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Abstract
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Providers of psychosocial support (PSS) for children in humanitarian settings have been accused of doing harm when interventions are offered that ignore the culturally and contextually-specific needs of populations under stress (see, for example, Bellido, Bernal, & Bonilla, 1995; Bernal, Trimble, Burlew, & Leong, 2003). Though programming may be offered with the best of intentions, there is potential for unintended negative impacts when interventions are imported into settings different from those where they were developed. One reason this occurs may be manualization. Though manualization may increase fidelity, programs for children may lose their relevance and decrease their efficacy when standardized (Hatzichristou, Lampropoulou, & Lykitsakou, 2006).
Despite efforts to decolonize knowledge and privilege marginalized perspectives on mental health, much of PSS in humanitarian settings continues to be done by outside experts who import evidence-based practices into contexts under severe stress. Wessells (2009) coined the term "parachuting" to indicate the arrival of Western doctorate-level psychologists trained in North American and European universities who lack knowledge about the culture, socio-historic context, or current situation of the young people they are trying to help. In particular, an emphasis on individualized solutions to complex social and environmental problems, incongruity between proposed solutions and local cultural norms, the excessive focus on deficits such as mental health issues and victimhood rather than collective resilience, power abuses such as the imposition of outsider approaches to intervention and evaluation, and the provision of inadequate training and supervision for staff have all been shown to contribute to the unintended harm of child populations requiring humanitarian assistance (Bonanno, 2004; Boothby, Crawford, & Halperin, 2006; Masten & Obradović, 2007; Masten, 2001; Wessells, 2006). Therefore, when designing treatment, prevention, and mental health services in humanitarian settings, cultural and social processes must be considered (Bernal & Sharron-Del-Rio, 2001; Gladstone et al., 2010; Raman et al., 2017). Despite this need, developing evidence-based, culturally sensitive interventions remains a challenge as there are very few orienting frameworks for PSS program developers who would like to tailor treatment or preventive interventions to work with specific child populations from different cultures (Bernal. & Sáez-Santiago, 2006; Ungar, 2018).
In this paper, we review different ways of designing and delivering psychosocial support (PSS) programs for children in humanitarian settings, describing a range of approaches that increase sensitivity to the cultural and contextual differences of program participants. In particular, we identify and address the barriers to the implementation of manualized programming in emergency settings and propose principle-driven design as a more culturally sensitive alternative.
To illustrate the application of a principle-driven approach to practice, we present a case study of the Tutor of Resilience (TOR) program (Giordano & Ferrari, 2018; Giordano, Ragnoli, Brajda, et al., 2019). TOR is a transnational model that provides social workers, educators, psychologists and other helping professionals with resilience-focused practical tools and general guidelines for developing and planning psychosocial interventions with children who have been victims of violence and other traumatic experiences. TOR is built on the premise that resilience is a process that helps individuduals navigate and negotiate for resources across social and physical ecologies through interpersonal relationships that increase access to psychosocial supports (Giordano, Caravita, & Jefferies, 2020; Hobfoll & De Jong, 2014; Ungar, 2011). TOR-trained facilitators work with service providers to protect vulnerable children against risk and promote positive development by flexibly delivering content that builds children's well-being...
Language: en |