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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905 EISSN: 1729-0503
Vol. 8, Num. s1, 2008, pp. S39-S40
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Untitled Document
African Health Sciences, Vol. 8, Suppl, 2008, pp. S39-S40
From trauma to resilience
Lene Christensen
Psychosocial Support Centre (IFRC), Copenhagen. http://psp.drk.dk/sw32204.asp
Correspondence: Lene Christensen, Technical Advisor ,International Federation of the Red Cross and Red Crescent
Societies (IFRC), Reference Centre for Psychosocial Support, C/o Danish Red Cross, Blegdamsvej 27, 2100 Copenhagen, Denmark Tel +45 3525 9200 / Fax +45 3525 9350 Email: lec@drk.dk
Code Number: hs08064
The Psychosocial Support Program of the
International Federation of the Red Cross and Red
Crescent (International Federation) emerged in the early
1990s, at a time when an increasing number of National
Societies realised that disasters may lead to both physical
and mental problems and that the simple provision of
shelter, food and medical care in many cases was not
sufficient. Hence in 1993 the General Assembly
recommended the International Federation to "give high priority
to psychological support issues and strongly advocate
the implementation of psychological support programs
in National Societies" and to "secure adequate material
and human resources to implement those
programs" (General Assembly, IXth Session, Birmingham,
1993, Decision 26). The same year this
recommendation resulted in the establishment of the IFRC
Reference Centre for Psychological Support.
The mid 1990s saw a growing
dissatisfaction with the traditional trauma-focused mental
health interventions that were being implemented in
the aftermath of disasters and conflicts. There was a
growing realisation within the Psychological Support
Program, informed by powerful critiques from Europe and
the USA that conceptualising the suffering caused by
natural catastrophes and conflicts primarily in terms of
Post-Traumatic Stress Disorder (PTSD) or associated
mental disorders was a hindrance to providing adequate
support. Experience has taught that major accidents and
disasters do not produce huge numbers of people with
acute psychiatric disturbances. Psychological reactions can
be considered "normal" in the context of
"abnormal"
circumstances"1. Whilst acknowledging that
some individuals do require treatment of
psychological disorders, the Psychosocial Support
Program believes that the majority of the affected people have a need for information and have practical, social, emotional
and psychological needs. This more generalised
support will enable them to better access the material and
social resources they seek.
Along with the critiques of the trauma
approach, the mid 1990s saw the articulation of many
alternative approaches to psychosocial intervention,
which acknowledged people's capacity for resilience and
aimed primarily to enhance and support this. Inspired by
such examples, the Psychosocial Support Program
attempts to develop interventions that address the
social, emotional and material concerns of people in ways
that strengthen their capacity to manage adverse circumstances or challenges to their well-being
within the limits of human, social and material resources of
the communities in which they live.
Basic emotional support would normally
be provided through existing social networks. In
many cases, family, friends and neighbours offer a helping
hand and a listening ear to survivors and their families in
order for them to cope with their loss and grief. But in
some situations, survivors may be physically separated
from their communities or the community's ability to
provide support may be seriously impaired. These
situations require anticipation and a pro-active response of
well coordinated multidisciplinary
support. Psycho-social needs are likely to persist over a much longer time
than the usual intervention period of emergency
services. Local National Societies, through their networks
of volunteers, have been and will continue to be
essential in facilitating psychosocial support after critical events.
Psychosocial Support Programmes in
the International Federation
The overall objective of the International
Federation's Psychosocial Support Program (PSP) is to assist the
Red Cross/Red Crescent Movement to create
awareness regarding psychological reactions at a time of disaster
or long-term social disruption, to set up and
improve preparedness and response mechanisms at
global, regional and local levels, to facilitate psychological
and psychosocial support before, during and after
disasters, to promote the resilience and thereby the
rehabilitation of individuals and communities, and to
enhance emotional assistance to staff and volunteers.
Definition
Psychosocial support is a process of facilitating
resilience within individuals, families and communities.
Through respecting individuals' and communities''
independence, dignity and coping mechanisms, psychosocial
support promotes the restoration of social cohesion
and infrastructure.
Within this framework the Reference Centre for Psychosocial Support (PS Centre), housed by
Danish Red Cross in Copenhagen, works to achieve these.
The main activities of the PS Centre include 1)
documentation and dissemination, 2) capacity building in
National Societies, and 3) operational assistance to
international programs.
Through its work with National
Societies throughout the Red Cross and Red Crescent
Movement, the PS Centre promotes a community-based
approach to promoting resilience and strengthening
coping mechanisms within individuals, families and the
wider community. Examples of community-based PS
activities that have seen to be effective at times of crises are:
- Supporting the return to school, work, normal
daily routines
- Play and recreational activities
- School-based programmes
- Children and youth clubs
- Religious and cultural ceremonies (and the
facilities for these)
- Community sensitization to increase awareness
on psychological reactions to critical events
- Drama, art, cultural activities
- Livelihood oriented activities and life-skills training
- Supporting families to function
- Supporting those who support others
In relation to the International
Resilience Workshop in Talloires the PS Centre, through
its representative, hopes to be able to contribute to the
on-going work of developing a Resilience Index. Being
on the practical end of implementing programs to
restore psychosocial well-being, we are especially interested
in the process of `translating' psychological states
into effective programmes that will make changes in the
lives of beneficiaries.
References
- Psycho-Social Support in Situations of Mass
Emergency. European Policy paper, 2001.
europa.eu.int/comm/environment/ civil/pdfdocs/cpact03h-en.pdf
© Copyright 2008 - Makerere Medical School, Uganda
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