From trauma to resilience

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 ongoing 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.