Arts Therapy Clinic-Children in Crisis-CAMBODIA

by The Ragamuffin Project
Vetted

"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. http://www.washingtonpost.com/news/morning-mix/wp/2015/02/12/the-country-where-valentines-day-is-the-most-dangerous-day-of-the-year/

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 projectmanager@ragamuffinboathouse.com

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.

Outcomes:

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.

 

Beautiful Me - Eating Disorders, The Image Complex and Notions of Beauty and Attraction for Men and Women.

“If we can only look at each person’s natural inner beauty, before looking at the physical beauty, its hope, like finding the light to light the darkness. Ragamuffin’s training course has made me feel valued again. It makes me want to continue my life., It has given me hope – a hope that I know I will now give this same degree of care and compassion to the young people in my care” (Course participant, social worker & educator)

Professional development training and development of clinical therapy services for young people

Young people in Cambodia, like young people anywhere in the world, are trying to make sense of who they are, and how to be who they are. In a rapidly changing urban climate, where development is in constant change, young people are facing the complex challenges of being increasingly exposed to international and Asian media’s notions and images of external beauty. Young people are having to navigate and quickly learn to manage the transition from a more traditional cultures’ notion of beauty towards a more contemporary context. There is no let-up from the pressures of materialism and a socially imbibed construct of self-image. This exists alongside ongoing challenges of poverty and societal challenges that impact well-being and resilience.

Almost every young person who is referred to our Arts Therapy service faces issues of self-esteem, confidence, self-image along with deeper stressors and troubles that have a more long lasting impact.It is these very issues of domestic violence, abuse, trafficking and chronic poverty that are compounding the very real challenge of transition in a changing climate for young people.

Ragamuffin seeks to design continuing professional development programmes (CPD) for our Clinical Arts Therapy team, organisational partners and the wider psychosocial community in Cambodia to support, equip and raise awareness of such pertinent issues. The aim is to enable Cambodian professionals to become more aware of the underlying issues and the range of coping strategies a young person may utilize to manage life. Such ongoing training increases the capacity of therapists and caregivers to effectively and compassionate respond to the needs of young people in distress. It also enables them to ask for help and gain support when they feel out of their depth or at the limits of their competence.

In response to these issues Ragamuffin provide a rolling programme fo CPD training workshops. One example is Beautiful Me, a 5-day Professional Development Course for Clinicians and Carers on Eating Disorders, The Image Complex and Notions of Beauty and Attraction for Men and Women.

The course was attended by therapists, educators, social workers and professionals including those who work in beauty industry in Cambodia.

On the course we explored:

Our weight, and whether we see ourselves, and others see us as attractive or not, which matters to so many of us. We know that both genders are affected by this pressure, but perhaps women suffer the greater demand to look the part.

There is growing anecdotal evidence that suggests that young Cambodian women are developing traits of what was once thought to be a Western disease; Eating Disorders: Anorexia Nervosa and Bulimia are on the rise.

The workshop flyer asked, What gives rise to this distorted perception of the self - A ‘Hall of Mirrors’ conspiracy where the mind attacks the body? What deep sorrow, or unmet need would lead someone to such obsession?” and further stated, “

Reassurance that, “you are beautiful just the way you are”, will unlikely be enough to put the mind at peace and ease the growing distress.

In a country where understanding of this is at present limted we aimed to address, “What is an Eating Disorder? What causes it? What can be done to help prevent young women, and sometimes men, from developing the symptoms, or treat those who have full-blown Bulimia or Anorexia Nervosa?

In this training workshop we worked toward a deepening understanding of what motivates those with eating disorders, and considered our reactions to those who suffer from them. We worked together in experiential contextualised dramatic role plays to increase our capacity to respond to the underlying issues that can result in the development of a potentially life threatening illness.

The course combined a creative study of the subject with creative approaches to working with those we come into contact with, who are either already unwell, or showing signs of developing an eating disorder.

This course is so important because this subject is invisible - people don't know about it. People have eating disorders but we can't identify it, there has been no education here, no research and nothing or little in the way of treatment programs. To be part of this course helped me to begin to consider the issue, and realise the number of people who aresuffering from this issue in Cambodia. As a therapist I am now more aware of what eating disorders are.,It has increased my capacity and confidence in being able to do assessments and how to help young people who are facing this crisis. It has also helped me to consider what support network is needed for anyone who has a severe eating disorder and how we can begin to find the appropriate resources to support such a person. It is such a gap in Cambodia to even consider these issues - it is so very important, many others need to learn about these issues.” Serey Samchet – Senior Arts Therapist – Be-yourself Project, Ragamuffin Cambodia.

“Throughout out the course I have learnt that there is so much more to eating disorders than just the thought of being skinny. Now I have a much deeper understanding. When we talked about what's inside of us, and emphasized this more than just looking at what's on the outside, we found so much beauty and this began to shine through everyone on the course.

I have learnt that often, when people change their outside appearances drastically, they are trying to protect, control or hide something inside of them that is so painful or distressing.

After the course I'm much more aware. I will approach my clients differently after getting this knowledge. I also think that my eyes will be more open to the signs that people with lower self-esteem or the potential to develop an eating disorder show. I will try to help them right away instead of waiting for it to get worse and worse.

I need to see those invisible people and help them. I know how I can see them more clearly now and am much more ready and able to respond” (Course participant, Social Worker)

“As a Cambodian educator, I never knew what an Eating Disorder was. However, during the course we explored the cultural issues for young Cambodians and I remembered an old novel we were all familiar with. It's a tragedy about a young woman whose circumstances of family conflict and lost love resulted in her gradually stopping eating to a point at which she died. I never thought that it could be a sickness of the heart which could lead people to death.

I now have learnt so much more about what this really is, how it can develop, what causes it, and what can be done to help prevent young women and men from developing a very serious illness.

I see this issue in the young people in our care who experience so much pressure from the media and each other to look a certain way. Some of them weigh themselves 4, 5, 6 times a day. It’s a real a problem this issue of self-image and beauty.

I can now begin to help them to be more aware and develop a positive relationship to inner beauty and self-confidence. We can also begin to recognize the reaction or behaviour of those who have, or who might be at risk of developing a more serious issue or illness. For those where that is the case, we can take them to get professional help and support – everyone who cares for young people in Cambodia needs to understand these important issues”(Course Participant, Education Leader). 

 

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Organization Information

The Ragamuffin Project

Location: Phnom Penh, NA - Cambodia
Website: http:/​/​www.ragamuffinproject.org
Project Leader:
Carrie Herbert
Ms
Phnom Penh, Cambodia
$16,615 raised of $50,000 goal
 
 
228 donations
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