Delivering appropriate care to refugee families requires complex care systems and models that take account of the social, cultural, and political dimensions as well as the psychologic dimension. Children born into these families are exposed to consequences of their own past experiences and also may be subject to the transmission of the traumas experienced by their parents. This exposure can lead to alterations in these children's individual creative resources. Early, tailored care should be provided for these families, so that the transmission of the trauma and its consequences can be managed or ameliorated.
"For children, D.W. Winnicott techniques [1,2] were adapted and used; for infants and young children under three, we employed mother-baby dyads. In order to assess difficulties and the functioning of the mother-child interaction , we used Lebovici technique based on a psychodynamic brief psychotherapy model [4,5]. In addition to psychotherapy, patients with depression or anxiety that met the following criteria received psychotropic medication: disorders that did not allow the patient to carry out basic daily activities, experience of suicidal ideas, significant disturbances of consciousness, no response or aggravated clinical criteria after psychological treatment. "
[Show abstract][Hide abstract] ABSTRACT: Colombia has been seriously affected by an internal armed conflict for more than 40 years affecting mainly the civilian population, who is forced to displace, suffers kidnapping, extortion, threats and assassinations. Between 2005 and 2008, Médecins Sans Frontières-France provided psychological care and treatment in the region of Tolima, a strategic place in the armed conflict. The mental health program was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here we describe the population attending during 2005-2008, in both urban and rural settings, as well as the psychological treatment provided during this period and its outcomes.
We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict.
Conflict and Health 12/2009; 3(1):13. DOI:10.1186/1752-1505-3-13
[Show abstract][Hide abstract] ABSTRACT: Since the beginning of Al Aqsa Intifada, Palestinian children and adults living in the occupied Palestinian territory have been exposed to stressful events on a daily basis. As a result, some individuals develop severe and chronic reactive psychological syndromes. The nongovernmental organisation Médecins Sans Frontières (MSF) provides medical and psychological support to them, using psychodynamic psychotherapy adapted to the Palestinian culture and to the low intensity conflict context. This article presents data from 1773 children and adults who received treatment by psychotherapists between November 2000 and January 2006, in the Gaza strip and the West Bank. Nearly half of the patients were children between 4 and 14 years. The three main diagnoses were a) anxiety disorder other than posttraumatic stress disorder (PTSD) or acute stress, b) mood disorder, and c) PTSD. The psychotherapy included a median of six sessions over a period of around 11 weeks. At the evaluation at the end of therapy almost 80% of all patients had improved. These observations suggest that brief psychodynamic psychotherapy could have positive effects on the psychological wellbeing of Palestinians, even in difficult circumstances (war context) and within an Arab culture. The authors argue that this type of individual psychological support can be a useful complement to a psychosocial approach at the community level.
[Show abstract][Hide abstract] ABSTRACT: Children born of wartime rape are particularly vulnerable and their case is complex as their needs intertwine with the needs of their mothers or their cultural community. To analyse the status of children born of rape and identify both risk factors and key issues, a systematic search among medical and psychological research articles was performed. In addition, historical, sociological and human rights literature was explored. Risk factors for the wellbeing of children born of rape are: pregnancy and delivery; poor parent-child relationships; discrimination and stigmatisation; and identity issues. Three key issues which should direct research and clinical practice are formulated: perceiving children born of rape as secondary rape victims; the existence of multiple perpetrators; and competing rights and interests. To assist children born of rape, clinicians, as well as researchers, are confronted with the challenge to develop a comprehensive perspective that considers the needs and rights of both children and mothers.
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