PART TWO

MHPSS Key
competencies,
Theory and
practice, and
Trauma informed
care
PART TWO: Section
One
MHPSS Key
competencies
Psychosocial Assessment and Identification

• Ability to assess mental health and

psychosocial needs, recognize signs and
symptoms of distress, and identify individuals
or groups who may require additional support.
 Psychological First Aid (PFA)

• Familiarity with the principles of PFA and how

to apply them in diverse settings, including
emergencies and disasters.
 Communication and Interpersonal Skills

• Effective verbal and non-verbal

communication, active listening, empathy, and
the ability to establish trust and rapport with
individuals from different cultural
backgrounds.
• Awareness of cultural and social norms that
may affect communication and understanding
in different contexts.
 Cultural Competence
Sensitivity to cultural differences, ability to
adapt interventions to fit the cultural context,
and respect for diverse values and beliefs and
understanding the role of traditional healing
practices.
 Referral and Coordination
• Ability to identify when specialized mental
health services are needed and facilitate
appropriate referrals.
• Coordination with other service providers to
ensure a holistic approach to care.
• Familiarity with the local mental health and
social support system, including available
resources and referral pathways.
 Community Engagement and Mobilization

• Engaging communities in participatory

processes, empowering them to identify and
address their own psychosocial needs, and
building local capacities for resilience.
• Understanding the importance of community
structures and support systems in mental
health and psychosocial interventions.
 Stress Management and Self-care

• Techniques for managing personal stress and

preventing burnout, as well as promoting self-
care among team members.
• Awareness of the impact of working in high-
stress environments and the importance of
maintaining personal well-being to provide
effective support.
 Ethical Practice and Professionalism

• Upholding confidentiality, respecting client

autonomy, and maintaining ethical standards
in all interactions and interventions.
• Understanding of ethical principles in mental
health and psychosocial work, including issues
of consent, privacy, and the rights of
individuals.
 Monitoring and Evaluation

• Ability to monitor the effectiveness of MHPSS

interventions, collect relevant data, and
evaluate outcomes to inform practice.
• Familiarity with tools and methods for
assessing the impact of MHPSS programs, and
the importance of continuous learning and
adaptation.
 Advocacy and Awareness Raising

Advocating for the integration of mental health

and psychosocial considerations into broader
public health and social services, and raising
awareness about mental health issues.
What do you think are the
characteristics of a good
helper?
 the good
helper
What skills does a
good social worker
need, when
interacting with
families?

This image was shared by counsellors working

in the Democratic Republic of the Congo.
 What do you think are
the roles of social worker
or frontline workers in
MHPSS?
 to families’ problems and work with
them to find solutions – identify
Listen
community supports, refer them to
social or medical services etc.
Recogni signs of distress amongst adults and
Role of ze children

social Identify
signs and symptoms of mental
health issues
worker or
frontline Refer
cases of adults and children with
severe mental health issues

workers - psychological first aid for people in

Provide
MHPSS distress following a crisis

awareness in communities about

Raise mental health, promote wellbeing
& reduce stigma
LISTEN

Listen to clients and their families

 Listen to clients’ and families’ problems –

then work with them to find solutions
 Use active listening skills,
noting verbal and non-verbal
communication
 Adapt your communication

skills when talking to children

 Listening and interview skills
will be covered in a separate
session
RECOGN
IZE

How to Recognize signs

of psychosocial distress
GROUP WORK- HOW DO ADULTS AND CHILDREN EXPERIENCE
OR SHOW THEIR DISTRESS?

GROUP 1: GROUP 2: GROUP 3: GROUP 4: PHYSICAL

THOUGHTS EMOTIONS BEHAVIOURS SYMPTOMS
 Confusion
Inability to concentrate
Difficulty making decision,
problem-solving
Thoughts and Repetitive/obsessive thoughts
thinking processes
Negative thoughts
Hopelessness
Nightmares, flashbacks,
intrusive memories
 Worry
Fear
Sadness
Despair
emoti ons
Grief
Anger
Frustration
Guilt, self-blame
Emotional numbing (not feeling
anything)
 behaviors

• Crying a lot
• Agitation, restlessness, difficulty concentrating
• Aggressive, fight with other children
• Not following parental guidance or refusing to go to
school
• Become shy, quiet, confused, isolated or sad, not playing
with other children
• Hug themselves a lot or sit in a curled-up position
• Show signs of neglect (not dressed, too thin, sick)
• Acting younger than actual age ( bedwetting, clinging to
their parents, or being afraid to be left alone)
• Youth: fearful about the future, anxious and nervous
• Youth: self-destructive or rebellious behavior, such as
drug taking, stealing or hypersexual activity
• Very attached to people who are not family and
physically touch them a lot or inappropriately
 Changes in appetite

Sleep disturbances (nightmares,

insomnia, shouting or screaming)

Lacking energy or always tired

PHYSICAL
SYMPTOMS Unexplained aches and pains
(headaches, stomachache etc.)

Decreased immunity

Feel sick, dizzy, or seizures

Look out for vulnerable children:
 Alone, without parents or caregivers, or very young
 Previously associated with armed forces or armed
groups
 Suffering from physical, emotional and/or sexual
abuse
 Suffering from neglect
 Have been exposed to conflict, violence,
abandonment, displacement or loss
 Trafficked or abducted children
 Showing severe symptoms of trauma
 Forced into child marriage
 Forced into child labour
 Have pre-existing mental health difficulties
 Have disabilities or chronic health conditions
• They were separated from loved ones
• They were physically hurt
• They were trapped or otherwise unable to escape
• They have watched loved ones being hurt
• They have caregivers who are themselves
overwhelmed
• They have experienced distressing events
repeatedly and/or for a long time
• They did not receive support after the events
• They were blamed, isolated, discriminated after
the events

In emergencies, Children and

adults are more likely to have
strong reactions if:
IDENT
IFY Common mental illnesses
ANXIETY – worrying
too much, highly
stressed, memory
and concentration
difficulties, panic
attacks
PSYCHOSIS – may
believe things aren’t
real, hear things that
aren’t there, disturbed
behaviour
DEPRESSION –
abnormal level of
prolonged sadness,
SUBSTANCE ABUSE – giving up on life,
excessive use of alcohol wanting to die
or khat
REFER

When & who to refer for

specialized psychological
services
 Demonstrate dramatic changes in behavior
 Cannot function in their daily life or are not able to care for their
children
 Do not improve over time
 Experience difficulties in different contexts (school, home,
community)

Children and adults may

need extra help if they:
 Is harming/threatening to harm
themselves

Is harming/threatening to harm others

Immediat
ely Refer Is threatening to end their own lives

a child or Is having hallucinations (hearing or seeing

things that are not there) or flashbacks

adult Is extremely confused or agitated

who: Is having seizures, paralysis or other

neurological symptoms

Has just been sexually assaulted

 Is severely depressed
You are
also likely Is experiencing severe
anxiety and panic attacks
to need to
Is abusing substances
refer a (alcohol, chat etc.)
child or
Is experiencing severe
adult grief
who:
Is a GBV survivor
 What is a referral pathway?

• A flexible mechanism that safely links vulnerable

children and survivors of abuse to supportive and
competent services

• It can include any or all of the following: Health,

Psychosocial, Security and Protection, Legal/Justice,
and/or Economic Reintegration support services

Source: Global Protection Cluster – GBV Prevention and Response

Guidelines for integrating gender based violence interventions in humanitarian action
ESTABLISHING A REFERRAL
PATHWAY – GROUP WORK
Scenario: You are a community service worker working in a local
community. A girl of thirteen approaches you and is very upset. You offer
psychological first aid and after listening to her you discover that she was
sexually assaulted by a soldier on her way home the evening before. You also
know the information below. What would be your referral pathway?

 MSF is offering counselling for GBV survivors

 There is a hospital in the city
 The local clinic has PEP kits
 IMC has a psychologist
 You and your colleagues are trained in case management and PSS
 The girl is separated from her parents and is living with an aunt
 There is a police post in the community
32
Referral form
ADDITIO
NAL
MATERIA
L
 FURTHER READING
IASC (2007). Guidelines on Mental Health and
Psychosocial Support in Emergency Settings
https://www.who.int/mental_health/emergencies/g
uidelines_iasc_mental_health_psychosocial_june_20
07.pdf
WHO (2011). Psychological First Aid: Guide for Field
Workers
https://www.who.int/mental_health/publications/gu
ide_field_workers/en/
UNICEF (2018). Community-based mental health and
psychosocial support
Part two: section
two
An Introduction to
Trauma Informed
Approach/Care
36
Understand the key concepts of trauma
and trauma informed approach/care

Understand how to create a culture of trauma informed approach/care.

Know how organizations can support staff experiencing stress, burnout,

and/or vicarious trauma

Understand ways in which organizational responses, professional

responses and personal responses contribute to a psychologically safe
and healthy workplace.

Learning goals
 Concept of Trauma
• Trauma is a common and damaging condition. It
occurs as a result of violence, abuse, neglect, loss,
disaster, war, and other emotionally damaging
experiences.
• Trauma knows no bounds in terms of age, gender,
social background, race, ethnicity, geography, or sexual
orientation.
• Is sudden, unexpected, and perceived as dangerous or
life threatening
• Overwhelms individual’s ability to manage daily
business as usual. 38
THE THREE “E’S” OF TRAUMA: EVENT(S),
EXPERIENCE OF EVENT(S), AND EFFECT

39
 Trauma-Informed Approach: Key
Assumptions

• THE FOUR “R’S: KEY ASSUMPTIONS IN A

TRAUMA- INFORMED APPROACH

40
41
 Trauma-informed care
• Trauma-informed care is a framework of care that
is comprised of common themes including:
– An awareness of how behaviors and symptoms
connect to traumatic experiences
– An emphasis on physical, psychological, and
emotional safety for staff and clients.
– An opportunity for people to regain a sense of
control.
– A focus on strengths rather than deficits.

42
 Why is Trauma-Informed care
important?
• trauma-informed practice is effective and can
benefit both trauma survivors and
professionals.
 It will provide Clients with a sense of safety, both
physically and psychologically.
– It will aid in the development of trust and connection
with the client..
– Assist professionals in becoming trauma aware and
knowledgeable, as well as comprehending the impact
and implications of traumatic experiences on clients
43
 Why is it important to be trauma-
informed?
 Learning how to identify the signs of stress and associated
behaviors to be able to respond with awareness and
empathy.
 Encouraging open communication. Listening and responding
with empathy.
 Supporting their existing strengths.
 Empowering them to have a voice in their healing by
involving them in developing coping strategies.
 Trauma-informed programs can provide trauma survivors
with hope, empowerment, and non-retraumatizing
assistance.
44
Core Principles of Trauma-Informed Care

45
 Group activity

• Objective: Discuss and reflect on the core principles' of

trauma informed care.
• Group format: 5 participant in one group
• Time: 10m
•

46
 Principle 1. Safety:
 Help patients feel they are in a safe space and recognize their
need for physical and emotional safety:

Ensure physical and emotional safety; do no harm
 Ensure a Safe Environment

47
 Establishing Physical and Emotional
Safety
 Speak in a calm, respectful voice
 Provide client with personal space
 Establish a safe place to talk and be alert to signs of discomfort
or unease
 Emphasize client ability to stop discussion and model respect
for client choices
 Try to make space as calm and relaxing as possible, including
removing any potential triggers for trauma
 Validate feelings and honor honesty

48
 Creating a Safe Environment

• Minimize re-victimization
• • Avoid such strategies as:
• Shaming
• Moral inventories in isolation
• Confrontation
• Intrusive monitoring
• • Reduce triggering situations.

49
Triggering Procedures or Situations
 Lack of control/ Powerlessness
 Threat or use of physical force
 Interacting with authority figures
 Loud noises
 Lack of information
 Intrusive or personal questions
 Unfamiliar surroundings
 Reminders of the past

50
 Principle 2. Trustworthiness:
 To Maximizing trustworthiness, making tasks clear,
maintaining appropriate boundaries.
• Consistency and predictability in the procedure of care
is essential
• A safe and predictable relationship with a health care
provider can be a critical component.

51
 Principle #2 Trustworthiness and
Transparency:
• 1. How is transparency and trustworthiness among
• staff and clients promoted and
demonstrated?
• Staff with staff?
• Staff with supervisors?
• Staff with administration?
• 2. What strategies are used to reduce the sense of
power differentials among staff and clients?
• 3. How do staff help people identify strategies that52
 Principle 3. Choice:

 Prioritizing client’s choice & control over recovery

• Actively involve patients in their own healing process
using informed choice.
• Presenting both positive and negative choices
(including the option to not engage in care)

53
 Principle 4. Collaboration:
 Maximizing collaboration & sharing of power with
clients
• Healing occurs in the context of relationships and the
meaningful sharing of power and decision making.
• Seek to develop truly collaborative relationships with
patients, despite the initial added time required to do
so.

54
 Principle 5. Empowerment:
 Identifying what a person can do for themselves;
prioritizing skill-building that promotes recovery;
helping clients find inner strengths to heal.
• Believe in the patient’s strength and resilience
• Support patient’s evolution from passive victim to
active, motivated participant is one the most
rewarding aspects of a health care provider’s work

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