Now,I’m Stronger: FOCUSED ACTIVITIES for Children’s eMoTions (FACE) Facilitation Manual Now,I’m Stronger: FOCUSED ACTIVITIES for Children’s EMOTIONS (FACE) Facilitation Manual Table of Contents Part I - Introduction 6 INTRODUCTION 6 1. Context 6 2. Challenges and problematic encountered 8 3. From needs to interventions 10 4. Children targeted and objectives of the curriculum Part II - The role of the facilitator 13 THE RIGHT ATTITUDE AND DISTANCE 13 1. Understanding who you’re talking to 13 2. Finding the right distance 14 3. Children see, children do: be a role model 14 4. Professional growth 15 OBSERVATION AND IDENTIFICATION SKILLS 15 1. Why we observe: Importance of observation in order to adapt and respond 16 2. How we observe: effective listing, participant observation, intuitions 17 3. What we observe: Identification of psychosocial and psychological distress 18 4. What to do with our observations: connect, share, respond 23 CREATING A FRAMEWORK 23 1. Ethical considerations and code of conduct 24 2. Working procedures and institutional frame 25 3. Type of environment we can or should provide 26 THE ROLE OF FACILITATORS IN HANDLING EMOTIONS 26 1. What is a difficult child and how some naturally tend to respond 27 2. Functions of moods, behaviors and emotions exhibited by children 27 3. Role of adults and caregivers in handling emotions 29 4. Teaching Mindfulness 32 5. Teaching positive resonance and positive affirmations 35 6. Involving parents 36 7. Providing psycho-education Part III - Guideline for difficult cases 42 EFFECTS OF EXTREME ADVERSITY AND RESILIENCE 42 1. About trauma and its consequences 43 2. How does our body respond to stress, cumulative stress and trauma? 44 3. Resilience, risk and protective factors 49 HANDLING STRESS AND ANXIETY 49 1. Understanding stress mechanisms and anxiety 49 2. How to detect and identify anxiety? 52 3. Behaviors that are signs of anxiety 56 4. Handling stress and anxiety: stress management techniques and relaxation 62 HANDLING ANGER AND AGGRESSIVENESS 62 1. Understanding the roots and functions of anger and aggressiveness 64 2. Identifying aggressiveness and evaluating risks 65 3. Handling anger and aggressiveness 73 IDENTIFYING AND DEALING WITH OTHER FORMS OF DISTRESS 73 1. Depression and depressive affects 74 2. Dealing with depressive affects 75 3. Cognitive and learning difficulties Part IV - Implementation guide 78 BEFORE GETTING INTO THE FIELD WORK 78 1. Review and understand the curriculum 79 2. Structuration of the sessions 79 3. Selecting, training and working with volunteers 80 4. Size of the group and group dynamic 81 5. Material and preparation of the sessions 82 RECRUITING HARD-TO-REACH CHILDREN AND PROVIDING A SAFE SPACE 82 1. Identifying and recruiting hard-to-reach children 83 2. Creating a safe space to conduct sessions wherever you are 84 FACILITATING SESSIONS 84 1. Running sessions 86 2. Facilitation tips 87 MONITORING AND EVALUATION TOOLKIT 87 1. What is monitoring and evaluation? 87 2. Difficulty of measuring psychosocial well-being 89 3. Qualitative data collection 93 4. Referral pathway 95 TAKING CARE OF YOURSELF: HEAL THE HEALER Acknowledgements The IRC would like to acknowledge the participation in the review and completion of this facilitation manual. Particular thanks go to Lauriane Pfeffer, Clinical psychologist/ MHPSS consultant (www.psyonthemove.com) for the development of the facilitation guide and complementary group sessions. Additional thanks to Sara Mabger and Ashley Nemiro, International Rescue Committee, for their technical expert reviews of this facilitation guide as well as the complementary session guide. We would also like to thank the IRC Lebanon Field Teams for their contextual knowledge and input into these materials. This curriculum was developed as a result of challenges faced by child protection staff working with street connected children who required additional support and whose needs were not met by other Child Protection psychosocial interventions. The child protection team began a long process of collecting feedback on activities that working children responded positively to, and expressed interest in, as well as their lessons learnt from working extensively with this very vulnerable group. This curriculum would not have been possible to develop without the extensive inputs and consultations with child protection teams determined to provide specialized support to children involved in the worst forms of child labour across the country. This curriculum was developed with the acknowledgement that after attending IRC activities, many of these children return to the street, mechanics shops, construction sites to continue working and continue to be at risk. It is therefore crucial that staff implementing this curriculum are adequately trained by a mental health or specialized child protection staff, and receive consistent clinical supervision both during sessions and after sessions. Written by: Laurianne Pfeffer Technical review, inputs and re-structuring: Ashley Nemiro Contributions by: IRC Lebanon Child Protection staff Oversight & Review: Child protection Coordinator Sara Mabger, Child protection Manager Sara Sannouh, Street and Working Children Deputy Manager Riwa Maktabi. Based on the experience and inputs by dedicated IRC Child Protection staff: Serene Ghazal, Nour Haddad, Amer Alwany, Ayman Nehme, Roy Hage Boutros, Meray Abou Khzam, Cynthia Sleiman, Farah Omari, Maher Ismail, Ibrahiem Salloum, Lama Houjeiry, and Genevieve Youssef. Part I INTRODUCTION Now, I’m Stronger: Focused Activities for Children’s Emotions (FACE) Facilitation Manual INTRODUCTION 1. Context 6 years of conflict in Syria have created one of the biggest humanitarian catastrophes since World War two: hundreds of thousands of civilians’ deaths1, millions displaced inside or outside the country, massive destruction of infrastructures, shattered political system. Besides the children and their families trapped inside Syria2, another 4.9 million people (including 2.3 million children) fled to neighboring countries such as Turkey, Lebanon, Jordan and Iraq. IRC has been working in Lebanon since 2012 in response to the Syrian crisis. Lebanon welcomes over 1 million Syrian refugees, which is approximately 25% of the total population of the country. With no formal refugee camps in Lebanon, Syrians are living in cramped apartments, unfinished buildings and tents. Currently, humanitarian services are unable to keep up with needs as refugees deplete their resources. Seven out of 10 Syrian refugees in Lebanon live in extreme poverty. Meanwhile, host communities, many of them already poor; have seen living conditions deteriorate in their neighborhoods. 2. Consequences on children: challenges and problematic encountered Most of Syrian children today have experienced extreme adversity, either while being in Syria, in exile or in their new host countries. A report from Save the Children released in March 20173 highlights the numerous stressors that those children have faced in the past years and their consequences on their well-being and development. The statistics are terrifying and raises serious concerns for the future of these people and the adults that they are to become. Psychological consequences of extreme adversity It goes without saying that children who witnessed directly bombings and horrors of war4, loss of relatives5 and displacement, suffer from a huge psychological distress. 45% of children show symptoms of post- traumatic stress disorders (PTSD) - ten times the prevalence worldwide- such as serious sleeping disorders (nightmare, bedwetting, fear of not waking up), hyper vigilance and hyper arousal, and mild to severe anxiety. 44% exhibit symptoms of depression. But life in exile, even if those children are not under direct life threats, is also tremendously challenging and affects both emotions and behaviors. In host countries where they don’t necessarily feel welcomed, facing precariousness, children have to adapt and develop negative coping mechanisms. Among those, aggressive behaviors or trivialized violence are very common, as a response to a chaotic world where notions of good and bad disappeared. 1. An estimation of 470.000 deaths according to Syrian Center for Policy research (2016, Confronting fragmentation). Though the UN stopped counting early 2014, when the death toll officially reached 250.000. 2. 13.5 million Syrians remain inside the country, including 5.8 million children (4.9 million still in besieged areas), according to OCHA, Syria Crisis Overview (16 February 2017) 3. The Invisible wounds, Save the Children (March 2017) 4. Almost all children and 84% of adults refer to it as the main cause of high stress level, according to Save the Children. 5. 2 children out of 3 suffered from direct loss of relatives in their families. 6 PART I - INTRODUCTION Damages on social and family fabric While facing adversity, it is now recognized that family and community structure are the number one factor of resilience for children. In the Syrian crisis context, we are talking about million people displaced and shattered communities. Relocating in a different country presents many cultural and identity challenges that can no longer be absorbed by the social fabric. Consequences such as difficulty in social integration (daily exposure to humiliation and rejection, inter-community tensions), domestic violence, increasing of early marriage (as an unrealistic attempt to offer a safe and stable environment for girls) and diminished parenting skills6 are then