More than half a million child refugees have reached Greece by sea since 2014. As a volunteer counsellor in refugee camps, Dr Foka identified an urgent need for mental health interventions for these children, many of whom had suffered trauma.
Together with her co-researchers, she developed "Strengths for the Journey" (SFJ), a positive psychology-based intervention that can be delivered in humanitarian crisis contexts with limited resources. SFJ uses a non-clinical, and preventive approach and promotes resilience and wellbeing among children when faced with adverse and challenging conditions.
An encouraging shift
This unique intervention was developed to improve the mental health of displaced children and adolescents in transit.
Children in camps have limited access to school and mental health services. Many experience suicidal thoughts, self-harming behaviours, panic attacks, anxiety, and aggression. NGOs working with children living in refugee camps in Lesvos highlighted the urgent need to help these children develop their well-being and resilience.
A trial evaluation of SFJ found that it led to marked improvements in wellbeing, self-esteem, optimism, and depressive symptoms in the children who participated.
Building positive psychological resources
Dr Foka and her team identified the need for an intervention that could be delivered in challenging conditions, and which didn’t rely on specialist treatments, expensive resources or health professionals. SFJ is a short (seven-day), group-based, preventive programme. It is built around different positive psychology themes and resilience-building skills, using art-related activities, discussions, description of personal strengths stories, easy-to-apply techniques and supplies that are cost-effective and easily obtainable.
An easy-to-use manual
Dr Foka’s team has created a free, downloadable manual that outlines the seven-day programme and contains planning and resource lists for workers who wish to deliver it
You give us a lot of advice and give us more trust in ourselves and more power, more strength.— Anonymous participant
"To be together"
Since July 2017, SFJ has been delivered to 291 children and adolescents living in Greek refugee camps, with more than 75 non-professionals from local NGOs trained in its delivery. A trial evaluation of SFJ found that it made a palpable difference to the children who participated. The trial indicated a better outcome in children participating in the intervention compared to age-matched control refugee children.
What the children said
Children who participated in the programme were asked about its effectiveness. They identified working as a team, building social connections, and talking about their issues together as the aspects they most enjoyed.
When asked about the best part of the intervention, for instance, one child responded, "To be together, to talk together, to speak together about our stories, to share our stories and experiences. And, to be happy together.” Another said, “It’s unusual living here to work as a team, so that this is why it is such a new and nice experience.”
Who has SFJ helped?
In seven destinations, including the Kara Tepe Refugee Camp and the Mosaik Support Centre, the programme has been delivered to hundreds of children by non-specialist staff. Some camps are developing further resources based on SFJ for adolescents who have experienced gender-based violence, as well as pre-schoolers.
In a study published in the journal Development and Psychopathology, the researchers showed that the intervention improved the children's sense of wellbeing. Their optimism increased and they experienced enhanced self-esteem. They also saw a reduction in depressive symptoms.
The findings suggest that it is possible to mitigate some of the negative effects of war and displacement on children with the help of a scalable low-cost intervention that specifically targets children’s psychological resilience and well-being. The researchers suggest that the intervention should be expanded to a larger group of refugee children in Greece - and potentially those living in refugee camps elsewhere - because it has real potential to improve their mental health and wellbeing.
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