From trauma to resilience.

Abstract

The Psychosocial Support Program of the International Federation of the Red Cross and Red Crescent (International Federation) emerged in the early 1990s, at a time when an increasing number of National Societies realised that disasters may lead to both physical and mental problems and that the simple provision of shelter, food and medical care in many cases was not sufficient. Hence in 1993 the General Assembly recommended the International Federation to “give high priority to psychological support issues and strongly advocate the implementation of psychological support programs in National Societies” and to “secure adequate material and human resources to implement those programs” (General Assembly, IXth Session, Birmingham, 1993, Decision 26). The same year this recommendation resulted in the establishment of the IFRC Reference Centre for Psychological Support. The mid 1990s saw a growing dissatisfaction with the traditional trauma-focused mental health interventions that were being implemented in the aftermath of disasters and conflicts. There was a growing realisation within the Psychological Support Program, informed by powerful critiques from Europe and the USA that conceptualising the suffering caused by natural catastrophes and conflicts primarily in terms of Post-Traumatic Stress Disorder (PTSD) or associated mental disorders was a hindrance to providing adequate support. Experience has taught that major accidents and disasters do not produce huge numbers of people with acute psychiatric disturbances. Psychological reactions can be considered “normal” in the context of “abnormal” circumstances”1. Whilst acknowledging that some individuals do require treatment of psychological disorders, the Psychosocial Support Program believes that the majority of the affected people have a need for information and have practical, social, emotional and psychological needs. This more generalised support will enable them to better access the material and social resources they seek. Along with the critiques of the trauma approach, the mid 1990s saw the articulation of many alternative approaches to psychosocial intervention, which acknowledged people's capacity for resilience and aimed primarily to enhance and support this. Inspired by such examples, the Psychosocial Support Program attempts to develop interventions that address the social, emotional and material concerns of people in ways that strengthen their capacity to manage adverse circumstances or challenges to their well-being — within the limits of human, social and material resources of the communities in which they live. Basic emotional support would normally be provided through existing social networks. In many cases, family, friends and neighbours offer a helping hand and a listening ear to survivors and their families in order for them to cope with their loss and grief. But in some situations, survivors may be physically separated from their communities or the community's ability to provide support may be seriously impaired. These situations require anticipation and a pro-active response of well coordinated multidisciplinary support. Psycho-social needs are likely to persist over a much longer time than the usual intervention period of emergency services. Local National Societies, through their networks of volunteers, have been and will continue to be essential in facilitating psychosocial support after critical events.