Tuesday, June 7, 2011

Contextually appropriate psychosocial support

Joseph O. Prewitt Diaz[1], PhD

A couple of months ago SPHERE 2011 was unveiled in several capitals around the world. This document provides the understanding of the humanitarian field about the standards to use to assure the “Do no harm” maxim. This event signaled a quantum leap in humanitarian assistance. It recognized that humanitarian assistance had two significant parts: (1) assistance and (2) protection. The importance of psychosocial support was recognized in the document as an important tool that will assure protection through (1) contextual sensitivity, (2) culturally appropriate techniques, (3) the strengths of local networks, and (4) focus on emerging victorious.

Contextual sensitivity. Bolton and Tang (2002) were trying to understand how a village fostered mental health support using qualitative research tools. They decided that the best way to gather their data was to sue the community members as key informants. A by-product of the study was a model on problem identification, symptoms, solutions and monitoring of the work being conducted. Sharing this work with some colleagues, the issue of time in developing a project arose. We know from successful models after disasters that the time it takes to identify the needs, prioritization, and project development are psychosocial support tools in themselves. They strengthen the capacity of the community to trust each other, identify social capital, and enhance their solution focused capacitates.

Culturally appropriate techniques. These have a great value in helping the outsiders understand what works and how it works within the local norms, culture, and spirituality.  While we are trying to comply with donor intent and requirements, we must recognize that we are outsiders in the disaster setting and must rely on development of trust, a two-way communication system, and a desire to truly belong to the community you are trying to help.

Strength of local networks. I reached Banda Aceh with a contingent of mental health workers. I went to the local Red Cross and asked where were the local personnel. The man looked at me with puffed eyes “they are no more”. It took a year to get a new group on-line, community and school groups functioning in their respective settings. It was hard to explain to my “higher ups” why it was taking so long. The correct answer was that the local community would take as much time as needed to develop the necessary networks, to get a semblance of what was, before they were comfortable accepting assistance from the outside.

Focus on emerging victorious. I am vehemently opposed to the use of standardized testing to measure the effects of psychosocial support programs. Without taking much time: “it is simply wrong”. The basic problem is the reliance on a deficit model. Most of the people have a “problem” generated or exacerbated by the disaster. The focus on providing psychosocial support to affected-people is to help them recognize their resilience, feel victorious and achieve well-being. Most communities want to return to “place”. It seems that in assessing risks and resilience factors, people gain a self-respect, capacity for problem solving, and the capabilities to use local skills to achieve solution focused activities. At the end of the day, the disaster affected people need to feel victorious.

[1] Dr. Prewitt Diaz is Visiting Professor of the School of Law and Director of the Disaster Law and Policy Center, University of Puerto Rico. He was awarded the 2008 APA International Humanitarian Award. 

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