Five key principles in promoting resilience Barbara Juen University of Innsbruck, Austrian Red Cross Johann Thoroddsen Icelandic Red Cross Annual ENPS Forum 2011 In doing Psychosocial Support We address both the psychological and social needs We aim at enhancing the resilience of the affected individual, group and community 2 1
Overall Europe we work with very different target groups Cancer patients Patients with chronic illness Disaster affected persons and groups/communities Elderly Caregives/relatives Asylum seekers/refugees People with socioeconomic problems Psychiatric In-patients Rape and assault survivors Clients with depression, alcohol problems Clients with HIV/Aids Dying people 3 Defining the terms Coping is about what the individual or community does in order to come to terms with an adverse situation or event Adaptation is the process of getting back a balance between the individual/community and his/her/it s environment - It includes two processes, we have to change ourselves and we have to change the environment or our view on the environment 4 2
Resilience as a capacity Resilience is generally defined as the capacity of an individual or group to bounce back to normality after adverse events (Bonanno, Galea et al, 2006, Paton, 2000; Gow & Paton, 2008) 5 Resilience as a social process According to Paton (2000, 2001b) resilience means the ability of communities to make use of internal personal and social resources and competencies to positively manage the challenges and changes that accompany adversities (Paton and Bishop 1996; Paton 2000). 6 3
Elements of Resilience I am I can I have Resilience Therefore we define resilience as the ability of an individual or community to make use of their resources in order to adapt to adverse situations/events - Sometimes resources are not there any more, access to resources may be blocked, resources cannot be identified or people may not have the capacity to use them 8 4
Resilience In our approach we have to be the facilitators of resilience and try to help people identify their resources, get access to their resources, rebuild their resources and be able to make use of them again 9 Main messages about resilience We do not create Resilience we just provide the framework for it Resilience is already out there, we just have to identify it and help people to make use of it Resilience is about giving back resources that have been lost and about helping to rebuild and make use of resources In order to promote it we may use the key principles identified by Hobfoll and colleagues 10 5
Five interlinked key elements to promote resilience after adverse events - A sense of safety - Connectedness - Self and community efficacy - Calm - Hope (Hobfoll et al 2007) 11 Safety To provide safe places, to re-establish the protective shield, reduce diseases, reunify the affected people with families and friends and protect from violence etc. (van Ommeren et al., 2005) 12 6
Protecting children s best interest COMMUNITY-BASED PSYCHOSOCIAL SUPPORT MODULE 6 General child protection measures Specific action if child abuse is suspected 13 Did you provide a safe place for people during the financial crisis in Iceland? Example Icelandic RC after financial crisis The IRC headquarter opened a service centre Individuals and families could seek support and counselling A playground for the children The service in the Red Cross House was available for everyone 14 7
Safety To provide accurate information: People need information after disasters e.g. about friends and relatives, after a bad diagnosis about the illness and its course etc. but also protection from bad rumours and from too much confrontation as well as information about coping and how to proceed (Hobfoll et al., 2007; Rao, 2006) To normalize everyday life through establishment of normal social activities, use of rituals (Mollica et al., 2004) 15 What kind of information was important for people to regain a sense of safety? Information on: - reaction - stress reduction methods, - support, recreation, activities - children - crisis 16 8
Connectedness To re-establish connections as quickly as possible after trauma and crisis To maintain connections (Litz & Gray, 2002; Shalev et al., 2004; Ursano et al., 1995; Hagan, 2005; Hobfoll et al. 2007). To be aware of social support loss cycles after trauma as well as negative social support (minimizing problems or needs, unrealistic expectations regarding recovery, invalidating messages etc.) (Andrews et al., 2003; Hobfoll & London, 1986) 17 Connectedness To provide group interventions, teaching forms of social support, identifying resources of such support and teaching how to appropriately recruit support (Layne et al., 2001) To include people without families into social networks (home visits, telephone support,.) To help people share their experiences and enhance group cohesion (e.g. by establishing self help groups) 18 9
How did you promote connectedness? Example Icelandic RC after financial crisis The Red Cross house was a venue for diverse social activities - Meeting place for people in the same situation - Different kind of groups 19 Self and collective efficacy - To involve the affected population into the planning and implementation of your programmes/projects - To make use of local healers, collective rituals - To rebuild resources together with the affected and restore of school community and other relevant community resources 20 10
Self and collective efficacy To promote self-sufficiency and self-government, teach emotion regulation and problem solving skills, e.g. by establishing peer support To provide opportunities for participation of children and other vulnerable groups e.g. age appropriate mourning rituals and involving them in pro-social activities (Saltzman et al., 2006) 21 Self and collective efficacy To encourage people to engage in tangible, purposeful activities of common interest To help people to take informed decisions for themselves To help to cope but not to cope for them 22 11
How a little cash and coffee affected psychosocial well-being COMMUNITY-BASED PSYCHOSOCIAL SUPPORT MODULE 4 A small coffee shop set up by an Indonesian couple in a camp after the tsunami positively affected psychosocial well-being 23 COMMUNITY-BASED PSYCHOSOCIAL SUPPORT MODULE 2 What is assisted coping? The goal is not to cope for others, but to provide the minimal necessary assistance to help them begin actively coping in their own best interest. 24 12
How did you promote self and collective efficacy? Example Icelandic RC after financial crisis Activate people in different kind of activities 25 Calm To normalize stress reactions To induce positive emotions and encourage people to increase activities that foster positive emotions To help people to break down problems into small manageable tasks To give input on how to calm down like sleep hygiene, guidelines for media exposure, relaxation training and anxiety management techniques 26 13
COMMUNITY-BASED PSYCHOSOCIAL SUPPORT MODULE 6 Induce positive emotions 27 How did you help people to calm down? Example Icelandic RC after financial crisis Information - Situation - Own reaction Relaxation technique 28 14
Hope To develop advocacy programs for the affected To focus on community and group interventions that help to develop positive goals and strengths that the affected have as individuals and as a community (see also Schreiber, 2004) 29 Hope To provide services to people that help them get their lives back in place - E.g. after a disaster in terms of housing, employment etc. The employment status has shown to be the best predictor of hope (Crowson et al., 2001) 30 15
How did you help people to get their lives back? Example Icelandic RC after financial crisis Activeting people - f.ex by becomming Red Cross volunteers, - mentors for jobseekers that had not been active and had become isolated - Think tank grassroot group of jobseekers with base in the Red Cross house - Interviews with psychologists 31 Thank you for your attention Picture from IFRC Reference Centre Community based Psychosocial support Manual 32 16