How to address the psycho-social support needs of children in Special Training Programmes ?

1. How to address the psycho-social support needs of children in Special Training Programmes? Presenter: VandanaKapur Clinical Psychologist Vimhans

2. About Don Bosco • Don BoscoAshalayam is part of the Don Bosco Global Network which caters to the rehabilitation of street children as well as the young at risk. • For the street children they provide Shelter, Health care, Alternative Education, Vocational Training, Life-skill training, and Rehabilitation

3. Issues commonly seen in street children

4. Trauma/ Abuse : • Many of these children have had traumatic pasts. having undergone emotional and psychological trauma as a result of extraordinarily stressful events. • Abuse in the form of physical beating and violence, emotional neglect or sexual abuse is a common experience for them.

5. This shatters ones sense of security, making children feel helpless and vulnerable in a dangerous world. • A traumatized person often struggles with feelings of inadequacy, self-doubt and low self worth.  • The trauma may also continue to frighten and disrupt person’s life even much after the traumatic event.

6. Abandonment • Tends to interfere with their ability to thrive affecting sense of security resulting in emotional imbalances. • May suffer from depression and anxiety disorders.

7. Manifests as withdrawal from social activities and interaction, a sense of guilt often tends to develop in the individual • Primarily as he/she thinks that there is something wrong with self, which has resulted in the abandonment.

8. Homelessness • A single child alone on the streets is especially vulnerable. • Homelessness can lead to further abuse through exploitative child labour and prostitution. • They are at high risk of suffering addiction, illness, have an uncertain supply of food, are likely to miss out on education and medical treatment, forced into child labour.

9. Children we are working with • Run away from home because they were beaten or sexually abused. • Forced into child labour • Swept by additions

10. Emotionally scarred ; often feel guilty and blame themselves for their past misfortunes • Many of the abused children are traumatized and some refuse to speak for months • Stubbornness, Aggressiveness, selfishness and unstable emotional behaviour

11. lack of concentration • constant rebellion against authority • mistrust of others, and • sometimes abusive behaviour towards other children.

12. Issues need to be addressed • These children carry a lot of trauma and hardships that they face. • Children come with a history of trauma or abuse that has not been dealt with they may also carry a lot of guilt from the past.

13. Adjustment to the new environment is a major issues to be handled as it is easy for them to slip back to the street life thus the running away tendency needs to be handled. • They find it difficult to trust adults and thus have difficulties in the interpersonal domains. • Issues regarding self and identity formation

14. Problems of aggression and emotion management • Guidance and encouragement for academics and career.

15. Method of working with children: • The main goal of any psychosocial support provided to these children is in helping them make sense of what happened to them in the past, • Providing a secure base from which they can progress in the present and • Imparting them skills that can be used by them in the future.

16. The therapeutic inputs can be given in the form of • individual sessions • group sessions and • life skills training sessions. • A combination of all the three approaches was used in the current project.

17. Individual therapy • Specific problems that the child was facing were dealt through individual therapy. • The therapy is child specific and problem specific. • The individual therapy sessions focused on expressive therapies.

18. Art therapy • Art therapy uses the creative process of art-making to improve and enhance the physical, mental, and emotional wellbeing of individuals of all ages. • Art therapy can enhance self-expression, increase locus of control, and improve quality of life in children.

19. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, • develop interpersonal skills, • manage behavior, • reduce stress,

20. increase self-esteem and self-awareness, • and achieve insight. • The key factor is giving the child power and control during a stressful and scary time. (American Art therapy Association, 2008).

21. Case example: • Name: Master V • Age: 13 • Schooling: Class 6 • Family History: V stays at DBA with his younger brother. His father lives near Nizamuddin railway station and works as a guard. His mother passed away years ago.

22. Case details • V used to stay near Nizamuddin railway station. • His father is alcoholic and was not able to take care of his two sons. • V would often run away, • would not go to school and • got involved with gang fights and drugs at the station.

23. He was approached by child line and was brought to the ashalyam. • The father felt that this was a safer place for his sons and left them here. • The father visits occasionally.

24. Presenting problems • Low confidence • Low self esteem • Giving less attention to academics • Aggression

25. His art work:

27. What he drew • The topic given was a person getting wet in rain. • He said that a tsunami had occurred and everything had drowned • There were mountains where some had taken shelter, but the way to the mountains was also under water

28. On exploration, the tsunami was metaphorical for the drug abuse in his past which is hindering his growth even now • We made him cover the part that had drowned and make a new scene where there was a clear path to the mountains for shelter.

29. This was accompanied by counseling using narrative therapy where his victory over drug abuse was emphasized as the alternative story.

30. Clay therapy • Innovative tool to facilitate the client to explore more fully his or her presenting experience in therapy. • The end product of the clay model is not as important as the whole process of making it.

31. During their creation process, they are able to think about the loss and later during sharing round they can talk about it and bring out their feelings. • Some children may not even talk but the process of making that model would have released some of their emotions.

32. There are three steps to consider when working with children who have been traumatized. • The first step is to create and maintain a therapeutic relationship with the child. • Clay therapy is an extremely effective tool in gaining and maintaining the therapeutic relationship, which keeps the child engaged and actively participating in the clinical process.

33. The second step of CLAY therapy is to generalize themes from clay therapy to the child’s life by specifically addressing therapeutic issues of identified problems through the use of clay. • The final directive of clay therapy, which is to engage the child in cognitive reframing and redirecting cognitive distortions and misattributions regarding their social environment.

34. To allow children to make free expression of the things they lost. • To regulate negative feelings towards positivism with the help of clay modeling. • To allow children to think and give shape to their imaginations of things they would like to possess and how they would want to shape their future.

35. Narrative therapy • Aims to encourage knowledge, skills and capacity for living to become consciously recognized and transformative. • It encourages re-structuring of existing perceptions, helping client with his ability to re-frame his experience.

36. Group Therapy • Group therapy is counseling, guidance, or training of children and adolescents involving interactions of three or more members that has the potential for reciprocal influence.

37. Therapeutic factors • Hope • Universality • Cohesiveness • Ventilation/Emotional expression • Imparting of information in secure environment • Mutual learning

38. Group therapy focuses on interpersonal interactions, so relationship problems are addressed well in groups.  • The subjects for discussion rise spontaneously from the group. • Group work for children and adolescents should be activity and experience based.

39. Life skills training • "Life Skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life." (WHO)

40. Life skills are a group of psychosocial competencies and interpersonal skills that help people make informed decisions, • solve problems, • think critically and creatively, • communicate effectively,

41. build relationships, • empathize with others, • cope with and manage their lives in a healthy and productive manner.

42. Life Skills are individual skills/abilities that each one of us possess and yet, need to enhance in order to meet the challenges of life. • Life Skills Education helps to promote 'protective' factors and reduce the impact of 'risk' factors.

43. Life skills training is essential • In order to protect children against vulnerability to psychological problems, • to make them more self-sufficient • and promote positive mental health providing them with adequate information

44. Module on Self awareness: • Theself can be defined as an individual person as the object of his or her own reflective consciousness. • The understanding of the self does not emerge on its own in children, but is a function of various factors , the most important being the primary group that an individual belongs to

45. Working on self included • perception of self • Self concept • Confidence and self respect • Loving your self

47. Module on Anger management • Causes of anger • Identifying bodily reactions to anger • Controlling anger • Useful alternatives

48. Module on Sexuality education • Sexuality and sex education is one area where these children are not given any information or education on the subject • Understanding sexuality helps children cope with their feelings and with peer pressure.

49. It helps protect them from sexual abuse. • Sex education with children should be done in a scientific manner including information giving as well as information on abuse, issues of consent and protection

50. UNDERSTANDING SEXUALITY • Myths and Facts • Handling of sexual feelings • Differing perception of girls and boys on sexuality • Saying ‘NO’ to your partner • Recognition of sexual abuse