Case Study 5: Psychosocial intervention for children in emergency situation

Assessment of the situation

When first assessing the psychosocial needs of children in conflict affected areas or crisis areas one should consider the existence of several different levels of intervention. At the Individual level one should assess the following elements:

· The child’s preexisting coping strategies
· Pre-existing biological or mental health issues
· The nature of the traumatic event that affected the child
· The presence or absence of aggravating factors such as physical pain or separation

A similar assessment should then be carried out at the mezzo or community level. Elements to consider include

· Economic and education attainments of the family
· Social fabric of the community. Is the community in conflict or unified?
· Presence or absence of other NGOs
· Availability and quality of health and education services in the community
· Security situation of the community and extent of security and safety mechanisms in place
· Status of food/water/shelter situation & provision of basic needs
· Infrastructure/community buildings that can be used for the program.

Finally the assessment will also need to take into account the broader national context and look at the macro factors that might affect and help shape the program design including:

· The nature of the cultural and religious practices (which may be adaptive or maladaptive)
· General perception of mental health interventions and attitude towards international organizations
· Functionality level of the state.

To collect this information several strategies can be used. For example the assessment team should meet with local organizations or institutions that are already familiar with child protection issues in the area and might be able to provide insights on what has proved effective before and what is culturally acceptable. Interviews with local government officials are also important in order to collect information but also create a sense of national ownership and inclusiveness. At the community level the assessment teams should carry out focus group interviews and participatory activities with both the adults and youth. Finally, direct observation should also be used to inform the final design of the project.

In order to mitigate the risk of cultural bias it is important that the assessment activities be carried out with the help of local staff that speak the language and have an understanding of the cultural practices that characterize the community. It is also good practice to ensure that all questionnaires are translated and translated back into the initial language to ensure the questions asked are indeed those initially intended. When conducting the interviews one must ensure that the interviewer uses a resilience-based approach and does not only focus on what is not working. Also ensure that participants have sufficient freedom to bring up new ideas and highlight their main concerns regardless of their nature (food, shelter, water) and are not forced to discuss the problems that the interviewer wants to address. Finally ensure that the people interviewed are representative of the community. Do not only focus on one or two groups of individuals but rather ensure that sufficient time is allocated to discuss the issue with people that might initially be less obvious interviewees or people that might often be absent from the community, for example, those that might commute between a nearby city where they spend the night due to security reasons and the community.