Community-based psychological trauma education and treatment project in Nepal

As part of its mission, the NICTT has worked in developing world contexts, particularly where there has been civil conflict, aiming to share its learning and skills with other practitioners and communities.  NICTT staff have worked in Sarajevo, Bosnia and in Sri Lanka.  This work has had a direct impact on the Centre’s training and treatment approaches. In 2006 the Centre was approached by Development Media Workshop with its partner Leprosy Mission Ireland to work in developing a psychosocial training programme in Nepal funded through Irish Aid.

Many Nepalese have experienced traumatic events, especially between 1995 and 2005.  The civil unrest between Maoist, Government and Monarchy forces has had a significant impact on the psychological well being of communities.  Amnesty International documented war atrocities perpetrated by soldiers from all sides of the conflict. Community elders and rural school teaches were targeted, and often brutally killed in front of pupils.  Children were conscripted as ‘runners’ to send messages between soldiers.  Opposing forces captured children and tortured them in the hope of gaining information.  The civil conflict left many children orphaned.

The partner organisation for the trauma education and treatment programme is a community based registered Non-Governmental Organisation based in Pokara, Western Nepal called Kopila Nepal. The group works with marginalised and disadvantaged children, and recognising the severe psycho-social impact of the conflict, Kopila Nepal actively sought strategic partners such as NICTT and Development Media Workshop to make a response to these needs.

Kopila Nepal’s Team Leader training in Northern Ireland

In February to June 2007, Kopila Nepal’s team leader came to Omagh for her placement with NICTT during which time she completed the NICTT’s’ Certificate Course in Cognitive Therapy Methods.  She made several visits to other Centres and services dealing with the consequences of the civil conflict in Northern Ireland.

The Certificate course was developed by NICTT to enhance the practice of mental health and other practitioners, by equipping them with knowledge of, and skills in cognitive therapy principles and methods.  It was not intended to qualify students as cognitive therapists, but to enhance their existing practice and psychological literacy

As the team leader subsequently developed the counselling and referral programme back in Nepal, she was provided with support and supervision of her practice d by senior training staff from the NICTT via telephone and email.

This was considered to be important in that students completing the Certificate course are expected to meet with problems and difficulties which, they will need support with, as part of ongoing learning and skills development.

Supervision

Supervision itself is recognised and acknowledged by many professional therapeutic bodies as ethically imperative to the therapeutic process. The supervisor was fully informed of the case load and details of cases were discussed in the meetings.  The purpose of the supervision was to assist and guide the team leader in her work with clients giving suggestions and information that would help the provision of the service. 

Support and encouragement from the supervisor helped the team leader personally and professionally.  She reported that the supervision time was ‘inspiring, encouraging and confidence building’ and helped her prepare and grow in her role as a counsellor as the supervisor and her worked together to build this relationship.  The pilot counselling programme indicates that those aspects of the NICTT approach applied in the Nepali context are effective in community based psychosocial well-being projects.

Evaluation

The project evaluation indicated that:

• The evidence based approach and methods from the NICTT model can be transferred and faithfully applied by trained and supported personnel in the Nepali context.

• Clients who were referred to the pilot counselling programme benefited from the approach developed and the counselling methods used.

• The methods used in this project can be applied to a number of psychosocial issues and psychological trauma other that those associated with conflict.

• Traditional healers were receptive to learning new knowledge about psychosocial well-being and based on this knowledge were able to make appropriate referrals to health services.