psychological first aid training manual for schools · 4 psychological first aid training manual...

PSYCHOLOGICAL FIRST AID TRAINING MANUAL FOR SCHOOLS 1

REPUBLIC OF LIBERIA

MIN

IS

TRY OF EDUCATION

THE PEOPLE WILL FIND THE W

AY

SHOW T H E LIGHT

PSYCHOLOGICAL FIRST AID TRAINING

MANUAL FOR SCHOOLS

Psychological First Aid for

Schools

AcknowledgementsThis project is a joint effort of many actors in the psychosocial field in Liberia and abroad.

The Government of Liberia, Ministry of Education (MoE) is grateful to USAID for financial support to develop this manual. The MoE wishes to acknowledge those who assisted in its development, including staff from the Ministry of Gender, Children, and Social Protection (MoGCSP), UNICEF, WHO, IOM, Action Contre le Faim, Child Fund, Carter Center, Concern, International Rescue Committee, Liberia Association of Psychosocial Services, Save the Children, SGI, and key members of the PSS Pillar and the Child Protection Sub-Cluster of the Ebola Response. This manual recognizes and cites learning from other sources as well:

Accepting and Supporting Ebola Survivors, Orphans, and Families of Ebola Patients in the Community: a Toolkit for Social Mobilisers and Communicators. Women’s Campaign International: Liberia.

Basic Psychosocial Support (PSS) in Education: A workshop manual for teachers and other stakeholders. Ministry of Education, Science and Technology: Sierra Leone

Guide to Basic Relaxation. Enabling Access to Mental Health: Sierra Leone.

Psychological first aid: guide for field workers. WHO: Geneva.

Psychological first aid workshop manual for child practitioners. Save the Children: UK.

Resilience and Empowerment Training and Workshop: IsraAid Manual for Trainees. IsraAid.


Objectives• To introduce participants to each other and to the content of today’s training• To understand from the group what questions/topics they hope will be addressed in the training (which should, wherever relevant or feasible, be covered during the training)

Materials Needed• Pre-Post Test• Flip Chart and Marker

Opening [40 min]

Prayer

IntroductionFacilitator introduces him/herself and explains the next two days are for the group to discuss and learn how to help themselves and the children in their classrooms when going through crisis. Something that we know is that play is an important part of childhood, and is a useful tool to help children cope. Therefore, as much as possible, we’ll be playing throughout this workshop. So to start- let us play a game while we introduce ourselves.

Game: Adjective IntroductionsFacilitator asks the group to think of a name they would like to use to describe themselves that starts with the first letter of their own name. In order to prompt the group- ask everyone to think first of their own name- now the starting letter- now find another word with that letter that you want to describe yourself with.

For example- Hawa, starting with H, could use words like: Helpful, Humble, Humorous, Hero. As each person chooses an adjective to go with their name, they should also choose an action to describe it. Once all have individually chosen, the group introduces themselves one by one using both names and action. For example, Hawa introduces herself with: Hi, my name is Helpful Hawa (and she opens her hands to the group as her action). The group should respond by repeating in unison her names and action.

• Opening• Session 1: Setting the Stage• Session 2: PFA• Session 3: Child Reactions to Crisis • Session 4: Relaxation Techniques

• Opening• Session 5: Communicating with Children• Session 6: Pointing Fingers/Stigma• Session 7: Linking to services • Session 8: Practical Activities for the Classroom• Closing

Day 1 Day 2

Agenda

Pre-testFacilitator shares the pre-test for participants to complete, explaining it is an anonymous exercise.

Day 1

PSYCHOLOGICAL FIRST AID TRAINING MANUAL FOR SCHOOLS2

Objectives of the WorkshopFacilitator introduces the objectives to the group

• Teachers be able to recognize child responses to crisis • Teachers equipped to address children reacting to crisis in the immediate moment • Teachers know referral sources to link children who have psychosocial needs • Teachers have self-care and classroom PSS strategies that help to reduce the impact of stress on all

Expectations of the groupDiscuss with the group what they would expect of each other and the trainer in the organization and management and content of the two day workshop.

Ask the group if they have any pressing questions they hope will be addressed in the training. Write these questions on a flip chart paper and hang on the wall for easy reference throughout the training.

Session 1: Setting the Stage [50 min]Objectives• Recognize the impact of EVD on the community and on children specifically- to demonstrate the need for PFA• Practice some self-care activities that will be useful in the session, and afterwards

Materials• Flip Chart and markers

Discussion with the GroupFacilitator should be aware these questions could bring up sensitive stories, and bring out emotional responses in persons. The facilitator should act with empathy and if a participant becomes too emotional- allow the person to speak till they feel heard, but also, support them by recognizing their pain and allowing time to step away from the workshop or time for silence if needed.

Self-Care StrategiesSelf-care strategies are practices a person uses to cope with distress and the negative impacts of stress. Before we get into the workshop, we want to talk about what the impact of stress is on the body, and the practical steps people take to care for themselves. This is important because today we may discuss potentially emotional topics, for which we will want to have good coping for

Defining StressFacilitator asks the group how they describe or define stress? Participants may define it as the feelings they get when they are going through a difficult time, or the energy that comes before a deadline.

Stress- is it good or bad? Facilitator asks the group is stress is good or bad?

What has been the negative impact of Ebola on communities and families?What has been the positive impact of Ebola on communities and families?How has Ebola specifically impacted children?

Facilitator writes the following questions on flipchart and asks the group:


Participants are asked to point out how stress impacts the various parts of the body. For example: • Head (lack of comprehension, headaches, lack of concentration or, when one’s mind cannot stay on one topic for too long)• Face (speech, perspective, ringing in ears, hunger/lack of appetite, short breathes)• Chest (chest pain, anxiety, rash, heart beating fast)• Stomach (emotions-fear, anxiety, depression, loneliness, anger, feeling butterflies, diarrhea, stomach pain)• Arms (weakness, aggressiveness, busyness, hands shaking)• Legs (weakness, restlessness, sleeplessness)• Whole body: (fatigue, withdrawn, feeling ill/fever/aches)

Facilitator asks a volunteer to draw a person on the flip chart.

Stress can have positive and negative impacts on a person. For example, the stress a person feels before an exam can give the person energy to stay awake to study the night before the exam. The stress a person feels if they are crossing the road and a car is coming towards them can cause a rush of adrenaline that will allow the person to jump from the road. Negatively, the stress a person may feel over money problems in the family can cause reactions such as fear, anger, or withdrawn behaviour.

Stress can show itself in many ways

Session 2: Psychological First Aid, the Basics [1hr 30min]Objectives• To learn how participants are responding presently to distressed children (empowering to keep doing positive behaviors)• To learn what the term PFA means, and define it for the local context• To learn who can do PFA• To understand the basics of PFA

Materials Needed:• Flipchart and markers• Psychological First Aid: What is it? Handout

What practical steps do you do to take care of yourself? How do you take care of your families and children?What should we do today if we find that someone is feeling distressed or sad?

The facilitator should guide this discussion so that the group agrees on how they want to support each other in the event someone is having an emotional reaction during the workshop.

Practical ActivityHave the group practice one of the strategies they have mentioned above. Ensure everyone feels comfortable to try it and that it is a safe activity.

Self-Care



Role Play OpeningThis activity is to understand from the trainees the way that they already approach and respond to children in distress. This serves as an introduction to the look, listen, and link principles of PFA.

Trainees select a few volunteers to role play a scenario in which there is a distressed or sad child in their classroom or community. They should role play how they would normally respond to such a child, demonstrating the way they would approach the child and how they would speak to the child.

Introduction to Psychological First AidExplain to the group that helping a child get access to the support needed when in distress could be called Psychological First Aid (PFA). Ask the group the following questions to set up the introduction to PFA.

Facilitator to the group: Psychological First Aid is like medical first aid, only it is for the psychosocial aspects of a person. Thinking about first aid for the physical body, what do you think psychological first aid is for a person? Use the Psychological First Aid: What is it? Handout to talk about what PFA is, and what it is not. Ensure that they know that PFA is not counselling, it is something to link people to what they need, and it can be done by teachers and community members.

Energizer Activity1

Facilitator introduces the basics of PFA: Look, Listen and Link. Write the three terms on the flipchart and ask the group:

Discussion Facilitator guides the discussion to help participants think about what are the best ways to approach and communicate with a child who is upset, distressed or sad. This discussion should include which approaches the group feels are not helpful or potentially harmful to the child.

Facilitator draws a line down the middle of a flipchart and writes on one side: ‘helps the child’ and on the other ‘doesn’t help’.

What did the caregiver do well when addressing the distressed child? What are things we do that help children when sad or distressed?

What are ways that you can help your students when they are distressed? How do teachers support each other?

For children who are in distress or sad, what are the ways we should not ap-proach? What are ways that will not be helpful?

What is medical first aid used for?What do you think psychosocial means?What are a person’s psychosocial needs?



1 Basic Psychosocial Support (PSS) in Education: A workshop manual for teachers and other stakeholders. Ministry of Education, Science and Technology, Sierra Leone


• Check for safety

• Look for children with obvious urgent basic needs

• Look for children and care- givers with serious distress reactions

• Approach children and care-givers who may need support

• Ask about children and care-givers’ needs and con cerns

• Listen to children and their care-givers and help them feel calm

• Help children and their families to address basic needs and access services

• Help children and their families cope with problems

• Provide information

• Connect children and their families with each other and with social support

Look Listen Link

Look Listen Link

Ask the group to identify an action they want to symbolize each word. The group can practice together the looking, listening, and linking.An example

• To “look”, place your hand to your forehead and pretend to be ‘looking’ out; to “listen”, place your hand at the back of your ear and push that side of your head forward slightly; to “link”, place your hands together in front of you. These images may help:

What is confidentiality?How does one practice confidentiality?To whom should one tell the story of a distressed child in need?Why does confidentiality even matter?


Repeat the chosen actions for Look, Listen, and Link at least 3 times with the group, then ‘mix them up’. E.g. call out “Listen” and ask them to do the right action, then call out “Look”, “Link” “Look”, “Listen”, “Look”, “Link”, and so forth. Do this a few times throughout the training to reinforce the three terms.

Confidentiality

Considering what we’ve now defined PFA as, what do you think Look, Listen and Link each mean when it comes to providing PFA to children?


Session 3: Child Responses to Crisis [1hr 30min]

Objectives• To identify common child reactions to crisis• To incomplete objective statement

Materials Needed:• Flipchart and markers• Children’s Reactions to Crisis Handout

Facilitator introduction: “In crisis events, children react and think differently to adults. They have specific needs according to their ages and are vulnerable to adverse effects due to their physical sizes and social and emotional attachments to care-givers. Therefore, children need psychological first aid developed especially for children.2”

Group Work3

Facilitator should be aware these questions could bring up sensitive stories, and bring out emotional responses in persons. The facilitator should follow the self-care processes the group has agreed upon earlier in the workshop to ensure that persons in distress receive support that they are comfortable with. On the flipchart write:

Case Study: child has lost a parent or caregiver to EVD. How might they be acting? What behavior changes do they have? • Children 0-2 • Children 3-6 • Children 7-12 • Children 13-17

Trainees split into groups of 5-8 people each. Ask the groups to discuss how they might expect a child who has lost a parent or caregiver to EVD to be acting/responding. What behaviour changes might you expect? How might different age groups respond?. Write out reactions you have seen or expect from each age group. Come back to plenary to discuss.

(Distribute Children’s Reactions to Crisis handout as further reading-noting to the group that it is not culturally adapted)

To explainHow children react in crisis depends on: • Age and developmental stage • How others react • What they have experienced • Past experiences such as abuse, family violence and neglect

Group workIn this exercise the group will practice approaching and responding to children in crisis.

Split the group into two groups. The first group will role play a child who is sad, burdened in distress (persons should select any of the following roles below to play), the second group will act as the teachers providing care. Their task will be to approach one child each and offer them support.

2 Psychological first aid workshop manual for child practitioners. Save the Children: UK.3 Psychological first aid workshop manual for child practitioners. Save the Children: UK. activity modified


Call out “go” to the first group so they can approach the “children” in the second group. Allow them about 5 minutes to interact in role play. Afterwards, discuss the exercise with the whole group, using the following questions to generate discussion:

• For those approaching the children, what behavior did you see? • For those approaching the children, what type of support did you think these children needed? • For those who acted out the children, what was especially helpful from the person who approached you? • For those who acted out the children, was there anything that was not helpful? • How did you approach the child? What techniques did you use?

We will talk more about communication skills with children tomorrow.

Session 4: Relaxation Activities4 [40min]Objectives• To gain practical strategies for managing stress

Materials Needed:• Relaxation Exercises Handout

Introduction • Breathing and relaxation exercises are great tool for soothing the nervous system. • They can help relieve the tension that builds in the body and mind from difficult life experiences, and can help alleviate feelings of stress, depression, anxiety, anger and grief. • They can help us feel calmer, steadier, and more balanced. • We call many of these activities mindfulness practices, because they help us to become more mindful of the present moment, and less caught up in distractions and stress.

Demonstration: Abdominal Breathing (or belly breathing) • Often when we are stressed our breathing becomes shallow, high in our chests, and we forget to breathe deeply into our bellies. • Abdominal breathing is very calming and centering, and helps us to draw nurturing oxygen deep into our lungs.

Instructions for leading the group • Bring your hands to your lower belly with the 3 middle fingers touching. • Relax your shoulders • Take a long, deep, gentle inhale, sending the breath all the way down to your belly, so your stomach expands (keep your shoulders relaxed). You should find that your middle fingers naturally part slightly as the belly expands with the breath. • Exhale slowly, feeling how the belly naturally draws inwards as the breath exits the body and the middle fingers slide to touch again. • Do this abdominal breathing a minimum of ten times (Inhale/Exhale).

• A child aged 8 years showing signs of anger• A child aged 15 years showing signs of deep sadness• A child aged 6 years showing signs of fear• A child aged 12 years behaving with extreme energy (hyper-activity)

Facilitator writes the following sentence on flipchart:

4Guide to Basic Relaxation. Enabling Access to Mental Health, Sierra Leone


• With children you can explain that when they inhale they are blowing up their tummy softly like a balloon, and when they exhale, the air is going slowly out of the balloon again.

Demonstration: Using Hands to Release Stress and Build CalmInstructions for the group: • Make a blow or fist with your hand. • Take an inhale and imagine you are squeezing all your worries and stress into your fist or blow, • Hold your breath. Squeeze those hands really tight! • Then exhale deeply, and release your fingers - letting the stress and worries go. • Now, with one hand, take hold of a finger on the opposite hand. • Squeeze the finger softly and inhale, saying in your head ‘I am calm’ • As you exhale, relax the squeeze and say ‘I am peaceful, I am kind’. • Variation - These words are an example. You can substitute many others, such as ‘I am loved, I am perfect just as I am, I am clever, and I am strong’, etc.

Closing [10 min]

Self ReflectionFacilitator to explain to participants to trace their hand outline on a piece of paper. Write in the five fingers five ways they will take care of themselves/their families to cope with distress. Keep this as a reminder to self.

Day 2

Objectives• To remind about yesterday’s learning• To remind about today’s agenda• To build greater understanding between participants before training begins

Materials Needed• Flipchart and Markers

Opening [30 min]

Prayer

Recap

• Opening• Session 5: Communicating with Children• Session 6: Pointing Fingers/Stigma• Session 7: Linking to services • Session 8: Practical Activities for the Classroom• Closing

Day 2Agenda

What did you learn yesterday? Did anyone use what you learned already?Do you have any pressing questions before we get started today?



Ice BreakerHave you ever? Participants all stand where they are sitting. Facilitators asks a series of questions, and as par-ticipants have experience with that question, they sit down. Continue with broader and broader questions until all persons have sat down.

Sample Questions:

Have you ever played the guitar? Have you been to Cote d’Ivoire? Have you more than 5 children?

Do you enjoy jogging? Do you like fufu? Can you sing?

Do you like Chelsea? Did you sleep well last night? Are you a first born?

Do you eat rice?

Session 5: Communicating with Children5[1 hour]Objectives• To be aware of and practice the skills necessary for good communication with children

Materials Needed:• Child Protection in Schools Brochure

Question for the group

Let’s talk about CommunicationFacilitator explainsCommunication is a two-way process of reaching mutual understanding, in which people exchange (encode-decode) or send and receive/interpret information, news, ideas and feelings. Effective communication is about listening for what people say, but also understanding the emotions and needs behind the information they share.Communication can be verbal, non-verbal (e.g. tone of voice or body language). We may need to approach adults or children differently depending on the mood and communication signals they send us.

Key messages for approaching people who may need supportGive out the Child Protection in Schools brochure • Be respectful and polite when approaching others. • Introduce yourself. • Ask for their names. • Explain you are here to support however you can • Always ensure the safety of yourself first and the other person.

What does good listening look like?How can you tell that someone is listening to you?For children, does listening looks different than for adults? Is there anything special one must do when approaching and listening to a child’s story?


5 Basic Psychosocial Support (PSS) in Education: A workshop manual for teachers and other stakeholders. Ministry of Education, Science and Technolo-gy, Sierra Leone


• Try to find a quiet and safe place to talk, but be aware that you should never be alone with the child- should have other people within eyesight- for protection of self and comfort of child • Remember to look for signs of distress or any other urgent needs. • Listen to the body-language being shared by the other person to give you clues about what might be concerning them. This is especially true for children who may not have the words to be able to explain how they feel. • Always practice confidentiality

Activity: Helping children feel calm6 • There are many ways to help children feel calm, but the most effective approach will be when the calming technique matches the mood or behavior of children. • We will cover more strategies for helping people and children feel calm in the stress management modules, but we can begin to explore ideas here as this is part of how we approach and engage children in a calming way to provide them with psychosocial support.

Instruction: Divide the group into four smaller groups. Each group will be given a scenario. They have to act out the scene in a 3 minute demonstration showing how they intend to help the child/children feel calm.At the end of discussions/ role plays, ask how each would create a safe environment for those children

Group 1/Scenario 1:

Group 3/Scenario 3: Group 4/Scenario 4:

Group 2/Scenario 2:

You have a classroom with many children. It is a hot day and they are not paying attention “. Some children are misbehaving others are sleepy. Show how the teacher can help create more calm in the classroom and re-en-gage the children to learn.

You are a teacher who has just witnessed an event in the yard where a small group of children were pointing and making fun of another child. The child moves away from the crowd, sits on the ground and cries.

You have a very active child who is causing noise in the classroom. He’s running up and down and doesn’t want to sit or engage with other students.

You have a crying child, who is quite upset, in the back of the classroom.

6 Basic Psychosocial Support (PSS) in Education: A workshop manual for teachers and other stakeholders. Ministry of Education, Science and Technolo-gy, Sierra Leone


Session 6: Linking [30min]Objectives• To remind about the importance of linking• To identify referral sources for linking children in need• To become aware of signs to look for to refer children for counselling or mental health support

Materials Needed:• Warning Signs Handout• County Contact Sheet

Introduction to Linking:7

Remind participants that we are continuing to build our skills in providing PFA to children and parents. So far we have covered Look and Listen and this session will focus on LINK. Do the actions for Look, Listen, and Link with the group again!

The Link aspect of PFA is about ensuring the person we are supporting are able to connect to others so that they can continue addressing their concerns and meeting their needs.

People often think that “link” or “referral” means professional support. However, most linking and referrals will be to informal supports that already exist in the community or by accessing services that are widely available.

Most people have others they can turn to for support on different problems.

Instruction: Point to a different trainee/participant and ask them each a different question, shown below (they will likely say people such as their imam, or father, or mother, or sister, or health nurse, or friend). • Who in your life would you speak to if you were having a spiritual problem? • Who in your life would you speak to if you were having a financial problem? • Who in your life would you speak to if you were having a medical problem? • Who in your life would you speak to if you were having a relationship problem? • Who in your life would you speak to if you were having a problem dealing with your child’s behavior?

Identifying when a child is in need of special attentionAsk the group to identify what they would consider to be warning signs that a child is in need of psychological counselling. Use Warning Signs handout to discuss.

Discuss responsibility of the teacher to connect children to the resources available to them!

Where do we link to in this County?



Session 7: Pointing Fingers/Stigma8 [1hr 20min]Objectives• To identify how the group defines stigma• To talk about how stigma has impacted them and their classroom• To identify steps to lessen stigma in their classroom

Materials Needed:• Women’s Campaign International Ebola Stigma Toolkit

Question for the Group

Key Message: it is fear and misunderstanding that causes rejection

Group WorkSplit participants into pairs. They should discuss, two by two, the following:

Think of a time when someone treated you differently, ignored you or told you to go away. What hap pened? How did it feel? How did it change you?

Picture CardsUse the Picture Cards from the Women’s Campaign International Anti Stigma Toolkit (1, 2, or 3) to facilitate dis-cussion with the group. Facilitator shows the picture to the group and asks: What is happening in this picture? Why do you think this is happening? Do you expect to encounter these situations in your schools? How can you make the child in the pictures feel more welcome?

Key Message: The survivors, orphans and children of those who died should not be called names and be reject-ed, they need to be welcomed and supported in school so they stay in school and finish their education. We need to focus on positive ways, like the ones you just discussed, that help us include everyone into the school and the community.

Key Note to Facilitator: There are different types of stigma and different ways to respond to reduce the stigma. With EVD, the reason for stigma is often due to a fear of the spread of the disease. In order to combat this fear, people need to have an understanding of EVD, how it is prevented and how it is spread.

What is stigma (or- what does pointing fingers mean?) What do you think causes people to reject other people? What are some ways that people reject other people?


8 Accepting and Supporting Ebola Survivors, Orphans, and Families of Ebola Patients in the Community: a Toolkit for Social Mobilisers and Communica-tors. Women’s Campaign International


Session 8: Practical Activities for the Classroom [1hr 40in]Objectives• To have practical PSS activities for the classroom

Materials Needed:• PSS Activities for the Classroom Handout

Facilitator Note: use the PSS Activities for the Classroom handout to select activities for this session. The ob-jective is for the trainees to do the activities during the training in order to learn how to conduct them in their classrooms. These first three activities are only the suggested activities to start with. Facilitator may choose to do others, but definitely should do more than these three, based on time.

Get MovingPhysical activity reduces stress reactivity, particularly in children. Encourage movement-orientated activities, such as sports, dance, and/or gentle activities such as walking and stretching. You could even add in a small stretching break in class if you see that energy levels are low or children are distracted.

Stretching exercise • Ask participants to stand • Inhale: Reach your arms up to touch the sky. • Exhale: Fold down to touch the earth • Inhale: Reach back to the sky (fly up like a bird) • Exhale: Fold down to touch the earth • Inhale: Stay here • Exhale: Sway your arms from side to side, like an elephant swaying its trunk. Come back to center. • Inhale: Fly back up to reach the sky. • Exhale: Bring your hands to your heart in ‘prayer’ position. • Tree Pose: Bend your right knee, find your balance, and place your foot on the inside of your left calf. Balance here for 5 deep breaths. Imagine you are like a tree, grounded, strong. If you want you can inhale and grow your branches to the sky, reaching your hands up. Exhale, bring your hands back to center. Repeat on the left side.

Game: Expressing tone Explain to participants we’re going to say a certain phrase in as many emotions as possible- anger, happiness, shock, fear, anxiety, joy, hopefulness, in love.

Ask participants to pick a phrase they want to say.

Play music and participants move around the room. When the music stops, each person finds their closest neighbour and expresses that phrase in the tone of their choosing. Continuing a couple rounds so that everyone can practice it. Sample Phrases: • Oh Henry • How you doing? • Carry my bag

Key message is that children pick up on more than we realize. The tone we use when we communicate, the body language we use, is all as important as the words we use.

Trainers may select this or other games from the PSS Activities for the Classroom handout to play with the trainees.


Activity: Action Steps for Using PFA and providing PSS in the School SettingInstructions:

Divide the group into groups of 8 persons or less. Groups should answer the following questions: • What are other games/activities that can be done to use coping skills, encourage social connection, and provide opportunity to process emotions? Think about Liberian games and traditions

• What practical steps will you take in your classroom to be more aware/more supportive of children in distress?

• What action steps can you take in your school to create a more supportive environment for teachers and students? • Ideas include: Focal persons for child protection, awareness raising in various forums, conduct PSS activities in the classroom on a weekly basis, create mentoring groups or peer support groups, do discussions about self care and support in the teacher/admin. meetings, invite PSS actors to visit the school on a regular basis and conduct activities

For plenary discussion, explore what might be additional ways teachers can share creative ideas for psychosocial support for pupils with other teachers at the school?

Discussion

ClosingFacilitator thanks the group for their participation, for continuing to remain aware of children in need of support in their classrooms and communities, and for passing the messages learned on to their colleagues.

Post-Test

How will you monitor this plan to ensure it goes forward?



Annexes and Handouts In order of reference in training

Pre-Post Test

Psychological First Aid: What is it?

Children’s Reactions to Crisis

Relaxation Exercises

Child Protection in Schools Brochure (separate attachment)

Warning Signs Handout

Women’s Campaign International Anti Stigma Tool Kit Picture Cards

PSS Activities for the Classroom


Psychological First Aid for Schools Pre/Post Test(Circle true or false for how you see each statement)

True False Linking is one of the key purposes of psychological first aid

True False Quietness in children can be a sign of distress

True False Confidentiality means telling other people’s secrets

True False Psychological First Aid is counselling by professionals

True False Good communication requires listening and speaking through your words, tone, and actions.


Psychological First Aid: What is it?

PFA is…9 PFA is not…Practical (providing practical/material care and support)

Something only professionals can do

Support that does not intrude or is forced upon others Professional counsellingAbout assessing the needs and concerns of people you are supporting

A clinical or psychiatric intervention

Part of good clinical care when used by professionals or non-professionals

Psychological debriefing

Helping people to access basic needs (e.g. food, water, information)

Asking people to analyze their experiences

Comforting Asking people to put their stories into a time frame and accurate order of events

Helping people to feel calm Pressing people to tell you their storyListening to people Pressing people to share the details of their storyHelping others to connect to information, services or other support systems

Asking people about in-depth feelings about what has happened to them

Protecting people from further harm Giving direct advice (unless necessary)Helping people to decide for themselves what their next actions will be

Something everybody needs or wants

Private and confidential A counselling ‘session’

Psychological First Aid (PFA) provide support children, parents and teachers in distress • Look for and identify children who are distressed or sad or in need of support

• Listen to persons and children in distress using good communication skills

• To handle common problems related to stress

• To know how and when to refer or link people to additional supports

• To use your skills for any child/person in distress – not just related to the Ebola crisis

9 Psychological first aid workshop manual for child practitioners. Save the Children: UK.


Chi

ld R

eact

ions

to C

risi

s10

Com

mon

reac

tions

to st

ress

for a

ll ag

e-gr

oups

Sign

s of f

ear t

hat t

he e

vent

will

take

pla

ce a

gain

Wor

ry th

at th

eir l

oved

one

s or t

hey

them

selv

es w

ill b

e hu

rt or

sepa

rate

dC

ryin

g

Rea

ctio

ns to

seei

ng th

eir c

omm

unity

des

troye

dR

eact

ions

to se

para

tion

from

par

ents

and

sibl

ings

Slee

p di

stur

banc

es

Com

mon

reac

tions

to st

ress

in th

e fu

nctio

n ch

ildre

n ag

ed 0

-3 y

ears

‘Clin

ging

‘to

thei

r car

egiv

ers

Reg

ress

to b

ehav

ior w

hen

youn

ger

Cha

nges

in sl

eep

and

eatin

g pa

ttern

Irrit

abili

tyA

frai

d of

thin

gs

Poor

con

cent

ratio

nH

yper

activ

eM

ore

dem

andi

ngC

hang

e in

pla

yC

ryin

gC

omm

on re

actio

ns to

stre

ss in

the

func

tion

child

ren

aged

4-6

yea

rsC

lingi

ng to

adu

ltsR

egre

ss to

you

nger

beh

avio

rSl

eep

dist

urba

nces

Cha

nges

in e

atin

g pa

ttern

sTa

ke o

n ad

ult r

oles

Irrit

abili

ty

Easi

ly c

onfu

sed

Poor

con

cent

ratio

nIn

activ

e / h

yper

activ

eSt

op ta

lkin

gSt

op p

layi

ngA

nxio

us o

r wor

ried

Com

mon

reac

tions

to st

ress

in th

e fu

nctio

n ch

ildre

n ag

ed 7

-12

year

sW

ithdr

awn

Con

cern

ed a

bout

oth

er a

ffect

edSl

eep

dist

urba

nces

Cha

nges

in e

atin

g pa

ttern

Feel

/ ex

pres

s fea

rIr

ritab

ility

Agg

ress

ion

/ res

tless

Po

or m

emor

y an

d co

ncen

tratio

nSo

mat

ic sy

mpt

oms

Feel

con

fuse

dTa

lk a

bout

the

even

tSe

lf-bl

ame/

guilt

Com

mon

reac

tions

to st

ress

in th

e fu

nctio

n ch

ildre

n ag

ed 1

3-17

(tee

ns)

Inte

nse

grie

fSh

ow e

xces

sive

con

cern

for o

ther

sSe

lf-co

nsci

ous

Feel

gui

lt an

d sh

ame

Self-

abso

rbed

Defi

ant o

f aut

horit

y

Incr

ease

d ris

k ta

king

Cha

nges

in re

latio

nshi

psA

ggre

ssiv

eSe

lf-de

stru

ctiv

eFe

elin

g ho

pele

ssR

elyi

ng m

ore

on p

eers

Com

mon

reac

tions

to st

ress

for a

ll ag

e-gr

oups

that

im

pact

the

body

(psy

chos

omat

ic/ p

hysi

cal r

eact

ions

)Ti

redn

ess

Tigh

t che

stSh

ortn

ess o

f bre

ath

Dry

mou

thM

uscl

e w

eakn

ess

Stom

ach

ache

Diz

zine

ssSh

akin

gH

eada

ches

Gen

eral

ach

esVe

ry se

rious

dis

tress

reac

tions

in c

hild

ren

whe

n th

ey

occu

r mos

t of t

he ti

me

With

draw

n or

ver

y qu

iet w

ith li

ttle

or n

o m

ovem

ents

Hid

e or

shy

away

from

oth

er p

eopl

eD

o no

t res

pond

to o

ther

s, do

not

spea

k at

all

Scar

ed, p

anic

king

, hys

teric

alW

orrie

d

Phys

ical

sym

ptom

s of n

ot fe

elin

g w

ell:

Shak

ing,

hea

d-ac

hes,

loss

of a

ppet

ite, a

ches

and

pai

nC

ry a

lot

Agg

ress

ive,

tryi

ng to

hur

t oth

ers

Clin

ging

to

thei

r car

e-gi

vers

Con

fuse

d or

dis

orie

ntat

ed

A ch

ild in

dis

tress

exp

erie

nces

one

or m

ore

stre

ss sy

mpt

oms,

whi

ch u

sual

ly re

sults

in th

em b

eing

una

ble

to fu

nctio

n to

thei

r opt

imal

leve

l

10 All material is taken from two main sources: (1) World Health Organization, War Trauma Foundation and World Vision International (2011). Psy-chological first aid: guide for field workers. WHO: Geneva – and (2) Save the Children (2013). Psychological first aid workshop manual for child practitioners. Save: UK.


Relaxation Exercises11

Demonstration 1: Abdominal Breathing (or belly breathing) [5 Minutes]

• Often when we are stressed our breathing becomes shallow, high in our chests, and we forget to breathe deeply into our bellies. • Abdominal breathing is very calming and centering, and helps us to draw nurturing oxygen deep into our lungs.

Instructions for the leading the group: • Bring your hands to your lower belly with the 3 middle fingers touching. • Relax your shoulders • Take a long, deep, gentle inhale, sending the breath all the way down to your belly, so your stomach expands (keep your shoulders relaxed). You should find that your middle fingers naturally part slightly as the belly expands with the breath. • Exhale slowly, feeling how the belly naturally draws inwards as the breath exits the body and the middle fingers slide to touch again. • Do this abdominal breathing a minimum of ten times (Inhale/Exhale). • With children you can explain that when they inhale they are blowing up their tummy softly like a balloon, and when they exhale, the air is going slowly out of the balloon again.

Demonstration 2: Using Hands to Release Stress and Build Calm [5 Minutes]

Instructions for the group: • Make a fist with your hand. • Take an inhale and imagine you are squeezing all your worries and stress into your fist, • Hold your breath. Squeeze those hands really tight! • Then exhale deeply, and release your fingers - letting the stress and worries go. • Now, with one hand, take hold of a finger on the opposite hand. • Squeeze the finger softly and inhale, saying in your head ‘I am calm’ • As you exhale, relax the squeeze and say ‘I am peaceful, I am kind’. • Variation - These words are an example. You can substitute many others, such as ‘I am loved, I am perfect just as I am, I am clever, and I am strong’, etc.

Demonstration 3: The Wave of Light [5 Minutes]

This exercise combines breath, movement and visualization. Instructions for the group: • Find a comfortable standing position. • Relax your shoulders. Ground your feet evenly. • Feel the length in your spine, from your tail-bone to the top of your head. • Place your left foot forward, grounding the feet again. • Inhale: float your hands forwards and over your head. Imagine you are drawing a wave of bright light above your head. • Exhale: move your hands downwards, past the shoulders, as if you are showering yourself with a wave of soothing cool light. • Keep this flowing for at least ten breaths. With each inhale imagine drawing that wave of beautiful, healing light above you. With each exhale, imagine that cool, shining light flowing down over you, taking your tightness and troubles away. • Repeat on the other side, with the right foot forward. Breathe in the shower of light. Exhale and let go of any negativity within you. Feel the flow of light cleansing and renewing you.

11 Guide to Basic Relaxation. Enabling Access to Mental Health, Sierra Leone


Warning signs that your child may need psychological counseling

If the child demonstrates some of the following, especially over prolonged period (2 weeks or more) • Persistent feelings of sadness or hopelessness • Constant anger and a tendency to overreact to situations • Persistent worry, anxiety, or fearfulness • Preoccupation with physical illness or their own appearance • Fear that someone is controlling his mind, or that he is “out of control” • A sudden, unexplained drop in grades at school • A loss of interest in activities that were once enjoyed • Changes in patterns of sleeping or eating • Reclusiveness, preferring to be alone rather than in the company of friends or family • Expressing thoughts of suicide • An inability to concentrate, think clearly, or make decisions • An inability to sit still for any amount of time • Performing routines obsessively throughout the day, such as washing hands or cleaning things • Experiencing regular nightmares • Alcohol or drug use • Dieting obsessively, or binging followed by vomiting or taking laxatives • Taking part in violent acts


43EBOLA STIGMA TOOLKIT

1


What is happening in this picture?

Why is the girl sitting alone?

What do you think she is feeling?

How can you make the girl feel better?

8 Resilience and Empowerment Training and Workshop: IsraAid Manual for Trainees. IsraAid.



2


What is happening in this picture?

Why is the girl standing alone?

What do you think she is feeling?

How can you make the girl feel better?




3


Everyone is finally returning to school, what are you looking forward to the most?

Is there anything that you are worried about being at school?

Do you know what to do to stay healthy at school?

Do you think that some students may avoid or reject students who are survivors of Ebola, are orphans or may have had someone

die in their family?

What would you say to them?



Psychosocial Support Activities for the Classroom12

CIRCLE OF SAFE EXPRESSIONLength of Activity: 15 Minutes

Materials Needed: None

Learning Objectives: 1. Establish a safe place for expression. 2. Encourage exploration of various modes of self-expression. 3. Promote creativity, spontaneity and imagination. 4. Create a model for respect and acceptance of others. 5. Encourage group cohesion and cooperation.

Recommended Age Group: All Ages

Activity Steps: 1. Children form a circle. 2. Facilitator begins a rhythm (clapping, drumming, or a song that is familiar to the children/ community. Alternatively, the facilitator can also request a rhythm or song from children.) 3. Facilitator sets up the rules: anyone can enter the circle, but only one child at a time (for now). When in the circle the child may lead a dance, song and or gesture (i.e. clap) that the group will then mimic/ copy. He or she will either decide when to leave the circle and invite another child to be in the center or the facilitator will decide if it’s time for a change. Facilitator may say, “Invite someone else to come into the circle.” The outgoing child will then take his/her place at the circle’s edge of the child going in. 4. Facilitator demonstrates and then invites children to join in. 5. Repeat until all children have had a chance to be in the center of the circle or until the attention of the children has been lost.

Activity Debrief: How does it feel to have everyone see your dance/song/gesture? How does it feel to have your story heard? Do you like to be in the center?

Variation: When child goes into circle the clapping/song can then stop. The child has various options including: share something about him/herself; share what he/she is feeling today; tell a short story of something that hap-pened to him/her or something he/she is excited about; demonstrate a physical ability that he/she is good at; or ask that the rhythm/song be continued. (This basic format of this circle can be used in many ways.)

Instruction from facilitator can also include: Tell us something you would like to have; something you miss; something you need; something you want to share with us, etc.

MOVE, MOVE, FREEZELength of Activity: 10-15 Minutes


Learning Objective: 1. Develop bodily awareness and coordination. 2. Enhance spatial awareness. 3. Promote sense of wellbeing and confidence. 4. Develop ability to follow auditory directions into 3 dimensional actions.



Facilitation Tip

Stick to the rule of only one person in the circle at a time Encourage any type of safe self-expression and allow a moment for the child to find what she/he wants to express Remind the child to invite someone new after no more than a minute. If the child wants to speak or sing make sure there is silence among the group so he/she can be heard.

Facilitation Tip

It is critical to vary the instructions, challenge, speed and duration. Encourage children to explore their bodies and movement styles.


Activity Steps: 1. Have the children spread out in the room at a 2. Instruct children that they will be moving according to instructions until they hear a clap (or other sound cue). 3. When they hear the sound cue they will then freeze into a sculpture according to the facilitator’s instruction. 4. Facilitator will vary locomotion styles and offer examples of various sculptures, as well as allow varying durations for each movement before calling out “freeze”.

Examples for locomotion: Run run run run.....freeze. Walk slowly..........Freeze. Skip high.......Freeze. Jump wide .....Freeze. Walk on tippy toes…..Freeze. Move low….Freeze.

Examples for sculptures: Freeze and feel your feet; Freeze and put your hands on your heart (feel your heartbeat); Freeze and put your hands on your head; Freeze and put one hand on belly and one hand on knee; Freeze and put one finger on nose one finger on elbow; Freeze on tippy toes…Facilitator is encouraged to be creative and increase coordination challenges for the children while remaining aware of age and skill appropriateness, especially on challenging options where children have to use right and left sides at the same time.

5. Facilitator then adds: freeze and make eye contact with the person closest to you; freeze and make eye contact with the child across the room; freeze and try to make contact with as many people as possible (WITHOUT MOVING). 6. Instruction: Now look around room and notice you are all together. 7. Now, put your arms around yourself and give yourself a hug. 8. Walk around and look for a space that feels attractive to you. Don’t touch anyone else. Find your OWN space. Go to this space. Get comfortable. Take a deep breath in it. Let this breath fill your heart. Take another breath. Put your hand on your heart. Now say “I feel inner peace”. 9. Repeat until children tire of the activity

Activity Debrief: How was that? What was harder, freezing or moving? What was your favorite thing to do with your body?

KING/QUEEN OF THE VILLAGELength of Activity: 20-30 Minutes


Learning Objective: 1. To promote social integration and acceptance. 2. Increase focus and attention. 3. Encourage shared joy.


Activity Steps: 1. Have the group stand in a circle and choose a volunteer to go outside of the room. (Second facilitator to go outside with the child volunteer.) 2. Pick another volunteer to be the “King” or “Queen.” 3. Instruct that the King/Queen will start a movement that everyone else in the group will copy. The volunteer will be called in and the King/Queen has to keep changing moves while the volunteer tries to guess who is doing the movement. The point of the game is to not let the volunteer figure out who the King/Queen is. 4. Have the King or Queen start their move and call the volunteer back into the room. 5. Tell the volunteer to try to figure out who is doing the movements or who is the King/Queen. 6. If the volunteer finds who the King/Queen is, he/she picks the next child to go out of the room. 7. The person who was the King/Queen picks a new King/Queen. 8. Play a few more times until the children get the flow of the game.

Facilitation Tip

If a child has not guessed whom the King or Queen is, give them 3 tries before restarting the game. Make sure most of the children have a chance to go. If there are too many children, divide them into smaller groups.


Activity Debrief: How was the activity? What was challenging? How did you find who was the King/Queen?

STORY CIRCLELength of Activity: 20-30 Minutes


Learning Objective: 1. Promote inclusion and acceptance of different ideas. 2. Provide opportunities for creative self-expression. 3. Encourage cognitive thinking and communication skills. 4. Promote self-confidence and self-esteem.

Recommended Age Group: 8 and up

Activity Steps: 1. In a circle, facilitator tells the children that they are going to imagine a story together in which they will each take a turn adding a sentence to the story as they go around the circle. 2. Facilitators demonstrate between themselves to children. 3. Then start, with facilitator starting the first sentence of the story. 4. The next child then adds their sentence, and so on until the story comes to some conclusion.

Variation: For children ages 13 and up: They can chose to spell words with one person starting with a specific letter and the next person adding the next letter until they spell a word or someone in the circle messes up.Activity Debrief: How was the activity? How can we use storytelling to include everyone? Can we all have dif-ferent ideas and still accept one another? Were there any challenges?

ALL ON BOARD THE BUSLength of Activity: 15-20 Minutes

Materials Needed: Length of rope

Learning Objective: 1. Promote body and spatial awareness. 2. Develop creativity and enhance imagination. 3. Allow opportunity for leadership. 4. Encourage inclusivity and cooperation.


Activity Steps: 1. Choose one child to be the “driver” and another child to be the “conductor”. 2. Give them a length of rope, tied at both ends (creating a circle). 3. Both the conductor (at one end) and the driver (at the front) will loop this around them creating a contained space as the “bus” or “Poda Poda.” 4. Set up different areas in the room/space as “bus stations.” 5. Other children will wait there. 6. Driver/conductor will decide their destination (i.e. Port Loko, Makeni, Waterloo, etc.) and call it out while beginning to drive around to pick up “passengers.” 7. Each passenger that “gets on” will step inside both ropes and hold on. 8. Passengers will call out when they want to get off. Other passengers get on. 9. Have the group play as long as they need. 10. Change drivers and conductors to give others a chance at those roles.

Activity Debrief: While resting encourage feedback: how was it? Did you like being driver or passenger? Where did you want to go?


ALL TOGETHERLength of Activity: 20-30 Minutes

Materials Needed: Paper, crayons, markers, scissors, and tape

Learning Objective: 1. To identify differences and to also celebrate those differences as being special. 2. Encourage self-expression and creativity. 3. To promote social inclusion and togetherness.

Recommended Age Group: 6 and up

Activity Steps: 1. Have children wash their hands before using the art materials. 2. Have one facilitator pass out a sheet of paper to each child; while the other facilitator asks the children to pick out their crayons or markers of choice. 3. Instruct that they will trace their hands on the paper first than write something unique about him/ herself in each finger (i.e. “I am smart. I am a good soccer player. I love to cook. I can draw really well. I am a good friend,” etc.). Then they will decorate hand using various patterns, shapes, and colors. 4. Facilitators then demonstrate. 5. Now invite the children to follow the steps together and go slowly. 6. With a pair of scissors have them (or facilitator) cut out the drawn hands. 7. The have them hang up their drawings on the wall (or put them on the floor in a circle). 8. Pay close attention to not overlap the designs too much. 9. Gather group before the wall and have them take turns sharing what they made.

Variation: For children ages 11 and younger: Some of the children may have difficulty writing, let them say what they want and write it down for them. If a majority of the children have difficulties writing, skip the writing and offer them to speak about what makes them special/unique.

Activity Debrief: What do we notice as we look at all these hands on the wall? How are we different? How are we the same? What is special about each one of us?

Facilitation Tip

Set limit at start how many “passengers” can be on board simultaneously. Give other children chance to be “driver” and “conductor”. Encourage children to really imagine they are on the transport. (Calling out their stops. Simulating the movement of the bus in their bodies. Driver can go any direction; any speed; All children must follow driver until they get off. Not all children may have an opportunity to be driver/conductor. So may create other roles (i.e. traffic police).

Facilitation Tip

Some children may not want to draw. Encourage them to participate but don’t push if they do not want to. Younger children may need assistance tracing their hand as they may have difficulty doing two things at once. Some children may require several takes/ want to do their drawing again. Provide them the material and encourage them. Encourage participants to make their own patterns and designs as some may be tempted to copy someone else’s. Allow for creativity and give out positive words of encouragement.

PSYCHOLOGICAL FIRST AID & PEDAGOGY MANUAL FOR SCHOOLS

psychological first aid training manual for schools · 4 psychological first aid training manual...

Documents