Tuesday, February 21, 2012

Intermission

So I am half way through my time, started slow and calm, now building momentum. The interesting aspect of my internship is the not so apparent cultural undertones that coincide with body language, eye contact, and lack of emotive. I am learning slowly, in addition to realizing my assumptions are often wrong.

As a response to the genocide, in 1998 the Rwanda government's Ministry of Rehabilitation, at the urging of a British citizen Rwandan women (who lost fifty members of her family in the genocide and returned to help bury the dead and help survivors), developed the Funds for Support of Genocide Survivors (FARG) which, among other objectives such as housing and education, recruited and trained the first lay trauma counselors. As reported by someone who was within this initial group training, their role was crisis intervention, going into schools and places of work, when a genocide survivor was having acute flashbacks or trauma stressors. In 1998, there were only 30 counselors nationwide, on call 24/7, providing counseling for both survivors and perpetrators. It was a daunting task. In resource limited countries lay counselor are trained to address the trauma of post conflict or natural disasters. In recent years over 10,000 Rwandans have accessed trauma counselors and the number is growing.

Part of my placement is working with WeAct's psychosocial team to provide case consolation in using Cognitive Behavioral Therapy (CBT). The complications arise when trauma counselors are trained in a specific active listening and trauma narrative training, so using CBT can be confusing and cumbersome to navigate at first, although it has been surprising me how quickly the youth grasp and apply cognitive restructuring as benefiting themselves and their relationships. As a way to help the youth counselor utilize CBT, we have been doing joint sessions together, beginning with me modeling CBT and will change over to her taking the lead and debriefing afterwards.

For many youth the living situation consists of a combative relationships with his/her mother or caregiver, unknown father, HIV+ status, and living in chronic poverty. To be honest, I understand how anger could be a major player and a negative self identity could be established. Although I felt like we were making progress in session with a young man, from what I gathered during the session, he would rarely make eye contact, never smiled even at my horribly cheese attempt to be funny, and seemed utterly bored and ready to bolt. At the end of our last session we were rescheduling for next week, he said he can't come next week, to be honest I was not surprised and thought at lest he is letting us know now instead of not showing up, I asked why, ready for him to make up an excuse, he said he didn't have bus money, I asked if you had the bus money would you come, he said yes, I said how much is it, 1000 Rwandan francs ($1.50). He said "I want to change, I want my family to change, I want to work on my anger". I choked back tears and gave him the money.......all the assumptions I was making during the session fell short of incorporating a cultural competent understanding of body language!
 Again, I learn ;)

Wish you all well, thanks for the feedback, it is both reassuring and inspiring.


Gives you an idea of the landscape,



May be little, may have a funny mohawk and a seemingly extra long tail , but wakes me up very morning at 5:30am. 


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