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13 July 2017

Trauma Work: Strong and self-confident

Many people, who have been forced to flee war and violence, have had traumatic experiences. To deal with these experiences, they need good social connections, a safe environment and supporters, who act with caution. In 2016, medica mondiale trained around 200 specialists and volunteers working with the refugee community in its stress and trauma-sensitive approach. Alongside providing information on trauma and self-care methods, the focus was on promoting self-help skills.

Symptoms of trauma and stress are often difficult to recognise immediately. What, at first sight, appears to be defensive or aggressive behaviour, can actually be caused by trauma. If helpers are unable to interpret these signs, the consequences of trauma can become chronic and lead all involved to feel powerless and overstretched.

Empowerment and stabilisation of refugees, development of sustainable support network

With financing from the Ministry of Health, Equalities, Care and Aging in North-Rhine Westphalia, medica mondiale responded to the growing number of people seeking refuge in Germany by launching the STAR training programme that focuses on a stress and trauma-sensitive approach to dealing with refugees. The series of courses seeks to empower and stabilise refugees. The programme aims on the one hand to give new arrivals competent support and, on the other, to contribute to the development of a sustainable support network. Employees should be able to recognise not only the symptoms of stress and trauma, but also the limits of their own resilience.

To be able to continue and expand the training courses after 2016, 16 women trauma experts were recruited as additional trainers and, over the course of several days, trained to jointly lead seminars. medica mondiale ran more than ten courses throughout the year, training a range of target groups including health workers, security personnel and volunteers in a stress and trauma-sensitive approach to dealing directly with refugees. A further 13 external training courses and lectures were held for different education providers and associations.

Promoting self-help structures: sharing experiences has stabilising impact

”We want to use this approach to empower asylum-seekers in Germany and, in the long term, facilitate their integration into society,” says Alena Mehlau, Programme Advisor on trauma work. After almost 25 years of working with survivors of violence in war and crisis regions, medica mondiale knows that talking to, and sharing experiences with, other people, who have been simi-larly affected, can, in itself, have a stabilising impact. Promoting self-help structures through group confidence-building programmes, was therefore a key programme component.

Since the autumn of 2016, medica mondiale has been training women – themselves refugees some years ago – to use their experience to support other refugees. ”All these women have their own particu-lar journey of stabilisation behind them,” Mehlau explains. ”They demonstrate that, despite all the difficulties, it is still possible to gain a foothold in an alien environment and continue to make progress.” What these peer-to-peer approaches can offer in a context, in which people are dis-placed and traumatised, and how they can be supported even more effectively, is something medica mondiale discussed with experts and volunteers from NRW at a symposium in April 2017.


Interview with trauma experts Karin Griese and Petra Keller

What are peer-to-peer approaches in trauma work?

After a traumatic experience, the person affected can gain a lot from the solidarity with others who have experienced something similar. The important thing here is to share experiences and helpful information and provide mutual support. This can take place in regular group or individual counselling sessions.

Why is the peer-to-peer approach particularly suitable for working with refugees?

Even after the most difficult experiences, people still have so much to offer. Women, who themselves were refugees and have been living in Germany for some time, not only have their own burdens to bear but have also developed their own particular coping strategies . They can act as a role model for new arrivals simply by demonstrating how they have learned to cope and restore confidence in their own strengths. In psychosocial terms, peer-to-peer encounters can be enormously stabilising and can significantly strengthen the affected person’s resilience. That is why it is so important not to allow structural problems to jeopardise the success of this form of support. Even successful self-help is insufficient, when people are forced to flee yet again from war and persecution and left to cope alone with their problems in the new host country.

How does peer-to-peer support work in practice?

Women refugees, with similar issues and problems, meet in a protected environment, where rules of confidentiality and mutual respect apply. To address the stress and trauma dynamics within the group, we recommend that sessions are led by a team of at least two women – a trauma expert and one, who herself was a refugee and is sufficiently stable to share her own experiences.

Which framework conditions are required for this?

The group meetings should always follow the same structure. This enables participants to feel secure throughout the session and in their interaction with each other. All the women, with their strengths and abilities, are to be actively included in the discussions. But other external factors, including rooms, translation, child-care and long-term financing, are also important for the success of the meetings.