Arts Therapy Clinic-Children in Crisis-CAMBODIA

by The Ragamuffin Project

Before we share some news and information on our staff care programmes. We would like to say thank you for your ongoing support, for your generosity and for your faith in Ragamuffin’s work with those who are often most marginalized. Every contribution whether financial or in reading these reports and staying connected is deeply valued, noted by our team and makes such a difference to us continuing to provide our services. On behalf of everyone in Ragamuffin Cambodia – Thank you!


‘Sustaining the Frontline’ - caring for those who care for others

 In any humanitarian work, staff well-being and professional de-briefing is as important as programme delivery. The human resource on the frontline of care is an organisation’s most vital asset and staff well-being, when dealing with daily trauma and crisis in their work, must be carefully considered if staff themselves, and their families, are not to become severely and negatively impacted by their commitment to bringing aid and solace to others.

Ragamuffin works together with those who aim to empower and sustain individuals, families and staff teams in the restoration and development of healthy communities and work places.

In partnership with local and International organisations in Cambodia, Ragamuffin provides staff care programmes and intensive de-briefing. This work is critical in the support of those who work with those who suffer. Ragamuffin has been recently working with over 10 partners who support those who have been victims of trafficking, forced labour, young girls in crisis, and those who have been through traumatic events. In a recent staff care progamme for an organization that provides crisis care for young girls, a member of the team explained:

“I got to know my colleagues so much more deeply – their value and contribution to the work and recognised their ability to work so well and faithfully…we learnt a lot from each other …we’re normally so busy we don’t get a chance to appreciate each other … we need to keep this in mind …there was so much meaning in our pictures! Such a surprise!”

These thoughts demonstrate the importance of an opportunity to deeply value each other. Through the creative work each member of the staff team was able to recognize how much they were giving out and the cost this has to them. This was both moving and fun! There were such poignant moments as internalized pain found expression; and lots of joy and laughter as gifts were made and shared – everyone made something for everyone!

Collaborative parterships with teams and organisations enable both strengths and resillience to be celebrated, and also the discovery of personal, professional and organisational tools for staff care and well-being initiatives that can be realistically and effectivley implemented into practice.

“It’s so important that we are able to do this - it’s our chance to express and journey through the impact of what we are holding with our clients, the terrible stories we are hearing and how to care for and protect ourselves”

These programmes help groups understand the phenomena of vicarious trauma as we consider (through a range of creative processes) what we give out and what we take in as we do our work. Staff tams are enabled to recognise that to ignore the symptoms of vicarious or secondary trauma and the stressors it places on ourselves, our colleagues and our families is to neglect the vital instrument of care that each member of staff is. People are not machines, but it would never cross our minds not to look after and maintain a machine on which we relied.

It is so evident that regular opportunities to debrief and be restored is essential to the well-being and effective functioning of these much needed teams of dedicated individuals working with those in crisis. As they too then support children and young people who both are supported by their organisations and also who are referred into Ragamuffin’s Arts Therapy Clinic.




"You have helped me find my light in my heart again" (Young woman recieving Arts Therapy)

'Throughout my therapeutic work this year, I have been working with young orphans who have had HIV since they were born. They were referred to Ragamuffin to receiving our arts therapy service as they are individuals with complex family backgrounds. They have experienced many problems and have challenges with attachments, depression, behavioral issues, social stigmatization, unprocessed grief, and poor quality of life. Some were abandoned by relatives or rejected by friends, teachers at schools or by some people in their communities even though there have been a lot of media and health programs to promote awareness on HIV transmission. Apparently, for most people with HIV they still struggle with both social and self-stigma and these young people feel like they are holding a deep shame with an invisible emotional wound throughout their lives. As the result, they feel their world is "small, dark, and chaotic in which no one could understand and see them”. So our work is about creating a safe therapeutic relationship in which these young people can learn to feel safe again, to feel valued, and deeply heard. 

During the arts therapy process, the young people found the process like a sacred, personal and healing journey to their heart, and soul which enabled them to find their truth, there deep selves, new courage, and hope in order to move on in life or to navigate a way to discover loving kindness and compassion toward themselves and others. The art forms and other creative processes were used as therapeutic tools to support them emotionally and spiritually which provided a gentle flowing and natural way to express and reflect on difficulties and life experiences. Ultimately, they found their lives getting better, they were able to feel braver and more able to cope with the challenges of their illness and share their deeper pain and distress in side through their art and with me as a therapist. On behalf of these young people I would like to express my gratitude to all the supporters from and through Global Giving that help to make these life changing experiences possible' It is so important young people on the edges of life can recieve this therapeutic support'. (Serey Samchet – Director of Ragamuffin Cambodia and Senior Arts Therapist

Young people living in Cambodia experience so many challenges and demonstrate such a degree of resilience. Ragamuffin Cambodia continues to support those who are in crisis, are marginalised and are in need of expressive and creative outlets for their pain and distress. We also support those who self harm or live with very destructive family and social contexts, creative arts therapy is a powerful process to support a young person to express violent or destructive energies safelyas a result of their own feelings and experiences inside and also  what they witness and experience around them. We continue to support staff teams and organisations who work with the most vulnerable through training, staff care and supervision programmes. We believe the vital resource of those who care for, nurture, protect and support others, especially needs support, encouragement and opportunity to reflect and be strengthened. Ragamuffin Cambodia are providing a series of intensive staff care programmes in partnership with the Chab Dai coalition Cambodia and will also be running its next professional development training in June on Arts therapy and conflict transformation as part of our on-going services.

Thank you again for your continued support of this important work in Cambodia and the beneficiaries its serves.

“On Valentine's day, we tend to look for love from our loved ones and other people, but we always forget ourselves. For me, Valentine's day is the day that reminds all of us of universal love and the day that enables us to reflect on what we can do to express love, gratitude, and forgiveness to one's self, our beloved persons, and other beings”. Bouyheak Lim, Arts Therapist Ragamuffin Cambodia.

Cambodia was recently described by the Washington Post as being “The country where Valentine’s Day is the most dangerous day of the year” for its high incidence of rape and non-consensual sex.

In a rapidly evolving city culture where traditional values and an emergent youth culture are trying to navigate the complexity of change. Finding positive creative channels for expression, self-awareness and choice becomes so important for young people.

Bouyheak Lim from Ragamuffin's ‘Be yourself’ - Arts Therapy Team created and ran a workshop to celebrate love in a different way on St Valentine's Day. “I wanted to provide an opportunity for young adults to use creativity to discover more about who they are and how they really want to live their lives. Discovering strengths, qualities and positive decision making through engaging in an in-depth creative and therapeutic process. This resulted in participants discovering more about who they are and what they can be in the world from the inside out. Creativity naturally empowered them, building esteem, confidence and fostering the skills to cope with the complexity of life decisions. It was such a success we are going to meet on a regular basis“.

In the Be-Yourself Arts Therapy Clinic – children and young people referred to a therapist face a myriad of complex problems from living with HIV, or having suffered abuse or the loss of a significant person, through to managing challenging family and social circumstances. Behaviour is so often a symptom of underlying distress and is so easily misunderstood. Giving these young people the opportunity to explore safely and gently through creativity the disturbing and distressing feelings they have helps to mediate destructive symptoms from challenging behavior acted out to self-harm.

“The arts therapy clinic is a critically important service to both prevent more problems whilst provide specialist treatment and support for those with more severe problems” Serey Samchet Senior Arts Therapist.

Ragamuffin’s music programme Songkites is working on an awareness raising campaign in collaboration with the Be-yourself project to promote positive messages about mental health and well-being for young people in Cambodia. A collective song is being written, recorded and a short film created by young people voicing their thoughts about what it means to ‘Be Yourself’ as a young person in Cambodia. This programme aims to raise confidence self-esteem and awareness.

Ragamuffin continues to also provide training and support for professionals who work with those who suffer. In March we will be providing a training course exploring loss and grief called Bitter Sweet Sorrow.

Learning how (and what) to grieve. Discovering what it is we deeply value and the impact and meaning of loss in our lives

Every loss is to be acknowledged. Every investment made matters. To lose someone or something dear to us is to lose something at the very heart of us, part of what makes our lives meaningful and fulfilled.

Grieving is so important. When the process of grief is blocked we too can become blocked; our pain is then displaced into a range of symptoms both physical and emotional/psychological. It impacts our confidence, our relationships, our personal sense of purpose, vitality and vision.

Grief is as complex as the experience. The loss of an elderly parent in a peaceful death is one we may have had time to prepare for. Sudden tragedy such as, for example, the collapsing of a bridge at the Cambodian water festival in 2010, leaves no time to prepare; nor does assault, suicide or a tragic accident. From wars and natural disasters to the loss of livelihood, every loss and grief, both individual and collective is unique and rarely follows a linear trajectory.

Learning to grieve and to value grief is crucial to psychological and physical well-being.

This is the subject of our training course. We will be using the gentle, powerful art of creativity to guide us in our explorations through an individual and collective reflective process. We will also consider how such insights and therapeutic techniques will apply to our work with others who are in the midst of grief.

Therapeutic training builds capacity of those working in the psychological sector in Cambodia and continues to strengthen the network of partners and multi-disciplinary responses to caring for those who suffer.

On behalf of our clients and the team here, Ragamuffin Cambodia would like to take the opportunity to deeply thank the generosity of supporters donating through Global Giving who are enabling this service to continue to benefit children and young people in Cambodia.

Ragamuffin's Arts Therapy Service - Be-yourself - responding to endemic trauma and violence in Cambodia's young people.

Violence against children in Cambodia: breaking the silence

“When we arrive at school and it is early and we are alone, it is quiet and we are afraid…”, admits a 13-year-old Cambodian girl. School should be a familiar and welcoming place; however, findings from the first-of-its-kind Cambodia's Violence Against Children Survey, coordinated by UNICEF Cambodia, reveal that many children are subjected to violence at the hands of people they know and should trust in places that should feel safe.

More than half of children experience physical violence before 18 years of age, with more than 20% facing emotional violence, and 5% sexual abuse. Parents, neighbours, family members, and friends are responsible, and many children remain silent, with 40% of girls and less than 6% of boys seeking help after sexual abuse. One 16—17-year-old girl explained that she did not tell anyone because the abuse was “embarrassing and shameful”, adding that “we are afraid that others will stop being our friends, or liking us; they will hate us, criticise and scorn us”.

The violence affects the children's health, causing mental distress and suicidal thoughts, and increases the likelihood of contracting sexually transmitted infections through later unsafe sexual behaviour.

What can be done about this appalling situation? The report provides recommendations in four key areas: prevention, response, laws and policies, and monitoring and evaluation.

(Above article cited from: The Lancet, Volume 384, Issue 9954, Page 1550, 1 November 2014 doi:10.1016/S0140-6736(14)61971-1)

How are we responding to this?

For many young people in Cambodia facing such complex psychological trauma healing takes time and begins with a young person finding a person they feel safe enough to begin to share their experiences.

The Be-Yourself Arts Therapy team working at Ragamuffin provide therapeutic support for young people in crisis, so many of whom have never had the opportunity to feel safe enough so as to begin to trust again – to be listened to and heard. Enabling a young person to feel safe, respected and valued are fundamental principles and foundational in the team’s approach to psychological care. The creative arts provide a safe, gentle and empowering approach to enabling young people to share their story. They don’t have to talk directly about their experiences unless they want to and so their creative code serves to create a sense of safety and emotional distance from experiences that would otherwise overwhelm them. The process engages the young person’s inner creative resource and naturally begins to restore and build their sense of value, self-confidence and self-esteem. This enables a young person to begin to acknowledge and realise their own sense of worth and resilience, and this becomes the first step in them being enabled to journey towards looking at deeper issues of trauma and violence.

Eight young people came for an initial assessment session at Ragamuffin Boathouse in partnership with M’Lop Russey an NGO working to enable young adult orphans to transition into community living from institutionalised care that is gradually being phased out in Cambodia in favour of more community based responses to supporting vulnerable young people. Through a creative therapeutic process the therapist worked with the group to enable them to feel safe to begin to share their experiences. Here is some of their feedback:


‘The first time in my life at Ragamuffin Boathouse

“It was inspirational today being at Ragamuffin.”

“It was the first time in my life I have felt supported and heard”

“I made a different kind of friend through this picture making … we are the same age and after all we have been through …. they understood me… I felt so understood by everyone today … I feel so relieved”

“I have never had the chance to look at good things in my life… everything has been bad, really bad, so I feel bad too about me its like all the flowers were torn apart until there was nothing growing anymore – I could only see what was lost and destroyed… nothing had any hope or life and I … didn’t want to live too….”

So far, when he thought of himself, he could only see the problems and what he has lost in his life. This morning, in the group was the first time for him to begin to reflect on who he is and what he is really worth. Sharing this in the group through creativity became so empowering and supportive. Everyone in the group began to recognize themselves for who they really are and also begin to see each other. “It made me feel not on my own anymore”. The group began to report feeling less isolated, more understood and respected. (Ragamuffin Arts Therapist)

“I have never thought that you would feel the same way too… I always felt so alone”

The process enabled them to begin to restore a sense of well-being, inner confidence and resilience that will enable them to draw nearer to deeper issues of challenge in sessions to follow. Together, through the healing power of creativity and relationship - hope breathes hope.

Thank you for your ongoing support of Ragamuffin’s Arts Therapy Service for vulnerable young people and children in crisis.

Please contact us if you would like to know more information about our services at

Foster Parents Capacity Building and Support Programme


Ragamuffin Cambodia is an INGO delivering Creative Arts Therapies, training and supervision in partnership with organizations in Cambodia. Ragamuffin is committed to the relief of emotional pain and psychological damage in children and adults. We work together with those who bring such relief to people who suffer.

In Cambodia, Ragamuffin has been working with M’Lop Ruessey (MLR) and previously with ICC/SKY since 2004, designing, delivering and evaluating Creative Arts Therapy, clinical supervision and staff support programs to build the capacity, empower and support those who work with emotional and psychological distress and trauma.

Be-Yourself is the Cambodian led Clinical Arts Therapy Service in Ragamuffin. Since 2012 Be-Yourself has been working closely with MLR delivering arts therapy for children and adolescents in crisis, multi- disciplinary team case working with social workers and support staff, along with support and de-briefing with foster carers. As Institutionalised care in Cambodia moves towards community led care, foster carers will be increasingly needed for short and long term placements of care leavers. Their support, capacity development is essential in providing effective care as they create family environments for young people.

MLR are currently supporting families who have been offering emergency foster care to vulnerable children. Those children were transitioned from the different orphanages that were legally shut down by Cambodian’s government. So far, those families are working closely with MLR in providing physical, psychological, and social care to the children before they will be reintegrated back to live with their families or transitioned to live with other long-term foster families. Serey Samchet from the Be-yourself Arts Therapy team is providing therapeutic de-briefing, capacity building and social worker case support for these families.


The creative process helped the foster families to begin to consider their needs in order to support themselves and children more effectively.

“ This is the first time for me to begin to see what I need for my work with children…by receiving more support this will help me and other foster families to build more confidence in supporting vulnerable and traumatised children”(Foster Parent)

“I feel so grateful with this opportunity as it is so helpful for me to realize that it is so important for me to learnto seek support for myself and children when I find myself feeling so overwhelming in dealing with problems and situations that are beyond my capacity to handle it. For example, if there is any child struggling with mental health issues, she may need a therapist, now I know I can refer children to get professional support – I feel so relieved” (Foster Parent)

The foster parents reported a significant decrease in their levels of anxiety and an increase of self-esteem by reflecting and being together as a group. They were able to learn from each other’s experiences and so deeply inspire each other. As a result, their sharing helped them to identify the similarities, difficulties, values, and helpful ways to handle problems.

“After hearing the challenges and positive things that other foster families have shared to the whole group, I found them to be so inspirational and I began to feel connected and realize that I am not alone in struggling the everyday difficulties in caring for vulnerable children” (Foster Parent)

‘Giving Gratitude’

“It is the first time for me that I felt the deep connection as we shared with each other as foster parents and I am so excited to learn and exchange my experiences with other foster families which I found it so inspirational and beneficial“ (Foster Parent)

“I have never been asked to consider things that I need to thank myself for before. It is the first time in my life to feel so deeply touched and see how much I have contributed mysupport to the children, family, and society, it really helps me to realize that I am important and I do not need to be perfect to be important” (Foster Parent)

Be-yourself – continues to support foster carers, social workers and vulnerable children in crisis in partnership with NGO’s such as MLR.

Thank you for taking time to read this and showing your support for Ragamuffin Cambodia and the mental health of those most in need.

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Organization Information

The Ragamuffin Project

Location: Phnom Penh, NA - Cambodia
Project Leader:
Carrie Herbert
Phnom Penh, Cambodia
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