PSYCHOSOCIAL SUPPORT FOR CHILDREN AND ADOLESCENTS IN DISASTER SITUATIONS
CONTENTS PART A : A MODULE FOR FACILITATORS
CODE OF CONDUCT 1 INTRODUCTION About Disasters Children, Teachers, Community Level Workers (CLW) and the Tsunami
Rationale for using School Teachers/CLWS in Dealing with Disaster What is the Role of Your School / Community?
CHILDREN AND THEIR RESPONSE TO DISASTER Usual Response To Trauma / Loss
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HELPING PROCESS FOR CHILDREN Psychological First Aid Four Tasks of Helping Suggested Support and Interventions by Developmental Level What Can the Teacher / CLW Advice to the Parents / Caregivers?
RECORD KEEPING Unusual Responses From A Child CARE FOR TEACHERS / CLWs APPENDIX - IDENTIFYING AND REFERRING FOR MENTAL HEALTH SERVICES
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Anxiety Symptom Checklist Symptoms of Depression in Older Children and Adults
PART B : ACTIVITIES MANUAL FOR SERVICE PROVIDERS HOW TO USE THE MANUAL SECTION I ACTIVITIES FOR CHILDREN I II Let’s Talk Let’s Draw 23 25 28 33
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III Let’s Write IV Let’s Create
SECTION II ACTIVITIES FOR ADOLESCENTS I II Developing Emotional Sensitivity (Empathy) Effective Communication Through Listening Skills 35 40 53 61
III Learning to Deal with Loss and Sadness IV Learning to Cope with Anger
LIST OF CONTRIBUTORS /
Dr. Cherian Varghese National Professional Officer Social Change & Non-Communicable Diseases, WHO, Office of the Representative to India, Room No. 536, A Wing, Nirman Bhavan, Maulana Azad Road, New Delhi E-mail: varghesec@whoindia.org
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Dr. Jitendra Nagpal Consultant Psychiatrist & Co-ordinator, Child Development & Adolescent Health Centre, VIMHANS, Nehru Nagar, New Delhi Telefax: 26926920 E-mail: jitendranagpal@rediffmail.com
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Dr. Swati Y. Bhave Chairperson, IAP Taskforce on Adolescent Care & IAP Sub-Chapter of Adolescent Health, New Delhi Ph: 23073388/23782074 E-mail: sybhave@vsnl.com
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Divya S. Prasad Clinical Psychologist Child Development & Adolescent Health Centre, VIMHANS, Nehru Nagar, New Delhi Telefax: 26926920
E-mail: divyasprasad73@rediffmail.com
/
Sheema Sen Gupta Consultant Child Protection, UNICEF73, Lodi Estate, New Delhi 110003 Email:ssengupta@unicef.org, sheemasengupta@yahoo.com
Part - A
A Module for Facilitators
CODE OF CONDUCT Principles of Conduct as stated by the International Red Cross and Red Crescent Movement and NGOs in disaster response programs
The humanitarian imperative comes first. Aid is given regardless of race, creed or nationality of the recipients and without discrimination of any kind, on the basis of need alone.
Aid will not be used to further a particular political or religious standpoint.
We shall endeavour not to act as instruments of any government’s foreign policy.
We shall respect individual culture and custom. We hold ourselves accountable to both those we seek to assist and those from who we accept resources. In our information, publicity and advertising activities, we shall recognize disaster affected people as dignified humans, not hopeless objects.
INTRODUCTION “Although difficult to quantify, mental health and psychosocial problems can be associated with any type of disaster and post-disaster setting. The horrors, losses, uncertainties and other stressors associated with disasters can place people at increased risk of various psychiatric and psychological and social problems” -SphereStandards
About Disasters India is one of the world’s most vulnerable countries in terms of disasters both manmade and natural. Due to the geographic and demographic structure of the country, the people of India are vulnerable to floods, droughts, cyclones, earthquakes, communal riots, conflicts, epidemics, fires throughout its states and union territories. The physical loss and devastation caused by these disasters is often accompanied by emotional suffering. Survivors are left without near and dear ones, source of livelihood, their life’s savings and assets and most severely, hope for the future. The development of psychosocial programming after disaster in India
WHO (1992) – Psychosocial Consequences of Disaster “A disaster is a service disruption, ecological and psychosocial, which greatly exceeds the coping capacity of the affected community.” 1
began during the Bangalore Circus tragedy where home-based care through simple emotional support added a new dimension to services provided to tackle various issues that emerged in the aftermath of the tragedy. Subsequently, the experience from the Bhopal Gas Tragedy, the Marathwada earthquake, the Orissa Super cyclone, the 2001 earthquake, the communal riots in Gujarat and the recent school fire tragedy in Kumbhakonam underlined the significance of simple emotional support provided by community level volunteers and paraprofessionals.
Children, Teachers, Community Level Workers (CLW) and the Tsunami How does the tsunami affect children / adolescents? Quite often, as in any other disaster, a tsunami too would result in every child experiencing a sense of loss. These losses could be in the form of:
1. Death of a near and dear one Witnessing death is very traumatic to a child, especially of: • • • Parent(s), sibling(s), grandparent(s), any relative(s) of a joint family Friend(s), classmate(s), teacher, neighbour, friendly shopkeeper Pet, cattle of the house
2. Loss of friends and relatives • Due to the child’s friend or relative migrating with his/her family after the tsunami. • The child him/herself moving into another village with his/her family. This means having to make new friends in an unfamiliar situation without peer and support group. There are too many new adjustments to be made. 2
3. Loss of property and familiar places • Property, which was part of his/her life – house, cattle shed, pets. • Personal belongings such as play material, books and other reading material • Familiar places like the school, place of worship, shops, especially those which he/she has a personal rapport with the shopkeeper.
4. Injury and hospitalisation • To self, parents, siblings, friends, relatives or pets
5. Struggle for food, shelter and other basic amenities • In their village or in a new place.
All these losses can be broadly classified as:
Loss of a stable life Loss of relationships Loss of a secure and familiar environment
Every child exposed to more number of adverse situations in a tsunami is likely to experience more mental suffering.
Rationale for using School Teachers/CLWs in Dealing with Disaster As a Teacher/CLW, you have an important role as facilitator or promoter because: Every child in your school spends a major part of his/her waking time with teachers like you. While in school, you play the role of a ‘parent’ in his/her development. As a CLW you do not have to “enter” the community. You are already a part of every day life. As a youth leader, you would have already guided and have
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been a mentor for out-of-school children and adolescent on several occasions Teachers/CLWs know the individual child, their personality and circumstances. Children’s trauma is reflected in their behaviour and interaction. Since teachers take the child through a specific daily routine, they are in a position to notice these behavioural changes. CLWs meet children and adolescent in several non formal settings and can observe their behaviour more closely. Teachers/CLWs know the cultural context As a committed teacher you promote total development of the child apart from teaching the curriculum You help the child understand the outside world. You are a role model where dressing, conducting him/her, and responding and handling stress/difficulties are concerned. You interact with the child’s parents on a regular basis, update and exchange information about the child. Hence you influence the child’s development by guiding the parents. You promote child-to-child learning – be it subjects or life issues. Most importantly teachers and youth leaders are well-known and trusted by the children. Teachers are experts in providing children with knowledge, more so than psychologists and psychiatrists. Youth leaders by virtue of their leadership qualities and status in the community are immediately listened to.
Hence YOU as a teacher and a leader have a vital double role. YOU ARE important in the recovery process of the children affected by a disaster. 4
What is the role of your school/community? Recognize that children at various stages of development are affected by the tsunami. Recognize the importance of helping children cope with the effects of disaster. Collaborate with the government and NGOs to mark their psychosocial work with in and out-of--school children. This work should be highlighted in the discussions with concerned school and other community authorities. Encourage and allot specific time for group activities facilitated by the teachers/CLWs to help children cope and adapt to the effects of tsunami. Regular staff/community meetings to take place enabling sharing of information about vulnerable children and adolescents. The meetings should include how each of these high risk children and adolescent are coping with the tsunami; the methods being used to handle these children and the effectiveness/ineffectiveness of the techniques. Identify special children (see section on ‘Needs of Special Children’) in their class/community and work with them. Be able to identify children who are more seriously affected and refer them to appropriate mental health professionals.
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CHILDREN AND THEIR RESPONSE TO DISASTER Disasters may strike quickly and without warning. These events can be frightening for adults, but they are traumatic for children if they don’t know what to do. Children depend on daily routines: When emergencies or disasters interrupt children’s routine, children may become anxious. Limited understanding and the inability to articulate their feelings, puts very young children at a special disadvantage. In a disaster, they’ll look to adults for help. How one reacts to an emergency gives them clues on how to act. If you react with alarm, a child may become more scared. They see your fear as proof that the danger is real. If parents, caregivers, teachers seem overwelmed with a sense of loss, a child may feel their losses more strongly. Children’s fears also may stem from their imagination, and you should take these feelings seriously. A child who feels afraid is afraid. Your words and actions can provide reassurance. When talking with the child, be sure to present a realistic picture that is both honest and manageable. Feelings of fear are healthy and natural for adults as well as children. But as an adult, you need to keep control of the situation.
After a disaster, children are most afraid that: The event will happen again. Someone they know will be injured or killed. They will be separated from the family. They will be left alone.
Children are as affected by disaster as adults, although they might react to it very differently. How they react to a crisis situation depends on how old they are and the nature of loss they have experienced. For example, young children may 6
sometimes feel guilty and scared, have trouble falling asleep, may start to wet their bed after having been dry, cry a lot without reason and cling to their mothers. Adolescents typically are going through an individuation phase of development. Their sense of “who they are” at this point in their lives may be tied to their possessions and friends. Having to change schools may be traumatic and telling friends that they are living in a temporary shelter, can be equally difficult. Adolescents can regress, become very angry and revengeful, and express their feelings by yelling and fighting or by indulging in alcohol and nicotine use and abuse. Some also respond by isolating themselves from parents and family members and withdrawing. The table summarizes the different types of normal stress related behaviours that you would notice in children of different ages after the tsunami
Young Children (0-5 years)
School Going Children (6-12 years)
Adolescents (13 years & above)
Getting angry Stubborn Nightmares Helplessness Regressive behaviour Irritability Crying Fearful
J
Feeling sad Body pain Fearful Nightmares Not relating with friends Worrying Regressive behaviour Problems in school, inability to concentrate
J
Denying the event Aggression Feeling helplessness Being aloof Feeling sad Low concentration Drinking & smoking Sleeplessness
J
Loss of appetite Sleep disturbance Clinging behaviour
Feeling guilty Anger and irritability
Thoughts of revenge Loss of appetite
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All these behaviour mentioned above are usual and common responses, established after a trauma. With time, through care by loved ones and the rebuilding process, these symptoms decrease and everyday functioning is resumed. The teacher/community level workers should watch out if above mentioned behaviours/symptoms: Show no indications of decreasing i.e., the symptoms are on-going and their intensity is more, Symptoms increase in severity Symptoms become very distressing to the child or family Symptoms interfere with the sleep, appetite and daily routine of the child Symptoms interfere with social functioning of the child with friends,relatives and others And symptoms interrupt his/her attendance to school/work. It is strongly recommended that the teacher or community level worker use the checklists for anxiety and depression given in the Appendix Titled: “Identifying and Referring for Mental Health Services”. Referral to mental health professionals in your area is VERY ESSENTIAL, apart from your continued support to the child. Keeping a record of these symptoms and treatment follow-up in the “Psychosocial Health Card - Record Keeping by the Teachers/ CLW” is helpful for the child, his family and help giving agencies for improving the services.
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HELPING PROCESS FOR CHILDREN The most appropriate response may be Psychological First Aid (PFA). During psychological first aid the survivors are encouraged to express their feelings and narrate their stories.
Psychological First Aid Entails : Basic, non-intrusive pragmatic care with a focus on listening but not forcing talk Assessing needs and ensuring that basic needs are met; Encouraging but not forcing company from significant others Protecting from further harm. Because of possible negative effects, it is not advised to organize forms of single session psychological debriefing that push persons to share their personal experience beyond what they would naturally share.
Four Tasks of Helping To accept the reality of the loss To work through the pain of grief To adjust to an environment in which the dead person is missing To relocate emotionally the deceased person and move on in life
Suggested Support and Interventions by Developmental Level Some suggested strategies for providing support are given below. Some of the interventions are relevant to all providers of care for children, while others are more specifically targeted at parents. The interventions aim to enhance children’s feelings of protection and security, sense of control, facilitate attachment to caregivers and peers, and increase a sense of belonging to a wider cultural community. 9
PRE-SCHOOL (AGES 0-5) Individually allot extra time for the child Reassure Comfort Allow him to talk, but do not force him to talk Allow flexibility of rules-in school/at home Limit media exposure-not showing gory/shocking pictures which may be traumatic to them Encourage physical activity-games Encourage other activities-drawing/painting/ collage In psychosomatic pains-after ruling out medical problems, do not give much importance to child’s complaints, but soothe him.
PRIMARY AGE CHILDREN (AGES 6-12) Give individual attention Encourage physical exercise Allow to ventilate, be patient with repetitive talk Do not interrupt / belittle their feelings Never force them to talk-be willing to wait for them to open up. Give structured work/schedules to follow Relax rules, but be firm that responsibilities need to be met with. Encourage activity relevant to their community Encourage expressions-by storytelling, dramas, skits, drawing, painting, singing, etc Teach drills-as a form of discipline; what to do in case of an emergency-in the form of physical/fire drills. In psychosomatic pains-after ruling out medical problems, do not pay much attention to the child’s complaints, but continue to be soothing 10
What Can the Teacher/CLW advice to the Parents/Caregivers? Model a healthy coping behaviour. Parents should follow regular time and routine as far as possible. Ensure that children also do the same and restart their schooling activities. Spend time with the children – playing and sharing thoughts and feelings Keep the family together. Suggest to the caregivers or parents that while they look for housing and assistance, they should try to keep the family together as much as possible and make children a part of what they are doing to get the family back on its feet. Children get anxious, and they’ll worry that their parents won’t return. Calmly and firmly explain the situation. As best as they can, tell children what they know about the disaster. Explain what will happen next. For example, say, “Tonight, we will all stay together in the shelter.” Get down to the child’s eye level and talk to them. Include children in recovery activities. Give children manageable chores that are their responsibility. This will help children feel they are part of the recovery. Having a task will help them understand that they have a role and responsibility too. Teach your child how to recognize danger signals. Make sure your child knows what warning systems (horns, sirens) sound like. Explain how to call for help. Teach your child how and when to call for help. Help your child memorize important family information. Children should memorize their family name and address. They should also know where to meet in case of an emergency. Some children may not be old enough to memorize the information. They could carry a small index card that lists emergency information.
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RECAP The children/adolescents and their families affected by the tsunami are basically normal people. Disaster situations like the Tsunami induces very severe anxiety and loss of control/comprehensibility in children/adolescents Most of them show some changes in behaviour due to this excessive anxiety The behaviour depends upon of age, development and loss Behavioural changes can be immediate or late; short or long lasting. Help by a caring adult can assist the child/adolescent to get control of the anxiety and get back faster to normalcy The approach used by you needs to help a child in his/her distress depending upon the age and development of the child
RECAP - REFERRALS There is no easy way to know when children need to be referred to a qualified professional for continued intervention. Below is a list of behaviours that could indicate just such a need: When the child verbalizes or indicates extreme anger, desire to hurt self or others, suicidal ideation/wishes, or past delinquent acts. Consistently expresses self in somber or self-deprecating terms. Repeated reliance on dark colors and dark themes in artwork. Repeated acting out aggressively or violently. Developmentally inappropriate behaviour- regression, precociousness, or repeated inappropriate sexual behaviour. Repeated isolation of self. Fire setting and other destructive acts. Repeated and deliberate harming of animals.
When in doubt discuss with other teachers or professionals 13
RECORD KEEPING UNUSUAL RESPONSES FROM A CHILD Name Age School Taluk/ Village Guardian’s Name Date of Visit Key problems identified Severity of the Problem 1 Low Help /Intervention Given to the Child 3 Medium 5 High Gender
Help / Intervention Given to the Family / Guardian
Success / Improvement Noted Low
1
3 Medium
5 High
Describe: Additional resources needed for this Case Any Other Comments
(Signature with date) 14
We only request you to remember these major do’s and don’ts .
DO’S Keep the child intact with the family/ nearest relatives Provide security and comfort Normalize the child’s life as early as possible and share information Offer a simple expression of sorrow and take time to listen. Encourage professional help when necessary. Limit the amount of media coverage they see. Accept them unconditionally.
DON’TS Do not send to far off places where everyone is unknown
Do not punish/frighten children to gain control
Do not give false promises Don’t offer false comfort. It doesn’t help when you say “it was for the best” or “you’ll get over it in time.”
Angry outbursts or criticism only deepens a child’s anxiety and delays recovery.
Don’t’ give advice.
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ADOLESCENTS (AGES 13-18) Spend time with them and explain to them what is happening Relax timing and rules-but be firm that they need to complete their tasks Allow them to talk/ventilate Encourage group activity to avoid isolation Encourage group activity to express and share their feelings Explain clearly how alcohol and drugs and sex in young people can lead to high risk situations. If possible-use AV aids. Engage parents/family/caregivers in discussions for additional support.
VULNERABLE GROUPS As teachers/CLWS, we need to be aware of the extra vulnerability that a section of these children can be subjected to. Points to be remembered for the children to be sensitized and protected – CLW/Teacher can be an important person with eyes and ears to prevent trafficking in children. Children most vulnerable to exploitation are orphans, displaced, migrant and refugees. Be aware of the guises in which trafficking can go unnoticed e.g., unknown mentors, people coming up to rehabilitate children without proper reference, etc. 11
CARE FOR TEACHERS/CLWs Dear Teacher / CLW, I The tsunami has affected you personally - directly or indirectly. You may also be under stress often. I In your need to care for your family and the children of your school, you may often overlook your own stress. I I I I Recognise your losses, grief and other emotions. As you advise your school children, form a routine for the day for yourself. Take care of your physical needs without fail - food, sleep, clothing, etc. Take part in the relief and rehabilitation work as much as possible - working with children is one such activity. I Form groups among teachers/other CLWs to discuss emotions and experiences pertaining to children and community (even family). I I Share emotions and experiences with your family. Include, 5-10 minutes of being alone and thinking about yourself - your behaviour and emotions over the day. I Include 15 minutes of some activity, which you had found to give you solace and pleasure prior to the tsunami like, reading, praying or meditating. I In the end, believe in yourself, your ability to cope and provide help to the children.
It is because of YOU, DEAR TEACHER/CLW, this programme has become a REALITY. 16
APPENDIX Identifying and Referring for Mental Health Services ANXIETY SYMPTOM CHECKLIST Check the column that best describes this child. If you have ticked “Yes” for many of the items (more than 12), then it is appropriate to discuss with the caregivers of the child and share this concern with them. Suggest that the child may benefit from detailed evaluation with a Doctor / Psychiatrist / Psychologist.
YES 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. Experience of fear Restlessness Irritability Avoidance Rapid labored breathing Sweating or perspiring Trembling or “shaking” Weakness Problems concentrating Poor memory Neglecting responsibilities Thoughts of danger Increased energy Frustration Impatience Rapid heart beat Chest pain or tension Muscle tension Indigestion or diarrhea Dizziness or feeling “light-headed” Racing thoughts Dwelling on fearful possibilities Problems performing tasks Frightening images
NO
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DEPRESSION SYMPTOM CHECKLIST Check the column that best describes this child. If you have ticked “Yes” for many of the items (more than 6), then it is appropriate to discuss with the caregivers of the child and share this concern with them. Suggest that the child may benefit from detailed evaluation with a Doctor / Psychiatrist / Psychologist.
Symptoms of Depression in Older Children and Adults
YES 1. Too much or too little sleep 2. Significant increase or decrease in appetite 3. Loss of interest or pleasure in others or most activities 4. Feeling discouraged or worthless 5. A significant drop in performance in school or at work 6. Fatigue or loss of energy most of the time 7. Restlessness, fidgeting or pacing 8. Crying, feeling sad, helpless or hopeless 9. Episodes of fear, tension or anxiety 10. Frustration, irritability, emotional outbursts 11. Excessive guilt or inappropriate self-blame 12. Repeated medical complaints without a known medical cause (headaches, stomach aches, pain in arms or legs)
NO
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Additional Symptoms of Depression Found in Younger Children YES 1 Emotionally brittle, temperamental, irritable or easily annoyed Losing friends Repeated rejection by other children Inability to sit still, fidgeting or pacing Stays in room and isolates. Repeated emotional outbursts, shouting or complaining Avoids and doesn’t talk to other children Irregular sleep habits (up at night and sleep during the day) Recent emergence of bed wetting
NO
2 3 4 5 6 7 8
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Serious and Critical Symptoms Suicidal thoughts, feelings or self-harming behaviour Aggressive, destructive, threatening or violent behaviour Abuse or prolonged use of alcohol or other drugs Symptoms of depression combined with strange, bizarre or unusual behaviour
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HOW TO USE THE MANUAL
Dear Teachers/ CLW, You have an important role in the rebuilding of the lives of the children. It is important that you, as a support person know what happens to children when faced with a natural calamity like tsunami and how you, as a teacher and community leader can help these children to rebuild their lives after the disaster. This manual is designed to provide caregivers like you, with the tools to better understand and help support the needs of your children and adolescent. These children are very young. For most of them the tsunami must be the first major tragic incident in their lives. They would never have experienced death, loss, deprivation, and displacement – all of which accompanies an tsunami. Not being prepared for a calamity of this dimension, the children are very disturbed at the happenings. Life at home, with friends and at school is no longer the same. Too much has happened. How do they cope with this? 21
How are they supposed to handle matters, which until now they are not equipped to do? The manual is divided into two parts. The first part gives a series of activities which can be used with children (3 to 11 years old) both in and out-of– school. The second part has activities for older children and adolescents. You are welcome to use your discretion in choosing the activity that you think is most suitable for your class/students/children in the community. Variations in executing the activity to suit your local setup is welcome.
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ACTIVITIES FOR CHILDREN Classroom Activities to Help Children Express Feelings There are a number of different kinds of activities that teachers can use in a classroom to prepare for or recover from a disaster. In using the General to Specific Approach, many methods and activities may be effective. Below are some suggested methods/techniques to use in your class to help defuse children after a disaster. In general (and depending on the age of students), teachers can :
TALKING
DRAWING
WRITING
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TOTAL TIME FOR THE WORKSHOP 2 hours (120 minutes)
OBJECTIVES OF THE WORKSHOP Behavioural - Children will Talk about the disaster situation They will discuss their own reactions to the tragedy Exchange ideas on how they would handle situation differently in future
Cognitive - Children will Ventilate about disaster situation Understand that talking and discussing a tragedy reduces the fear and pain. They will appreciate that listening to others can help us feel better.
MATERIALS Chalk and black board.
ACTIVITY AND DISCUSSION 1. FIRST, introduce talking as a way of : Expressing thoughts and ideas Letting people know your feelings
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2. 3. 4.
Talking should be presented to the child as an OPTION for expression, not as a compulsory activity! Explain that we all have had bad days. Ask students if they have ever had a bad day prior to this. There are some LEADING QUESTIONS and suggested themes that can be used to help children express themselves: How did you go through bad days before? What would you do differently if it happened again? How did you help others? How would you help next time?
5.
Be sure that the questions are OPEN - ENDED, which means that they can not be answered by a “Yes” or “No” only. Open-ended questions facilitate verbal expression. Note the key points on the black board using simple words or child friendly drawings e.g.,
6.
7.
Summarize the activity by going over the key points and highlighting the positive aspects that have emerged from the above discussion. 25
TOTAL TIME FOR THE WORKSHOP 3 hours (180 minutes)
OBJECTIVES OF THE WORKSHOP Behavioural - Children will Draw about the disaster situation They will discuss their own drawings of the tragedy Exchange ideas on how they would handle situation differently in future
Cognitive - Children will Be able to ventilate their feelings about the disaster situation Understand that drawing and discussing the drawing of the tragedy reduces the fear and pain They will appreciate that seeing and listening to others can help us feel better
MATERIALS Drawing sheets or blank paper, crayons, paints, brushes, pencil, eraser 26
ACTIVITY AND DISCUSSION 1. Introduce drawing as: another way of explaining a means of expression (Point out that some people express themselves by talking, some by singing, some by dancing. . . some by drawing!) 2. 3. Drawing should be presented to the child as an OPTION for expression,not as a mandatory activity! Students are asked to remember early scribbling experiences; what and where they scribbled. These stories are shared in the total group with an emphasis on humor and a reminder that despite the outcome, their intentions were good and innocent. 4. For about 3 to 4 minutes let students scribble on a full sheet of paper. They are encouraged to try each hand. These are shared with an emphasis upon showing how each student has a different style. 5. Brief comment about how we usually talk about the disaster, but this time we will draw about it, not talking while we draw. On the final sheet of paper each student is asked to draw what he/she remembers about the disaster, or what came into their minds. After a few minutes they are reminded to include themselves in the drawing if that seems appropriate. 6. Students meet as a group and discuss their drawings. Questions are asked to clarify drawings. 7. Next, the children are asked to share their pictures. “Let’s take a few minutes to tell about our disaster pictures,””Tell me about your drawing”. 8. Explain that drawing and talking about the picture reduces fear and pain and helps us understand that we are not alone.
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SOME POINTS TO REMEMBER Remember when introducing drawing of any sort, clearly say that the goal is not to draw a “pretty picture” but rather, a picture of expression! Reassure them that there is NO “RIGHT WAY”to draw. Try to keep it factual. Content responses and/or specific questions are most helpful in encouraging children to tell their stories. Ask specific questions about drawings for children who are having difficulty talking. “What’s happened here?” “How did that figure get there?” You might then ask exploratory questions based on content, encouraging them to talk about themselves. “You were with your friend”. “Was anyone else with you or close by?” “How was that for you?” Don’t ask why questions, ask what questions or where questions. Ex. Not “Why aren’t you in the picture?”, Say, “Where are you in the picture?” Avoid judgments about quality of drawings or situations. Help set limits for children who talk a lot by acknowledging they need to talk and letting them know you will meet with them later. It’s likely that children will make drawings about things other than the disaster. Allow a full range of expression: some kids draw recognizable “things” others draw “abstracts.” Respect all varieties. Allow children to discard their art work. It’s preferable to draw with more than one adult present. Exercise as little control as possible over the artwork. 28
TOTAL TIME FOR THE WORKSHOP 3 hours (180 minutes)
OBJECTIVES OF THE WORKSHOP Behavioural - Children will Write about the disaster situation They will discuss their own writings of the tragedy Exchange ideas on how they would handle situation differently in future
Cognitive - Children will Be able to ventilate their feelings about the disaster situation Understand that writing and discussing the writing of the tragedy reduces the fear and pain They will appreciate that seeing and listening to others can help us feel better
MATERIALS Writing sheets or blank paper, pencil, eraser
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ACTIVITY AND DISCUSSION 1. Introduce writing as: Another way of “talking” A means of expressing thoughts and feelings. 2. Writing should be presented to the child as an OPTION for expression, not as a compulsory activity! 3. 4. Students should not be forced to share their work. Begin by explaining that thoughts and feelings are very important and can be expressed in writing. Students need to be assured that they can express their thoughts and feelings without fear of criticism. Explain that when they have completed their writing they can choose whether or not to share their writing with the group. 5. Start by practising a short “free write” activity to help students begin writing. Everyone is instructed to write and not put down their pencils for five minutes. There is no topic for this writing exercise; the instructions are to write about whatever they are thinking about. If they run out of ideas then they can write the last word they wrote again and again for the remaining time. The purpose is to keep the pencil moving. The activity concludes at the end of five minutes. Discuss with the class the variety of topics that came up during the five minute period. 6. Tell the class that today’s writing activity is going to be “My Favourite Day. . .” or they can write about “My Worst Day. . .” — the choice is theirs. They will be given time for several days to work on their story. 7. The class can then begin working on their stories. Those who wish can illustrate their stories. 8. After the students have completed their stories, those who wish can share their stories.
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9.
Questions you might ask during sharing time: Has anyone else had similar feelings? Did anyone else have a similar experience? How did you feel when that was happening? How do you feel now that is over? What else happened during that time? How do you feel about the event today? What did it look like, feel like, or smell like?
Concluding Talking/Drawing/Writing Activities–a must A key element of these Methods is the discussion of the activities, afterwards. This discussion can help to bring CLOSURE to the experience; and important step of the process of expressing feelings. Allow those who want to, to talk about their work. Others will “close” by listening to others. Use open-ended questions in this process.
NOTE Although group discussions are a good vehicle for validating children’s feelings about their experiences, it is important to end the discussion on a positive note by focusing on things that promote a sense of security, mastery, or preparedness. This may come from students themselves, and teachers can reinforce or elaborate on these points. Some positive outcomes might include: Feeling closer to family and friends Meeting new friends or caring adults Learning new skills or getting a sense of responsibility, strength, or mastery Having the community pull together to deal with the crisis Seeing that people want to help
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Pictures for Story Writing
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TOTAL TIME FOR THE WORKSHOP 3 hours (180 minutes)
OBJECTIVES OF THE WORKSHOP Behavioural - Children will Use any material from the rubble to create anything that they want They will discuss their own creations
Cognitive - Children will Be able to understand that their can be rebuilding from things that are destroyed and new beginnings Be motivated by other student’s creations to take a hopeful approach
MATERIALS Pieces of materials, rubble, crayons, paints, water color, scissors, gum, fevicol, brushes, pencil, eraser, stapler, string, old magazines, coloured paper, play dough.
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ACTIVITY AND DISCUSSION 1. Use some leading questions such as, “Where were you when the tsunami happened? 2. Children cut and paste photos, magazine pictures, articles, fabric pieces, etc., around central theme. 3. 4. 5. 6. 7. Tell children they may draw what they cannot find in magazines, etc. Give the collage a “place of honor” in the classroom. Make it accessible every day for viewing, additions, etc. Fill it in on an ongoing basis. “Celebrate” it: use it to demonstrate getting through something tough, facilitate discussions about it, etc. 8. 9. Take photos of it if/when “completed.” The children can also be asked as what they would want the teacher to draw. Children are encouraged to share how they were able to use old destroyed pieces and create new object.
10.
Collages are the “safest” form of “drawing” because child is using other’s symbols. Collage tell a “collective story”. Collage develop/support teamwork. They feel “safer” for some children as opposed to individual art.
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TOTAL TIME FOR THE WORKSHOP 2hours (120 minutes)
INTRODUCTION AND BACKGROUND Effective helping involves, being sensitive and sensing. Empathy is the ability to imagine what life is like for another person, even in a situation that we may not be familiar with. Empathy can help us to understand and accept others, who may be very different from ourselves, which can improve social interactions, for example, in situations of ethnic or cultural diversity. Empathy can also help to encourage nurturing behaviour towards people in need of care and assistance, or tolerance, as is the case with AIDS sufferers, or people with mental disorders, who may be stigmatized and ostracized by the very people they depend upon for support.
OBJECTIVES OF THE WORKSHOP Behavioural – Adolescents will List their hopes and fears Exchange their personal aspirations with other group members Exchange their inner insecurities with other group members Would learn the skill of empathy by listening to other group members 37
Cognitive – Adolescents will Feel sense of belongingness to the group because of commonalities of their fears and aspirations
MATERIALS Copy of “Highest Hopes, Deepest Fears” worksheet for each member Ink pens or pencils Copies of the feed-back form.
ACTIVITY AND DISCUSSION Divide the participants into pairs (not more than 30 pairs in one session). Hand out xerographic copies of the worksheet and instruct adolescents to think about their highest hopes and deepest fears. Each person writes his own aspirations and fears in the space provided. Tell the pairs to share their worksheets with one another, making sure they have a good understanding of what their partner means by what he or she has written in the worksheet. Move around the room and facilitate the partners to question and explore the other persons work. Give 30 minutes for this activity. After this, ask all the participants to regroup together. Then ask each member to share his or her partner’s worksheet with the whole group. partner. After this is completed, explain that the writer now has a chance to comment on how well the presenter understood him or her. Encourage feedback from the group. Each speaker is given 2 minutes to talk about his
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One-by-one call on the next participant, so that every body presents their understanding of their partners.
CONCLUSION AND MESSAGE Comment on the fact that although we may feel that only we suffer from fears and insecurities, but after the exercise adolescent will be able to see the commonalities in the hopes and fears expressed. Highlight that how relieved each person felt when the listener was understanding (empathetic) and could understand their viewpoint.
HANDOUTS AND FEEDBACK FORM (Distribution and collection of the filled forms)
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HIGHEST HOPES 1.___________________________ 2.___________________________
3.___________________________
4.___________________________
5.___________________________
DEEPEST FEARS 1.___________________________
2.___________________________
3.___________________________
4.___________________________
5.___________________________
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FEED-BACK FORM Name:________________________Age: ________ Sex: __________
Class: _____ School: _______________________________ 1= Strongly Disagree
2 = Disagree
3 = No Opinion
4 =Agree 5 = Strongly Agree
(encircle choice) 1. I liked the idea of discussing life skills in this group. I learnt something about another group member too. I felt comfortable in this group. I shared something about myself in the group. I felt supported by the trainer. My participation and discussions will bring about a change in my ‘attitude’ and behaviour in future. I am looking forward to the next group meeting.
1 1 1 1 1 1
2 2 2 2 2 2
3 3 3 3 3 3
4 4 4 4 4 4
5 5 5 5 5 5
2.
3. 4.
5. 6.
7.
1
2
3
4
5
Life themes that I would like the group to discuss in the future meetings are
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TOTAL TIME FOR THE WORKSHOP 3 hours (180 minutes)
INTRODUCTION AND BACKGROUND What you say and how you say it are the two keys of success Communication skills can be divided into two categories:sending and receiving.
Sending Skills (skills used when speaking to someone): Deal in the present. Information is more useful when it is shared at the earliest appropriate opportunity. Talk directly to the listener rather than about them. When you do this, the other person feels respected and receives accurate information about your feelings. Speak courteously. This creates positive role model. Take responsibility for statements by using the personal pronoun “I.” Example: “when I’m interrupted, I get distracted and have difficulty in focusing”. Make statements rather than asking questions. Questions often create defensiveness.
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Receiving Skills
(techniques for becoming a more effective listener):
Use empathic, non-evaluative listening. This makes the speaker feel that he or she has been clearly heard and that the feelings expressed are acceptable. Use paraphrasing, active listening, or reflecting in order to make the speaker feel heard. This allows the listener to become involved in the dialogue. Make eye contact and be aware of nonverbal messages. Suggest strong leadership by using body carriage, facial expressions, and gestures.
Understanding each other’s point of view Good communication can be achieved by creating a situation in which each of the different parties come to understand the other from other’s point of view. A rational argument should be listened to patiently with a willingness to change your mind; if you do, explain why. Communication works better if participants are open to new information and different points of view. This would help in generating new ideas and make the communication richer. Each member should be given the opportunity of expression even if you have doubts about the likely wisdom of their views.
Agree to disagree Points of agreement should be stressed and areas of disagreement should be minimized with a view to finding solution to a problem. Do not argue on points of difference.
Do not be personal Mutual respect is the key to effective group communication. If you believe someone is wrong criticize the idea, not the person. Cooperate to find an overall solution.
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An efficient system of communication aims at removing illusions and misunderstandings by concluding with clear ideas about the topic. Good listeners have a style that lets the speaker know that he/she is heard, understood, and cared about. A good reflective listener helps a speaker sort out emotions and issues and put the pieces together to make a problem more manageable.
OBJECTIVES OF THE WORKSHOP Behavioural – Adolescents will Practice techniques of reflective listening which is a key to effective problem solving. Cognitive – Adolescents will Understand the difference between open and closed listening styles. Get familiar with a vocabulary of “good” and “bad” feelings so that they can listen more effectively.
MATERIALS Blackboard, chalk, markers, handouts, OHP. Copies of the feed-back form
ACTIVITY AND DISCUSSION ROLE OF TRAINERS
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EXERCISE 1 UNDERSTANDING THE VALUE OF COMMUNICATION SKILLS Before the workshop begins, ask one of your more outgoing participants to think of a problem in his/her family that he/she would feel comfortable sharing with the group. Prepare a MINI-LECTURE (5 to 7 minutes) using the material at the end of the workshop. Present this material to the whole group. Position yourself where all adolescents can see and hear you easily. Ask your “volunteer trainee” to sit beside you. Tell the group that you will be doing a communication exercise, but give no more information.
PART 1 1. Ask the volunteer to begin talking about his/her problem. As he/she talks, use the “know-it-all” method to respond. Be sure to over emphasize the body language of a powerful, imposing, inhibiting helper.
“The Know-It-All” The “know-it-all” emphasizes his/her superiority by lecturing, advising, and appealing to reason. He/she views others as incapable of dealing with their own problems acting as though only he/she has the answers and the speaker better shape up and listen. 2. Continue the conversation for about three minutes, being as inappropriate as possible. 3. Ask the volunteer how he/she felt when you “listened.” Ask the group how they felt as they listened to the exchange. 4. List the speaker’s feelings on the blackboard under “KNOW-IT-ALL.” Comment on the body language during that exercise. Explain that the “know-it-all” style is useless. This is a form of closed communication.
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PART 2 1. Ask for another volunteer to share a minor problem with the group. This time listen as you would if you were “the judge”
“The Judge” The “judge” pronounces a person guilty without a trial, proving that he/she is always right and the others are wrong. For judges, the answers to life are always clear-cut. “The boy is wrong. When I was young, one simply did not do things this way.” The body language is inhibiting and pompous. Follow the steps in Part I.
PART 3 1. Ask for another volunteer to share a minor problem. Then act as the
“consoler” “The Consoler” The “consoler” pats the speaker on the back, pretending that there is no real problem. He/she thinks a pat on the back and kind words will make everything better. Consolers make light of things: “It’s only your mother’s old car.” “It’s only puppy love.” Follow the steps in Part I.
PART 4 1. Ask the first volunteer to return to the chair next to you and talk about his/ her problem again. This time, reflect his/her feelings, aiming to clarify the problem. When reflecting remember: Body langu age is important. Use eye contact and a relaxed,attentive posture Do not parrot the speaker. Listen carefully and try to give back to the speaker the feeling you hear and the problem that causes that feeling. Reflect until the problem seems clear. 46
Do not problem-solve during this session. Discourage others from problem solving. At the end of the reflecting exercise, ask the speaker to tell how he/she felt about the situation. Write the comments on the board. Ask the group how they felt and why. Emphasize that clarifying the problem is often helpful to a person. Explain that reflective listening keeps communication open. Then give a few clear examples of reflecting responses as they might relate to a problem situation. In responding to a survivor who yells, “What is the government doing, they only talk big” - a reflective listener might say: “ I am sure it’s frustrating when help is delayed.” In response to the mother who says, “we are doomed. Everything is lost!” - a reflective listener might say: “You seem to feel like giving up because of your losses” Write the CLOSED STYLE OF LISTENING on the blackboard and summarize. Distribute Xerox copy of the handout to each participant.
EXERCISE 2 DEVELOPING A REFLECTIVE VOCABULARY Tell the group that reflecting is not always easy, especially for those who have never been encouraged to express their feelings. Before you practice reflecting, develop a list of “FEELINGS” words. Brainstorm with the group, listing on the board, words that express positive feelings. Brainstorm with the group a list of words that express negative feelings. Keep the lists visible as you go on with this workshop. An already prepared list is available at the end.
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EXERCISE 3 PRACTICING LISTENING SKILLS Write the STEPS OF REFLECTIVE LISTENING using the blackboard or display them on a chart paper. Divide the group into pairs. Ask one person to share a problem and the other to practice reflective listening. The goal of the exercise is to identify the heart of the problem. Move around the room and help the pairs through the process when required. Reunite the group and have everyone discuss the exercise. Now ask for a volunteer pair. Give them one of the situations to role-play their reflective process for the whole group. Highlight what worked during the role-play. If time permits ask for another pair to volunteer and give them the second situation. Explain that a good reflector can get very tired when listening to too many problems. It is okay to hint that you must end a session. It is okay to say, “I’m just too worried about something else to listen right now let’s talk later”. Make sure participants know that it’s important to say no when necessary and that there are gentle ways of doing this.
CONCLUSION AND MESSAGE Conclude the session by discussing that listening also entails communicating which gives the message of being understood. When we reflect in listening, we are trying to help the person in need to truly understand their problem. Through clarifying their feelings about what is happening, the person will: Feel better about the problem at hand and let the situation take care of itself, or 48
Set up a situation for problem solving that will work. With good reflective listening, the person in need will begin to feel some control of the situation at hand. This will empower them to work effectively on that problem.
HANDOUTS AND FEEDBACK FORM (Distribution and collection of the filled forms) MATERIAL TO PREPARE MINI LECTURE (Required for Exercise 1) Understanding what people say in the way, in which they mean it, is a skill valuable in all human interaction. A number of other qualities are useful in achieving good listening skills. These include: Being able to challenge contributions in a creative and constructive way. Being able to build links between an individual’ contribution and something else they have said or done, or between individual’s contribution and something that another person has said or done. The ability to concentrate fully on another person and suspend your own personal anxieties and concerns. Showing that you take someone seriously and that you recognize the uniqueness of their experiences and feelings. Being able to make sense of events, which for the person experiencing them seem to be confusing and bewildering. There are a number of strategies, which you may find helpful in developing your listening skills. Some of these are detailed below: Show that you are giving your undivided attention by having adequate eye contact, which is comfortable for you. Find a balance between staring and avoiding all eye contact. Some body language will directly encourage people to talk to you. If you lean slightly forward you will encourage communication, slouching can indicate boredom or lack of interest, smiling and occasionally nodding 49
your head generally encourages a person to continue, crossed arms can communicate superiority or defensiveness and may well create a barrier. Asking open-ended questions, which encourage an individual to expand upon what they are saying. For example How? What do you feel about…? Can you give me an example of…? Repeating key words is sometimes a useful way of prompting and avoids breaking into a train of thought. For example the response to “I find it all so frustrating… … “Frustrating”?” Where any uncertainty exists, check with individuals as to what they are really saying. It is all too easy to make inaccurate assumptions about what some one else is saying or feeling. Also if you try to work out the meaning of what someone has said whilst they continue talking you are likely to miss what they go on to say. Summarizing provides an opportunity for you to check that you have heard accurately what has been said. It also enables the individual speaking to see more of a total situation. Reflecting back to an individual what they are saying can provide helpful clarification for them. It also provides them with an opportunity to tell you if you are misunderstanding what they are saying. Noticing disparities between verbal and non-verbal messages. Before finishing a discussion on a topic, take time to check that everyone who wants to contribute has had the opportunity to do so. Conversely there are a number of behaviours, which will be unhelpful and counterproductive.
These include: Displaying boredom, impatience or hostility Being condescending or patronizing Devaluing, by minimizing, disbelieving or laughing inappropriately Prematurely drawing conclusions from a contribution Passing judgement 50
Overtly favouring one to two people Joining in with a group to scapegoat an individual Talking too much Distracting body gestures like fiddling with a pen or constantly looking at your watch Filling in a silence too quickly Interrupting Asking too many questions when someone is trying to think something out Insisting that your perceptions and beliefs are the correct and the only view.
Write on the blackboard and make Xerox copies and distribute at the end of workshop to all participants (Exercise 1).
CLOSED STYLES OF LISTENING The Know-It-All: These persons have all the “right” answers because they feel they know everything about the problem. They lecture, quote facts and figures, and often act superior to the person in need. They feel they have helped the person by giving information with the expectation that the person in need will use that information in order to solve their problem. The Judge: These listeners feel they are always right. No matter what the person in need feels might help the situation, the judge will decide if the solution is right according to his judgment. The judge is always interested in proving that he or she is right and others are likely to be wrong when they disagree. The Consoler: Consolers try to make things better through a sympathetic ear and lots of stroking. They often make light of problems that seem much more serious to the person in need. They often tell the person in need “Things will be all right. I’ll be there for you”.
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Commander in Chief: Persons who play the role of the commander in chief are interested in keeping things under control. They tell the person in trouble to “get rid of the bad feelings” and take control of their lives. They order, command, demand, or threaten the person in need, thinking that, through demand, the person they are helping will be forced to “feel better”.
The Moralist: The moralists find the solutions to problems via their own value system and life’s experience. “You should do this; you should do that” is a common line offered. They feel their ideas of what will work best should be the starting point for problem-solving, forgetting that the person in need might live in different circumstances with different pressures affecting their behaviour.
The Critic: Critics try to change behaviour through criticism, ridicule, cajoling and subtle comments with hidden agendas. Their method can be especially discouraging as the person in need is consistently “beaten down” with ridicule relative to their problem. The Psychologist: Psychologists try to analyze the problem, often with too little information and skills to make a difference. They quote “experts” and theory as a way to offer answers. They exasperate the person in need with too many questions as they try to find the “issue at hand.”
REFLECTIVE VOCABULARY (Exercise 2) “GOOD FEELINGS” Happy Encouraged Satisfied Proud Accepted Comfortable listened-to Grateful Thankful Liked Excited Interested Safe Wanted Great Loved Confident Able “BAD FEELINGS” Unloved Hated Hurt Dumb Disliked Unable Angry Sad Revengeful Helpless Guilty Embarrassed Frightened Bored Anxious Indifferent Upset Worried
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Write on the blackboard or display on a chart paper (Exercise 3)
STEPS OF REFLECTING LISTENING STEP 1 Let the person know you respect him/her by taking the time to set up a good listening situation with few distractions and enough time to listen effectively.
STEP 2 STEP 3
Concentrate on what is being said. Make eye contact. Try to listen more than respond. Listen and reflect the feelings behind the problem stated. “You sound frustrated because the husband keeps saying he will help, but never follows through”
STEP 4 STEP 5
Avoid the “closed responses” of the judge, Consoler, or KnowIt- All. Do not make every situation a problem-solving session. Often good reflective listening helps the person in need to solve the problem him/herself. Sometimes they will need to explore alternatives to solve the problem.
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FEED-BACK FORM Name: _____________________Age: ________ Sex: ______ Class: _________ School: _____________________________ 1. Name one thing you do that makes you a good listener.
2. Name one thing you will change to make yourself a better listener.
3. What is the most important thing you learnt today?
4. What did you like best about this workshop?
5. What is one thing in this workshop you would change?
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TOTAL TIME FOR THE WORKSHOP 3 hours (180 minutes)
INTRODUCTION AND BACKGROUND Depressive moments come in every one’s life and it depends on the capabilities of an individual that how he/she manages these moments. Slight tilt towards the other side can make one vulnerable to develop depressive disorders. Such moments may come more frequently in the life of adolescents as their coping abilities are highly variable and they are more likely to develop these disorders. And more importantly the adolescents may not be even aware that what depression means in their life. Adolescents are very sensitive to criticism and failure, and can feel sad for any adverse events. These reactive mood changes can be dealt by proper counseling by any person the adolescent loves and respects. This could be you, a teacher or the parents. Such cases do not need a referral to a psychiatrist.
Depressive illness The symptoms of depressive illness are much the same in adolescents as in adults - low mood, lack of pleasure in any activity, altered sleep and appetite, and depressive thoughts. Fleeting suicidal thoughts are quite common, but completed suicide is rare. 55
Suicidal Adolescent One of the most serious outcomes of depression is suicide. Suicide is the 3rd leading cause of death in youth ages 10 - 24 years. Majority of the children who attempt or contemplate suicide are likely to suffer from depression. Prompt identification and treatment of depression is important. Untreated depression may lead to failure to achieve full academic potential, disruption of key relationships within and outside the family, loss of self esteem, and self-harming behaviours which may include drug use, risk taking behaviours, and suicide. Media reports suggest that lot of young adults seem to use suicide (attempted / or completed) as an effect of their frustration and stress. An attempt is often seen as a cry for help, by the teenager who is feeling overwhelmed and incapable. Stressors sometimes are acute (sudden losses and unforeseen events e.g. - loss of a parent by death or accident) and sometimes chronic (long-term, ongoing issues for which no solution seems to be forthcoming). The first type of stressors takes the teenager unawares and he / she may find coping with the stress beyond his immediate resources. The second type gradually saps the energy and leads to growing feelings of helplessness, hopelessness and worthlessness. Nothing seems to work. Young people who have a very inhibited personality, are excessively shy, lack close friends, do not share problems, and tend to be lonely and are extremely sensitive are at a disadvantage. Due of lack of communication with same age group peers, they feel that it is only they who are going through the distressing experience, no one close has suffered similarly and ventilation and sharing which can reduce the depression is not available to them. 56
OBJECTIVES OF THE WORKSHOP Behavioural – Adolescents will Identify the losses they have faced and discuss them in the group. Discuss how they have gone through the loss cycle. Identify the stage(s) they might be in at present.
Cognitive – Adolescents will Understand the normal stages that the person undergoes during grief. Understand about why teenagers attempt suicide Identify factors that lead to depression
MATERIALS Chalkboard Copy of “The Loss Cycle” handout for each participant Copies of the feed back form
ACTIVITY AND DISCUSSION ROLE OF TRAINERS In this activity the trainers take the role of a teacher as well as a therapist, since this area is new for adolescents. Participants are encouraged throughout the workshop to participate and share their experiences of loss. The workshop helps participants to look at their experiences from a new perspective. It also helps them to recognize and understand their emotions when faced with losses. Ask each adolescent to think of a situation / episode when he or she felt very sad for a long period of time. These losses may have happened in the past or may be current. If the number of participants is large then ask them to discuss it within their group. Each group member shares one significant loss with the group (give 1 ½ hours for this discussion). The group leader (whoever is chosen by the group) then comes forward and describes what was shared
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in their group. When the group is small the facilitator can write responses on the board as each adolescent shares his memory. Common responses that generally come up include the following:
Losing property & possessions. Separation from parents. Losing friends due to death. A love relationship ends. A brother or sister leaves home.
Death of family members and relatives Shifting to new place / shelter. Meeting with an accident. Physical injury and disability. Failure in exams.
Define these events for the group as “losses”. Do not make one loss seem bigger than the other. Explain that depression is often the result of a loss. The facilitator moves from one group to the other and helps in the sharing process within the group. Draw the LOSS CYCLE MODEL (Kubler-Ross, 1969) on a chart paper using thick marker pen or on theblackboard. Explain to the group that life proceeds along, “Like this” (indicating the horizontal line). When a loss occurs (referring to the -mark), the lifeline is interrupted. The individual goes in a ) predictable cycle of reactions (point to the circle going downward from the). Recovering from a loss is painful business, however; the process changes a person, makes him or her stronger and more resilient (point to the line coming out of the circle higher than the line entering the circle to symbolize life on a “higher plane”). 58
The trainer can use the following questions for further sharing. Some of these questions are…
1.
What do you think is the first feeling after a loss? e.g., This is not happening to me, everything is fine (denial), shock
2. 3.
What happened when you were in shock and denial? Can you think of a time when you were ready to exchange everything to make things back to the way they were (Bartering)?
4.
What do you think happens when things cannot be the way they were? e.g., Anger, frustration, irritability?
5.
Whom were you most angry with and why? e.g., Teacher, parents, God, myself, authorities Keep the interaction going with all the group members. Encourage what ever personal disclosure come forth. Keep filling the responses in the various stages of the model. Explain the feeling of reaching the bottom where one feels hopelessness, helplessness, life is not worth living, despair, and depression. Mention that people do not just go stage by stage through this process, in a sequence. Mostly people swing between the stages. For example, it is common that a person may re experience denial again even when he is in the acceptance stage. The person might have been in the stage of acceptance and then find himself or herself thinking, “It just can’t be true”. Summarize the session with the key message that having gone through the loss can bring about a new understanding and positive characte strengths. Ask the group members to identify what strengths they have discovered in themselves after the loss. Encourage as many participants to contribute as possible. 59
Make Xerox copies and distribute to all participants at the end of the workshop.
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CONCLUSION AND MESSAGE After this discussion, it is helpful to explain how some cultures assist people through grieving. In Hinduism, the 13 days ritual, for example, allows mourners a “time out” from their usual lives in order to get through the business of grieving. Crying, weeping, wailing, pulling hair, and tearing clothing are all acceptable behaviours for mourners in some cultures. Unfortunately, boys are not given permission for such displays of emotionality. Instead, they are encouraged to “be strong” and to “stay in control”. This exercise allows exploration of depression in a new light. Presenting information in terms of losses helps all participants identify feelings of depression. Also, this exercise is important because it describes the usual reactions to loss. It may help young people normalize their own behaviour in reaction to loss.
HANDOUTS AND FEEDBACK FORM (Distribution and collection of the filled forms)
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FEED-BACK FORM Name:________________________Age: ________ Sex: __________
Class: _____ School: _______________________________ 1= Strongly Disagree
2 = Disagree
3 = No Opinion
4 =Agree 5 = Strongly Agree
(encircle the choice) 1. I liked the idea of discussing losses in this group. I learnt something about another group member too. I felt comfortable in this group. I shared something about myself in the group. I felt supported by the trainer. I am looking forward to the next group meeting.
1 1 1 1 1 1
2 2 2 2 2 2
3 3 3 3 3 3
4 4 4 4 4 4
5 5 5 5 5 5
2.
3. 4.
5. 6.
Next time when I’m feeling depressed this is what I would do?
Next time when I’m feeling depressed this is what I would not do?
Now I will think of losses as
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(IV) Learning to Cope with Anger
TOTAL TIME FOR THE WORKSHOP 2 hours (120 minutes)
INTRODUCTION AND BACKGROUND Some people explode when they are angry while others keep things inside and let their anger eat at them. Some people get boiling hot and some people get ice cold. From one extreme to the other, it is important for group members to look at themselves and recognize how they handle their anger. This activity helps the group members become aware of the choices that they make. This understanding moves everyone a step closer to making good, healthy choices. The connection between thoughts and actions is two way. Also feelings and actions affect each other. It is important to acknowledge, accept, manage and appropriately express feelings rather than being overwhelmed by their strength.
OBJECTIVES OF THE WORKSHOP Behavioural - Adolescents will Choose how they respond when they are angry Discuss their reactions to feeling angry Exchange ideas on what could be more constructive ways to deal with anger.
Cognitive—Adolescents will Understand their common pattern of response when faced with anger producing situations 63
Identify healthy and unhealthy reactions to anger Identify myths about anger
MATERIALS Copy of “When you are Angry you are most like. . . . ....” for the trainer (Exercise 1) Copies of “HANDLING ANGER” worksheet for each participant (Exercise 2) Pens or pencils, marker board or chalk Copies of the feed-back form.
ACTIVITY AND DISCUSSION ROLE OF TRAINERS
EXERCISE I This exercise is suitable for adolescents and children who may not be comfortable with writing Write “A” and “B” room. with chalk on the floor on the two opposite sides of the
The trainer reads from “When you are Angry you are most like. . . . .” and asks each participant to make their choice. Based on their choice they have to stand in either area “A” or area “B”. After each choice is read and participants make their choices, the trainer asks them to explain why they particularly chose what they chose. Then get the group back together and go on to the next set of choices. The trainer facilitates group discussion among the members using the discussion prompts given below. 64
DISCUSSION PROMPTS 1. 2. 3. Why did you pick your response? What are the benefits of being like a cat vs. a tiger? How does behaving like a lake feel?
When you are angry you are most like. . . (Exercise 1) A. A. A. A. A. A. Shaken soda Lake Hammer Swimmer Flute Tiger B. B. B. B. B. B. Nariyal pani Ocean Nail Hockey Player Trumpet Cat
Variation (Exercise 1) Mark four areas in the room for choices a, b, c, or d using chalk. Read the situations (found below) and ask participants to choose how they would react to the situation. After each choice is read and participants make their choices, the trainer asks them to explain why they particularly chose what they chose. Then get the group back together and go on to the next set of choices. The trainer facilitates group discussion among the members using the discus sion prompts given below.
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SITUATION CHOICES (Variation Exercise 1) 1. Your friend breaks your favorite pen. You... say (a) It’s Okay it was an accident (b) Yell at him/her and make sure s/he feels bad. (c) Break his/her pen. (d) Make him/her pay for it.
2. Your friend is supposed to be at your house at 7:00 and doesn’t show up until 8:00 and gives you no excuse. Inside you feel very upset and hurt. You... (a) Act like it doesn’t bother you and let it go. (b) Act like you just got ready and are also running late. (c) Tell your friend that you have to go to another friends house and cannot go with him. (d) Ask your friend to explain why s/he is late and then express your feelings.
3.
Someone that you know very well tells you that your face is really ugly and teases you about how fat you are. You... (a) Abuse him/her and make fun of him/her. (b) Ignore him/her and walk away. (c) Tell the person that the comment was rude, that you didn’t like it and that it hurt your feelings. (d) Hit the person in the face and tell him/her to “shut up”
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DISCUSSION PROMPTS 1. 2. Why did you pick your response? Do you think the other people in the group made correct choices? 3. Do you think that your choice is really the best choice?
EXERCISE 2 EXPLORING INDIVIDUAL COPING WITH ANGER Divide the children into groups through any suitable activity suggested earlier. There should not be more than 10 to 12 participants per group. Distribute the worksheet “Coping with Anger” to each person. Give 15 to 20 minutes for the participants to fill their sheets without discussion with other group members. Ask the group to choose a group representative. The group representative discusses the questions given in “Coping with Anger.” He summarizes the group opinions. After all the groups have finished each group representative is invited to come forward and present his group opinion. The trainer writes every technique (both healthy and unhealthy) of dealing with anger which emerges from all the groups, on the board.
Common responses which may come forth would include the following: Take revenge Shut myself in the room Shout Talk to a friend about it Ignore it Go out of the house Hit something (usually the wall) Throw things Run Do nothing o exercise Scream Hit someone (fight)
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The trainer discusses each response with the large group and gets opinions on whether the response is healthy or unhealthy. Ignoring, bottling up, or doing nothing is not too healthy nor is reacting in a way that is harmful to self or other.
CONCLUSION AND MESSAGE Conclude the session with “anger” as a natural feeling. Managing our emotions is a big part of growing up. Help the group name the “big six” emotions: 1. 2. 3. Mad Glad Sad 4. 5. 6. Scared Guilty Lonely
Repeat that emotions are neither good or bad. It is how we express them that makes it healthy or unhealthy. Ask the group to try something new and healthy the next time they feel angry.
HANDOUTS AND FEEDBACK FORM (Distribution and collection of the filled forms)
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Make Xerox copies and distribute to each participant for filling (Exercise 2).
1.
When I get angry I generally
2.
Do you think this behaviour helps you? Why/Why not?
3.
In your opinion which method of expressing anger is used commonly by people around you?
4.
Write a situation where you just could not control your anger?
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FEED-BACK FORM Name: _________________________Age: ________ Sex: _______ Class: _____ School: _____________________________ Very Much Some What Very Little
1. Did you find the workshop interesting Why / Why not? Please write in your reply:
5
4
3
2
1
2. Did you find the workshop informative? Why / Why not? Please write in your reply:
5
4
3
2
1
3. Which healthy practices of dealing with anger have you been using till now?
4. Which unhealthy practices of anger expression have you been using till now?
5. What were the commonalities among your group that you discovered during this workshop?
6. How can you help a friend who has anger control problem?
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