativecareandworkingchildren. 5 Articles19and29 Psychosocialsupportpromotesnonviolence byprovidingopportunitiesforsocialintegration,encouragingfairplayandchannelling energyawayfrompotentialdestructivebehaviour.
Foundationmodule7Psychosocialsupport Section2 Arightsbasedapproach:principlesandapproaches
6 Article39 Psychosocialsupportisarehabilitationandreintegrationtoolto supportthephysicalandpsychologicalrehabilitationandsocialreintegrationof childrenandfamiliesimpacteduponbyconflictandotherhumanitarianemergencies. Thechilddevelopmentandthechildrightsapproachestochildrenaffectedby humanitarianemergencies Thetwodominantapproachestounderstandingthesituationofchildreninemergency situationsandprovidingassistancetothemhavebeenorientedaroundchild developmentandchildrights.Thesetwoapproachescomplementeachotherevenas 9 theyplacedifferentemphasisonvariousaspectsofchildrenssituations.
Thechilddevelopmentapproach Ageandstagerelateddevelopmentalneeds, vulnerabilities,andcapacitiesthatmustbe addressedforhealthyandholistic developmentinchildren. Aimistominimiserisksandpreventfurther harmwhilereinforcingprotectivefactorsthat facilitatechildrensphysicalandpsychosocial wellbeing. Culturalinfluencesandcontextualfactors suchaspatternsofsocialisation,education, andcarecanhaveaprofoundinfluenceona childsdevelopingattitudes,values,and beliefs,andshouldbeconsideredwhen adoptingadevelopmentalapproach. Participatinginculturalandsocialactivitiesis alsoadevelopmentalneedofchildren,and thewayinwhichthishappenswillbediverse. Themainaimistoallowchildrentoreach theirfullestpotentialinaholisticmanner. Bothchilddevelopmentandchildrightsapproachesplaceprimaryimportanceonthe protectionofchildrenfromviolations,maltreatment,injury,andexploitation.Bothapproaches alsoemphasisetheprovisionofservicestochildren,forinstancetherighttofoodand healthcare,therighttoeducation,andtherighttoenjoysecurity.Therightsapproachplaces additionalimportanceontherighttoparticipation. Therightsbasedapproach Childrenhavenotonlyneeds,butalsothe righttohavetheseneedsmet,aswellas otherrightssuchassurvivalrights,protection rights,andparticipationrights. TheCRC,whichwaslaunchedin1989and widelyratifiedbygovernmentsaroundthe world,andtheAfricancharterontherights andwelfareofthechild(1990),set internationalnormsfortherecognitionand observanceofchildrensrights. ThethreekeyprinciplesoftheCRCare: thebestinterestsofthechildmustbe observed nondiscriminationistoassurethatall childrenhavetherighttobetreated equally childrenmusthavetherighttoparticipation
Therightsbasedapproachconsidersthattheprovisionofpsychosocialsupportisa childsright,especiallyinhumanitarianemergencies.Materialandsocialneeds,along withsafetyandsecurity,arekeyfactorsinensuringpsychosocialwellbeingandshould berecognisedaspartofeffectivepsychosocialsupport.Activitiestoaddresstheneeds ofchildren(education,protectionmeasures,healthcare)shouldbeprovidedinaway whichenhancesratherthanfurtherdisruptspsychosocialwellbeing. Byadoptingarightsbasedapproach,psychosocialsupportinterventionsshould adheretothefollowingcoreprinciplesasfaraspossible.
Interventionsandprojectsaredesignedusingaparticipatoryframework.Thisincludes usingparticipatoryactionresearch,collectingsystematicinformationthatisthenused toconstructevidencedriveninterventions. Takinganecologicalapproachthatidentifiestheproblematthedifferentindividual, familyandcommunitylevels.Thuscollectingsystemicinformationnecessarytoguide theinterventionatmultiplelevels,andattemptingaholisticresponsetothesituation. Identifyingtheexistingknowledgeandskillsoftheparticipants,drawinglessonsfrom theirresilienceandcopingstrategiesandseekingtoidentifybarriersthathamper accesstosupportandservices,andtoaddressthegapsthatexistregardingsupport andserviceprovision. Informationissoughtfrom,andassistanceprovidedimpartiallyto,allparticipants regardlessofpoliticalorsocialaffiliationorlocation. Participatingpartnersareaccountabletotheparticipantsandbeneficiariesandensure fulltransparencyduringtheplanning,implementationandmonitoringofprojectsand anysubsequentfollowup. Mechanismstoadvocateforchildrensrightsneedtobeincludedinthedesignand followupplans. Interventionsarehighlysupportiveandconstructedinamannerthatprotectsallthe participants.Thisiscriticalsincetheresearchandinterventionprocessitselfcan increasevulnerability.Informedconsentneedstobesoughtfromallparticipants. Likewise,humanitarianstaffneedstobemonitoredonaregularbasis,ensuringthat ethicalissuesarerespectedandethicalnormsappropriatelyapplied. Inaddition,workingwithchildrenandfamiliesinemergencycontextscanbe dangerousandextremelystressfulforprojectworkers,andincludesthepossibilityof vicarioustraumatisation.Supportanddebriefingneedstobemadeavailabletostaff workinginthesesituations. Emergencyrightsbasedpsychosocialsupportprogramming:
focusesassistanceonthemostvulnerablegroupsbutpursuesanintegrative strategybyincludingallchildreninprogramming makesthebestuseofexistingscarceresources,andlaysthegroundworkfor futurereconstructionprogrammes ensuresthatpartnershiprelationshipspromoteoperationalflexibility,crucial becauseofthevariablesecuritysituationandthepoliticalsensitivitiesprevalentin humanitarianemergenciesfactorsthatcanatanytimelimitgeographicalaccess andaccesstoparticipants.
Guidingprinciplesoftherightsbasedapproachwithinthecontextofpsychosocial supportforprogramminginhumanitarianemergenciesareincludedinSection3.
Sportfordevelopmentandpeace TheUNHCRhaslongusedsportinitsprogrammestofosterrefugeereintegration. In2005,UNHCRexpandeditsactivities,developingmorepartnershipswithsports orienteddonorstoenableittoexpanditssportsprogrammesfurther.UNHCRhas foundthatsportsprogrammesinrefugeecampsprovideaneffectivetoolfor empoweringgirls,giventhattheyareoftenexcludedfromparticipatingand enjoyingthephysicalandpsychosocialbenefitsofferedbysport.Bydirectly challenginganddispellingmisperceptionsaboutwomenscapabilities,integrated sportsprogrammeshelptoreducediscriminationandwidentherolesprescribedto womenandgirls. Playingforpeace Intimesofconflict,postconflictandemergencies,sport,recreationandplaycan providechildrenandadolescentswithasenseofhopeandnormalcy.Theyhelp traumatisedchildrenlearntointegratetheexperienceofpain,fearandloss.They helphealemotionalscars,creatingasafeenvironmentthatenableschildrenand adolescentstoexpresstheirfeelingsandbuildtheirselfesteem,selfconfidenceand trust.Sport,especiallyparticipatinginateamoraclub,canprovide[children formerlyassociatedwitharmedforcesorarmedgroups]acriticalsenseof belonging,necessaryfortheirreintegrationintothecommunity.Childrenwhoplay sportsseethatinteractionispossiblewithoutcoercionorexploitation.Players cooperatewithinaframeworkofrulesarefereeadjudicatesonthejustnessof activityduringagame.Penaltiesexisttosanctiontransgressionsandenable reconciliationbetweensportingadversaries. Sportfordevelopmentandpeace:towardsachievingthemillenniumdevelopment goalsUnitedNationsInteragencyTaskForce,2003
Trainingmaterialforthissection Exercise1 Exercise2 Childrightsandpsychosocialsupport CRCarticleslinkedtopsychosocialsupport
Keylearningpoints
Differentbutcomplementaryinterventionsarerequiredinemergencies. Accesstobasicservicesandsecurityisthefirststeptoensurethepsychosocial wellbeingofchildren. Promotingcommunitybasedpsychosocialinterventionshelpsamajorityofchildren willbeabletoregainasenseofnormalcyfollowinganemergency. Asmallergroupofchildren,suchasthoseatriskorvictimsofexploitationandabuse, willbenefitfromfocused,nonspecialisedsupportbysocialworkersorpsychologists. PsychosocialprogrammesandinterventionsshouldbebasedontheCRCandpromote thefollowingprinciplesandvalues. Childrensrighttolife,survival,anddevelopment(CRCArticle6) Theoverallobjectiveofpsychosocialinterventionsistoreestablishastateof wellbeingthatisnecessaryforandpromotesthehealthydevelopmentofthechild. Thisalsomeansthatwherechildrenfacelifethreateningsituations,psychosocial interventionsshouldconsiderwhatpracticalstepscanbetakentoprotectchildren fromfurtherharmandexposuretoviolence. Donoharm Workonpsychosocialsupporthasthepotentialtocauseharmbecauseitdealswith highlysensitiveissues.Humanitarianactorsmayreducetheriskofharminvarious ways.
Informedconsent Priortoundertakingpsychosocialinterventions,consentshould beobtainedfromchildrenandtheirfamilywithfullknowledgeofwhatwillhappenand theprobableeffectsonthechild. Confidentiality Psychosocialassessmentsandinterventionsshouldrespect confidentiality,includingwhentheinterventionsareundertakeningroups psychosocialinstitutionsshouldprotectthisconfidentialityandensureanonymitywhen communicatingabouttheirinterventions. Honestyandobjectivity Psychosocialworkersmustnotmisleadthebeneficiaries, andmusttellthemthetruthinanageappropriatemannerandtothedegreetowhich itcontributestotheirlongtermdevelopment.Institutionsandindividualsshouldalso behonestandrecognisetheirownlimitsandbeabletorefercasesbeyondtheirarea ofcompetency. Responsibility Intervenersmusttakeresponsibilityfortheimpactoftheir interventions.Thismeanstheymustmakeanaccurateassessmentoftheriskinvolved andchoosetheappropriatemethodologyforoptimumbenefitsandminimalrisksfor thebeneficiaries.Theyareresponsibleforcloselymonitoringtheimplementationand impactoftheintervention.Tothedegreethatisfeasible,theyarealsoresponsiblefor providingassistance,includingfollowuporreferral,foranybeneficiarieswhocannot beadequatelyassistedthroughtheintervention.
Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming
Participatingincoordinationgroupstolearnfromothersandtominimise duplicationandgapsinresponse(seemultilayeredsupportbelow). Designinginterventionsonthebasisofsufficientinformation(seeContextual approachbelow). Committingtoevaluation,opennesstoscrutinyandexternalreview. Developingculturalsensitivityandcompetenceintheareasinwhichtheyintervene andwork. Developinganunderstandingof,andconsistentlyreflectingupon,universalhuman rights,powerrelationsbetweenoutsidersandemergencyaffectedpeople,andthe valueofparticipatoryapproaches.
Nonviolenceinallitsforms Childrenshouldbeprotectedfromallformsofviolencebytheirfamilyandcommunity, includingpoliticalviolence,violenceatschool,familyviolence,violenceamongpeers, andrepresentationsofviolence,includinginthemedia.Psychosocialinterventions shouldbefreefromallformsofviolenceagainstorinthepresenceofchildren.Where itisabsolutelynecessarytoencourageorallowthechildtoexpresshisorher experienceofviolenceaspartofahealingprocess,thisshouldbedoneusingthe safestformofexpression,forexample,drawingratherthanacting,andshouldhappen inaconfidential,supportivesettinginvolvingonlythosewhodirectlyexperiencedthe violence.Itshouldoccurassoonaspossibleaftertheoccurrenceoftheeventaspart ofacontinuumofinterventionsthathelpthechildtodeveloppositiveandconstructive behaviour. Participation InlinewiththeCRC,childrenshouldhaveanactiveroleinthedesignand implementationofprogrammes.Achildhastherighttofreelyexpressanopinionin allmattersaffectingherorhimandtohavethatopiniontakenintoaccount.Every childhaspersonalandsocialresourceswhichheorsheemploysatdifferentmoments inhisorherlife.Interventionsfocusontheidentificationofinternalandexternal resourcesinorderforthechildtodevelopprotectionmechanismsforherorhisown wellbeing.Psychosocialinterventionsworktoenablechildrentobecomeactiveagents inbuildingcommunitiesandplanningtheirfutures. Respectfortheviewsofthechild Psychosocialinterventionsmustensurethatchildrensviewsareacknowledgedand respectedsothattheyparticipateintheirownhealinganddevelopment,andsothat theirdignityispreserved. Bestinterestsofthechild Inalldecisionsaffectingthepsychologicalandsocialwellbeingofthechild,primary considerationshouldbegiventothechildshealthydevelopment.Eachchildsviews aretheirreality,andthismustbeweighedagainstthebestinterestsofthechildwhen anydecisionsaretaken.Psychosocialprogrammesandtheiroutcomesshouldnotbe usedforanypurposeotherthanthepsychosocialdevelopmentofchildren,in particular,suchactivitiesshouldnotbeusedforpolitical,media,economicorsocial gainfortheimplementingorganisationorindividual.Thelongtermdevelopmentof thechildandtheindirectconsequencesofanyshortterminterventionshouldbetaken intoaccountwhenimplementingprogrammes.Shortterminterventionsthat
underminethetrustbetweenthechildrenandtheircaregiversorthatmakechildren moreawareoftheirproblemswithouthelpingthemtofindsolutionsforthese problemscanbeharmfulforthechildren. Nondiscriminationofanykind Includingonthebasisofsex,age,religion,socioeconomicstatus,ethnicity,and disabilitystatus,particularlyregardingavailabilityandappropriatenessofservices. Psychosocialworkersshouldalsominimisethepositiveornegativestereotypingof childrenwhohaveexperiencedpsychologicalorsocialdistressorbeenexposedtoor involvedinviolence. Usingagendersensitiveapproach Takesintoaccountthesituation,dynamicsandneedsofeachmemberofthe community,women,men,girlsandboys,inordertobetterachieveprogramme objectivesintheinitialstageofselectingtargetgroupsandthemostappropriateway toinfluencechange. Inclusionofadolescents Adolescentsareusuallyoverlookedinprogramming,asresourcesaredirectedtowards 13 youngerchildrenwhoareperhapsperceivedasmoreworthyrecipientsofaid. Not onlyaretheneedsofadolescentsoverlooked,buttheirstrengthsandtheirpotentialas constructivecontributorstosocietiesalsoremainunrecognised.Adolescentsare affectedbyarmedconflictinparticularwaysthatexposethemtoincreasedriskssuch asrecruitmentintoarmedgroups,sexualabuse,thecontractionofsexually transmitteddiseases,andeconomicexploitation.Theymayassumeadult responsibilitiessuchasheadinghouseholds,yetarefrequentlynotaccordeddecision makingpowersincommunities.Adolescentsmaythusbefacedwithparticular problemsandmayhavespecificpsychosocialissuesthattheywanttoaddress.Ina 14 participatoryresearchstudywithyoungpeopleinKosovo, adolescentsidentified psychosocialproblemsastheirsecondmostimportantconcern,supersededonlyby securityconcerns.Thelossoffamilyandfriendsanduncertainlyaboutthefutureand feelingsofhopelessnesswerementionedasissueswithwhichtheyneededhelp. Workingwithfamiliesandcommunities Thepsychosocialwellbeingofadults,particularlyparentsandcaregivershasadirect impactonthatofchildren,andshouldthusbeaddressedthroughconcurrentparent focusedinterventions.Psychosocialinterventionsshouldbedirectedatenabling connectednesstoanadultinthechildslifeandsocialinclusionintothelarger communitynetwork,psychosocialinterventionsneedtomaintainafocuson strengtheningcommunities,familiesandothersocialinstitutionsasresponsiveand protectivespacesforchildren. Inaddition,therightsbasedapproachdemandsthatpsychosocialworkersdevelopan understandingof,andconsistentlyreflectupon,universalhumanrights,power relationsbetweenoutsidersandemergencyaffectedpeople,andthevalueof participatoryapproaches.
AnapproachrootedinthecultureofrefugeesfromsouthSudan InaremotepartofnorthernKenyaisalargerefugeecampinwhichthereisan extraordinarilylargeconcentrationofunaccompaniedchildren,mainlyboys. TheexactcircumstancesoftheirflightfromSudanandtheirseparationfromtheir familiesarenotentirelyclear.Whatisclearisthatintheprocessofflight,initially intoEthiopia,andlaterbecauseofthreatstotheirsafetythere,thelongwalk throughsouthSudanandintoKenyawasfraughtwithdangers,fromsoldiers,from wildanimalsandfromthethreatofstarvation,dehydrationanddisease.Ifany groupofrefugeechildrenwouldbeexpectedtobedeeplyaffectedbytheir experiencesofwar,separation,multipledisplacementandhardship,itwouldbethis group. Fromthebeginning,SavetheChildrenSwedensawtheneedtoconstructa compositeprogrammebasedcarefullyandsensitivelyaroundtheculturaltraditions andpracticesoftherefugees.Carearrangementswerebasedonthetraditionof grouplivingincattlecampsandtheacceptabilityofcareprovidedbyunrelated families.Arangeofactivitiesfacilitatedthechildren'srecoveryfromtraumatic experiencesinawaywhichrespectedcultureandtraditiontheseincluded storytelling,composingpoems,recountinganddiscussingdreams,traditional singinganddancingandanartformbasedonthetraditionalimportanceofknowing thecoloursofeachboysbull.Theinvolvementofthewholecommunitywas significantinemphasisingtheimportanceofcollectivelycopingwithshared experiences.Despitetherepeatedexperiencesofdanger,fearandflight,andthe factofseparationfromtheirfamilies,thepsychosocialhealthofthesechildren remainedremarkablygood:onlyatinypercentagewerefunctionallyimpaired,as evidencedbytheirbehaviourpatterns,thequalityofinterpersonalrelationships andtheirperformanceinschool.Aninvestigationoftheirpsychologicalhealth revealedremarkablyfewchildrenreportingsymptomsofstressanditwasclear that,ingeneral,thesechildrenwerecopingremarkablywell. Workingwithchildrenmodule,ARCtrainingpackage2002
Accesstoavailableresourcesandcapacities Buildingonavailableresourcesandcapacities Allaffectedgroupshaveassetsorresourcesthatsupporttheirmentalhealthand psychosocialwellbeing.Akeyprinciple,evenintheearlystagesofanemergency,is buildinglocalcapacities,supportingselfhelpandstrengtheningtheresourcesalready present.Externallydrivenandimplementedprogrammesoftenleadtoinappropriate mentalhealthandpsychosocialsupportandfrequentlyhavelimitedsustainability. Wherepossible,itisimportanttobuildbothgovernmentandcivilsocietycapacities. Universalaccesstoessentialservicesforchildren Therightsbasedapproachispredicatedonthecentralprincipleofidentifyingbarriers toaccessingresources,andadvocatingforuniversalaccesstoessentialservicesand Stateprotectionforchildren.
Contextualapproach Programmedecisionsandprioritiesmustderivefromasituationanalysisonthe 15 ground, namelytheprioritiesandkeyindicatorsidentifiedbytheorganisations programmedandacomprehensiveassessmentbytheserviceprovidertodetermine 16 theplannedintervention.
Relevanceandappropriateness Allinterventionsshouldbesensitivetotheprevailingculture,traditions,socioeconomic andpoliticalcontext,andpsychosocialworkershavecompetenceintheareasinwhich theyinterveneandwork. Itisimportantthatthemonitoringandevaluationsystemisbaseduponparticipatory, contextrelevantindicatordevelopment.
Intermsofpsychosocialprogramming,achievementinthepsychosocialdomains outlinedaboveistargetedonthebasisthatthiswillsupportlongertermimpacts onthelivesofchildren.Itisclearthattheresponsesareframedbytheprevailing culturalpracticesandtoalesserextentthesocioeconomicconditions,andthusthe identificationofoutcomesandindicatorsneedstobemadewithinthiscontext. Anapproachthatonlyemphasisesindividualbehaviourslikeincreasedself esteemascriticalindicatorsofimprovedpsychosocialwellbeing,neglectingmore prosocialbehaviourslikeachangeintheperformanceofdailytasks,changeinthe proportionofthetargetgroupshowinglocallydefinedprosocialbehaviours,orthe resumptionofculturalactivitiesandtraditions,willresultinunattainableoutcomes anddiscriminateagainstchildrenandtheirfamilies. Definingspecificoutcomesandindicatorsthatarerelevanttothechildrensand theircaregiverslivesinalocalcontext,andassessingsuchimpactsisacrucialtask inthepsychosocialfieldbecausetheevidencebaseforthelongertermvalueof suchprogrammingiscurrentlyweak.
StrengtheningappropriateStateandcommunitystructures Projectsbecomepartofthecommunitysocialworkmechanisms,forexamplesocial welfareorchildprotectionnetworkstoprovidecommunitybasedprogrammesto enablechildrentoaccesspsychosocialsupportopportunities(eg.playandleisure opportunities)andtorefervulnerablechildrentolocallyavailableservices(eg.primary school,healthservices,psychosocialprogrammesorlocallybasedskillstraining).

17 Mainstreaming Psychosocialsupportinitiativesworktowardsmainstreamingtheirinterventionswithin governmentandlocalnongovernmentalserviceproviders.Psychosocialsupport mainstreamingisaboutlookingatallaspectsofprogramming,policydevelopmentand organisationaldevelopmentalwayskeepinginmindchildrenspsychosocialwellbeing. Attheinstitutionallevel,itmeansratherthanhavingasinglepsychosocialdepartment ordeskorverticalpsychosocialprogrammethattriestoaddresspsychosocialissues (integration),theyarediffusedbothdownandacrossallprogrammesandprocedures withinanorganisation(mainstreaming).Itinvolvesincorporatingpsychosocialsupport elementsinto:
policiesandprocedures programmedesignandactivities planningandbudgeting
capacitybuildingandhumanresourcedevelopment monitoringandevaluation networkingwithgovernmentsectorsandinstitutions.

18 Multilayered,integratedpsychosocialsupport
Inemergencies,peopleareaffectedindifferentwaysandrequiredifferentkindsof support.Akeytoorganisingpsychosocialsupportistodevelopalayeredsystemof complementarysupportthatmeetstheneedsofdifferentgroups.Itiscriticalthat duringandafteranemergency,plannersandprovidersofpsychosocialinterventions participateincoordinationgroupstolearnfromothersandtominimiseduplicationand gapsinresponse.Thisgoessomewaytoensuringthatinterventionsaredesignedon thebasisofsufficientinformation,andcommittingtoevaluation,opennesstoscrutiny andexternalreview.TheIASCpyramid(seefollowingdiagram)demonstratesthat psychosocialsupportcanbeprovidedinmanydifferentforms,andwhiletimingand contextiscritical,onelayerisnotmeanttobeprioritisedoveranotheralllayersof thepyramidareimportantandshouldideallybeimplementedconcurrently. Ifpsychosocialinterventionsremainstandalone,withoutlinkstofamilyand communityinteractions,andtootherprogrammaticareas,theyhavelimitedpotential toeffectivelycontributetothepsychosocialwellbeingoftheindividualandthegroup. Forexample,manyinterventionsthatarenotplannedorconceivedaspsychosocial interventionshavebeenrecognisedashavingsignificantpsychosocialimpact,like welfaregrantsandnutritionalsupport,theprovisionoffoodandwaterandthe constructionofshelter.Byremovingothersignificantstressors,likehunger,general wellbeing,includingpsychosocialwellbeing,islikelytoimprove.Whatisalsoimportant ishowthenutritionalsupportisofferedandthatpsychosocialissuesarenotignored. AsseenintheIASCpyramidofmultilayeredpsychosocialsupport,psychosocial interventionsmakeuponlyasmallpercentageofwhatconstitutespsychosocial support.
TheIASCpsychosocialsupportpyramidmodel
Descriptionofsupport 1 Advocacyforpyschosocialsupportandaccesstobasicservices (food,shelter,water,hygiene,functioninggovernance systems,healthcare)intowhichpsychosocialsupportneedsto bemainstreamed,andtheassuranceofsecurityinorderto reestablishwellbeingandmitigatefurtherpsychosocialharm. Aimtoreachmanychildrenandsupportwaysofcoping. 2 Careandsupportprovidedbycaregivers,friendsand communitymembers.Childrenwhohaveexperiencedtheloss offamilyandcommunitylevelsupports,throughdeath, separationandlossoflivelihoodopportunitieswillrequire specificsupporttorestoretheprotectivefactorsthatthese systemsprovideeg.familyreunion,healingritualsfor reconciliation,vocationaltraining. 3 Asmallerpercentageofthepopulation,withparticularly stressfulreactions,willrequiremorefocusedandspecialised supportinterventionswithattentiontotheindividual,familyor group(eg.psychosocialfirstaidbyhealthworkers). 4 Childrenexperiencingsignificantdistressthatdisruptstheir abilitytofunctiononadaytodaybasiswillrequirespecialised mentalhealthandpsychosocialsupport(tobeprovidedby trainedprofessionalsincludingspecialisedtraditionalhealers).
Peopleinvolved Animatorsorcommunity workers
Childprotectionofficersor socialworkers
Psychologist
Psychiatristormental healthspecialist
IntheIASCpyramid,achildwithinacommunitywhohasrecentlylostbothparents and/orhasexperiencedviolenceortraumamightthen:
benefitfromindividualcounsellingwithasocialworkerorpsychologist(mentalhealth interventionofferedtoaverysmallpercentageofthechildreninthecommunity) laterjoinasmallgroupofotherdirectlyaffectedchildrenwithinagroupstructured approachinterventiondesignedtoprovideopportunitiesforgrievingandnormalisation (specialisedpsychosocialsupport)offeredtoasmallpercentageofthechildreninthe community makeaherobookwithalltheotherchildreninhisorherclassorschool,and/or participatewithasignificantnumberofotherchildreninthecommunityaspartofa youthorganisation(everydaypsychosocialcareandsupport) Psychosocialprogrammingexistsgenerallywithintherealmofeveryday psychosocialcareandsupport,andtoalesserextenttherealmofspecialised psychosocialsupport. Trainingmaterialforthissection Exercise1 Exercise2 Exercise3 Handout1 Handout2 Handout3 Handout4 Handout5 Psychosocialwellbeing:everybodysresponsibility Psychosocialinterventionpyramid Communityandfamilysupport Scenario Roleplayidentities Scenario TheIASCpsychosocialsupportpyramidmodel Scenario
Section4 Implementationstrategies
Keylearningpoints
Theimmediatereestablishmentofsecurity,adequategovernanceandservicesis crucialinanyemergencysituationinordertohelpprotectthewellbeingofchildren. Oneofthemostimportantaspectsinpromotingpsychosocialwellbeingistofacilitate conditionsforcommunitymobilisation,ownershipandcontroloftheemergency response. Childrenwhoarestrugglingtocopewithintheirexistingcarenetwork,whoarenot progressingintermsoftheirdevelopment,orareunabletofunctionaswellastheir peersmayrequireactivitieswhichaddresstheirpsychosocialneedsmoredirectlyand areimplementedbyspecialisedstaff. Level1Basicservicesandsecurity
19 Ineachemergency thewellbeingofallpeopleshouldbeprotectedthroughthe reestablishmentofsecurity,adequategovernanceandservicesthataddressbasic physicalneeds(food,shelter,water,basichealthcare,controlofcommunicable disease)soitisimportanttoidentifywhichaspectsoftheenvironmentarehavingthe greatestimpactonthepsychosocialwellbeingofchildrenaslackingofbasicservices thisshouldhavebeendoneaspartoftheinitialassessmentandtheongoing programmeimplementationandmonitoringthroughdialoguewiththeaffected population(Foundationmodule3Programmedesign).Belowarelistedavarietyof issuesthathavebeenfoundtohaveacrucialimpactonpsychosocialwellbeingof childreninvarioussituationsanduponwhichapsychosocialprogrammemaychoose toconductadvocacy.Giventhatsomeoftheseactivitiesrequirespecialised knowledge,normallyaspecialisedsectorororganisationwillberesponsiblefor implementingprogrammestoaddresstheseissues.
Establishmentofsecuritymeasures. Protectionofchildren(andtheircaregivers)fromviolence,abuseandexploitation. Accesstobasicneeds:shelter,food,healthcare,waterandsanitation. Accesstoanyspecialservicesparticularlythoseneededbyatriskchildren. Promotionoffamilyunity(seeCriticalissuemodule6Separatedchildren)through preventionofseparation,immediateidentificationofseparatedchildren,and appropriatecareandprotectionforseparatedchildren. Promotionofthecontinuationofbreastfeeding. Promotionoffamilyselfsufficiencythroughincomegenerationandaccesstoeconomic supportactivities. Reestablishingformalandinformaleducationopportunitiesforallchildren. Disseminatingessentialinformationofexistingservices.Suchinformationcanreach childrenatchildfriendlyspaces,clinics,feedingcentres,distributionsites,water collectionpoints.Otherwaysofdisseminatinginformationincludeannouncements,
Foundationmodule7Psychosocialsupport Section4 Implementationstrategies
meetings,posters,homevisits,largeandsmallgroupdiscussions,communityradios, localnewspapers.
Enhancingpsychosocialwellbeingconsiderationsintheprovisionoffoodandshelter. Includingpsychosocialconsiderationsinprovisionofwaterandsanitation,for example,locationsoflatrinesandwaterresources. Ensuringaccesstosafeandsupportiveeducation. Providingbirthanddeathcertificatesifneeded. Advocacyandpromotionoftherightstohealthcare,adequatelivingconditionsand education.
Theneedforculturalsensitivityinprogramming InAlbania,followingtheexodusofhundredsofthousandsofKosovarsinApril1999 intorefugeecamps,manyorganisationsgavefoodtoKosovars.Inonecamp,the elderssaidtheyfeltdemeanedbybeingfedAlbanianfoodandtreatedasiftheir ownculturedidnotmatter.Thefoodhandoutswereunintentionallyhavinga negativeimpact.TheywantedtoeatKosovarfood,notAlbanianfood.Accordingly, theygavenongovernmentalorganisationsalistoftheingredientstheywanted. Havingtakenoverabuildingforakitchen,theybegancookingandservingtheir ownmealsandworking12hourseachday.Youthinthecamphelpedtoorganise peopleinshiftsinordertoavoidlonglines.Boththecooksandtherecipients reportedthattheyfeltmuchbetteraboutthefood,feltmoreincontrolovertheir circumstances,andexperiencedprideinwhattheyhadaccomplished.Throughtheir demandformorecontrolovertheircircumstances,whathadbeenastraightforward fooddistributionprojectintegratedapsychosocialcomponenttoaddresssocialand emotionalwellbeing. Childrenincrisis,goodpracticesinevaluatingpsychosocialprogramming DuncanJ,Ph.D.andArntsonL,Ph.D.MPH,fortheInternationalPsychosocial EvaluationCommitteeandSavetheChildrenFederation,Inc.withsupportfromthe AndrewW.MellonFoundation
Level2Communityandfamilysupports Oneofthemostimportantaspectsinpromotingpsychosocialwellbeingistofacilitate conditionsforcommunitymobilisation,ownershipandcontroloftheemergency response.Oftenafteradisaster,socialstructuresaredisruptedpeopleareunder extremestressandneedtomeetbasicneedssuchasshelter,foodandhealthcare. Communitymobilisationisaconceptthatincludestheuseofcommunityresources (humanandmaterial)andstrengths(existingmechanisms),andtakesinto considerationthewishesofacommunityanditsfeedbackinordertodevelopa project.Inthisway,families,teachers,communityandreligiousleaders,aswellas governmentandnongovernmentalrepresentatives,allworktogethertosupportthe reestablishmentofexistingornewcopingmechanismswithinacommunity.Inorder toachievetheseobjectives,specificcommunitymembersmaybeinvolvedatdifferent
timesduringtheproject,suchastheassessment,planning,implementation,or evaluation(seeFoundationmodule6Communitymobilisation). Themainobjectiveofimplementingcommunitybasedpsychosocialprogrammesisto buildandenhancethecapacityofthecommunitytobeabletoprovidecareand responsetochildrenspsychosocialneeds.Thisisaccomplishedbyinvolvingthemin eachstepoftheprogrammeandlearninghowtodesignfurtherinterventionsbasedon theirownresources.Thesewillbemoresustainableinterventions,assuredbyan assessmentwithchildren,parentsandothercommunitymembersthattheirneedsare prioritisedintheactivitiesandtheirparticipationissoughtintheimplementation.One exampleistheinvolvementofcommunitymembersasanimatorsinchildfriendly spaces,whichcanhelpinrestoringasenseofnormalitybecausethesecommunity membersarecaringforthemagainastheydidintheiroriginalhomeareas.Thiscan makethemfeelsecureandopentosharetheirconcernsandfears,astheparentsand communityfeltthesamewhendiscussingtheirchildrenspsychosocialconcerns. Additionally,theanimatorsworkasmessengersforraisingcommunityawareness.
Strengtheningthefamilyandcommunitysabilitytocarefortheirchildren Manyyoungparentsfeeloverwhelmedorotherwisevulnerablethereforetrainingin skillsofpositiveparentingisjustasimportantasprenatalandpostnatalcare. Buildingconfidenceintheskillsrequiredtobeapositiveparent,includingbasic informationonhealthcare,educationandconflictresolution,couldbegininan informalschoolsettingthroughacomprehensiveprogrammeaimedatyouthaswell asnewparents,forexample,inchildfriendlyspaces. EastTimorassessmentofthesituationofseparatedchildrenandorphansinEast TimorIRCandUNICEF,2002
Psychosocialsupportactivitieswithchildren Resilience(seeFoundationmodule1Understandingchildhoods)meanstheabilityto recoverfrom(ortoresistbeingaffectedby)ashockordisturbance.Inpsychology, resilienceisatermusedtodescribethecapacityofpeopletocopewithstressand catastrophe.Toberesilient,apersonneedstodrawuponalloftheresourcesathisor herdisposal,bothpsychologicalandenvironmental.Resilienceisbuiltthroughthe existenceandstrengtheningofprotectivefactorsintheenvironmentandrelationships, familyandsocietal,aswellasinnerresourcesandstrengths. Theabilitytoreestablishregularactivitiesisacrucialstepinfeelingsecureand confidentthatrecoveryispossible.Itsupportschildrensdevelopmentandcoping,and itenablesfamiliestomaintainsocialnetworksandrestoreincomegeneration.Itis importantforachildtobecomeinvolvedinaroutine,andactivitieswithchildrencan supportthis.Whenconductingactivitieswithchildren,thepriorityshouldbeto mobilisethechildsexistingsupportsystem,includingfamily,friends,teachers,social workers,communityandreligiousleaders.Usingthisapproach,activitiescanbe determinedandimplementedinpartnershipwithchildren,familiesandcommunities, andwithunderstandingofwhatlifewaslikebeforethecrisis.Themostcommontypes ofrequiredactivitiesarelistedbelow.
Childfriendlyspacesandenvironments Childrenneedtoplayitistheirwayoflearningandassimilatingtheireveryday experiences.Thismaybeparticularlyhelpfulincampenvironmentswherethereare feweropportunitiesforchildrentoplaysafely.Achildfriendlyspacemaybeina mosqueortemple,communitycentre,designatedareawithinacamporinpeoples houses.Itisasafelocationwherechildrencanspendafewhoursaday,wherethey canfeelsecureandcomfortableandwheretheycantakepartinvariouspsychosocial, educationandotherchildprotectionactivities.Theyalsoserveaswaysforchildrento accessotherservices(suchashealthandnutrition),eitherthroughreferringchildren totheotherservices,orhavingbuiltuponhemintegratedinthechildfriendlyspace. Childrenshouldbeinvolvedineverystepofsettingupandorganisingthechild friendlyspaces.
Itisimportantthatthisspacebuildsuponthetraditionsandpracticesinthe communityregardingwhen,whereandhowchildrengather.Whenestablishinga childfriendlyspace,itisimportanttofirstidentifywhethertherearesomeexisting practicesthatcouldbebuiltupon. Insomesituationsitisappropriatetohaveacentralhuborphysicalspace,for example,inIDPcamps,whereasinothersitismoreappropriatetohavemultiple activitiesindifferentlocations,forexample,whereemergencyaffectedpopulations arestilllivingintheirvillages. Childfriendlyspacesprovidechildrenopportunitiestomeetwithotherchildrenand socialise,aswellastobefriendtheadultschargedwiththeircare.Thespacesalso makeiteasiertodetectchildrenwithparticularproblemsandprovideassistanceto themandtheirfamilies. Childfriendlyspacesprovideanenvironmentforengagementandsupportof parentsandfamiliestobegincommunitymobilisationbasedontheneedsoftheir children. Someactivitiesthatcanbeeasilyimplementedinsuchenvironmentsincludeplay, artandsportingactivities.Differentagegroupsrequiredifferenttypesofactivities, forexampleyoungchildrenwillfocusmoreonplay,whileolderchildrenusually preferartsortheatre.Ifconditionspermit,activitygroupsshouldbeorganised roughlyaccordingtochildrensageandstageofdevelopment(0to18months,18 monthstothreeyears,threetosixyears,sixto12years,12to18years). Differentactivitiesmaybeappropriateforboysorgirls,dependingontheculture, age,interestandskillsofthechildren.
Itshouldberecognisedthatpsychosocialinterventionswillonlybeonecomponentof achildfriendlyspaceandthattherewilloftenbeotherbroaderchildprotection interventionstakingplaceinachildfriendlyspace.

20 Childtochild programmes Childtochildprogrammeslinkchildren's(andadolescents)learningwithactionto promotethewellbeinganddevelopmentofthemselves,theirfamiliesandtheir communities.
Youthclubs Itisimportantthatchildrenareabletoengageinmeaningfulactivitiesthatcanhelpin theirdevelopment,inregainingasenseofcontrolfortherebuildingofsociety.Thisis particularlyimportantforadolescents,manyofwhomstruggletomakesenseofthe
emergencyandtheirroleinit.Opportunitiesforadolescentstobeconstructively involvedinrespondingtotheemergencycanprovidethemwitharenewedsenseof purpose,strengthentheirsenseofselfworth,expandsocialnetworks,anddevelop theirsenseofcompetence. Psychosocialsupportactivitieswithfamiliesandothercaregivers Thepeoplewhocareforandareincontactwithchildrenonadailybasisareinthe bestpositiontohelpthem.Thefirstthingistoassesswhomchildreninteractwith, whomtheytrustandwhocaninfluencethem.Strengtheningtheabilityofthese peopletounderstandandsupportchildrenandtodealwiththeirownproblemsis essential.Belowaresomeexamplesofactivitieswithfamiliesandcaregivers. Supportcaregiversandfamilymemberstodealwiththeirowndifficulties Helpingparents,grandparentsorothercaregiverstodealwiththeirowndistressand reestablishtheircapacityforgoodparentingisvitalfortheirownpsychological healingandthatoftheirchildren.Makingavailableculturallyappropriateinformation onconstructivecopingmethods,awarenessofharmfulpractices,andenabling traditionalgrievingceremoniesareallusefulstepsinhealing.Providingasafegroup settingtosharefeelingswithotherswithsimilarexperienceshasproveneffective.Itis preferableforthesegroupstohaveaccesstoprofessionalsupport.Thetypeof awarenessandsupportactivitieschosenshouldbeculturallyspecific,anddetermined intandemwiththecommunity.Examplesincludeindividualcasework,groupwork, informationviathemedia,orfundingforcommunityledinitiatives.Trainingsessions, mediaactivities,parentsupportgroups,andoutreachprogrammesarewaysparents canbereached. Supportandfacilitatecaregivercommitteesand/orchildprotection committees Theymaybeinformalgatheringsororganisedeventsthatserveasaforumtodiscuss childrensreactionstoemergencies,whattodoandhowtoreferwhenneeded.They mayalsoprovideanopportunityforcaregiverstoparticipateanddecideuponissues affectingthem.Childprotectioncommitteescanidentifychildrenatrisk,monitorrisks, intervenewhenpossibleandrefercasestoprotectionauthoritiesorcommunity serviceswhenappropriate. Carryoutregularfamilyvisitsforcaregiversinneedofadditionalsupport Thesevisitsareanopportunitytodiscussproblemsandissuesinanopenandhonest mannerandtopreventfamilybreakdown.Thisisvitalforfamilieswhohavebeen reunited,orwheretheremaybeissuesofstigmaordiscrimination.Forexample:girl mothers,childrenformerlyassociatedwitharmedforces,childrenlivingwithunfamiliar relativesornewcarers,grandparentheadedhouseholdsandchildheadedhouseholds. Supportfamilyaccesstobasicservices Helpingfamiliestoaccessappropriatesocial,health,legal,economicandhousing supportisalsoimportant.Thiscanbedonethroughreferraltoappropriateservices and/ormobilisingthecommunitytohelpfamiliesinneed. Promotefamilyselfsufficiency Emergenciescancausedestitutioninmillionsoffamilies,eitherbythetotallossofall oftheireconomicassets(suchashome,land,livestockandbelongings)and/orthe lossofthecashearningmember(s)ofthefamily(throughdeath,recruitment,mental distressandinjuryordesertion).Destitutionleadstonumerousdistressingsituations
forchildrenandtheirfamilies.Providingincomegeneratingopportunitieshelpsfamily membersgaincontrolovertheirlivesanddevelopasenseofselfworth.(Income generationisacomplexfieldandrequiresspecialexpertiseandunderstandingoflocal marketmechanismsbeforeinitiatingthistypeofhelp)Inaddition,legalaidshouldbe provided.Legalaccesstolandforwidowedwomenandorphanedchildrenisoftenan issuetobeaddressed. Level3Focusednonspecialisedsupports Formostchildren,theprovisionofbasicservicesandsecurity(Level1activities), combinedwithgeneralactivitiestorestoreroutine,socialnetworks,andasenseof purpose(Level2activities),areenoughtorestoreormaintainpsychosocialwellbeing. Therewillbeasmallerproportionofchildrenwhowillrequiremorefocusedsupport. Childrenwhoarestrugglingtocopewithintheirexistingcarenetwork,whoarenot progressingintermsoftheirdevelopment,orareunabletofunctionaswellastheir peersmayrequireactivitieswhichaddresstheirpsychosocialneedsmoredirectly.This sectionsuggeststypesofactivitiesthatcanhelpthoseinneedofmorespecific psychosocialsupports. Itisimportanttonotethatthislevelofsupportrequiresspecialisedstaffoftenthese activitiesarecarriedoutbysocialworkers.Fieldworkers(animators,community mobilisersorprotectionofficers)playacrucialroleinidentifyingandreferringchildren inneedoffocusedsupport. Ensureindividualfollowup Addressingindividualprotectionneedscanbecomeparticularlycomplicatedwithina programme.Efficientandaccountablemanagementsystemsarenecessarybutmust beflexibletoallowforindividualdifferences.Themainstepsforprovidingsocial assistanceareto:
identifychildreninneedofimmediatecare developaninformationmanagementsystem setupareferralmechanism establishasystematicprocesstoassistchildrenandtheirfamilies establishaclearactionplanforeverychildthatincludesexitstrategies. Setuphotlinesandothercommunitybasedreportingmechanisms Followinganemergency,hotlinesorothercommunitybasedreportingmechanisms maybesetupinordertoreportcasesofabuse,exploitationorotherprotectionissues andtoconnectindividualswithappropriateresourcesandsupportnetworks.Reporting mechanismsshouldbechildfriendly,freeandconfidential.Hotlinesandother reportingmechanismsshouldalwaysbeoperatedincoordinationwithgovernmental institutionsinordertoensurethattheycomplementexistingstructuresandare sustainable. Provideculturallyappropriatecounselling Althoughmostchildrenwillnotneedoneononecounselling,paraprofessionals: teachers,socialworkers,psychologists,canofferanalyticalandproblemsolvingskills tomoreseverelyaffectedchildrenoradults.Counselling,onlycarriedoutbytrained staff,maybeconductedinindividual,grouporfamilysettings.Theseactivitiescan takeplacewhereotherpsychosocialsupportactivitiesoccur,inordertobeincontact
withthechildrenandadults,andalsotoidentifyotherchildreninneedofindividual followup. Level4Specialisedservices TheWorldHealthOrganisationhasprojectedthatinemergencies,onaverage,the percentageofpeoplewithaseverementaldisorder(psychosisandseverelydisabling presentationsofmoodandanxietydisorders)increasesbyonepercent,abovean estimatedbaselineoftwotothreepercent.Inaddition,thepercentageofpeoplewith mildormoderatementaldisorders,includingmostpresentationsofmoodandanxiety disorders(suchasposttraumaticstressdisorder,orPTSD),mayincreasebyfiveto 10%aboveanestimatedbaselineof10%.Despitecommunityworkorgeneral childrensactivities,somechildrenwillnotbeabletofunctionaswellastheirpeers. Examplesofdisturbancesincludethefollowing.
Prolongedseverereactionstoacrisis.Intheaftermathofadisasteralmosteveryone willshowinitialanxietyandbehaviouralchanges.Thesewouldnotbeconsidereda disorderunlessitwentonforalongtime,worsenedovertimeorinterferedwith normalactivitiessuchasgoingtoschoolorworking.Childreninparticularmay experienceseparationanxietyafteradisasterordeath,andwillwanttostaycloseto caregivers,thisisexpectedforaperiodofmonths.Prolongedreactionsshouldnotbe consideredPTSDunlessdiagnosedbyapsychiatrist. Addictiontodrugsoralcohol. Disabilityorbecomingmute(thatis,notspeaking). Excessiveaggression,thatis,dangeroustothemselvesorothers. Socialexclusionrelatingtopastorpresentcircumstances.Somechildrenmaybe excludedfromparticipatinginsocietyasaresultofculturalbeliefs.Forexample,agirl whohasbeenrapedmaybeviewedasuncleanandunmarriageableorachildwho haskilledwhenforcedintoanarmedforceorgroupmayberejectedashaving offendedthespiritworld. Mentalhealthproblems,forexample:
Depression Childrenoftendemonstratedepressionthroughirritability,or boredom.Theywillnotknowthattheyaredepressed,anditcanbedifficultto distinguishdepressionfromothertransientconditions.Severelydepressedchildren willdemonstrateoneormoreofthefollowingbehavioursforanumberofweeks: feelssadallofthetimeandmaycryalotdoesnoteatandisgettingthinnerand thinnerisfrequentlytiredanddoesnotfeellikedoinganythingisunabletosleep atnightseemstohavelostinterestinmostofthethingsinwhichtheyusedto takepleasure. Suicide isaveryrealriskinadolescents,andshouldbetakenseriously.Ifthereis anydoubt,theyshouldbeaskeddirectly.Thereisnoriskthatthiswillputinto theirheadtheideaofsuicideiftheyhavenotbeenthinkingaboutit.Although rare,childrenbelowtheageof10havebeenknowntoconsidersuicideandtohave carrieditout.Anychildoradolescentwhotalksaboutnotwantingtoliveshouldbe referredtoaprofessionalandshouldnotbeleftalone. Psychosis Itisunusual,butnotimpossibleforchildrentodemonstratethatthey havelosttouchwithreality.Losingtouchwithrealitymeansthattheycantseem
todistinguishbetweenwhatisrealandwhatisnotreal.Itisinadolescencethat manypsychoticconditionsfirstappear.Foryoungerchildren,careshouldbetaken nottoconfusenormalfantasyandlosingtouchwithreality.
Ifattheoutsetthereisnotlocalhealthinfrastructureorlocalcapacity,outside organisationsshouldprovideemergencymentalhealthservices.However,services needtobeestablishedinsuchawaythattheydonotdisplaceexistingsocial mechanisms.
Foranyoftheseissues,professionalhelpshouldbesoughtfortheindividual.Those withoutspecialisedtrainingshouldidentifyandmakereferralsinthesecases,but shouldnotattempttoaddresstheproblemthemselves.

21 Whatshouldbeavoidedinpsychosocialprogrammesinemergencies
Counsellingorotherinterventionsthatfocusonsingleeventsortypesofreactions,for example,posttraumaticstresssymptoms,shouldbeavoidedintheacuteandmedium termphaseoftheemergency,becauseasdescribedabove,peoplehavemultiple causesofdistressandvariousreactions.Anymentalhealthorpsychosocial intervention,includingcounselling,shouldrespondtothevarioussourcesandformsof distressfromwhichpeoplearesuffering.Theonlyexceptiontotheaboveisthe provisionofcognitivebehaviouraltherapybyfullytrainedclinicianswhohavehad extensivetrainingandsupervisioninthisadvancedformofpsychotherapy. Allprogrammesandstaffshouldbecarefulnottoelicitemotionalmaterialtooearly, beforepeopleareinasafeenvironmentwheretheirbasicneedsaremetandwithout guaranteeoffollowup.Suchpracticesareusuallyineffectiveandcancausemore distressandharmtotheperson. Donothaveuntrainedand/orunsupervisedstaffperformdiagnosticassessment and/orcounselling. Avoidinappropriateexplorationsofthestressfulexperiences.However,ifthesurvivor wishestospeak,donotstophimorherfromtellingtheirstory. Donotpathologisewhatarelikelytobenormalreactionstoextremelydistressing events. Supportpeoplewiththemostseverementalhealthproblemsreferthemtohealth servicesorcommunityhealthcentresifotherwaysofsupportingthemarenot effective. Donotdiscourageorencouragepeoplefromusingtraditionaland/orfaithbased copingmechanisms,itisuptotheindividual.Inotheremergenciesthroughoutthe world,disastersurvivorshaveoftenfoundsuchsupportshelpful. Avoidculturallyinappropriateinvestigationandmisuseofdiagnostictools. Donotscreenpeopleforproblemswithoutbeingabletoreferthepersontoaservice whichcanprovideeffectivesupport. Donotcarryoutanyinterventionsthatriskfurtherisolationorstigmatisationof particularvulnerablegroupsamongtheaffectedpopulation.
Section5 Monitoringandlearninginpsychosocialprogrammes
Keylearningpoints
Itisimportanttohaveclearandmeasurableobjectivesandindicatorsthatare establishedattheinitialstagesofapsychosocialsupportintervention. Children,theirfamiliesandkeymembersoftheircommunitiesmustparticipatein planning,monitoringandevaluatingpsychosocialinterventions,especiallybyassisting indevelopingprojectobjectivesandprovidinglocalunderstandingsofwellbeing. Methodsformonitoringandlearningincludequantitativeandqualitativetools. Psychosocialinterventionswithintheprogrammecycle Designing,monitoringandevaluatingpsychosocialprogrammesisnotaneasytask. Evaluationsofmostpsychosocialinterventionsandprogrammestendtobelargely descriptiveandanecdotal,andremainattheoutputlevelratherthanmeasuring changeattheoutcomeandeventheimpactlevels.Thesecircumstancesaredueto therelativenewnessofthisfieldofprogrammingwithinhumanitarianand developmentaid,aswellastothefactthattheseprogrammesoftenmeasurea subjectivestateofmind,areculturallybound,andtheinterventionsmayonlyhavean effectoveralongerperiodoftime.Forexample,measuringprojectsrelatedto physicalhealthtendtobeeasierbecauseinternationalstandardsforobjective, measurableandshorttermobjectivesandindicatorshavebeenestablished. Forexample1000childrensufferingfrompoliohavereceivedtreatmentoverasix monthperiod. Itisimportantthatthestatedobjectivesofpsychosocialprojectsshouldprovidethe clearestdefinitionofwhattheinterventionsareseekingtoachieve.Muchtime,energy andmoneyisspentontheseprojects,thusprogrammersmustensurethattherewill beanactualpositivechangeforchildrenandtheirfamiliesand/orcommunitieswithin 22 thecorepsychosocialdomains.
Psychosocialdomain Skillsandknowledge Forexample:lifeskills,using culturallyappropriatecoping mechanisms,vocationalskills, conflictmanagement Emotionalwellbeing Forexample:feelingsafe,trust inothers,selfworth,hopeful forthefuture Socialwellbeing Forexample:attachmentwith caregivers,relationshipswith peers,senseofbelongingtoa community,accesstosocially appropriateroles,resuming culturalactivitiesandtraditions Somemeasureofimproved socialfunctioning Somemeasureofimproved emotionaladjustment Coreindicator Somemeasureofacquisition ofskills
Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes
Thesedomainsmaybereflectedindifferentwaysindifferentculturesbutthey representthecommoncoreofmostpsychosocialwork. Programmecycle Aswithotherhumanitariananddevelopmentaidprogrammes, whendesigning,monitoringandevaluatingpsychosocialprojects,thefollowing systematicenquiryandanalysisshouldtakeplace.

Assess Situationanalysis Baseline Design Reviewfindings Identifyinterventions Designproject Monitor Createindicators Implementproject Evaluate Measurethe effectivenessofthe interventions
1 Oncethesituationanalysishasbeencarriedout(seeFoundationmodule3 Programmedesign)itisimportanttotakeastepbackandevaluatethegeneral concern:whyisthisprogrammebeingestablished?Example:alargenumberof childrendisplayhighlyaggressivebehaviours.Followingthisreflection,staffcan determinethegoal:whataretheobjectivesandwhatshouldbeactedon? Example:therateofaggressivebehaviouramongchildreninPalestineisreduced. Projectimpactistheoverallchangeinthelivesofchildren(andtheirfamiliesand communities)thatresultsfromaproject. 2 Oncetheimpacthasbeenexplicitlydefined,staffcandecidewhatwillbethefocusof theprojectandhowtocontribute.Thiswillbecalledtheoutcome.Inpsychosocial programmingtherearegenerallythreetypesofoutcomes,allindicatingpositive change.
Emotionalwellbeingisimproved:childrenarelessstressed. Socialwellbeingisimproved:childrenhaveanincreasedsenseofbelonging. Skillsandknowledgeareimproved:parentsknowhowtorespondtotheirchildrens emotionalneeds.
Projectoutcomesaretheeffectsthatcomeaboutduringthecourseofaprojectas aresultoftheoutputsachieved. 3 Thenextstepwillbetodiscusswhatneedstobedoneinordertoreachthisoutcome. Thisistheoutput.Iftheoutcomeoftheprojectisthatchildrenarelessstressed,the outputcanbe:900childrenparticipatedinrecreationalactivitiesonceamonth(and thereforeshouldbelessstressed).Iftheoutcomeisthatchildrensolvetheirproblems peacefully,theoutputcanbe:900childrenparticipatedinclassroombased interventionsessionsreinforcingtheircooperationskills. Projectoutputsaretheplannedachievementsputoutbyimplementingaproject (suchasnewlytrainedstaff,improvedservicesorfacilities)whichsignalsthatworkis ontrack. 4 Inordertoachievetheoutput,theprojectdefinesactivitieswithspecificdetailson forexample,participants,frequency,numberofchildren.Example:conductsix sessionsofrecreationalactivitieswith120childreneachtimeconduct10sessionsof classroombasedinterventionsin25schoolswith25studentspergrouprecruitand trainstaffandvolunteersonclassroombasedinterventionandrecreationalactivities.
Projectinputsarethemoney,materials,equipment,staffandotherresourcesputin toprojectactivities. 5 Thenextstepistoestablishindicatorsthatwillmeasuretheeffectivenessofthe interventionsandtheactualchangethathasoccurredwiththechildren(andtheir caregivers,theplannedtargetgroup)asaresultofthepsychosocialintervention. Changecanbemeasuredbydevelopingindicatorsattheplanning(situationanalysis, baselineresearch),output,outcomeandimpactlevelsoftheproject.Indicatorsare establishedattheplanningstage,monitoredthroughouttheprogramme(output)and measuredbothattheendoftheprogramme(outcomes)andifpossiblesometime aftertheinterventionhasendedinordertomeasureimpact.
23 Examplesofpsychosocialindicators
Indicator Impact
Skillsandknowledge Qualityofcare providedtochildrenby familiesisimproved (measuredby interviewswithchildren andparents,andby reducedreportsofchild abuse)
Emotionalwellbeing Strengthenedreferral networksbetween communitiesand serviceproviders (measuredby increasedcaseloadsof communityreferrals)
Socialwellbeing Reductioninnumberof conflictsbetweenIDPs andhostcommunities (measuredby communityinterviews andbyreductionin policereportsofsocial disturbancesinvolving IDPs)
Outcome
Increasedawarenessof parentingskillsand childrensrights (measuredby increasedknowledgeof parentsandchildren)
Appropriatereferralof childrenrequiring specificsupport (measuredbyincrease ofreferralsthrough districtchildprotection committee)
Strengthened relationshipsbetween IDPsandhost communities (measuredby frequencyof communityactivities featuringIDPsandhost communities)
Output
Psychoeducationalprogrammedeliveredthroughdramaandtheatre activitiesforchildrenandfamiliesinallIDPcampsandhostcommunitiesin Batticoloa(measuredbynumberofprogrammesessionsandnumberof deliverysites)
Childfriendlymethodsfordesign,monitoringandevaluation Planninganddesign Determineobjectivesandappropriateindicatorsfortheproject.Forexample:establish abaselinewithparentsandchildrenregardingthechangestheywanttoseechildren, familiesandcommunitiesprovidelocalunderstandingofwellbeing. Implementationandmonitoring Providingtheirviewsontheproject.Forexample:runafeedbackgamewithchildren attheendofeveryactivityandrecordfindings.
Reflectingandevaluating Providefeedbackondraftresultsandtheimplicationsfortheircommunityandfuture similarprojects.Forexample:childrenandparentshelpdefineobjectivesand indicators. Levelsofparticipation Therearedifferentlevelsofparticipation(seeFoundationmodule4Participation 24 andinclusion).TheladderofparticipationbyRogerHart isoftenusedtorepresent levelsofchildrensparticipation(however,itisnotalwaysappropriatetoconsider movinguptheladderasalineardevelopmentwhatismeaningfulandgoodpractice willdependonthesituation,contextandcapacitiesandresourcesofthoseinvolved). Thiscanprovideausefulprompttounderstandingthewaychildrenmightbe involved.Theladderhaseightrungsspanningparticipation,withmanipulationat oneendandchildinitiatedshareddecisionmakingattheother.Keyquestionsto askincludethefollowing.
Howdothechildren,keystakeholders,projectstaffanddonorsinvolvedintheproject identifywhattheywanttoknow? Whowillmonitortheprogramme?Examplesofmonitoringinitiativesmayincludethe following.
Questionnaireswithteachers:findquestionsthatallowthemtoevaluatethelevel ofconcentrationofthestudent.Forexample:Arestudentslisteningwell?Dothey daydream?Dotheyforgetwhathomeworktheyweresupposedtodo? Questionnaireswithparents,forexample:Howwelldotheirchildrensleep? Interviewswithschoolcounsellors:Whatarethemainissuesforeducational achievement?Isconcentrationaproblem? Focusgroupwithparents:Whatdifficultiesdotheirchildrenface?Ispoorsleepone ofthem?Isitmajororminor?
Whoistheevaluationfor?Whoshouldbeinvolved? Methodsusedfordesigning,monitoringandevaluatingpsychosocial programmes Usingmixedmethodsisthemostpracticalandreliablewaytoplan,researchand learnfromprogrammes.Thisinvolvesusingbothqualitativemethodsie.thosemore focusedondescriptionandquantitativemethodsie.thosefocusedonnumbers.

Qualitative Aimofinterpretiveunderstanding. Contextualisingstrategy:smallersamples, flexibledesignfeatures. Subjective,descriptiveandverycontentrich. Notionofobjectivitybasedoninter subjectivity:gainingtrustandrapportfor trustworthy,credibledescriptionsand interpretations. Quantitative Aimofexplanationandprediction. Generalisingstrategy:quantifiableand thereforereasonablyreliable. Disadvantageoflackingdepthofsubstance, donotalwaysknowwhythingsaretheway theyare,detailsoftenlost. Notionofobjectivitybasedonnatural science:maxcontroloverextraneousfactors.
Maytriggerstrongemotions,whichneedsto beanticipatedandadequatesupportputin placetosupportchildrenindistress.This shouldreflecttheprincipleofdonoharmand useoftheethicalguidelinesdiscussedearlier. Examples Childfriendlykeyinformantinterviews. Focusgroupdiscussionsincludingnonverbal methodsofenquiry. Creativeselfexpression.Forexample: evaluationsong,evaluationbodies. Participatoryactionresearch.Forexample: journeyoflifetimelines,socialmapexercise (whodoIvisit?),spiderdiagrams,daily diaries,riskandresourcemaps,bodymaps. Casestudies.Forexample:mostsignificant changetechnique,lifehistoryandindividual casestudy,communitystudies,socialgroup studies,studiesoforganisationsand institutions,studiesofevents,rolesand responsibilities. Observation.Forexample:develop observationchecklist. Documentreview.Forexample:ofprimary andsecondarymaterial.
Difficulttofindreliablequantitativetoolsfor measuringpsychosocialwellbeing,most existingtoolsnotvalidatedand/or appropriateforuseinmanycountries.
Examples: questionnaires surveys
Researchandlearningisimprovedanddeepenedandtheresultsareseenasmore reliableifthesameissueisconsideredfromarangeofmethodologicalperspectives. Collectinginformationfromdifferentsourcesinthiswayisknownastriangulation. Theaimandlogicofpsychosocialprogrammes 1 Howtoensuretheprogrammeasawholeandtheselectedmonitoringandevaluation toolsinparticular,arereallyshowingwhatitwasthathasmadeadifference. 2 Howtoidentifythishasbeenachievedinthelivesofchildrenie.Whatbehaviourand characteristicswilltheyshowtodemonstratetheobjectiveshavebeenachieved?
Howshouldevaluationbedoneorapproached? Whatevaluationtoolsshouldbedeveloped? Howtodevelopindicatorsrelevanttothelocalcontextandprevailingcultural norms?
Typeofdesign PosttestonlydesignXO
Questionsthatcanbeanswered Howwellaretheparticipantsdoing
Forexample: postsurveyonly Attheendoftheprogramme,askingparentsor teachersWhatwerethethreebiggestproblemsyour childfacedsixmonthsago?Whataretheseproblems now?andAresleepingproblemslessofanissue? PretestandposttestdesignOXO Forexample: preandpostsurveys Collectthesameinformationbeforeandafterthe programmeandseewhethertherewasapositive change.Thiscanbequantitativeinformation (forinstance,75%oftheparentsdeclarethattheir childrensleptbadlybeforetheproject,andonly20% attheend),orqualitative(forinstance,duringfocus groups,badsleepingwasalwaysmentionedby parentsatthebeginningoftheprogramme,thenitis nolongermentionedattheend).
attheendoftheprogramme? Areminimumlevelsofoutcome beingobtained?
Bothquestionsabove,plus: Howmuchdidtheparticipants changeduringtheirparticipationin theprogramme?
25 Keyevaluationcriteriaforpsychosocialprogrammes
Evaluationcriteria Relevance concernstheextenttowhich programmeshaveaddressedimportant needs,andhavedonethisaccordingto currentpolicyguidance.Thismeansthe extenttowhichaninterventionhasaddressed thepsychosocialdomainsofskillsand knowledge,emotionalwellbeingandsocial wellbeingforchildren,theirfamiliesand communities. Efficiency isgenerallythenumberofpeople aprogrammehasreachedinrelationtothe resourcesexpended.Itcanbeseenasa measureofhowwelloutputshavebeen achieved,giventheinputsmade.
Evaluationquestions Didtheprogrammearticulateobjectives relatedtochangesinchildrenswellbeingand lives,andthatoftheirfamilyandcommunity? Wereclearneedsdefinedwithrespectto requiredlevelsofpsychosocialsupport? Werepotentialbeneficiariesinvolvedin developingprogramming? Isprogrammeresponserelevanttoidentified needs? Haveactivitiesbeendeliveredcost effectively? Hasprogrammingreachedanappropriate numberofbeneficiaries,givenprogramme costs? Wastheprogrammeimplementedinatimely manner?
Effectiveness needstobemeasuredin termsoftheoutcomesofaprogramme. Whathascomeaboutasaresultofthe programmethathasmadeachangefor children,theirfamiliesandtheir communities?
Havestatedprogrammeoutcomesbeen achieved? Whatdifferencehascomeaboutforchildren intermsofskillsandknowledge,emotional wellbeing,andsocialwellbeing? Whatdifferencehasprogrammingmadeto theskills,capacitiesorattitudesoffamilies andothercaregivers,andcommunities?
Impact referstoevidencethatsuch outcomeshavebroughtaboutrealchangein
Hasthecentralgoaloftheproject,theneeds thatprovidedtherationaleforintervention,
thelivesofchildrenandtheircommunities.
beenmet? Whatenduringchangescanbeidentifiedin thelivesofchildren,caregiversandthewider communitysengagementwithchildren relatedtoprogramming?
Wherelongertermchangesreflectnewor restoredcapacitywithincommunities,orthe servicesthatareavailabletothem,theissue ofsustainabilityofchangeisaddressed.
Whatnewcapacitieswithinservicesor communitieshavebeenestablishedor restored? Arethesecapacitiesbeingactivelyusedinthe psychosocialsupportanddevelopmentof children?
Inpsychosocialwork,coverage meansthe proportionofaffectedchildren(and communities)thathavebeenreachedbyan intervention,focusingbothongeographical coverageandtheinterventionreachingsub groupsofapopulationwhomaybe particularlyvulnerable,forexample,children withdisabilities,adolescents. Coordination usuallymeansthe effectivenessofcollaborationand communicationamongstagenciesdelivering psychosocialsupportandotherservicestoa community.Thisincludesensuringthatthe workofoneagencyneitherdisruptsnor duplicatestheworkofanother,establishing commonprogrammingguidelinesand strategies,coordinatinggeographical distributionofprogrammes,establishing referralmechanismsandsharingofresources andinformation. Coherence meansthatworkhasbeen consistentwiththeapproachandprinciples setdownincurrentpolicy.Inemergencies, thismeansthatpsychosocialprogramming shouldbeconsistentwiththeIASCGuidelines onmentalhealthandpsychosocialsupportin emergencysituations. Intermsofprotectiontheissuefor psychosocialprogrammingiswhether activitieshaveworkedtostrengthenthe protectiveenvironmentsupporting children.
Hasprogrammingreachedallgeographical areastargeted? Havepotentiallyvulnerableormarginalised childrenandcommunitiesbeenreached? Havetheneedsandcapacitiesofdifferentage groupsbeenappropriatelyaddressed?
Haveagenciesworkedwelltogethertowards thecommongoalofimprovedpsychosocial wellbeingamongstchildren?
Hasworkbeenconsistentwiththestated approachoftheIASCguidelinesonmental healthandpsychosocialsupport?
Doestheprojectcontributetoprotecting childrenbystrengtheningtheprotective environment?
TheAngolanprovincebasedwartraumateam Thisprojectwasdesignedtoaddresstheeffectsofcivilwaronchildrenandfamilies. InAngola,warhascontinuedfornearly40years,andbothchildren,whocomprise nearlyhalfthepopulation,andcaregivershavebeenaffectedbypoverty,hunger, displacement,homelessness,deathoflovedones,landmines,andviolenceat multiplelevels.From1995to1998theprojectsoughttosupporttheLusakaPeace Processthroughcommunitybasedhealingaimedatalleviatingsufferingand breakingcyclesofviolence(includingtheintergenerationalcyclesassociatedwith violence). SeeProjectlogicmodelchartbelow. GoodpracticesinevaluatingpsychosocialprogrammingDuncanJ,Ph.D.and ArntsonL,Ph.D.MPH,forTheInternationalPsychosocialEvaluationCommitteeand SavetheChildrenFederation,Inc.withsupportfromtheAndrewW.Mellon Foundation
Angolanprojectlogicmodelchart
Endnotes
1 AdaptedfromPsychosocialinterventionincomplexemergencies:aframeworkfor practiceThePsychosocialWorkingGroup 2 IASCguidelinesonmentalhealthandpsychosocialsupportinemergencysettings InteragencyStandingCommittee(IASC),Geneva2007 3 Programmingforpsychosocialsupport,frequentlyaskedquestionsUNICEF, 18August2005 4 Wheretheheartis,meetingthepsychosocialneedsofyoungchildreninthecontextof HIVandAIDSRichterL,FosterGandSherL,2006 5 StavrouP 6 Aguidetotheevaluationofpsychosocialprogramminginemergencies BoothbyN,AgerAandAgerW,UNICEF,2007 7 Aguidetotheevaluationofpsychosocialprogramminginemergencies BoothbyN,AgerAandAgerW,UNICEF,2007. ThesedomainsdrawonPsychosocialinterventionincomplexemergencies:a frameworkforpracticeThePsychosocialWorkingGroup www.forcedmigration.org/psychsocialA%Framework%20for%20Practice.pdf 8 ReviewofUNICEFsupportedrighttoplayinterventionsRespondingtothe psychosocialneedsofchildrenaffectedbyconflictinnorthernandeasternUganda StavrouV,UNICEF,UgandaSeptember2007 9 EyberC 10 Workingwithchildreninunstablesituations,guidingmanualforpsychosocialsupport UniversityofOxfordandUNICEF,2002 11AdaptedbyStavrouV,fromChildprotectioninemergenciesinteragencytrainingand resourceCD:foundationmoduleUNICEF 12AdaptedfromProgrammingforpsychosocialsupport:frequentlyaskedquestions UNICEF18August2005andThePalestiniancharterforpsychosocialwork committeecomprisedof:NPASecretariatforChildren,SCF/US,CIDA,UNRWA andUNICEF,10July2001 13UntappedpotentialWomenscommissionforrefugeewomenandchildren 14Lowicki2001http://www.womenscommission.org/pdf/yu_adol.pdf 15AreviewofUNICEFpoliciesandstrategiesonchildprotectionUnitedNationsEconomic andSecurityCouncil,UNICEFexecutiveboardannualsessionJune1996(Item E/ICRF/1995/13,item(b)) 16SeeFoundationmodule3Programmedesign 17GlossaryofkeyandrelatedpsychosocialtermsREPSSIregionalpsychosocialsupport initiative,2008 18Guidelinesonmentalhealthandpsychosocialsupportinemergencysettings InteragencyStandingCommittee(IASC) 19Ibid
Foundationmodule7Psychosocialsupport Endnotes
20ChildtochildTrustbasedattheUniversityofLondon'sInstituteofEducation 21InteragencystatementonmentalhealthandpsychosocialsupportinGasain2009: principlesandresponse 22Aguidetotheevaluationofpsychosocialprogramminginemergencies BoothbyN,AgerAandAgerW,UNICEF,2007 ThesedomainsdrawonPsychosocialinterventionincomplexemergencies:a frameworkforpracticePsychosocialworkinggroup www.forcedmigration.org/psychsocialA%Framework%20for%20Practice.pdf 23Aguidetotheevaluationofpsychosocialprogramminginemergencies BoothbyN,AgerAandAgerW,UNICEF,2007 24Childrensparticipation: fromtokenismtocitizenshipHartR,UNICEF,1992 25Monitoring&evaluationquickreference:extractsfromtheprogrammepolicyand proceduremanualrevisedUNICEF,May2005 www.unicef.org/
Furtherreading
AguidetotheevaluationofpsychosocialprogramminginemergenciesBoothbyN, AgerAandAgerW,UNICEF,2007 AladderofcitizenparticipationJournaloftheAmericanplanningassociation,vol.35, No.4ArnsteinS,July1969pp216to224 AreviewofUNICEFpoliciesandstrategiesonchildprotectionUnitedNationsEconomic andSecurityCouncil,UNICEFexecutiveboardannualsessionJune1996(Item E/ICRF/1995/13,item(b)) AtoolkitonpositivedisciplinewithparticularemphasisonSouthandCentralAsia SavetheChildren,2007 http://sca.savethechildren.se/sca/Publications/Childrenandviolence/ CommunitybasedpsychosocialsupporttrainingmanualIFRC Childrenincrisis:goodpracticesinevaluatingpsychosocialprogramming DuncanJandArntsonL,SavetheChildrenUS,2004 EastTimorassessmentofthesituationofseparatedchildrenandorphansinEast TimorIRCandUNICEF,2002 Emergenciesandpsychosocialcareandprotectionofaffectedchildren SavetheChildrenSweden,2005 GlossaryofkeyandrelatedpsychosocialtermsREPSSIregionalpsychosocialsupport initiative,2008 IASCGuidelinesonmentalhealthandpsychosocialsupportinemergencysettings InteragencyStandingCommittee(IASC),Geneva2007 InteragencystatementonmentalhealthandpsychosocialsupportinGazain2009: principlesandresponse Monitoringandevaluationquickreference:extractsfromtheprogrammepolicyand proceduremanualrevisedUNICEF,May2005 www.unicef.org/ Programmingforpsychosocialsupport:frequentlyaskedquestionsUNICEF, 18August2005 Promotingpsychosocialwellbeingamongchildrenaffectedbyarmedconflictand displacement:principlesandapproachesSavetheChildrenUK,1996 Psychosocialcareandprotectionofchildreninemergenciesafieldguide SavetheChildren,2004 Psychosocialcareandprotectionoftsunamiaffectedchildren:guidingprinciples IRC,SCUK,UNHCR,UNICEFandWVI.,2005 Psychosocialinterventionincomplexemergencies:aframeworkforpractice ThePsychosocialWorkingGroup www.forcedmigration.org/psychsocialA%Framework%20for%20Practice.pdf PsychosocialinterventionstrainingmanualSavetheChildren,2001Therefugee experiencepsychosocialtrainingmoduleRefugeeStudyCentre,OxfordUniversity, 2001
Foundationmodule7Psychosocialsupport Furtherreading
ReviewofUNICEFsupportedrighttoplayinterventionsRespondingtothe psychosocialneedsofchildrenaffectedbyconflictinnorthernandeasternUganda StavrouV,UNICEF,UgandaSeptember2007 Sportfordevelopmentandpeace:towardsachievingthemillenniumdevelopmentgoal UnitedNationsInteragencyTaskForce,2003 TheConventionoftherightsofthechild(adoptedbytheGeneralAssemblyofthe UnitedNationson20November1989) ThePalestiniancharterforpsychosocialwork,committeecomprisedof:NPA SecretariatforChildren,SCF/US,CIDA,UNRWAandUNICEF,10July2001 UNICEFprogrammingforpsychosocialsupport,frequentlyaskedquestions August182005 UntappedpotentialLowickiJ,Womenscommissionforrefugeewomenandchildren http://www.womenscommission.org/pdf/yu_adol.pdf Wheretheheartis,meetingthepsychosocialneedsofyoungchildreninthecontextof HIVandAIDSRichterL,FosterGandSherL,2006 Workingwithchildreninunstablesituations,guidingmanualforpsychosocialsupport UniversityofOxfordandUNICEF,2002 Workingwithchildreninunstablesituationsprinciplesandconceptstoguide psychosocialresponsesUNICEF,2003

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ARCresourcepack Studymaterial Foundationmodule7 Psychosocialsupport

Section1 Whatispsychosocialsupportandwhyisit importantinemergencies?

Section2 Arightsbasedapproach: principlesandapproaches

Section5 Monitoringandlearningin psychosocialprogrammes

Section1 Whatispsychosocialsupportandwhyisit importantinemergencies?

Section2 Arightsbasedapproach: principlesandapproaches

Section4 Implementationstrategies Section5 Monitoringandlearningin psychosocialprogrammes

Acknowledgements Thefollowingindividualsandorganisationscontributedtothedevelopmentofthe materialinthismodule.

Section1 Whatispsychosocialsupportandwhyisitimportantin emergencies?

Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?

Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?

Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?

Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?

Foundationmodule7Psychosocialsupport Section1 Whatispsychosocialsupportandwhyisitimportantinemergencies?

familyandcommunityaswellasindividualissuesareaddressed thereisadeliberateandexplicitfocusonbringingtogetherpsychologicalfactors andsocialinclusion,andnotfocussingonmaterial,psychological,spiritualor welfaresupport.

Foundationmodule7Psychosocialsupport Section2 Arightsbasedapproach:principlesandapproaches

Foundationmodule7Psychosocialsupport Section2 Arightsbasedapproach:principlesandapproaches

Foundationmodule7Psychosocialsupport Section2 Arightsbasedapproach:principlesandapproaches

Trainingmaterialforthissection Exercise1 Exercise2 Childrightsandpsychosocialsupport CRCarticleslinkedtopsychosocialsupport

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Contextualapproach Programmedecisionsandprioritiesmustderivefromasituationanalysisonthe 15 ground, namelytheprioritiesandkeyindicatorsidentifiedbytheorganisations programmedandacomprehensiveassessmentbytheserviceprovidertodetermine 16 theplannedintervention.

policiesandprocedures programmedesignandactivities planningandbudgeting

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

capacitybuildingandhumanresourcedevelopment monitoringandevaluation networkingwithgovernmentsectorsandinstitutions.

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Peopleinvolved Animatorsorcommunity workers

Foundationmodule7Psychosocialsupport Section3 Principlesofpsychosocialprogramming

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Itshouldberecognisedthatpsychosocialinterventionswillonlybeonecomponentof achildfriendlyspaceandthattherewilloftenbeotherbroaderchildprotection interventionstakingplaceinachildfriendlyspace.

Youthclubs Itisimportantthatchildrenareabletoengageinmeaningfulactivitiesthatcanhelpin theirdevelopment,inregainingasenseofcontrolfortherebuildingofsociety.Thisis particularlyimportantforadolescents,manyofwhomstruggletomakesenseofthe

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

Foundationmodule7Psychosocialsupport Section4 Implementationstrategies

todistinguishbetweenwhatisrealandwhatisnotreal.Itisinadolescencethat manypsychoticconditionsfirstappear.Foryoungerchildren,careshouldbetaken nottoconfusenormalfantasyandlosingtouchwithreality.

Ifattheoutsetthereisnotlocalhealthinfrastructureorlocalcapacity,outside organisationsshouldprovideemergencymentalhealthservices.However,services needtobeestablishedinsuchawaythattheydonotdisplaceexistingsocial mechanisms.

Foranyoftheseissues,professionalhelpshouldbesoughtfortheindividual.Those withoutspecialisedtrainingshouldidentifyandmakereferralsinthesecases,but shouldnotattempttoaddresstheproblemthemselves.

Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes

Thesedomainsmaybereflectedindifferentwaysindifferentculturesbutthey representthecommoncoreofmostpsychosocialwork. Programmecycle Aswithotherhumanitariananddevelopmentaidprogrammes, whendesigning,monitoringandevaluatingpsychosocialprojects,thefollowing systematicenquiryandanalysisshouldtakeplace.

Emotionalwellbeingisimproved:childrenarelessstressed. Socialwellbeingisimproved:childrenhaveanincreasedsenseofbelonging. Skillsandknowledgeareimproved:parentsknowhowtorespondtotheirchildrens emotionalneeds.

Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes

Skillsandknowledge Qualityofcare providedtochildrenby familiesisimproved (measuredby interviewswithchildren andparents,andby reducedreportsofchild abuse)

Emotionalwellbeing Strengthenedreferral networksbetween communitiesand serviceproviders (measuredby increasedcaseloadsof communityreferrals)

Increasedawarenessof parentingskillsand childrensrights (measuredby increasedknowledgeof parentsandchildren)

Appropriatereferralof childrenrequiring specificsupport (measuredbyincrease ofreferralsthrough districtchildprotection committee)

Strengthened relationshipsbetween IDPsandhost communities (measuredby frequencyof communityactivities featuringIDPsandhost communities)

Psychoeducationalprogrammedeliveredthroughdramaandtheatre activitiesforchildrenandfamiliesinallIDPcampsandhostcommunitiesin Batticoloa(measuredbynumberofprogrammesessionsandnumberof deliverysites)

Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes

Howdothechildren,keystakeholders,projectstaffanddonorsinvolvedintheproject identifywhattheywanttoknow? Whowillmonitortheprogramme?Examplesofmonitoringinitiativesmayincludethe following.

Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes

Difficulttofindreliablequantitativetoolsfor measuringpsychosocialwellbeing,most existingtoolsnotvalidatedand/or appropriateforuseinmanycountries.

Examples: questionnaires surveys

Howshouldevaluationbedoneorapproached? Whatevaluationtoolsshouldbedeveloped? Howtodevelopindicatorsrelevanttothelocalcontextandprevailingcultural norms?

Foundationmodule7Psychosocialsupport Section5 Monitoringandlearninginpsychosocialprogrammes

attheendoftheprogramme? Areminimumlevelsofoutcome beingobtained?

Bothquestionsabove,plus: Howmuchdidtheparticipants changeduringtheirparticipationin theprogramme?

Effectiveness needstobemeasuredin termsoftheoutcomesofaprogramme. Whathascomeaboutasaresultofthe programmethathasmadeachangefor children,theirfamiliesandtheir communities?

Havestatedprogrammeoutcomesbeen achieved? Whatdifferencehascomeaboutforchildren intermsofskillsandknowledge,emotional wellbeing,andsocialwellbeing? Whatdifferencehasprogrammingmadeto theskills,capacitiesorattitudesoffamilies andothercaregivers,andcommunities?

Impact referstoevidencethatsuch outcomeshavebroughtaboutrealchangein