Arts Therapy Clinic-Children in Crisis-CAMBODIA

 
$16,531
$33,469
Raised
Remaining
Thank You!
Thank You!

Message from Carrie Herbert and Kit Loring - Directors of Arts Therapy Services, Ragamuffin International

August 2012 will bring us to the end of our 2-year pilot programme of Ragamuffin's Creative Arts Therapy Clinic for traumatised and distressed children, families and communities in Cambodia. 

Ragamuffin’s critical incident and emergency de-briefing and staff-support for front line humanitarian organisations continues in response to demand in the region

As we come towards the end of a funding cycle in August, the need for our services in Cambodia is only increasing in a context where trauma is endemic and the incidence of trafficking, abuse and exploitation continues to rise. Unless we obtain ongoing funding -  critical and much needed services will need to be cut back - so your support at this time remains so very important.

The future of the Arts Therapy Clinic

Obtaining funding for the ongoing sustainability of the clinic continues to be a challenge. The areas of mental health and Arts Therapy are notoriously underfunded globally. The challenge to Ragamuffin is how our services can meet the demand and continue to grow and strengthen in such a climate. The clinic service has met such a need amongst vulnerable children and young adult and has only just begun to take root. The following are some of the thoughts and reflections from the clinical team as we continue to promote the continuation of this work and work hard to secure its future in the same way that we are seeking to secure the future of the lives of marginalized and traumatised children and young people.

 

“As I am a Khmer citizen as well as an Arts Therapist with Ragamuffin, I am really please and proud that a clinic such as Ragamuffin exists in Cambodia.  The Ragamuffin Project is the only clinic providing a professional standard of Arts Therapy in Cambodia. I have worked with so many children that make me realize how much suffering they endure. Trauma affects the quality of their lives because these children are living with suffering that penetrates deeply on their soul and their inner strength. Moreover, there are many children that could not safe at all. Ehen they  they have chance of healing at the Arts Therapy clinic of Ragamuffin, I can comprehend positive change of them since they can use the inner strength from oneself.

 

If Clinic Therapy of Ragamuffin is ends in August, it is the most regret ever for me as well as many children in Cambodia as it would be a tremendous loss for them. I do not want the trauma to continue from generation after generation, it makes my heart ache. When I have worked with those children, they have told me that coming here to “Ragamuffin” means so much to them, moreover, this place is not only a beautiful place, but it also provides them a peaceful, safe place of healing that they have never had. This place it’s a place where they can truly be themselves and recover their heart and soul.

 

I hope this Clinic will continue to receive funding in order to continue helping children in Cambodia and provide them a chance to explore, express, and acknowledge their emotions, their world and work through the issues that cause them so much distress. Ragamuffin work allows traumatized children the ability to search deep within themselves and help them gain inner strength and confidence”. (Panchakna Khlok)

 

“I think it is so important for Ragamuffin clinic to be funded for long-term work at least for another 5 years in order to ensure the sufficient healing to the clients. Right now, I have provided ongoing therapy to 36 fragile clients including individual and group work. All my clients are suffer severe depression, anxiety, and behavioural problems that are caused by sexual abuse, domestic violence, addiction, and HIV/AIDS. The clients have found this therapy process as breath and sacred space to look deeply into their inner world that is full of unresolved conflict. And, it also helps them to find new positive relationship between their inside and outside world, and to navigate to new hope and a new way to solve their conflict, and to embrace self-love one again. Therefore, if the therapy process is uncompleted, their journey of self-discovery of finding light is stopped, and this will have strong impact on their courage and hope to move on in life. Sadly some who so need longer term support would go back to the same state of mind and be left with many unprocessed or unresolved issues”. (Serey Samchet – Arts Therapist)

Kit and I and the team here in Cambodia deeply appreciate your support and contribution to our Arts Therapy service for children and families in Cambodia. 

Please see our thank you card attached with the opportunity of how to become a long-term friend of Ragamuffin by joining our partnership scheme – please let us know if that is of interest to you and we will provide further details.

 We are aiming to continue to develop our support base through this scheme and create a network of people around the world who believe not only in the work of Ragamuffin, but also how Creative Arts Therapy can help support those most traumatised in our world.

Your support is important in many shapes and forms...including raising awareness, volunteering with specific skills - like fundraising and web building, through to donations  - which of course can make a real practical difference to the service here.

Most importantly it’s the relationships that matter to us - as this is at the heart of the work we do. People together connected and believing in the gentle power of the Arts and Therapy in helping those with mental health problems.

With gratitude.

Carrie and Kit on behalf of The Ragamuffin Team Cambodia

 

Development of Arts Therapy Service with M’Lop Tapang Centre for Street and working Children, Kompong Som, Cambodia. An Overview By Rachel Hiskins and Hun Jeudyla - Creative Arts Therapists.

 

M’Lop Tapang (MTP) and The Ragamuffin Project have been working together since 2004 in the development of capacity of the MTP team in both psychological services and staff support. The clinic partnership started in September 2010.

 

The mission for this partnership is to strengthen the resilience and internal/eternal resources of the children most at risk who use the MTP services. Together with MTP we aim to also help the reduction of the symptoms of distress, improve self-esteem and confidence, empowerment and social relationships. This partnership will also provide and support MTP staff that provide psychological care and add to the overall culture of care.

 

Ragamuffin provides:

  • Drop in Therapy service for individual sessions
  • Open Studio Arts Therapy Service for groups
  • Supervision, on the job training and support of MTP staff involved in Arts Therapy and counselling.
  • Ongoing training of MTP staff in Creative Arts Therapy

 

Reasons for Referral

The referrals stem from a broad range of psychological and behavioural issues, all have poverty as a major contributing factor in the overall well-being of the young people and their families. The Drop in Therapy clients are mainly self-referred which we believe enhanced their commitment and motivation for both the therapeutic process and a desire to develop personally in their lives.  We have been deeply encouraged by the choices young people at MTP are making to use this service. We believe it has  been made possible due to the context and organisation culture of care at MTP which fosters relationships and empowers young people to make positive choices in and for their lives.

Issues that are been addressed in sessions include the following areas: (please note that many of these issues are complex, multifaceted and interlinked – they are are long term and need, as a result, a long term investment in their care and support).

 

  • Sexual Abuse
  • Physical Abuse
  • Mental/psychological Abuse
  • Abandonment
  • Self esteem and Self-worth
  • Mental Illness
  • Adolescence and child development (sexuality, protection, independence)
  • Relationship challenges and dilemmas
  • Desires, hopes and dreams for the future

 

Art mediums used include the following: (Arts therapists work responsively with the creativity of a child or young person helping them to strengthen their creativity, innovation, assertiveness and choice, inner resources and literacy in emotions)

  • Drawing
  • Sand tray and play with miniatures and objects
  • Mandalas
  • Puppets
  • Painting
  • Play-dough
  • Body work and movement
  • Breath, relaxation and meditation work

 

Outcomes from Drop in therapy and Open Studio

From the Drop In therapy, there have been 3 reported child protection cases to MTP. The identification of children at risk and those in existing abusive situations is critical. This has been an area where the partnership and the skill of MTP child protection team has been working effectively to respond and reduce risk of harm wherever possible. Ongoing follow up of these young people has enabled the Ragamuffin team to witness MTP’s child protection policy and team in action.  We are together exploring the development of case conferencing with the Multi-disciplinary team of Child Protection, social workers, and counsellors/therapists so as to strengthen the multi-disciplinary care around children at risk and living in violent or abusive situations.

 

The clients have begun to develop an understanding of the therapeutic use of the arts, becoming increasingly open and receptive to exploring their own thoughts and feelings through a range of creative media. The children/young people are demonstrating the ability to develop rapport with the team and an increased confidence in attending and participating in sessions. Fort many Arts Therapy is a new experience, this can create some initial anxiety for some children, however, it doesn’t take long for them to understand and trust the process and so discover how their creative voice can empower, motivate and encourage them to be who they are. Over 80% of clients attending the drop in sessions would like to come more frequently to regular arts therapy sessions.

 

I am happy that I came and played and told my story – my life has many difficult stories”

I am so happy and excited to come here and play and not work on the streets”

I saw my future for the first time”

 

It is clear that providing the space purely for the client to be listened to and felt heard, allows them to express and begin to understand their own story.

 

“I want to continue to work with Ragamuffin in the future – its so important for these children and for us – we need to learn more how to give this kind of support to children.” (MTP Staff)

 

“It’s a very good psychological support and therapy program that can help people to explore themselves and could speak out or express their feelings of stress or suffering through using any form of creative expression, without needing to only focus on talking. I feel comfortable working with my clients when I use Arts Therapy, many are children who love drawing, drama, dancing... is a good way to make them interested with the therapy.”(MTP Staff)

 

Willderness Therapy Programme Pilot - a new innovative approach in Cambodia

Wilderness Therapist, Lois Woodward from the UK is now working with the Ragamuffin Project and is bringing a new and innovative dimension to our therapeutic service to include the therapeutic use of the outdoors, in adventure, play and outdoor pursuits.

In June 2012 the first wilderness therapy pilot programme will be run my Lois and The Ragamuffin Team with M'Lop Tapang in Kep, Cambodia. The pilot programme is for young people who are living with challenging and distressing life experiences such as domestic violence, poverty and HIV. The pilot wilderness therapy/ creative therapy project will benefit 6 young people suffering from traumatic experiences who will have opportunity to experience an innovative form of therapeutic intervention combining creative arts, adventurous activities, wilderness expedition, camp craft, teambuilding, play, exploration and therapeutic support.

Wilderness Therapy has successfully been used with adolescents ‘at-risk’ of disaffection in the UK (Woodward, 2010) and with traumatised, militarised youth in south Africa (Schell-Faucon, 2001). Wilderness and creative therapies have been combined in programmes to treat young people suffering from addictions and with mental health conditions in the US (Crisp, 1996) this innovative programme, combining wilderness and creative therapies, is the first of its kind to be explored in Cambodia. 

The pilot project will test will the following questions;

  • Can wilderness therapy and Arts Therapy be successfully integrated in a programme to treat young people suffering from trauma in post conflict Cambodia?
  • How do the participating young people view their levels of self-esteem, pre and post intervention?
  • What happens to the participating young people’s levels of involvement as the programme progresses?
  • What happens to participants levels of resilience during the course of the programme?

The programme will be evaluated to inform the design of future creative/wilderness therapy programmes at Ragamuffin Project.

Please contact us if you would like to know more or specifically support this exciting programme.

 

 

_________________________________________________________________________________________________

References:

Crisp, S (1996)  An Investigation of Selected Innovative Mental Health Programs for Adolescents using Wilderness and Adventure Activities as a Primary Therapeutic Modality in the United Kingdom, United States of America and New Zealand. Winston Churchhill fellowship, Melbourne

Schell-Faucon, S (2001) Journey into the Inner Self and Encounter with the Other: Transformation Trails with Militarised Youth of Katorus, Centre for the study of violence and reconciliation.

Woodward, LJ (2010)  How can increased access to the outdoor environment via a 22 week intervention project have positive impact on emotional intelligence and self esteem of young people at-risk of disaffection?, Swansea University

 

 

 

 


With Ragamuffin Therapy
With Ragamuffin Therapy

Jacqueline Lee is an InTheField Traveler with GlobalGiving who is visiting our partners’ projects throughout Southeast Asia. Her “Postcard” from the visit in Phnom Penh, Cambodia:

On March 5, 2012 – I was able to visit Ragamuffin Project's Arts Therapy Clinic in Phnom Penh Cambodia and meet with Carrie and project staff. Immediately upon entering the Arts Therapy Clinic, I felt calm and at ease. Beyond the white building where therapy is done, there is a relaxing pond with fish and a back office. I was told that the participants are able to relax at the pond between sessions.

Carrie and the staff were open to discuss the programs, challenges, goals, and how the monitoring and evaluation is built into the program. After this we toured the space and a group therapy session was going on beyond the windows in the main room. Kids were smiling, playing, drawing, and interacting with two staff. The upstairs therapy room was designed as a "ship." When you walk in - the area is supposed to represent taking a journey through a storm towards "the light on shore". This journey is depicted in beautiful paintings around the space designed by a friend of Carrie's.

Finally, I was able to sit with Sam and Dyla, two staff therapists, on the giant colorful main-room pillows to discuss their background and the Ragamuffin art therapy program. This area was for children and adults to use as a peaceful and creative safe space after severe trauma. Creative therapy includes toys, art, music.. anything to allow participants' to express what they cannot say, understand, or immediately confront. Dyla also told me that because some children cannot travel to Ragamuffin's clinic - the staff will go to them to support and care via art therapy.  

Overall Ragamuffin Project is providing an innovative and positive response to a need for trauma therapy via art, music, and creative outlets for children.  Their success stories include breakthroughs in ability to communicate, reflect, and destress – as well as behavioral changes and a decrease in opting in for violence. The Ragamuffin Project, clinic, and even staff eminated care, expertise, creativity, and peace. 

Run for Hope - Welsh women run half marathon for Ragamuffin Arts Therapy Centre Cambodia

Run for Hope - Three welsh women are running with Ragamuffin Cambodia on the 11th of March in the 1st Sihanoukville International Half Marathon for Ragamuffin's Creative Arts Therapy Centre - all donations will go towards providing an opportunity for vulnerable and traumatized young people to benefit from Wilderness and Creative Arts Therapy. This will enable them to build confidence, self-esteem, strengths and hope in managing complex life challenges such as violence, abuse and poverty.

 

As Ragamuffin’s Arts Therapy Clinic for children and young people continues to grow and develop we have a challenge to resource and fund this ongoing work.

In partnership with six organisations, Ragamuffin’s Arts Therapists are working with children and young people with diverse needs and who are often from complex and extremely difficult socio/economic backgrounds for example:

 

  1. Children who live with HIV and have lost one or both parents from the disease.
  2. Those who have experienced abuse or the violence of being trafficked and sexually exploited.
  3. Children who grow up in families where domestic violence and addictions are prevalent.
  4. Children in situations of poverty where they are forced to be involved in child labour to enable their family to survive
  5. Children whose home is the streets or beach and are at risk from being exploited
  6. Families who have been evicted from their land and have become refugees in their own country

 

Creative arts therapy for Individuals and groups of children from challenging backgrounds where there is poverty, domestic violence, abuse, addictions and child labour.

 

The children attending Arts Therapy sessions have demonstrated the capacity to build strong connections and friendship both with each other and the therapists. They have understood the process and allowed themselves to become deeply involved with both their creative process and their challenging life experiences. They have been able to be more aware and express their feelings through different arts form such as drawing, singing, picture making, movement and play.

 

“when I drew the picture, I thought of my family’s problem and I have put all the feelings inside this image and this made me feel so much relief ” (10 year old client)

 

The group of children have learnt how to respect each other, to understand their personal and the group’s boundaries through their play and establishing corporate ground rules. They report experiencing warmth and love from each other as they have been learning to listen, hear and respect each other. Exploring understanding, empathy and forgiveness. Practicing how to manage relationships with each other in a safe and healthy way is enabling them to not follow destructive role models in their village and community life, enabling them to be more empowered. Some children noticed the positive changes happened to a few children in their group. For example, one of the boys said:

 

Recently, I noticed how Meyya has changed a lot since she came to Ragamuffin, she did not curse or beat other children in the village like before, the older children do that – its like you are showing us a new way”

 

Due to the organization and therapy team observation and the children’s own reflections, all the children do not have any safe place for them to play within their community. Coming to the arts therapy group has given them the opportunities to explore their creativity, resilience and positive resources, capacity to build up good relationships, to be connected, to be heard, and to be themselves. There were some key themes emerged through their arts work such as child labour, violence, family problem and poverty. Children have witnessed the violence of their family and other children’s family. They have suppressed a lot of individual and collective and trauma, and they were impacted in various ways such as losing motivation at school, depression, stealing, using drug, and bullying other. This creative arts therapy is critical for the development of these vulnerable children both now and in the future.

 

Development of research partner – The International Resilience Centre, Canada.

In order to both strengthen our research into the effectiveness of the clinic and also to explore and measure the impact of arts therapy on the levels of resilience in children and young people who use the service. The ragamuffin project are partnering with a pioneering International programme and will become one 5 programmes around the world exploring and disseminating models of best practice when working with young people.

 

Wilderness Therapy and therapeutic use of the Outdoors -

In September 2011 we were also joined by a Wilderness Therapist, Lois Woodward from the UK who is bringing a new and innovative dimension to our therapeutic service to include the therapeutic use of the outdoors, in adventure, play and outdoor pursuits.

These two recent developments are helping Ragamuffin develop the clinical work into new and rigorous areas and we are excited as a team of the benefits to Cambodian young people who face challenges.

 

“The children are lucky to have Ragamuffin’s support. I’ve noticed that they have better self-esteem, have less behavioural problems and are more open to exploring how we might support their medical care.” (Partner rganisatin Social Worker)

 

“Our collaboration with Ragamuffin is critical for the well-being of our clients, we are so please to have this partnership and see the benefits it is having. In the future we hope that this service can benefit all the clients in our care”  (Director of Partner organisation)

 

The partnerships also help Ragamuffin to support and respond to critical incidents and emergencies for the teams. Recent critical incident de-briefing has been provided for one partner who have been working to support children and women on the frontline of community land rights and eviction processes in Cambodia. A safe place where they can bring the impact of the work on themselves and receive professional supervision enables them to be more effective in the care of those they work with.

 

“As I am a Khmer citizen as well as an art therapist with Ragamuffin, I am really please and proud that a clinic such as Ragamuffin exist in Cambodia.  The Ragamuffin Project the few clinics was having the standard professional in Cambodia to use creative therapy tools. More than a year that I have been working as an Art Therapist in Ragamuffin, I have worked with many children that make me realize how they live in suffering condition, which affected from society to their life. Trauma affects the quality of their human being because those children are living with suffering that penetrates deeply on their soul and their inner strength. Moreover, there are many children that could not safe with themselves at all. At the event that they have chances to healing from Clinic Art Therapy of Ragamuffin, I can comprehend positive change of them since they can use the inner strength from oneself.

 

I do not want the trauma to continue from generation after generation, it makes my heart ache. When I have worked with those children, they have told me that they like to come here to “Ragamuffin”, moreover, this place is not only a beautiful place, but it also provides them a peaceful, safety and healing that they have never had besides this place it’s a place where they can truly be themselves and recover their heart and soul. 

I hope this Clinic will continue to receive funding in order to continue helping children in Cambodia and provide them a chance to explore, express, and acknowledge their emotions, their world and process, and allows traumatized children the ability to search deep within themselves and help them gain inner strength and confidence”. (Panchakna Khlok)

“I think it is so important for Ragamuffin clinic to be founded for a long-term work at least for another 5 years in order to ensure the sufficient healing to the clients. Right now, I have provided ongoing therapy to 36 fragile clients including individual and group work. All my clients are suffered by severe depression, anxiety, and behavioural problems that are caused by sexual abuse, domestic violent, addiction, and HIV aid. The clients have found this therapy process as the breath and sacred space to look deeply into their inner world that is full of unresolved conflict. And, it also helps them to find new positive relationship between their inside and outside world, and to navigate new hope, new way to solve their conflict, and to embrace self-love one again. Therefore, if the therapy process is uncompleted, their journey of self-discovery of finding light is stopped, and this will give strong impact to their courage and hope to move on in life. Obviously, they would go back to the same state of mind or left with many unprocessed or unresolved issue”. (Serey Samchet – Arts Therapist)

Why is the Ragamuffin Arts Therapy clinic important?

  • Firstly, Ragamuffin clinic is the only provider of art therapy in Cambodia and one of two specialist child mental health services.
  • The clinic has qualified art therapists which provide a high quality service.
  • The clients have the chance to work through deeper emotional issues, which may never otherwise be possible and so discover relief from a variety of symptoms of distress. 
  • Cambodia has had such hardships in the past and emotional and psychological health is a service area that is overlooked and not prioritised. There is a direct correlation between a person’s mental health and their ability to become an active and healthy citizen.
  • Having a safe, caring environment for clients to explore their own thoughts and emotions in a non-judgmental environment is rare.
  • The clinic has many beneficiaries, the clients, their familiars, partnerships, society and even at a conscious level for all of human kind, healing one heart one step at a time, will influence the greater consciousness of this country and this region.

What if the funding ends, what will happen and what will be the impact on the client and family?

  • If funding ends it does not only affect the current clients, but also the future clients that desperately need this service.
  • If we take this service away, Cambodians are left with a big hole, where the clients cannot access qualified creative arts therapist.
  • The clients emotional and wellbeing will be negatively affected and thus, may serve a greater threat to the future of the clients being.
  • Each individuals emotional growth and healing has no time limit and if we dictate a result without the consent of the client, individuation cannot be attained and hurt the clients sense of self.
  • Client’s emotional and psychological problems in their very real lives are vast and deep, hence finding answers can take time, if the funding ends client’s solutions to their vast thoughts and feelings will be hindered.

(The Ragamuffin Clinical Team 2012)

 

Every contribution makes a difference.

 

Thank you for your contribution and ongoing support. 

 

Carrie Herbert on behalf of the Ragamuffin Team Cambodia

Director of Arts Therapy Services

March 2012

Cambodia November 2011

The Khmer rouge trials continue and stir up memories. It is not that anything has been forgotten; not really, it is just that it is easier to live with the past if you try to forget it. It is, of course, impossible, and the pain, visceral and bitter haunts the lives of the Cambodian people who lived through the war and unsettles their children.

We are in our 10th year of working in Cambodia. Those who were not protected as children and young adults struggle to find the resources to protect children today – it operates like a blind spot on awareness; it has always been thus. Like a child who has never known the affirmation and security of loving parents has no internalised model of what this means.

Whilst there are parents who love their children and are doing all they can to care for them and prepare them for a future free of the trauma they suffered, there is nonetheless an increasing number of child abuse cases that few staff are equipped to effectively manage.

This is an intrinsic part of Ragamuffin’s work: to identify children at risk and provide a safe enough environment within the clinic for them to disclose their suffering and ask for help. Along with the training of staff teams in safeguarding Children using the powerful creative tools of Arts Therapy where Drama especially enables the re-creation of a real life situation and an opportunity to rehearse and refine a response in the context of a safe and supervised training process.  

We are, of course, not the only ones. This is an objective for many who work with vulnerable children. But for a child who seeks help from one of our therapy team in the context of the Ragamuffin clinic the therapist is sometimes the first and only one with whom the child feels their cry is heard and the anguish felt understood and respected.

It is very difficult to imagine a time here when there will be sufficient statutory resources to provide such services in Cambodia. For now The Ragamuffin Project is the only organisation in Cambodia providing Creative Arts Therapy, Training and clinical supervision.

The Ragamuffin Arts Therapy Team work with over 200 children and young adults monthly in individual and group therapy sessions. Young people are enabled to express their most difficult stories, emotions and pain through the safety of the imagination and creativity. A creative distance enables them to speak sometimes for the first time about their stories of rape, abuse, violence and trauma. These are unfortunately endemic issues in Cambodia and together with our partner organisations FRC/CRC, ISF, MTP, E&D, LICHADO we are seeking to address what lies at the root of these issues.

Your support is making the difference to the lives and souls of this work. This investment is an investment in the existing and ongoing capacity of this country. It is making a difference and will make a difference. Be inspired and be encouraged. When people feel well and happy in their body heart soul and mind they become true participants of their families and communities investing in the future for themselves, their children and their nation. 

"Your expression of care in the form of financial support continues to be an investment in the futures of children, and the adults who seek to serve them."

Kit Loring & Carrie Herbert

Drops of hope
Drops of hope

This narrative report provides an overview of the development and progress of the clinic from the perspectives of the clinical team, clients and organisational partners. September 2010 to August 2011 has seen remarkable developments and growth in Ragamuffin’s pioneering Arts Therapy work in Cambodia:

 

The door is opened!

The Ragamuffin Project recruited and employed a team of six Arts Therapists. For the first time in Cambodia Cambodians are providing effective and culturally sensitive therapeutic care for traumatised and vulnerable children and young people through Creative Arts Therapy.  In the past 12 months the therapy team have provided 262 individual client therapy sessions and over 760 children and young people have attended group therapy sessions. Our team of young and dynamic Cambodian Arts Therapists are pioneers in the use of Arts Therapy in the transformation of suffering into hope for the future.

A word from members of the Therapy Team…

Sophea Kuy – Ragamuffin Arts Therapist 2011

“Working as a therapist with the children is like the morning mist that gives the freshness to the grass and flowers as the new day dawns. Through the sorrow and pain, beauty is found as together we create and grow. As I watch them heal, I too am being healed. Arts Therapy helps those who are suffering to find a find space to breath and begin to discover a new way for their life and to see the world anew. As an Arts Therapist I believe that art helps the clients to face the most difficult challenges they have in life and find relief and hope.

 

In Cambodia many people from young children to the elderly faced the war and have also been abused. Culture and tradition means there are few opportunities for them to speak out the deep feelings and painful stories they hold inside. Cambodians are suffering and this clinic is one of the few places that provides a great help to them. I believe the clinic does not only benefit the children but also their families too, the children lead the way and they are our country’s hope for a different future.” (Sophea Kuy 2011)


Chatti Phal – Ragamuffin Arts Therapist 2011. 

“As a Khmer-American, I did not realize the immense need for psychological services in Cambodia until I came here.  As a foreigner, we are so removed from the problems of a different nation that sometimes it becomes invisible to us.  We see stories on television, but we don’t fully understand the impact it has on a society. Being an Arts Therapist in Cambodia has been eye opening.  There is a lot of injustice happening: forced evictions, prostitution and sexual slavery, children are made to go out on the street to work in order to support their families, there is so much domestic violence, and everyone is impacted by generational trauma.  These are all children that we see in the Ragamuffin Arts Therapy Clinic. Arts Therapy helps the children to self-regulate, to recognize and assess their inner resources, to start to learn the different ways in which one can explore and express themselves. I also believe that the work that Ragamuffin is doing is setting the standards for professional mental healthcare in Cambodia.  Our therapists are all trained in Arts Therapy, we understanding the therapist professional code of conduct. We have strengthened our Child Protection Policy and Protocol with our team and our partners, so that all children who come to Ragamuffin will feel safe and protected from harm” (Chatti Phal 2011).

 

Complex, multiple needs...

Ragamuffin’s Arts Therapy Clinic for children and young people continues to grow and develop. In partnership with six organisations, Ragamuffin’s Arts Therapists are working with children and young people with diverse needs and who are often from complex and extremely difficult socio/economic backgrounds for example:

 

  1. Children who live with HIV and have lost one or both parents from the disease.
  2. Those who have experienced abuse or the violence of being trafficked and sexually exploited.
  3. Children who grow up in families where domestic violence and addictions are prevalent.
  4. Children in situations of poverty where they are forced to be involved in child labour to enable their family to survive
  5. Children whose home is the streets or beach and are at risk from being exploited
  6. Families who have been evicted from their land and have become refugees in their own country

The following is an extract from a report by one of Ragamuffin’s Arts Therapists:

Creative Arts Therapy work by Serey Samchet (Ragamuffin Arts Therapist 2011)

During the past 6 months I have been working with clients in both individual and group therapy. These include clients referred by the French/Cambodian Red Cross who are infected by HIV, and referrals from Enfants et Developpmment who work to improve life opportunities and psychosocial support for vulnerable children and their families. During the therapy sessions, I have used different arts forms as the tools to allow the clients to assess and express their feelings and problems.

Positive outcomes:

Throughout my journey as an Arts Therapist, all clients have reported the benefits of receiving the therapy and how Arts Therapy has given them the healing space to explore their creativity, competencies, strengths, values, safety and trust and find calmness in difficult circumstances, and so begin to find change, light, hope and their capacity for empathy and love. The therapy journey has become the inspirational space for them to discover themselves and so find the courage to move on in life. The series of changes and transformation emerges with the flow of creativity and the therapeutic relationship during each session. 


Case study:

 I have a client who is 14 years old, and he is HIV infected. He is under medication (ARV) second line. He is an orphan. He used to be burnt and physically abused by his father. Tragically the whole family died in a fire and he was the only person who survived and witnessed everything during the incident. He became withdrawn, and unable to engage or communicate with anyone after this event. During the first therapy sessions, he was so quiet and said very few words to me, there were often long pauses of silence and it was difficult for him to stay for the whole session. I felt his silence was communicating so much, I too became still and patient, it was important for me to wait until he was ready and felt safe enough to begin to open up. By the third session, he drew some pictures silently and I witnessed how his pictures reflected the deep stories he was holding inside him. 

 

In sessions we used art, objects and played musical instruments. He never talked or told me directly of what happened to him but we interacted with each other through the language of these creative mediums. He repeatedly created battle scenes where he acted out a war between soldiers and monsters. It was violent and aggressive. Over time he began to discover how he could express his deep rage safely through the Arts. In the torn paper (see image left) he started to share the story of the torn paper mess that he made. Through the torn paper he began to express his torn life and all the fear and suffering within his heart, body and soul. This was such a breakthrough for him – he was brave and honest. In each session that followed, he was on the journey of self-discovery to find the courage to fight with all the discrimination he had experienced from family, friends and his community and so begin to discover his true identity and self worth.

 

Each session has become the remarkable moment of helping him to restore his inner resources, creativity, self-identity, confidence and resilience. We were together in a sacred connection through the Arts.

 

Over the course of the therapy he started to take the lead and create very different play experiences and through this he began to tell me about his hope for the future. He began to discover that he had dreams, a talent and a realistic vision to learn to be a chef and cook delicious food. His joy has spread from the inside out and other people have started to recognise the changes in him.

Feedback from our partner organisation:

“I am so surprised to see a lot of remarkable changes in his behaviour, communication, and self-care. He was totally withdrawn and now he initiates play with other children in the orphanage, and can verbally communicate with other people both at school, and in the community. He can tell me and other people what he needs, especially; he can take medicine (ARV) regularly by himself without any need for me to remind or do this for him. It is a truly remarkable change!.“

(Support Staff French/Cambodian Red Cross 2011)

 

 The therapy has been an ongoing process to help bring positive transformation to the client ‘s life.

 

“I have noticed a lot of positive changes in him, he has became cheerful and socialize with other children in the centre. And he is looked completely different from the past.”

(Feedbacks from one of the housemothers in the orphanage)

Arts Therapy has become the oxygen for some clients to move on in life. As another of my client’s reflected saying:

“My heart has already died but no one knew of what going on inside me, but whenever I come to Ragamuffin, I have found the new breath and oxygen to live for the next day”

 And from clients...

Arts Therapy and the therapist can become the only safe place and survival space for the clients to find their courage to live through their distress and challenges as another client describes:

 

“ At Ragamuffin, I can see what really happens to me, my life is so complex and nothing can change it, but to be here helps me to look at other possibilities and find a new hope to live alongside with the complexity of my life. I am so thankful – I know so many more children need to come here to have what I have found. ”

 

My reflections as therapist 

"Overall, throughout the first year of Arts Therapy work, it has been a fruitful, creative and beneficial journey for all my vulnerable clients. The positive transformation of the clients has inspired me and given me so much energy to keep on my therapeutic journey by using the arts. Arts Therapy has shown to be the medicine to heal people’s soul, to bring the positive transformation and to be the bridge for people to walk across to another side of their life. It has helped them to discover the truth and to look for a new hope, and courage beyond fear. I strongly believe in Arts Therapy and my work. I can see how Arts Therapy has naturally helped my clients to find healing and to discover their inner resources by its gentle and powerful process. The more I work in this field, the more I feel that Arts Therapy is one of the most powerful and safest tools for trauma therapy in Cambodia". (Serey Samchet 2011)

 

Healing home...healing hearts...

Ragamuffin House is a unique sanctuary for Creative Arts Therapy, Training and Supervision. The environment is one of peace, safety, healing and playfulness. An outdoor meditation garden brings the inspiration and comfort of nature to support all who come for Arts Therapy.

 

“ A house surrounded by the nature, waterfall, flowers and sunshine - it makes me feel protected and I want this environment at work and in my life because I feel safe here and it’s the same feeling for the children coming here too!” (Organisation Partner Support Staff 2011)

 

Hand in hand...

The clinical team also work closely with the partner organisations. This includes provincial work in Kompong Cham and Kompong Som. Such work has enabled the development of psychosocial programmes of care within organisations in remoter provinces where there are fewer services.

 

Working with Partner Organisations enables us to develop joined up services and strengthen the capacity of each organisation’s psychological services. Training, the development of policies and protocols for safeguarding children, and providing programmes of individual and group Creative Arts Therapy all serve to meet children in their need and deepen an understanding of the emotional and psychological needs of children for the staff team. This helps create a response to children that is sensitive,and aware. To this end Ragamuffin Therapists also provide a specialist service that works alongside social workers, caregivers and medical staff.

 

Capacity building with partenr organisations:

 Ragamuffin are also building the capacity of 8 key staff from the partnerships through our Foundation and Advanced Training Courses in the Healing Arts. This will build the capacity of the organisations to provide Arts Therapy whilst also increasing continuity of the care for young people.

 

“The clinic team come to MT every 2 weeks to work on difficult individual cases and group work with many children. The team offers great supervision and has helped our staff to learn how to reflect more and use art forms to express themselves and help their clients to discuss issues that may be hard to talk about with more traditional counselling. We have used what we have learnt for so many children and use regular art therapy with 150 youth in prisions every 2 weeks, and to 20+adult clients in our alcohol support group. We also use Art Therapy in our staff peer support groups as well as for group work with our youth groups: Happy Bird and Red Rose groups. We have worked in close partnership with Ragamuffin for over 6 years and they have consistently supported us on many levels, training individual staff on the foundation and advanced Healing Arts Therapy courses, and offering tailor made group training for our social workers and counsellors. They have a good understanding of the setting we work in and the training / lessons are well planned to meet the needs of our staff. Our relationship is positive and long term”. (Maggie Eno MTP Director 2011)

 

Clinical supervision and care for staff teams.

Capacity building and de-briefing for staff is critical for those working on the frontline of care in ensuring they are themselves resourced and sustained in their roles of caring for vulnerable or traumatised children and young people:

Giving space and a chance for someone to share their feeling with others is like giving them light to find the way out from a very dark room. The therapeutic training creates empathy, support and care to the staff. It is like the water that helps people to live everyday (Phea – Ragamuffin Arts Therapist 2011).  

 

“ I did not know it helps this much when you can share your story or your feeling with someone you feel you can trust until I tried it. It helps a lot and I feel fresh in my mind after that, especially they listen with care and empathy. I feel this will help me to understand the children more”.

(Organisational Partner staff 2011)

 

Responding to Emergencies - Koh Pich Bridge Stampede

During this time Cambodia suffered another tragedy. On November 22, 2010, during Cambodia’s most celebrated Water Festival, a stampede on Koh Pich Bridge in Phnom Penh killed 347 people and injured over 700. Working alongside organisations involved in frontline care, Ragamuffin has been providing Arts Therapy sessions for survivors and de-briefing for organisations whose staff responded to the emergency.

 

After such a shocking and unexpected event, many were deeply distressed. In particular, children and adolescents are struggling and needed support. Such an immediate response helped ameliorate what might otherwise result in more deeply set psychological reactions to this trauma. Giving vulnerable young people  the opportunity to address their psychological and social needs has been crucial to their longer–term well being. Shock and grief can be extremely debilitating when the impact of a traumatic experience is not recognised and understood and meaningful, sensitive and professional help is not available. The clinic staff, together with our partners, have all played a significant role in this process. Ragamuffin’s Arts Therapy Clinic has now developed a policy and protocol for responding to emergencies in Cambodia and will work together with the National Disaster Management Committee and our Clinic Partners in the provision of any programmes of response in the future.

 

Concluding thoughts - Rachel Hiskins - Arts Therapist 2011

The positive thing about the clinic is that the clients have a space to be and explore their lives through creativity in a safe and therapeutic environment. The client's would never have the opportunity to be able to work with the Art Therapy team and their skills if the clinic was not funded. Art Therapy is so important for clients that find it hard to express their emotions and feelings through words, thus working in Cambodia serves to be a stupendous match. I have found my client to be enthusiastic and passionate about visiting Ragamuffin every time. Coming to Ragamuffin is where she can explore her self without judgement in a beautiful and safe environment. As a therapist I feel that in each moment spent at Ragamuffin I am enriched with more knowledge and skills.


I recommend that this clinic be funded so Ragamuffin can expand and develop and that the clients are able to access such a great service. Its important to remember that Art therapy like other helping professions, do not have a quick fix. Art therapy is marvellous, as it can trigger empowerment and allow the unconscious to speak. Through our lives, we become detached at times, so when we speaking through the image, the client is able to transcend and speak from their true inner self. (Rachel Hiskins 2011) 

Thank you for your continued support...for believing and giving hope...

The Ragamuffin Team Cambodia
The Ragamuffin Team Cambodia

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Organization

Project Leader

Carrie Herbert

Ms
Phnom Penh, Cambodia

Where is this project located?

Map of Arts Therapy Clinic-Children in Crisis-CAMBODIA