Psychosocial
interventions

A handbook

Psychosocial interventions
A handbook

Psychosocial interventions
A handbook

International Federation Reference Centre
for Psychosocial Support
Blegdamsvej 27
DK-2100 Copenhagen
Denmark
Telephone: +45 35 25 92 00
Fax: +45 35 25 93 50
Mail: psychosocial.center@ifrc.org
Website: http://www.ifrc.org/psychosocial

Front page photo: Tomas Bertelsen/Danish Red Cross.
A young boy in Zimbabwe writing in his memory book
Design and production: Paramedia 1388
Printed in Denmark 2009ISBN 978-87-92490-02-5

The International Federation Reference Centre for
Psychosocial Support would like to express its
gratitude to the American Red Cross for contributing
direct support to the entire project of collecting
lessons learned on the psychosocial response to
the tsunami, including support to this publication.

Please also see other publications by the PS Centre
Community-based psychosocial support training kit© International Federation of
Red Cross and Red CrescentSocieties Reference Centre for
Psychosocial Support.
Please contact the ReferenceCentre for Psychosocial Support
if you wish to translate or adapt
any part of the Handbook on
psychosocial interventions.
The Reference Centre for
Psychosocial Support will
supply further material as wellas information on how to state
the source. Mail:
psychosocial.center@ifrc.org

a handbook Psychosocial interventions

Foreword
In the field of psychosocial support, the past two decades haveseen immense development. The need for community-based
psychosocial support in crisis response and development
work has become increasingly clear, particularly as we havewatched major operations such as the 2003 Bam earthquake,the 2004 Indian Ocean tsunami and subsequent emergency
responses. Psychosocial support empowers individuals and theircommunities to tackle emotional reactions to critical eventsand also creates community cohesion essential for adaptation,transforming problems into opportunities for sustainable progressand moving forward. Psychosocial programmes, when planned
and implemented correctly, can help prevent an emergency fromturning into a disaster. As such, it is vital in all Red Cross Red
Crescent work.
Although the benefits of appropriate psychosocial support
programmes and activities have become more apparent, we cannot
rest on our laurels. The International Federation, through its
Reference Centre for Psychosocial Support, has a responsibility toensure that capacity is built, and that appropriate support reaches
those who need it most. This handbook provides guidance on how
to plan and implement psychosocial interventions. The practices
outlined are derived from a large study of lessons learned after the
Indian Ocean tsunami, made possible through the allocation of
resources from the American Red Cross. I hope and believe that the
handbook will be a useful resource for psychosocial practitioners
worldwide.
Nana Wiedemann
Head of International Federation ReferenceCentre for Psychosocial Support5

Psychosocial interventions a handbook

Acknowledgements
This handbook is the product of an extensive review ofpsychosocial interventions that has focused especially on thelessons learned from the psychosocial response to the Indian
Ocean tsunami of 2004. We would therefore like to acknowledge
the valuable input and support given to this process, with special
mention of all who were visited in the tsunami-affected countriesof Thailand, the Maldives, Indonesia, Sri Lanka and India. This
includes members of the affected populations, Red Cross Red
Crescent Movement volunteers and staff, representatives ofother organisations working with psychosocial interventions,and representatives of governmental departments. Gratitude
is also extended to colleagues of Red Cross and Red CrescentSocieties who participated in and supported earlier and completed
psychosocial interventions who have contributed to this project.
Thanks to
Belgian Red Cross, the Canadian Red Cross Society, Danish Red
Cross, French Red Cross, Indian Red Cross, Indonesian Red Cross
Society: Palang Merah Indonesia, American Red Cross, the Sri
Lanka Red Cross Society, the Thai Red Cross Society and theInternational Federation Secretariat staff in the Asia Pacific region
and at headquarters.
Written by
Pernille Hansen
EditorWendy Ager
Contributors and reviewers
Ea Suzanne Akasha, Christina Bitar, Dr. Subhasis Bhadra,
Lene Christensen, Janine Clayton, Dr. Satyabrata Dash,Ananda Galappatti, Rikke Gormsen, Amin Khoja,
Dr. Sinha Wickremesekera, Nana Wiedemann and Åsta Ytre.

6

a handbook Psychosocial interventions

Contents
Introduction................................................ 11
The International Federation of Red Cross and
Red Crescent Societies................................................................................. 13
The International Federation Reference Centre
for Psychosocial Support............................................................................ 17
How to use the handbook.......................................................................... 20
What is in the handbook?.......................................................................... 21

Setting the context...................................... 23
What is psychosocial support?................................................................. 25
What is psychosocial well-being?............................................................ 26
Why are psychosocial activities needed?.............................................. 30
Who are psychosocial services provided to?........................................ 34
Who provides psychosocial services?..................................................... 38
How to respond to psychosocial needs.................................................. 42
Final note......................................................................................................... 52

Assessment................................................ 53
What are assessments?................................................................................ 55
Why are assessments needed?.................................................................. 57
When are assessments done?.................................................................... 58
How to conduct assessments..................................................................... 62
Who conducts assessments?..................................................................... 71
Who provides the information?............................................................... 72

Planning and implementation...................... 75
The planning and implementation process.......................................... 77
When does planning a response begin?................................................. 78
Who is involved in a psychosocial response?....................................... 78
Who is targeted in a psychosocial response?........................................ 83
What activities are appropriate in a psychosocial response?.......... 88

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Psychosocial interventions a handbook

Programme management....................................................................... 109
Flexibility............................................................................................... 112
Human Resources................................................................................ 117
Partnerships and relations............................................................... 120
Advocacy issues.................................................................................... 122
Information dissemination.............................................................. 124

Training..................................................... 127
Why is training needed?.......................................................................... 129
What training should be done and for whom?................................. 130
Who does the training?............................................................................ 138
When should training take place?........................................................ 141
How to train in psychosocial support.................................................. 146

Monitoring and Evaluation......................... 153
What is monitoring?................................................................................. 155
Why is monitoring important?............................................................. 157
Who is involved in monitoring?............................................................ 157
What is evaluation?................................................................................... 159
Why is evaluation important?............................................................... 162
Who is involved in evaluations?............................................................ 162
When to monitor and evaluate............................................................. 164
Planning for monitoring and evaluation............................................ 165
How to monitor and evaluate................................................................ 166
Ethical principles to data collection..................................................... 168
Indicators...................................................................................................... 170
Measuring psychosocial well-being..................................................... 173
Monitoring and evaluation as research tools.................................... 177

Final Notes................................................ 179
Reference Notes.......................................................................................... 181
Bibliography................................................................................................ 182
Glossary........................................................................................................ 183
Acronyms and abbreviations................................................................. 186
CD Contents................................................................................................ 187
Links to useful websites........................................................................... 193
Recommended reading............................................................................ 194
8

Introduction

Setting the context

Assessment

PLANNING AND IMPLEMENTATION

Training

Monitoring and Evaluation

Final Notes

Introduction

Introduction

Jakob Dall/Danish Red Crossintroduction Psychosocial interventionsThis handbook prepared by the International Federation
Reference Centre for Psychosocial Support (the PS Centre)
reflects the increasingly active role that the Red Cross
Red Crescent Movement plays in psychosocial responses. The
development of the handbook is a result of collecting lessons
learned on the many varied psychosocial interventions thathave been implemented in different countries recently, witha particular focus on the psychosocial response to the Indian
Ocean tsunami of December 2004. This event led to one of thelargest emergency responses in history, with the involvementof a multitude of organisations and individuals in many varied
psychosocial interventions. These interventions helped thousandsof communities, families and individuals and contributed toincreasing global awareness on psychosocial needs and responses
following critical events and during crises.

The International Federation of Red Cross and
Red Crescent Societies
Whenever there are disasters, conflicts and health emergencies
and people lose their relatives, friends or homes and livelihood,there will be human suffering. Emotional pain, grief, anger andfrustration are all part of such experiences. Providing psychosocial
support in these circumstances reflects the principles and valuesof the Red Cross Red Crescent Movement. This introduction sets
out the history, mission and principles of the Movement andintroduces the work of the PS Centre.
History
In 1859 Henry Dunant, a young Swiss man, came upon a bloody
battle between the armies of Imperial Austria and the FrancoSardinian Alliance in Solferino, Italy. Some 40,000 men lay deador dying on the battlefield and the wounded lacked medical
attention. Dunant organized local people to bind the soldiers’
wounds and to feed and comfort them. On his return, he called forthe creation of national relief societies to assist those wounded inwar, and pointed the way to the future Geneva Conventions.

13

Psychosocial interventions introduction

The Red Cross was born in 1863 when five Geneva men, including
Dunant, set up the International Committee for Relief to the
Wounded, later to become the International Committee of the
Red Cross. Its emblem was a red cross on a white background – thereverse of the Swiss flag.
Mission and role
The International Federation of Red Cross and Red CrescentSocieties (IFRC) is the world’s largest humanitarian organisation
providing assistance without discrimination as to nationality,
race, religious beliefs, class or political opinions. The International
Federation strives, through voluntary action, for a world of
empowered communities better able to address human sufferingand crises with hope, respect for dignity and a concern for equity.
The mission of the Federation is “to improve the lives of vulnerable
people by mobilizing the power of humanity”.
Nozimjon Kalandarov/IFRC

Tajikistan Red Crescent Society members training in disaster preparedness

14

introduction Psychosocial interventions

Founded in 1919, the International Federation comprises 185
member Red Cross and Red Crescent National Societies, aSecretariat in Geneva and more than 60 delegations strategicallylocated to support activities around the world.
The Federation carries out relief operations to assist victims ofdisasters and combines this with development work to strengthen
the capacities of its member National Societies. The Federation’s
work focuses on four core areas:• Promotion of humanitarian values• Disaster response• Disaster preparedness• Health and community care
Psychosocial support is vital and it is essential that it is integrated
into activities in all four areas.
The International Federation of Red Cross and Red CrescentSocieties is one of three components of the International Red
Cross and Red Crescent Movement. The other two are the National
Societies and the International Committee of the Red Cross (ICRC).
National Societies provide a range of services in the humanitarian
field including disaster relief, health and social programmes. Many
are also providing psychosocial support. During wartime, National
Societies also assist affected civilian populations and support army
medical services, where appropriate.
The International Committee of the Red Cross is an organisation
whose humanitarian mission is to protect the lives and dignityof victims of war and internal violence and to provide them withassistance. It directs and coordinates international relief activities
conducted by the Movement in situations of conflict.

15

Psychosocial interventions introduction

Principles
Actions of the Red Cross and Red Crescent Movement should at all
times be guided by these Fundamental Principles:

Humanity: The International Red Cross and Red Crescent
Movement, born out of a desire to bring assistance without
discrimination to the wounded on the battlefield, strives in its
international and national capacity, to prevent and alleviate
human suffering wherever it may be found. Its purpose is toprotect life and health and to ensure respect for the human being,
and to promote mutual understanding, friendship, cooperationand lasting peace amongst all peoples.
Impartiality: The Movement makes no discrimination as tonationality, race, religious beliefs, class or political opinions. It
strives to relieve the suffering of individuals, being guided solely by
their needs, and to give priority to the most urgent cases of distress.
Neutrality: In order to enjoy the confidence of all, the Movement
may not take sides in hostilities or engage in controversies of apolitical, racial, religious or ideological nature.
Independence: The Movement is independent. The National
Societies, while auxiliaries in the humanitarian services of theirgovernments and subject to the laws of their respective countries,
must always maintain their autonomy so that they may be able at
all times to act in accordance with the principles of the Movement.
Voluntary service: It is a voluntary relief movement not driven
in any manner by desire for economic gain.
Unity: There can be only one Red Cross or Red Crescent Society in
any one country. The Society must be open to all. It must carry on
its humanitarian work throughout its territory.
Universality: The International Red Cross and Red Crescent
Movement, in which all Societies have equal status and share equal
responsibilities and duties in helping each other, is worldwide.

16

introduction Psychosocial interventions

Emblems
The International Federation uses as its symbol two globally
recognized emblems – the red cross and the red crescent, set on awhite background within a red rectangle.
The emblems have a long history.
The red cross was formally adopted
in the first Geneva Convention of1864. The red crescent was adopted
by the Ottoman Empire in 1876 andrecognized in the 1929 Geneva Convention. The red crescentsymbol is used today in place of the red cross in many Islamic
countries.
With the adoption of the Third Additional
Protocol in 2005, a third emblem – the red crystal– is now also a recognized distinctive sign underinternational law, with the same status as the redcross and red crescent. By offering new possibilities for protection
and identification to National Societies and States that wish to use
the red crystal, the Third Protocol exemplifies the Movement’s
commitment to neutral and independent humanitarian action.

The International Federation ReferenceCentre for Psychosocial Support
In recent decades, disasters and conflicts have taken their toll
increasingly on civilian populations. In addition to traditional
programming to address the physical and most basic needs ofaffected populations in the form of food, water and shelter, theInternational Federation of Red Cross and Red Crescent National
Societies, as well as other humanitarian organisations, havedeveloped programmes to address the psychological and social
suffering of affected populations.

17

Psychosocial interventions introduction

Till Mayer/IFRC

Psychosocial support starts with supportive listening

The international community’s continued and growing interest in
the psychological and social impact of disasters and war is revealedin the growing literature on psychosocial well-being, as well as
in an increase in projects and resources addressing psychosocial
assistance. This is a relatively new field and evidence about theeffectiveness of psychosocial support is emerging.
In 1991 the International Federation launched the Psychological
Support Programme (PSP) as a crosscutting programme underthe Health and Care Division. To assist the Federation with theimplementation of the programme, the Danish Red Cross and theFederation established the Reference Centre for Psychological Support as a centre of excellence in 1993. In 2004 the centre changed
its name to the Reference Centre for Psychosocial Support.

18

introduction Psychosocial interventions

As a centre of excellence, the International Federation ReferenceCentre for Psychosocial Support (the PS Centre) assists Red
Cross and Red Crescent Societies to develop community-based
psychosocial services in areas affected by catastrophic events andarmed conflicts.

The PS Centre aims to:• help increase awareness of psychological reactions during
disasters and/or social disruption• facilitate psychosocial support• promote the restoration of community networks and coping
mechanisms• enable National Societies in particular to understand andrespond better to the psychosocial needs of vulnerable groups• promote care for the carers, emotional assistance for staff andvolunteers
The PS Centre does not intervene directly with affected people.
Rather, it assists Red Cross and Red Crescent National Societies
to do so through their local staff and volunteers and assists inbuilding regional and local psychosocial support networks.
Please feel welcome to contact the PS Centre for additional
information. You may also send suggestions or comments.
The International Federation Reference Centre
for Psychosocial Support
c/o Danish Red Cross
Blegdamsvej 27,
2100 Copenhagen,Denmark
Tel.: +45 3525 9200
Email: psychosocial.center@ifrc.org

19

Psychosocial interventions introduction

How to use the handbook
This handbook is for psychosocial practitioners who are planninga psychosocial intervention in response to a crisis or critical event.
It is specifically targeted at practitioners working for Red Cross Red
Crescent National Societies, looking at the particular operations of
the Red Cross and Red Crescent Movement. However, most of thesuggestions and recommendations presented are relevant to all
stakeholders working in the field of psychosocial support.

Crisis
A crisis is understood as one critical event or series of events that leads tomajor changes in the lives of the affected. It can be due to natural disasters(such as floods, earthquakes, cyclones etc) and man-made events,(conflicts, population displacements, large-scale accidents etc). A disasteris understood as “a severe disruption, ecological and psychological which
greatly exceeds the coping capacity of the individual” (WHO, 1992).
This handbook pays particular attention to the response phases that follow
a crisis. It is also relevant for planning and implementing responses toongoing crises, such as continuing conflicts; health emergencies such as
the HIV pandemic; environmental challenges, such as persistent droughts;
and economic or political challenges that influence psychological and social
well-being.

The handbook draws on the experiences of psychosocial
interventions in different countries and contexts. Examples oflessons learned are presented in three ways, as best practices,promising practices or as those best to avoid.
CD

Each chapter includes references further reading which can befound on the companion CD. The contents list of all documents on
the CD is in the last chapter of the handbook with the final notes.

WWW

References are also made to useful websites. These are also listed in
the last chapter with the final notes.

20introduction Psychosocial interventions

What is in the handbook?
Following the first chapter, which introduces concepts central to
psychosocial interventions, there are four chapters which cover
key aspects of planning and implementing psychosocial interventions. Each chapter contains explanations of the presented topic;
why it is an important aspect to consider; when it is relevant to a
psychosocial intervention; who is involved in this particular aspectof the intervention. Recommendations are included throughout the
handbook. Please see the short descriptions of the chapters below.

Setting the context
The first chapter sets the context of the handbook by defining
the concepts of psychosocial support and psychosocial wellbeing, explaining when psychosocial support is needed and why.
It introduces the approach of community-based psychosocial
support and presents the current psychosocial models typicallyused by Red Cross and Red Crescent National Societies worldwide.
Finally it refers to the international standards and guidelinesthat lay the foundation for the psychosocial interventions
recommended in this handbook.

Assessment
The initial step in planning and implementing a psychosocial
response is assessing how the population in question has been
affected, and how best to help them. This chapter describes thedifferent kinds of assessments that can be used and their relevanceat different stages of an intervention. It gives examples of questions
to be considered in different kinds of assessments and suggests
sampling techniques to get as detailed information as possible.

Planning and implementation
After an introduction to the planning and implementation
process in a typical psychosocial intervention, the different
stages of a response are outlined, ranging from considerations ofdisaster preparedness in anticipation of a crisis to the planningneeds following such an event. Attention is paid to the multiple

21

Psychosocial interventions introductiongroups involved in a psychosocial intervention, including theaffected population, volunteers, the psychosocial team of Red
Cross Red Crescent National Societies and other partners.
Examples of possible activities that could be implemented aspart of a psychosocial intervention are followed by a number ofrecommendations for successful programme management.

Training
This chapter looks at training needs at different stages of a
psychosocial response, describing a range of training methods
and examining who is involved in training activities. One of thefirst and most important activities in a psychosocial response isensuring that the team responsible for the planned intervention
has the necessary knowledge and skills. Once immediate training
needs are met, further training may follow throughout theimplementation period of an intervention with varied groups.
In this way, a psychosocial response has the potential to build
resources in responding to future psychosocial needs, both in
National Societies and affected communities.

Monitoring and Evaluation
Monitoring and evaluation is essential to good management
practice and is closely related to the process of assessment (seethe chapter on assessment). This chapter explains the conceptsof monitoring and evaluation and shows how monitoring andevaluation tools are used in relation to psychosocial programmes.
Particular attention is paid to the challenge of identifying
indicators to measure psychosocial well-being. The chapter
concludes by encouraging practitioners to use monitoring andevaluation to contribute to the growing field of research on
psychosocial responses.

Final notes
The last section includes reference notes from the five chapters, abibliography, a glossary and list of abbreviations, contents of the CD,
links to useful websites and a list of recommended further reading.

22

Setting the context

Setting the context

REUTERS/Stringer (courtesy of www.AlertNet.org)

Setting the context Psychosocial interventionst

his chapter sets the context for the following chapters,
highlighting commonalities in psychosocial interventions,whilst simultaneously stressing the importance of carefulconsideration of each specific situation. When planning andimplementing a psychosocial response, certain common factors
should always be considered, even though the specific context andcircumstances that accompany and follow every crisis differ.
The chapter defines the concepts of psychosocial support andpsychosocial well-being. It looks at why psychosocial interventions
are needed, and considers who the main actors are in suchinterventions. Different models and methods of responding to
psychosocial needs are introduced and reference is made to theinternational standards and guidelines that should be followed
when planning and implementing a psychosocial response.

What is psychosocial support?
The Psychosocial Framework of 2005 – 2007 of the International
Federation defines psychosocial support as “a process of facilitating
resilience within individuals, families and communities” [enabling
families to bounce back from the impact of crises and helping
them to deal with such events in the future]. By respecting theindependence, dignity and coping mechanisms of individuals andcommunities, psychosocial support promotes the restoration ofsocial cohesion and infrastructure”. 1
In other words, psychosocial support helps people recover after
a crisis has disrupted their lives. Red Cross and Red Crescent
National Societies implement community-based psychosocial
support interventions which concentrate on strengthening thesocial bonds of people in affected communities, by improving
the psychosocial well-being of individuals and of communities as
whole entities. This approach is based on the idea that if people are
empowered to care for themselves and each other, their individualand communal self-confidence and resources will improve. This, in25

Psychosocial interventions Setting the context

International Federation of Red Cross and Red Crescent Societies

Community involvement is the foundation for community based psychosocial
interventions

turn, will encourage positive recovery and strengthen their ability
to deal with challenges in the future.
Psychosocial support can be both preventive and curative. It ispreventive when it decreases the risk of developing mental healthproblems. It is curative when it helps individuals and communities
to overcome and deal with psychosocial problems that may havearisen from the shock and effects of crises. These two aspects ofpsychosocial support contribute to the building of resilience in theface of new crises or other challenging life circumstances.
WWW

PS Centre film on psychosocial support

What is psychosocial well-being?
The Constitution of the World Health Organisation defines healthas “a state of complete physical, mental and social well-being” andnot merely “the absence of disease or infirmity”.2

26

Setting the context Psychosocial interventions

The Psychosocial Working Group suggests that the psychosocial
well-being of individuals and communities is best defined withrespect to three core domains:3

Human capacity refers to physical and mental health andspecifically considers individuals’ knowledge, capacity and skills.
Identifying an individual’s own human capacity is the same asrealizing his or her own strengths and values.
Social ecology refers to social connections and support,
including relationships, social networks, and support systems of
the individual and the community. Mental health and psychosocial
well-being are dependent on cohesive relationships that encouragesocial equilibrium.

Culture and values refers to cultural norms and behaviour
that are linked to the value systems in each society, together withindividual and social expectations. Both culture and value systems
influence the individual and social aspects of functioning, andthereby play an important role in determining psychosocial wellbeing.
Psychosocial well-being isdependent on the capacity
to draw on resourcesfrom these three core
domains in response to thechallenge of experienced
events and conditions.
The Psychosocial Working
Group suggests thatchallenging circumstances,such as crises, deplete
these resources resulting
in the need for externalinterventions andExternal influences on
psychosocial well-being

Although psychosocial well-being
is defined according to these threecore domains, it is important toremember that other extenuating
factors also have significant
influence on well-being. The loss ofphysical and economic resources
available to households, disruption
to community and regional
infrastructure, and degradation of
the natural environment are all such
examples of additional factors that
may impact the psychosocial wellbeing of communities.

27

Psychosocial interventions Setting the context

assistance to rebuild individual and communal psychosocial wellbeing.
Psychosocial well-being is experienced both in the personal
individual and the social interactive domain, and is also influenced
by external factors, such as livelihood, shelter and physical health,as shown in the model below.
Economic Resources
Human Capacity
Environmental
Resources

Social Ecology

Culture and values

PhysicalResources

Source: The Psychosocial Working Group. (2003) Working Paper. ‘Psychosocial Intervention inComplex Emergencies: A Conceptual Framework’CD

Psychosocial Working Group Conceptual Framework

Dynamic and contextually determined
An individual’s experience of psychosocial well-being is determinedlargely by the context he or she lives in. If an individual’s immediatesurroundings and community are disrupted, whether in theimmediate impact of a critical event or in the aftermath, family andneighbours will be in distress. It is unlikely in these circumstancesthat individuals will experience positive psychosocial well-being.
Since contexts and influential factors are always changing, so will
the experience of psychosocial well-being. This dynamic nature of
the experience of psychosocial well-being makes it very difficult toprovide a standard definition of what psychosocial well-being is, or
how to recognize it. A common understanding of what defines
psychosocial well-being may differ not only from country tocountry, but even in different populations within the same country.

28Setting the context Psychosocial interventions

Psychosocial well-being and mental health
Till Mayer/IFRC

The Inter-Agency Standing Committee describes mental healthand psychosocial
support as“any type of
local or outside
support thataims to protect
or promote
psychosocial
well-being and/or prevent or treat
mental disorder”.4...very differently to conflicts, such as in Iraq, 2003
Although mental

29

Matthew Marek/American Red Cross

It is therefore very
important to learn
and understand what
psychosocial wellbeing means locally forthe particular affected
population before
planning a psychosocial
response. This is the
only way to ensurethat the planned andContexts determine how populations are affected. Flooding,
implemented activities
such as in Haiti after Hurricane Hanna, 2008, may impact a
population...
are indeed relevant to
the target populationand not merely a replication of psychosocial activities that worked
elsewhere. In the process of defining psychosocial well-being, it
will be necessary to find a local and culturally appropriate way to
explain what is meant by psychosocial well-being and psychosocial
support when training and working with others who do notknow the concept. More details on this are given in the chapter on
assessments.

Psychosocial interventions Setting the context

health problems and psychosocial support needs require different
approaches, they are strongly related. Psychosocial problems thatare either very severe or persist over a long period of time without
any intervention can lead to the development of mild, moderate oreven severe mental health problems. Equally, people with mental
health problems also often have psychosocial problems.
Although this handbook includes some references to mental
health problems and accompanying issues, the primary focus is oncommunity-based psychosocial interventions that do not require
professional mental health services.

Why are psychosocial activities needed?
Crises typically disrupt a person’s life in many different ways. They
can lead to the loss of:• near and significant loved ones
• control over own life and future• a sense of security• hope and initiative• dignity• social infrastructure and institutions• access to services• property• prospects of a livelihood
Everyone who has experienced or witnessed crises is likely tobe affected in one way or another. Reactions may be shock fromthe actual event; grief reactions to having lost loved ones; feelinga ‘loss of place’ and feeling distress due to other consequencesof the crises. The extent of reactions varies between individuals
and whole communities, as does the need for responding
interventions.

30Setting the context Psychosocial interventions

Loss of place

Following a crisis, people commonly experience a loss of confidence
in the norms, networks, and mutual trust in the society that is
supposed to protect them and provide for interaction between
themselves and institutions. This feeling has been defined as a ‘loss ofplace’ (Perkins & Long, 2002). This concept is used as the underlying
basis for developing psychosocial support activities that aim tore-establish a ‘sense of place’. (See the chapter on planning andimplementation for further details.)
Sense of place (2 documents)

CD

See short movie ‘Root Shock’ made by school students in India incollaboration with the American Red Cross

WWW
Sho Huang/IFRC

Experiences of loss can be disorienting and emotionally painful for individuals andwhole communities

Psychosocial support activities should be planned for wholecommunities, focusing both on individual and community needs,
and on their resources to cope and recover. Such activities can help
individuals, families and communities to overcome stress reactions
and adopt positive coping mechanisms through community-based
activities.

31

Psychosocial interventions Setting the context

Rodney Dekker/Australian Red Cross

Psychosocial support activities are best planned with the participation of entire communities

Psychosocial support services play a crucial role in responding tocrises that involve large populations, as they cater for the needs ofthe majority of the affected population. They help in the recovery
process and reduce the development of mental health problems. In
this way, psychosocial support services contribute to broadening
outreach services, whilst also easing the overload on healthsystems.
Psychosocial support activities also include identifying andreferring individuals requiring specialized support throughprofessional mental health services, besides addressing thepsychological and social factors mentioned earlier.

32

Setting the context Psychosocial interventions

An example of a psychosocial response:
Beslan School Hostage Crisis

On 1 September 2004, more than 1,100 children, parents and teachers
were taken hostage by a group of armed terrorists at School Number
One in Beslan, in the Republic of North Ossetia-Alania, RussianFederation. On the third day the crisis reached a peak, resulting in
the death of at least 334 people, including 186 children. The whole
population of Beslan was deeply affected by this crisis event.

Åsta Ytre/PS Centre

The Russian Red Cross Society responded with a psychosocial
programme with two main components. The first consisted of home
visits to affected families by nurses, initially providing psychologicalfirst aid, and subsequently offering on-going emotional support. A
community centre, the second component, was established as the
hub of the psychosocial programme, serving as the base for thevisiting-nurse service, and also as a venue for psychosocial supportsocial and practical activities.
An evaluation of the programme in2007 showed that the Red Cross
community centre had served as animportant mechanism in restoring social
ties and cultural values of the affected
population. It had thus contributed
to the psychosocial rehabilitationof both individuals and the entire
community. The home visiting service
Community centre, Beslan
was also evaluated as appropriate
and successful, considering the atmosphere of mistrust towards
professional psychologists, the high incidences of individual isolationand societal division that had arisen after the tragedy.
“After I lost my child I did not want to attend public meetings, but thehome visiting nurse persuaded me. I did not expect that I would findpeople here just like me, with similar problems. From then on I tried toattend the tea-parties at the centre. There we discussed things that
helped us to live on”.
Mother of a child killed in the school siege
The combination of these strategies – family visits and opportunities
for social interaction at a communal venue – are a good example of
how community-based psychosocial approaches aim to improve bothindividual and community psychosocial well-being.
33

Psychosocial interventions Setting the context

Who are psychosocial services provided to?
The affected population
Psychosocial support should be available to all persons affectedby a crisis. Different groups such as children, adults, men, women,
older people and people with disabilities, have different reactions
to crises. Even within these groups, some will have stronger ordifferent reactions than others. For this reason, psychosocial
interventions are designed according to the particular needs
and resources in a group or subpopulation, and according to theindividuals in these groups.
The diagram below illustrates in the form of a pyramid a layered
system of complementary supports needed for a population
affected by a crisis.
Mental health and psychosocial support services
Responses suggested

Professional treatment
for individuals or families
Individual, family orgroup interventions
Psychosocial
support activities
Fulfilling basic
needs, providing
security

Impacts on population due to crises

1
2
3
4

Specialised
services
Focused, non
specialised support
Community andfamily supports
Basic services
and security

Severe psychologicaldisorders
Mild to moderate mental
health disorders
Mild psychological distress (natural reactions
to crisis event)
General population
affected by crisis

Source: This illustration is based on the intervention pyramid for mental health and psychosocial support inemergencies in the IASC Guidelines (2007).

34

Setting the context Psychosocial interventions

International Federation of Red Cross and
Red Crescent Societies

Level 1
Basic services and security
The well-being of all who are
affected by a crisis should beprotected by services that
address their basic needs andprovide protection from harm.
Most of these services areprovided through the other
Providing basic services and security helps
areas of response of healthpromote psychosocial well-being
and care, water and sanitation,
food distribution and nutrition, and shelter. When planning a
psychosocial intervention it is very important to be aware of these
services, and to advocate for basic physical needs to be met. Allinteractions with the affected population should in fact be donewith consideration of psychosocial well-being. Further notes on
the crosscutting nature of psychosocial well-being are presented
later in this chapter.
Jakob Dall/Danish Red Cross

Assisting families to mourn the death of loved ones is a key activity in psychosocial
interventions

35

Psychosocial interventions Setting the context

Level 2 Community and family support
The majority of the affected population will need some formof psychosocial support to restore a sense of normality in theirlives, enabling people to get on with daily tasks and demands.
Psychosocial support can assist in a multitude of ways, for example
helping those affected to mourn the loss of loved ones and to adapt
to changed life circumstances. Family and community networks
may have broken down and family tracing and reunification may
therefore be included as activities in a psychosocial response at thislevel of intervention.

Level 3 Focused, non-specialized support
A small percentage of the population will be more severely
affected than others by a crisis and may develop mild to moderatemental health disorders. These people will need individual,family or group interventions, typically carried out by trained andsupervised staff or volunteers. Without any intervention, recovery
from feelings of distress is likely to take much longer and there is arisk of developing severe psychological disorders.

Level 4 Specialized services
A smaller percentage of the affected population will need referraland care for severe psychological disorders, which includes
professional psychological or psychiatric support. This can be
individuals, entire families or whole communities who experiencea very strong reaction to the crisis. It also includes individuals who
have pre-existing psychological disorders, or pre-dispositions
for such developments. The support given at this level can be
individual or may require complex social interventions.
The need for referral to services in levels three and four is commonly
identified through community-based psychosocial activities
led by Red Cross Red Crescent National Societies. It is therefore
very important that those working in this area have a basic
understanding of mental health and psychological disorders, andknow where and how to refer such persons for the necessary help.

36

Setting the context Psychosocial interventions

People needing support at levels three and four are also likely
to benefit from psychosocial support and community-based
activities. If some are so challenged by severe psychologicaldisorders that they are isolated, for example, plans should be madeto assist their reintegration into the community.

Helping the helper
Responding to crises is more often than not an emotionallyand physically challenging experience for everyone involved,
regardless of which area of response they are involved in. This isespecially so in the immediate aftermath of a crisis, but can also
continue in a long-term response.

Ulrik Norup Jørgensen/Danish Red Cross

Red Cross Red Crescent volunteers and staff who are part of the
population directly affected by the crisis or critical event may haveexperienced loss of loved ones and loss of place themselves. Other
volunteers and staff who have come to help from other areas orcountries are often away from their families and usual support
networks. A common experience of all staff and volunteers is thatthe initial enthusiasm and motivation to assist is challenged, as thework is more demanding, both emotionally and physically, thanthey were prepared for. They may experience sleep deprivation,
anxiety overwhether the help
they are giving
is adequate,
frustration
over things not
happening the way
they hoped theywould and sadness
or emotional
reactions to thesuffering witnessed.
It is important toStaff and volunteers also need psychosocial support
ensure that staff and37

Psychosocial interventions Setting the context

volunteers are cared for and are offered the same opportunities
for referrals to specialized services as the population targeted by
the psychosocial interventions. See the chapter on planning andimplementation for more on helping the helper.
BEST PRACTICE

Waiting to respond to Cyclone Nargis
The circumstances in Myanmar immediately following Cyclone
Nargis prevented the influx of international assistance thatusually follows such a crisis. A host of international agencies andorganisations were on standby and ready to respond, but were
not granted entry into the country to assess the impact of thecyclone. Consequently they created a response hub in Bangkok, inneighbouring Thailand. However, as the weeks went by, very few
of the ready-to-go team were able to enter Myanmar and most ofthem had to eventually return to the countries that had sent themout. Many reported feelings of deep frustration and inadequacy,
from knowing that their assistance had the potential to save lives,and yet they were unable to do anything. A psychosocial support
focal person was part of the team, waiting like the others to takepart in assessment activities. She recognized that her co-workers
were emotionally challenged by the situation, and offered thememotional support using active listening and reflection skills.

WWW

Links to Antares Foundation and People in Aid, bothorganisations that work to improve management andsupport to staff and volunteers.

Who provides psychosocial services?
Psychosocial support is typically provided to affected populations
with the help of trained community members that often comefrom the same affected population. Ideally such people are
identified through an interactive community process and aretrusted and respected in the community.

38Setting the context Psychosocial interventions

The model below gives an example of the flow of support tocommunity members from the programme managers in a Red
Cross Red Crescent National Society. The triangular shape ofthe model indicates that whilst there are very few people atthe programme management level, there are many involved
community facilitators and volunteers who work directly with alarge number of affected people. The responsibility for supervisionflows in a downward direction, with the overall responsibility lying
with programme management.
In countries that do not have much, if any, experience of
psychosocial responses, it is beneficial and often necessary tobring in external resources, such as independent consultants orexperienced colleagues from within the Red Cross Red Crescent
Movement, to help to plan a psychosocial intervention.
Psychosocial support responders
Supervise programme planningand implementation

Flow of support
to community

Managing
programme staff

Participate in and supervise activity
implementation and monitoring andevaluation

Programme staff
and cluster leaders(of community facilitators)

Implement activities with beneficiaries– direct link to community. Typicallyhave responsibility for specificfamilies

Community facilitatorsand volunteers

Source: American Red Cross

Affected population
Beneficiaries

Coordination
More and more organisations are focusing on psychosocial needs
in response to crises. It is therefore very important to find out who

39

Psychosocial interventions Setting the context

the other active organisations are and whether a coordinating
body or network group focusing on psychosocial support has
been established. Coordinating efforts with other stakeholders
will increase the potential coverage of psychosocial activities,
and reduce the risk of duplication. Coordination meetings area good place to discuss common issues influencing the successof activities. One example of a common issue would be how
best to engage and retain community volunteers. Another isthe standardisation of psycho-education training for front-line
workers to ensure that they are providing the same information.
BEST PRACTICE

Coordination

Ananda Galappatti

During the months following the Indian Ocean tsunami, thenumber of active stakeholders working in the district of Batticaloa,
in Sri Lanka increased from below 20 to over 70. A coordinating
body had been set up within two weeks of the crisis to protect
affected communities from being overwhelmed by poorly
integrated services offered by the multiple organisations arrivingin the area. The coordinating body served as a clearing-house forresources, a facilitator of inter-agency cooperation and a forum
for discussing problems emerging from the field. Its success waslargely due to the steering group comprising widely-trusted
representatives of the various types of organisations working in the
sector (UN agencies, international NGOs, local NGOs, government
and faith groups),
and the fact that
it functioned
according to a setof clearly definedand equitableprinciples.

40

Setting the context Psychosocial interventions

Community members

The targeted population will largely determine who will be the mostappropriate community members to work with. In a school-based
programme, for example, teachers, parents and others who are
involved in the life of the school and the children are the most likely
candidates. Psychosocial activities done in connection with a healthresponse may recruit local health workers to implement a programme.
Community members working to provide psychosocial services areoften from the population who have been directly affected by thecrisis. This means they have a deeper understanding of the challenges
the target population is experiencing, but also means they may need
psychosocial support themselves. See section above on ‘Helping thehelper’.

Psychosocial well-being as a crosscutting issue
Within the organisational structure of the International Federationof Red Cross and Red Crescent Societies, psychosocial support islocated in the Health and Care Department. However, other areasof assistance also impact the psychosocial well-being of individuals
and communities. Examples are:Food distribution
Families who have no food and are fighting for survival may getcaught up in domestic or community conflicts due to competition
for resources, impacting social relations and emotional well-being.
Shelter
Having no place to live and relocating to a refugee or internallydisplaced people’s camp usually results in a complete breakdownof one’s social network. The loss of one’s home and personal
belongings is often accompanied by strong emotions ofdisorientation and loss.

41

Psychosocial interventions Setting the context

It is essential to join a coordination network where responses
from all assistance areas are represented and advocate forthe consideration of psychosocial needs in all of the differing
approaches. Examples of attending to psychosocial needs are:Relocation
It is important for individuals and families who are relocated
due to a crisis to be reconnected with others from their previous
communities. This will lead to a sense of belonging and trust in
their surroundings.
Relief distribution
Families who have become dependent on food and relief
distribution due to a crisis often experience a sense of humiliationand disempowerment. It is important that distribution is done in a
respectful way, so that beneficiaries can maintain a sense of dignity.
Health care
Health care service points are ideal forums for psycho-education
where people can learn about normal psychological reactions
to crisis and self-help techniques. For example, psychosomatic
reactions, where psychological problems are expressed throughphysical problems or pain, are very common. Being empoweredwith such knowledge can reduce symptoms and increase
understanding of one’s own and others’ reactions.

How to respond to psychosocial needs
A community-based approach
Red Cross and Red Crescent National Societies primarily use acommunity-based approach in responding to psychosocial needs.
This is based on the premise that communities will be empowered
to take care of themselves and each other. In this way dependency
on outside resources is reduced, through community mobilisationand strengthening of community relationships and networks.

42

Setting the context Psychosocial interventions

The Sri Lanka Red Cross Society

Self-sufficiency is essential for communal well-being

The term ‘community-based’ does not in fact refer to the physicallocation of activities. Rather it stresses that the approach strives toinvolve the community itself as much as possible in the planning,
implementation and monitoring and evaluation of the response.
It is an approach that encourages the affected community to gain
ownership of and take responsibility for the responses to theirchallenges. Community participation is therefore an integral
aspect of a community-based approach.
Given the uniqueness of every crisis situation, there is no blueprint
on how best to respond to psychosocial needs. At present, there are
four main models of psychosocial responses practised by Red Cross
Red Crescent National Societies, as illustrated in the diagram on
the next page.

43

Psychosocial interventions Setting the context

Psychosocial response models

Needs
Assessment

Critical
EventContext
analysis

Model options:Stand alone psychosocial
programme
Psychosocial plus: ‘Standalone’ psychosocial programme that includes other aspects
e.g. basic needs, livelihood
supportIntegrated model A:
Psychosocial activities
integrated into other response
e.g. Health services / disastermanagement
Integrated model B:
Psychosocial intervention as
platform for other responses

Source: PS Centre, 2009

1. Stand alone psychosocial programme
The first model is a stand alone psychosocial programme, focusing
solely on psychosocial needs. Usually this type of programme has
an independent staff and budget, and although administratively
it may be run separately, it is implemented in collaboration andcooperation with other areas of response.

ExampleMany Red Cross Red Crescent National Societies have telephone
and online support activities, where people in distress can receive
immediate support through these communication channels. An
example is the peer support programme run by the Danish Red Cross
Youth. Youth volunteers trained in supportive communication speakwith other young people with various kinds of problems, such as
having been sexually abused, eating disorders, anxiety, loneliness,
love problems, conflicts in the family, drug problems etc. The
volunteers know how and where to refer the distressed youth if needbe, and receive regular supervision.

44

Setting the context Psychosocial interventions

2. Psychosocial plus
The second model is also called a psychosocial programme, but it
typically integrates psychosocial needs with others, such as food,shelter, water, clothing or livelihood, all needed for basic survival.
It is based on the principle of integration and provides a holistic
response, but is administratively managed as a psychosocial
programme.

ExampleAs part of a school-based psychosocial programme in Sri Lanka,
following the Indian Ocean tsunami, the children were given milk at
the school on a daily basis. This was to supplement their diets andalso to encourage school attendance, as this would contribute to therestoration of normal daily activities and encourage social interaction.

David Chancellor/ IFRC

3. Integrated model A
In this model psychosocial activities are included in other response
programmes, such as health and care, or disaster management.
Psychosocial activities here are a component of a much larger
and broader programme that addresses additional needs andaspects. In thesetypes of programmes, staff may
not be specificallyrecruited to focus
on psychosocial
activities, and theadministrativeand financial
management of
the programmelies with the larger
focus area.
Psychosocial support is an integral part of providing
home-based care, even if the primary focus is on
physical health needs

45

Psychosocial interventions Setting the context

ExampleMost of the countries in sub-Saharan Africa are subject to persistently
high levels of poverty and repeated natural disasters (such as drought,
floods, cyclones etc). These factors contribute to the high prevalenceof infectious diseases, such as tuberculosis, and to this area having
the highest HIV and AIDS prevalence in the world. In response tothese health challenges, it is a common approach for Red Cross Red
Crescent National Societies to engage in home-based care activities.
Volunteers visit the homes of sick and/or vulnerable individuals andfamilies to provide basic medical care. Providing psychosocial carethrough supportive communication is a natural component of thesehome visits. The focus of these programmes may be primarily on
medical care, but volunteers are also trained in skills to respond to
psychosocial issues.

HousingWatsan er &
itat
ion

Ed
uc

h
alt

Integrated approach

He

od
liho

Psychosocial
supportdiss I neion
at n
rm tiofo ina
m

n

ve
Li

at
io

4. Integrated model B
The fourth model uses psychosocial support as an entry point
to the affected population, as a platform for all other responses.
The multi-sectoral responses needed to assist communities are
identified and responded to, based on the outcome of initial
psychosocial activities. This integrated approach aims to provide
a holistic ‘umbrella of support’ to the individual, family andcommunity.

Umbrella of support

Individual

Family Community

Source: Dr. Subhasis, American Red Cross and Indian Red Cross Society

46

Setting the context Psychosocial interventions

ExampleIndian Red Cross Society is implementing a programme focusing on
recovery after the tsunami of December 2004, where psychosocial
support activities are used as a platform for the identification andinitiation of other needed areas of responses. It is through thepsychosocial support activities that community members volunteer
to be trained as ‘integrated programme technicians’. They thenbecome the focal point between the community and the Indian Red
Cross Society staff and volunteers. The emphasis is on communities
taking responsibility for their own recovery, by being empowered
to identify, design, implement and evaluate relevant community
interventions. Great effort is made to link the communities with otherservice providers, such as relevant government departments, so that
communities themselves can address the varying identified needs
that affect their individual and community well-being.

Which model is used depends on needs and resources, thecontext and the realistic opportunities available. It may be that
one model is chosen at the beginning of a response, and anotherlater on. It can, for example, be appropriate to start a responsewith a stand alone psychosocial programme (model 1) and, withtime, work towards integrating
psychosocial actions andVertical and horizontal
activities into another area ofprogrammes
response, such as health andSometimes stand alonecare (model 3), as the needs inpsychosocial programmes are
the affected population change.
called ‘vertical programmes’
and integrated programmes
Psychosocial needs change all
are termed ‘horizontal’, as
the time, and it is important tothey are broader in focus.
make sure chosen interventions
This is merely a difference inare always relevant.
terminology, but they refer tothe same thing.

47

Psychosocial interventions Setting the context

National and international standards for responding to
psychosocial needs
National standards
There may be national standards and guidelines available about
psychosocial responses in crisis events. Where these are notavailable, health and care responses or other areas of operation
may integrate psychosocial activities, for example, in a National
Disaster Management Plan. Make sure to investigate what thenational standards are and ensure that all the work done complies
with these standards. This will make cooperation with local
authorities easier.
International standards and guidelines
A number of specific documents exist, that are relevant forplanning and implementing psychosocial interventions. It is
important to be familiar with these documents and to use theguidelines, principles and suggestions as much as possible inplanning all work, whilst adhering to specified standards.
Universal Declaration of Human Rights
Most humanitarian responses are based on the aim to fulfil therights in this declaration. Individuals, families and communities
are at heightened risk of human rights violations during crises. It
is vital that staff and volunteers promote the human rights of all
those in their care. For example, access to psychosocial supportshould be on the basis of equity and non-discrimination.
WWW

Link to Universal Declaration of Human Rights
Convention on the Rights of the Child (CRC)
The Convention on the Rights of the Child sets out the rightsthat must be realized for children to develop their full potential,

48

Setting the context Psychosocial interventions

free from hunger and want, neglect and abuse. The CRC applies
to all children equally, with special protections for particularly
vulnerable groups, such as refugee children. In the course ofplanning, implementing and evaluating psychosocial programmes,
it is crucial that the standard of ‘do no harm’ is observed at every
stage. For example, Article 3 of the CRC states that ‘in all actions
concerning children….the best interests of the child shall be a
primary consideration.’
Convention on the Rights of the Child

CD WWW

The Sphere Project. 2004. Humanitarian Charter and MinimumStandards in a Disaster Response
Actions for acute phases following crises are presented in thesection on mental and social aspects of health in the chapter on“standards on control of non-communicable diseases”. The
standard reads:“People have access to social and mental health services to reduce
mental health morbidity, disability and social problems.”
Supporting this standard, the Sphere
Handbook lists key access points across thecommunity. These access points combine
external assistance alongside engaging family,community and cultural resources. In this way,
they provide a good example of psychosocial
support. For example, the family tracing
service, which is an example of external
assistance, in the list of social interventions
stands alongside cultural and religious events
being maintained, which is an example ofcommunity and cultural resources.
The Sphere Project

CD WWW

49

Psychosocial interventions Setting the context

Inter-Agency Standing Committee, 2007. IASC
Guidelines on Mental Health and Psychosocial
Support in Emergency Settings
This comprehensive document provides
detailed guidelines for minimum (immediate)
responses in emergency settings. A matrix ofinterventions indicates 11 key areas of workin crisis settings. Areas of work include suchfunctions as coordination, health services, foodsecurity and nutrition. For every area of work,
the table shows what actions might be taken
before, during and after a crisis.
The final section of the guidelines contains action sheets for all
actions suggested during a crisis as a minimum response.
The three main topics are common functions (action sheets 1- 4),core mental health and psychosocial support (action sheets 5 -8),and social considerations in sectoral domains (action sheets 9 -11)
Each action sheet includes practical steps that can be taken,
provides sample indicators, gives examples, and indicates online
resources.
A summary version of the guidelines is available in the form of a‘check-list for field use’. This check-list can be used for programme
planning and emergency response, but it is recommended that it isused in conjunction with the full guidelines.
CD WWW IASC Guidelines; IASC Guidelines Checklist for Field Use

The Psychological Support Policy of the International Federationof Red Cross and Red Crescent Societies
Psychological support applies across the range of the services
provided by the Red Cross and Red Crescent National Societies.
The International Federation psychological support policy

50Setting the context Psychosocial interventions

establishes a basis of Red Cross and Red Crescent action, bothin emergency response operations and in the implementationof long-term developmental programmes. It outlines the main
responsibilities of the International Federation and all its National
Societies in the field of psychosocial support. The policy applies toany type of psychological support activity carried out by an individual National Society or any of its branches, staff or volunteers orby the International Federation acting collectively. It should beconsidered in conjunction with all other Federation policies.
International Federation Psychological Support Policy

CD WWW

The Inter-Agency Network on Education in
Emergency: Minimum Standards for Educationin Emergencies, Chronic Crises and Early
Reconstruction (INEE)
Although these minimum standards relate
to education, they are relevant since a lot of
psychosocial work is done through the education
sector, in schools and other institutions. Capacity
building and training are also usually core
activities in psychosocial interventions, andthese should be developed with consideration of
the INEE guidelines.
The INEE Minimum Standards provide examples of good practiceand concrete guidance to governments and humanitarian workers
on how to enhance the resilience of education systems. They arealso used for programme and policy planning, assessment, design,
implementation, monitoring and evaluation, as well as advocacy
and preparedness in order reach the ‘Education for All’ goals.
INEE Minimum Standards

CD WWW

51

Psychosocial interventions Setting the context

Final note
Planning and implementing psychosocial interventions after acrisis is no easy task in terms of:• responding best to the impact of the crisis• working in a challenging environment• conforming to national and international standards• meeting requirements set by the Red Cross Red Crescent
National Societies involved in the response• facing decisions at times that are taken above one’s own
level of operation, which poses immense challenges to theimplementation of the psychosocial work
Whilst facing challenges like these, keep in mind that protecting
the psychosocial well-being of adults and children caught up incrisis situations will lead to short-term and long-term benefits forindividuals, families and communities.

52

Assessment

Assessment

Jakob Dall/Danish Red Crossassessment Psychosocial interventionsassessments play a critical role in determining what
activities are planned in a psychosocial response.
Before planning can begin, it is necessary to find out
what has happened and how people have been affected. This
chapter explains what assessments are, and why they are needed
in a psychosocial response. It gives an overview of what kindof assessments are done at the different stages of planning andimplementation, and gives guidance on how to do assessments.
Attention is paid to who is involved in assessments, both in termsof who conducts them and who provides the data needed to create
information.
Assessments are closely linked to monitoring and evaluation
activities. References are given to supplementary information in
the chapter on monitoring and evaluation.

What are assessments?
Assessments are, simply put, the processes and tools that help
to find the facts. They measure and report the needs of a given
population and in this way establish the status of well-being of thatgroup. They also help identify particularly vulnerable sub-groups
such as children, women, men or older people. Assessments pave
the way for deciding where, when and how to start an activity.
Pernille Hansen/PS Centre

The kind of data that iscollected in assessments
depends on the context andthe nature of the crisis thatis being responded to. It also
depends on when in the
response the assessment istaking place. Informationneeded in the initiation phasesof a response differs frominformation needed later or at
the end of the response.

Ethical principles should always be followed in datacollection

55

Psychosocial interventions assessment

There are two major kinds of assessments:

Needs assessments explore the needs and resources of anaffected population.

Impact assessments or evaluations look at the impact ofinterventions (see the chapter on monitoring and evaluation for
more on this topic.)
Needs assessments generally include information on:• demographics – how many people are affected, where they are,how old they are, and so on• impact – how the disaster has
Examples of needs
affected the population physically,assessment tools:
emotionally and socially
The Vulnerability and• problems – what potential
Capacity Assessment
problems are likely to arise in the(VCA) of the International
near future
Federation.5• resources and capacities – what
SWOT analysis method,is the capacity of the affected
looking at the strengths,
population to help themselves
weaknesses, opportunities
including the normal coping
and threats of the affectedmechanisms
communities, the local• assistance – what is needed togovernance and response
help the population to achieveagencies.
psychosocial well-being
Impact assessments explore similar factors, but focus on changes
in status of well-being and on the needs and resources of the
population since an earlier assessment. See the chapter onmonitoring and evaluation.

CD

56

IFRC Emergency Assessment Guidelines; VCA folder;
IASC Action Sheet 2.1

assessment Psychosocial interventions

Why are assessments needed?
Assessments provide the information needed to plan good
responses, ensuring that programme design and activities
implemented are a response to the actual needs of the affected
population. Assessments also explore the resources and strengthsof the population, which are as important as identifying the needs,
when planning a good psychosocial intervention. Assessments
lay the groundwork for realistic expectations of what results theplanned psychosocial interventions can lead to.
Best to avoid

Making assumptions
It can be damaging to assume knowledge of how people react to asituation, or their needs following a crisis, due to having responded
to a similar crisis event before. Every situation will be different andunique, as good assessments demonstrate. It is therefore important
to make assessment as neutral as possible, and not to ask questions
through a predefined model of understanding.
Jérôme Grimaud/ French Red Cross

An example of such a mistake
would be assuming thatthe affected population isseverely distressed by theirexperiences, and asking themspecific questions relating
to one’s own expectationsof how people shouldbe affected. This invites
misinterpretation and canhave long lasting negative
consequences by planning
inappropriate responses.
When conducting assessments each context should
be considered unique57

Psychosocial interventions assessment

BEST PRACTICE

Assessment leading to specified actions
In Kabul, Afghanistan, after the overthrow of the Taliban regime,
a broad structured consultation process with children provided
valuable information about the sources of threat to children’s wellbeing, which included, “war and displacement; poverty, whichleads to family tensions, heavy and exploitive work by children, andlack of access to schooling; family loss, which can lead to poverty
and family separation which leads to anxiety and vulnerability;
family tensions, including physical punishment at home andabuse against adopted children; and pressure at schools, including
teasing and bullying, and abusive teachers. Other risks included
unattended sickness and disability, gender discrimination, earlymarriage, kidnapping, and busy, unregulated traffic as well as thedamaged and dangerous environment.” This assessment process
led to the development of interventions that attempted to addressthese identified problems, rather than simply provide the generic
activities often rolled out in post-conflict situations.
Source: Save the Children Federation Inc. (2003)

CDChildren of Kabul

When are assessments done?
Different kinds of assessments are done at different stages ofthe psychosocial response. This is illustrated in the diagram on
the following page. Please note that the timeframe shown is an
example, and every response will vary according to the presenting
circumstances.

Types of assessments
Rapid assessments are undertaken as soon as possible following acrisis to determine both the needs and the resources of the affected
population. They are usually done quickly and can last from a
few days to a few weeks. The International Federation can assist

58assessment Psychosocial interventions

National Societies with rapid assessments through the deploymentof field assessment and coordination teams (FACT) or regional
disaster response teams (RDRT).
Emergency

Recovery and development

Rapid 	Detailed	Baseline	Continuous
assessment assessment study
assessment

Final
evaluation

Immediate
Response

Recommended
future activities

Critical
EventLong term
programme
design3 mthsActivity review
and adaptation(Or exit– cessationof activities)

6 mths1 year

2 years

3 years
Source: PS Centre, 2009BEST PRACTICE

Including psychosocial needs in FACT missions
The field assessment coordination teams (FACT) are one of the
global emergency response tools of the International Federation.
They have been created to ensure sufficient support is provided
to Red Cross and Red Crescent National Societies during the
emergency phase of a response operation. This allows operations
to begin, whilst longer term human resource support is mobilized.
The International Federation has started to include FACT teammembers with a psychosocial focus when appropriate, to increase
the attention to psychosocial needs. The inclusion of psychosocial
FACT members allows the International Federation and its National Societies to make better plans for psychosocial interventions
early on, thus drastically improving the psychosocial response tocrisis events.

59Psychosocial interventions assessment

CD

WHO Rapid Assessment Tool

WWW

Sites for information on FACT and RDRT

Detailed assessments follow a rapid assessment and areundertaken because more information is needed. These kinds ofassessments focus in more detail on all of the issues listed above forneeds assessments, as well as on descriptions of the community
power structure and set-up. They lay the groundwork for a goodentry into a community, encouraging positive communication
with community members and community participation inplanned activities. To make sure that all aspects of community
life are investigated thoroughly, detailed assessments should bemade with full community participation. They are the first step indesigning a long-term programme.
Christopher Black/IFRC

A combination of various data collection methods will always be useful in assessments,
including focus group discussions and interviews with key individuals.

60

assessment Psychosocial interventions

Baseline studies should be conducted as one of the very firstplanned activities of a long-term response, if the resources tosupport long term interventions are available. A baseline study
can be anything from a simple profile to a detailed study. The datacollected in a baseline can be used for comparison after a periodof implementation, e.g. half way through the time frame andagain at the end of the time frame. The data collected is used tomeasure indicators of psychosocial well-being that are specific to
the planned psychosocial activities. The same indicators are thus
measured at the different time intervals mostly using the same
tool. This kind of assessment therefore provides an analysis of the
impact of the psychosocial interventions, looking specifically atwhether the expected changes have been achieved.
Continuous assessments take place throughout theimplementation of a psychosocial intervention. They have to beincorporated into the planning and the design of the response,
being a regular and obligatory activity. These assessments
play a vital role in monitoring activities, ensuring that thepsychosocial interventions are responding to the actual needs ofthe targeted population, as these are likely to change with time.
The information from continuous assessments is used to regularly
review and, if necessary, adapt the implemented activities (see also
the chapter on monitoring and evaluation.)
Final evaluations are final assessments that investigate boththe impact of the implemented activities, as well as the need for
future activities or interventions. To assess the impact, the datathat is collected is compared against that collected in the baseline
study. The need for future activities will be based on the needs ofthe population at the time of the evaluation. It is thus a tool thatcombines methodologies of needs and impact measurement.
More guidance on final evaluations is presented in the chapter onmonitoring and evaluation.

61

Psychosocial interventions assessment

Contextual understanding of psychosocial well-being:
In the very early stages of a response, it is important to establish
a clear understanding of how the affected population experiences
psychosocial well-being. The following questions explore local
meanings of psychosocial well-being:• How do you know when people in your community are doing well?
Not doing well?
• What has changed in your daily life and in the community following
the crisis event?
• What were the good things in your life prior to the crisis event?
What changes would be desirable for you and for your community inthe next month and within a year?
• How can you and your community contribute towards suchchanges?
Further aspects to explore would be feelings of life-satisfaction,
defined roles and responsibilities in the family and the community,
confidence in dealing with challenges, and dreams about the future.

How to conduct assessments
Assessment methods
It is common to use a variety of methods to collect data, when
conducting both needs and impact assessments. This data is either
quantitative or qualitative. Collected data is analysed, providing
information needed for planning, monitoring and evaluation.

Quantitative data is always described in numbers, such as counts,
percentages, rates or ratios. Common methods of quantitative datacollection include population counts, surveys and questionnaires
with scaled answers, such as the Likert scale, and observations.
An example is a count of how many children have been orphaned
following or during a crisis.

Qualitative data is described in words, and is of a more personal
nature, such as perceptions on a situation or feelings of psychosocial
well-being. Methods of collecting qualitative data include key
informant interviews, focus group discussions, case studies,62

assessment Psychosocial interventions

observations and selfreporting using open-ended
questionnaires. An example
would be descriptions of
how people have reacted
emotionally to a crisis.
When collecting qualitative
information, it is best touse open-ended or semistructured questions that allow
for the exploration of new
topics, instead of following arigidly set list of questions.

Likert scaleThis type of measurement
is often used in surveys andquestionnaires to record
answers on Likert items. A
series of statements is given
and the scale is used to indicate
how much one agrees ordisagrees with the statements.
A typical five-level Likert scale
uses the following terms:
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly Agree

More details on conducting
assessments are found in
the IFRC Emergency Assessment Guidelines

CD

Thomas Bertelsen/Danish Red Cross

Data collected for assessments should be both quantitative and qualitative63

Psychosocial interventions assessment

BEST PRACTICE

Volunteer participation in assessments
Following the Indian Ocean tsunami, new volunteers wererecruited in the affected areas of Sri Lanka. The Sri Lanka Red Cross
Society programme manager of the psychosocial response engaged
the local Red Cross volunteers in an initial assessment. This served
both as a source of information for the programme and also as an
introductory activity for the volunteers.
The volunteers were asked in groups to draw a map of the area,
noting the sea, houses, schools, institutions and any other relevant
details. The volunteers were asked to include the houses they
lived in themselves. When the volunteers explained what they
had drawn, it became clear that some of them had lost everything
due to the tsunami. They were in fact part of the same affected
population they had been recruited to help. This information
surprised the programme manager and some of the othervolunteers. The expectation had been that the volunteers who hadsigned up to help were not part of the affected population. It wasa very useful activity for both the programme manager and thevolunteer groups, as personal challenges were shared amongst thevolunteers in this way, strengthening understanding and bonds
between the group. It also informed the programme manager on
the extent of the impact of the crisis event.

Conducting a situational analysis
A situational analysis is usually part of a rapid assessment,
undertaken as soon as possible following a crisis. A situational
analysis differs from a rapid assessment, in that it does notnecessarily focus on the needs and resources of the population, but
analyses the context, looking at the political, economic, social andecological environments. Situational analyses provide additionaland crucial information that enable National Societies to assess
how best to respond to needs in the given circumstances.

64

assessment Psychosocial interventions

Community in emergency context
Local
governanceand laws

Local organisatio

ty

ies

ationsCommunity
powersystem

ce to

org
anis

it
communion
alcommunity

Assistan

te
In

at

Familly intargetedons
ctati nExpe peratio
Coo

So
cie

fe

mal’ liof norrn

International
laws

ind

Gov
ern
me
nt

ce
tan /
sis lies
As fami uals
to ividtion
DisrupnA,B,C

Source: PS Centre, 2009

The diagram shows that there are always different factors
influencing and affecting families in crises. These need to be
explored fully to get an understanding of the context that
individuals, families and communities are living in. Such increased
understanding will make the planning of activities and responses
more realistic and relevant to the presenting needs. Somequestions to guide a situational analysis relevant to responding to
psychosocial needs are presented below:
Family considerations• What are the cultural and traditional family structures in thecommunities affected by the crisis?
The family in the community• Have people been relocated due to the crisis?
• Are the families living in the same community they lived in
before the emergency situation?

65

Psychosocial interventions assessment• What power structures exist within the community and how dothese affect the families?
• What roles do the targeted families play in the community?
• What are influential factors in the community that existed
before the disaster that still influence the families?
• How disrupted is the community by the crisis event? How does
this affect each family?

Larger influencing factors• What are the social, political and economic factors that influence
the communities?
• How do these circumstances affect the planning andimplementation of a psychosocial response?

Considering childrenChildren are the most vulnerable population in any crisis, as they are
fully dependent on others for their safety and well-being. Include ina situational analysis specific questions on how children have been
affected and what mechanisms there are to protect children fromviolence and abuse. See the chapter on monitoring and evaluation on
specific considerations when collecting data from children.

66

Marko Kokic/ICRC

Assistance to the community• Which stakeholders areplanning to or alreadyassisting the targetedcommunity?
• What is the role of the
Operating National Society
in comparison to otherstakeholders?
• What do the assisting
stakeholders expect from thecommunity?
• What does the community expect from the assisting
stakeholders?
• Does the community have specific expectations to each family?

assessment Psychosocial interventions
Claus Aamundsen/Danish Red

Particular attention should always be paid to the situation of children

Designing an assessment
1. The first step in designing an assessment is to gather all
background information available about the situation at handand about the populations that have been affected. Read all the
documents available to get as much relevant information as
possible. Be sure to get hold of other assessments that have alreadybeen undertaken, for example, from government ministries, UN
agencies or from other psychosocial stakeholders. Additionally,
interview colleagues and other key informants knowledgeable
about the environment and the situation. Key informants might
be members of the population affected directly by the crisis orcolleagues from other organisations or governmental departments
already responding to the crisis.
2. The next step is to focus on what information is needed. If theassessment is undertaken with partners from response areas otherthan psychosocial support, ensure that a psychosocial support
programme person is part of the larger assessment design process.
3. Consider the time frame of the planned intervention in theassessment design. The information needed for an immediate
response is different from that needed for a three month, sixmonth or a one year long programme.

67

Psychosocial interventions assessment

4. Decide on the best methods to gather the necessary
information. It is good practice to use both qualitative andquantitative data collection methods. Choose ways of inquiry thatare culturally appropriate.
5. When using assessment tools that have been used before, makesure the terms and wording used are relevant in this situation andthat both interviewer and respondents will understand what isbeing asked. If translations from other languages are necessary,
make sure to have at least one back-translation to confirm that theterms and wording used will get the information required.
6. Make sure that the questions
to be asked are both culturally
and politically appropriate. Never
include any questions that will
make the people interviewed
feel uncomfortable or in any way
jeopardise their safety and security.

Community-based focus

When collecting information
to guide the design ofa psychosocial support
programme, it is usually
not helpful to use tools thatmeasure psychologicaldisorders or conditions.
Treatment of such disorders
is beyond the scope ofcommunity-based psychosocial
programme.

7. Decide who will actuallyconduct the interviews. Make surethat all who conduct interviews
have cultural awareness, relevant
language skills and have been trained in interview skills and theethical principles concerning data collection (see the chapters on
training and on monitoring and evaluation).

8. If possible, pre-test the assessment tool with a small sampleof the affected population to ensure that it truly does collect the
information needed. Some questions may need to be reformulated,
modified or changed completely.
9. Consider whether it is appropriate to take something to the
population being interviewed, for example in the form of gifts,
information, leaflets on reactions, etc.

68

assessment Psychosocial interventions

BEST PRACTICE

Initial contact
Note that the very first time members of an affected population areapproached, for example to collect data in assessment, is actually
the initial contact in a psychosocial response. It is important tobe aware of this, and to be conscious of how this initial contact
is made, as it lays the foundation for future interaction with theaffected population.
In Aceh, Indonesia, following the Indian Ocean tsunami, the firstcontact with the affected population was through psychologicalfirst aid activities. This proved to be a positive way of making
initial contact, as the affected individuals and families were asked
how they were, instead of what they felt they needed. After the
initial contact had been made and trust had been establishedbetween the staff and volunteers and those affected, then topics ofconversation could move into an exploration of impact and needs.

Data analysis
Once data has been collected by the assessment team, it is time tomake sense of the data to provide useful information for planningpurposes. Revert to the original questions from the beginningof the design phase, and analyse the data in relation to thesequestions. The derived information guides the planning for the
next activities of the psychosocial response.

Joint coordinated assessments
When planning assessments, it is best to join with other response
areas of the Operating National Society and other collaborating
stakeholders, especially concerning psychosocial reactions to adisaster or emergency situation. Make sure that all questions thatneed to be answered are included in a multi-sectoral assessment,as psychosocial needs are often overlooked or not prioritized byother areas of response.

69

Psychosocial interventions assessment

If it is not possible to conduct joint assessments, try to get
information from other stakeholders’ assessments. Always beready to share results with others, as most active partners in a
psychosocial response are looking for the same information.

Benefits of joint assessments

It is overwhelming for families to be visited by many different people
representing different organisations or agencies, and to be asked
over and over again about their well-being. “How has the present
situation affected them?” “What problems are they experiencing?”“What assistance do they require?” This can cause distress, asemotional pain is felt when difficult experiences are relived. It is more
respectful and considerate for stakeholders to plan and undertake
joint assessments, where the information needed can be collected in
one family visit or in joint community events.

BEST PRACTICE

Sharing information
In the Maldives, the American Red Cross and UNFPA supported
the implementation of a psychosocial support programmein the emergency phase after the Indian Ocean tsunami. A
number of challenges led to a gap in implementation between
the closure of the emergency programme and the start of along-term programme by the American Red Cross. During thisperiod, the UNFPA conducted programmes in various tsunamiaffected islands, which included an extensive assessment of
the psychosocial situation in these islands. The results of thisassessment provided detailed recommendations for long-term
programmes, which were then followed by the American Red
Cross when designing the long-term development response.

70

assessment Psychosocial interventions

Who conducts assessments?
The Red Cross Red Crescent Society programme managers of thepsychosocial intervention, whether in a stand-alone programme
or in an integrated response, have the responsibility thatappropriate assessments are designed and conducted ethicallyand according to international, local and Red Cross Red Crescentstandards and principles.
It is usually National Society volunteers or others from the affected
communities who visit those affected to conduct interviews or
focus groups. This is less intimidating for the affected population,and helps to prevent too high expectations of the Operating
National Society. Cultural norms of communication have to beconsidered in facilitating interactions between those interviewing
and those being interviewed. In some countries, for example, it is
not appropriate for women to interview men, or vice versa, about
personal issues or states of emotion.
The International Federation recommends that the same people
are responsible for all assessments in a programme cycle, as thisminimizes loss of information and improves consistency between
different programme phases.6

Ethical principles ofdata collection
There are specific ethicalprinciples to consider
when planning any formof data collection. Pleaserefer to the chapter onmonitoring and evaluation
for these details.

Supporting data collectors
Collecting information from
affected people in a crisis situation
can be an emotionally challenging
experience. Volunteers who arerecruited to assist in assessments
need care and support, especiallyas they themselves may also beaffected by the crisis.

71

Psychosocial interventions assessment
Mark Kokic/IFRC

It is always best to get information from as many varied subgroups as possible,
especially in the initial phases of gathering information

Who provides the information?
Sampling
In the early stages of a response, when conducting an initialassessment, a sampling method reaching as many subgroups
in the affected population as possible is recommended. This
will give the broadest overview of the impact of the disaster or
emergency situation. Use a mixed method approach, combining
quantitative methods such as questionnaires, with qualitative
methods of observations and focus group discussions to investigate
psychosocial well-being.

Broad sampling
Sampling as broadly as possible will ensure that the assessment
is robust. Careful planning in the timing and scope of sampling
will help in ensuring that as many different groups as possible
are included in the process. Work out when the most suitable
time would be in visiting groups. Visiting children in a school, forexample, will need to be synchronised with class times. Work out
which public institutions (such as hospitals, health care facilities,
government offices, schools), work places; and public social sites,(such as markets, coffee houses) would be relevant.

72

assessment Psychosocial interventions

Different kinds of information can be accessed from different
groups, for example:

Individuals available at home: impact on their family andneighbours; coping mechanisms

Parents: impact on children and needs of children; parenting
needs

Older people: historical perspectives on previous crises
and earlier coping mechanisms; earlier best practices withincommunity; capacities of community; impact on themselvesChildren and youth: impact on self; awareness about
psychological and social issues after event; major concerns for
futureCommunity leaders: overall impact on communities; overview
of key activities or support already received; future community
plans; geography of community; key people in response andcommunity structure
Religious leaders: impact on religious aspects of life and coping
mechanisms; spiritual coping practices that should be consideredin programme design
Teachers: impact on children and overview of their reactions;
impact on behaviours in schools; personal impact on teachers andtheir specific needs for support
Crisis responders or caregivers already working in
affected population: sensitive information that may be difficult
to ask the affected population themselves
Government officials: overall impact and overview of ongoing
activities

How to ask questions

Asking people direct personal questions can be experienced as
intrusive and may discourage people from answering in an open andhonest manner. Questions can be posed instead in a non-personalmanner, such as ‘does (this) happen in your community?’, or ‘do you
know anyone in the community who has experienced (this)?’73

Psychosocial interventions assessment

Once the target group for the psychosocial response is identified, amore detailed assessment will need to be conducted. In this kindof assessment, the sampling needs to be more specific, involving
representatives of that target group to get as much detailed
information about their situation as possible.
When conducting impact assessments, if possible it is good tocollect data from the same people at regular intervals. This willallow for a comparison of the data over time and will measure if
the response is having the desired impact.
BEST PRACTICE

Community mapping

74

Stephen Regel/Nottinghamshire Healthcare NHS

One effective method of gathering information on the strengths
and resources of an affected population is to engage community
members in community mapping. In this exercise, community
members are asked to draw or build their community with real
size and distance proportions, and to describe the community
as they are mapping it. It is an invaluable source of information
on who lives in the community, what losses and damage havebeen experienced, what the community structure is, including
power relations between community members and also what
are its resources
and strengths.
Community
mapping is also an
excellent exercise
when engaging
in disaster
preparedness
planning.

Planning and Implementation

Planning and
Implementation

John Pilkington

Planning and Implementation Psychosocial interventionst

his chapter is about planning and implementing a
psychosocial intervention. It looks at when the various
aspects of planning and implementation take place, anddescribes who is involved in a psychosocial intervention. Detailed
attention is paid to the planning of activities and examples ofactivities in different kinds of settings are given. The chapter
ends with a section on programme administration, consideringboth general and specific psychosocial aspects of programmemanagement.

The planning and implementation process
The diagram below gives an overview of the planning andimplementation process in response to all stages of a crisis, looking
at preparedness, assessment, activity planning and monitoringand evaluation activities. Even though the time frame will vary
according to each specific context, the logic in the planning process
is applicable to most processes.
Preparedness

Emergency

Recovery and development

Rapid 	Detailed	Baseline	Continuous
assessment assessment study
assessment
Risk
analysisFinalevaluation

Immediate 		Long term	Regular programme review
activity planning
programme design
adaptation according to				findings of M and E
Activity implementation

Any time
beforecritical
event

CriticalEvent

3 mths6 mths1 year

2 years

3 years

Source: PS Centre, 200977

Psychosocial interventions Planning and Implementation

When does planning a response begin?
Disaster preparedness
A number of factors may encourage disaster preparedness ina country. These include a high risk for natural disasters, suchas hurricanes, floods, cyclones, earthquakes; political unrest or
instability that may lead to armed conflict or possible terrorist
attacks; ongoing poverty that may add to a vicious cycle ofvulnerability to disease. An analysis of risks and resources will
guide the specific requirements of disaster preparedness in acountry. However, one thing is certain. It will always be beneficial
if the staff and volunteers who are trained in disaster preparedness
are also trained on psychosocial effects of disaster, and on possible
interventions needed in the immediate aftermath of a crisis.
Having a team of people trained in recognizing and responding to
psychosocial needs is a huge resource when responding to a crisis.

Responding to a critical event
Immediately after, or even during, a critical event, a rapid
assessment enables the planning of instantaneous activities to
respond to urgent needs. A detailed assessment should be initiatedas soon as possible, to identify the needs and resources of theaffected population and to clarify how the event has impacted
psychosocial well-being. This information creates the platform forplanning the next steps of the response. See more in the chapter on
assessment.

Who is involved in a psychosocial response?
Community
The most important population to work with is the affected
population, also referred to as the community. A community isinterpreted as a group of people who live together in a town, village
or smaller unit. However, a community may also be defined as anygroup of people who interact and share certain things as a group.
Examples of communities could be those who belong to the same
ethnic group; those who go to the same church; those who work as
farmers, or those who are volunteers in the same organisation.

78

Planning and Implementation Psychosocial interventions

Community participation – a key to success
Active community participation is one of the key factors to
successfully planning and implementing relevant and helpful
psychosocial activities. Engaging the community has been
introduced in the chapter on assessments, where it was stressedthat the community members themselves are the experts on what
the needs and resources of the communities are. They are also thepeople who have the appropriate solutions to the problems andchallenges of the affected population.
True community participation means that the community has
ownership of the programme and the activities, and that the
Red Cross Red Crescent psychosocial team is more in the role offacilitators. Ideally community members should be involved in allphases of the programme or activity planning and implementation
including:• assessing needs, planning activities and drafting proposals• implementing activities including mobilizing fellow community
members to participate• engaging in the monitoring and evaluation processes

Jakob Dall/Danish Red Cross

Full involvement does two very important things. First, itestablishes and continually confirms the mutual responsibilities
and roles of the
responding National
Societies andthe community.
Second, it makes itmuch easier for thecommunity to takeover the activities,
if needed, once the
National Society isready to leave the
area.

79

Psychosocial interventions Planning and Implementation

Community capacity
Crises typically cause physical and emotional upheaval inaffected communities, whilst also disrupting social systems
and networks. It may therefore be necessary to assist with reestablishing or strengthening community systems, and to invest
in capacity building of selected community members, as a way ofensuring successful community participation in the psychosocial
intervention. It may take some time to identify the people best
suited for this role, when inviting community members toparticipate in the planning and implementation process.
Promising practiceVillage tract committees
In response to the devastation caused in Myanmar by Cyclone
Nargis in 2008, the International Federation supported the
Myanmar Red Cross Society in forming village tract committees ineach of the targeted affected villages. These committees comprisevillage representatives, women, older people, monks, teachers andother influential community village members. The main aim of
the committees is to facilitate the integration and implementationof all of the Myanmar Red Cross Society activities targeting theaffected community. Committee members will coordinate andcooperate with Myanmar Red Cross Society hubs to be fully
involved in:• all needs and impact assessments• identifying and prioritizing relevant activities• identifying beneficiaries for distributions of relief items andpsychosocial support kits
• helping to identify audiences that should be targeted withawareness-raising activities and talks on topical issues, such as
health and psychosocial support• working with the water and sanitation sector response team to
identify locations of water points and latrines• advising and guiding the Myanmar Red Cross Society on
culturally accepted ways of implementation

80Planning and Implementation Psychosocial interventions

Working with communities; Participation by
Crisis-Affected Populations; Community Participation

CD

Volunteers
One of the Fundamental Principles of the Red Cross and Red
Crescent Movement is voluntary service. The Movement is avolunteer-based organisation and carries out its mission ‘toimprove the lives of vulnerable people by mobilizing the power ofhumanity’ through the help of volunteers.
Mel Tolnay/Australian Red Cross Society

Working withvolunteers
is a positive
investment inall countries,
as it leads toincreasedcapacity andresources. It
also encourages
community
participationand involvement inresponses.
Volunteers who are involved in a psychosocial response are
empowered with the knowledge and skills, encouraging longterm sustainability of psychosocial activities beyond the life of theplanned response.
Be sure to plan for adequate training on psychosocial supportand related issues for all the volunteers who are recruited to the
response (see the chapter on training).
Managing stress in the fieldCD

81

Psychosocial interventions Planning and Implementation

Caring for volunteers

It is common in a crisis situation that the same people volunteer
for different tasks in a community. At times this is a good thing, asfamilies develop close relationships with the same volunteers. It is
important, however, to be sure that volunteers are not overwhelmedwith too many different tasks, or overworked so that they cannot copewith the demands.

The psychosocial team
The composition of a Red Cross Red Crescent psychosocial teamdepends on the financial and human resources available, and thetype of psychosocial intervention model selected. If a stand-alone
programme is going to be implemented, it is likely that a teamsolely dedicated to working with the psychosocial intervention
is needed. If psychosocial activities are integrated into a larger
and broader response, other programme staff, for example froma health and care programme, may be the ones who are given
responsibility for the psychosocial interventions and thus need therelevant training.

Internal and external partners

Indonesian Red Cross Society: Palang Merah Indonesia

It is very important to coordinate with other partners in otherareas of a response to a crisis, internally within the Operating
National Society, externally with Participating National Societies
and also with otheractive stakeholders in
the targeted area. In
this way all existingneeds and resources
can be identified todetermine the roles
and responsibilitiesof each active partner,
encouraging a holistic
and comprehensive
response.
Red Cross volunteers from Palang Merah Indonesia play withchildren in a tent provided by UNICEF

82

Planning and Implementation Psychosocial interventions

Coordination challenges

Coordination is always a challenge. Although organisations may
be willing to share information about what they are doing at acoordination meeting, they may not always be willing to change ormodify their plans, when coordination of future activities is attempted.
Reasons for this include predetermined mandates that reduce scopefor flexibility and competition for visibility in the response.
See IASC Action Sheet 1.1 for good practices on coordination

CD

Best practiceBest practice: Coordination and sharing of responsibilities
The Maldives consist of 198 inhabited islands; more than 50 weredirectly affected by the Indian Ocean tsunami. There were only
two psychiatrists on the capital island of Male at the time of thetsunami and no mental health services on any of the other islands.
No technical capacity for community-based psychosocial support
was available within the existing agencies in the country. Therefore
the two major challenges were logistics and technical know-how
for community-based psychosocial support. The American Red
Cross under the International Federation provided the technicalsupport; UNFPA (for the community component) and UNICEF (forthe school component) supported the logistics and the programme
was implemented by the National Disaster Management Centre of
the Government of Maldives.

Who is targeted in a psychosocial response?
Choosing the target group
It is obvious that people with psychosocial difficulties should
be targeted when planning a psychosocial response. However,depending on the definition of psychosocial well-being that isbeing used, it may appear that everyone in the affected population
has psychosocial difficulties.

83

Psychosocial interventions Planning and Implementation

Coordinating with other active
psychosocial stakeholders at thistime to prioritize identified needs
is recommended, as a joint effort
will reach a wider population.
Coordinating planning alsomeans services can be focussed
on target groups to which ahigh quality response can becommitted, rather than trying toreach everyone with poor quality
services.

Inaccessibility leads tovulnerability

Avoiding duplicationand overwhelming theaffected population

It is important to be consciousof available resources andcapabilities. It makes sense
not to duplicate what otherstakeholders in a psychosocial
response are already doingwith the same population. It isoverwhelming and can be very
demanding for a community,
when there are many different
organisations that all want
to offer services and engage
them in similar activities.

A population that is hard toreach, either by road or other means, is vulnerable by this factor of
inaccessibility. It is therefore important to consider the practicaland logistical arrangements needed to make sure that such groups
are reached with the help they need.
American Red Cross

84

Planning and Implementation Psychosocial interventions

Till Mayer/IFRC

Specific needs
Subgroups, suchas children, men,
women, young
and older people,
have different
needs that haveto be consideredin all activity
and programme
planning.
Attention should always be paid to the special needs of children
Make sure that
activities targeting children of different age groups, for example,
consider the children’s development stages. Also recognize special
needs within groups such as the specific needs of children who
are separated from their guardians or families, child soldiers,
child-headed households, widows, widowers and people withdisabilities.

Vulnerable and voicelessAs the mission of the Red Cross and Red Crescent Movement is toimprove the lives of vulnerable people, remember to look beyond
the obvious when identifying who the vulnerable are. The weakest
and worst affected can be difficult to find, as they may not be able
to reach out and actively seekhelp themselves.
Very young children, an example of a particularly vulnerable
group, may be overlooked in the course of a crisis on theassumption that families are taking care of them. Unfortunatelyfamilies may be so challenged by the consequences of the crisis
that they are not in a position to provide the care needed. Children
are also usually targeted through school activities for which
this group is too young and therefore very young children may
slip through the net. Early childhood care is critical for healthy
development and as such, specific activities directed towards
families and very young children themselves may well be needed.

85

Psychosocial interventions Planning and Implementation

The most vulnerable may also have social challenges, either by
being ostracised from social circles, or from finding it too difficult
to interact with others on their own account. It is therefore
important when planning activities for specific vulnerable groups
that these activities do not contribute further to social separation,
but instead try to create social links. Plan activities for wholecommunities which include those who may be dissociated, at leastin the beginning of the response. If it remains clear that certain
individuals are coping less well later in the response, then activities
and interventions to address these continued challenges should be
developed.
Best practice

Supporting widows in Sri Lanka
The Danish Red Cross and Sri Lanka Red Cross Society
implemented a psychosocial support programme after the Indian
Ocean tsunami. The programme had varied components linked
to the needs of the subgroups targeted. Many of the women who
were widowed were unable to leave their homes for the first few
months after the tsunami, according to the accepted norms of theirreligion. This heightened their vulnerability, as they were unable
to seek employment or otherwise support themselves in thecommunity. The two National Red Cross societies gave the women
sewing machines, so that they could make clothes for other people.
This was a psychosocial intervention in that it aimed to increase
the women’s sense of empowerment and independence. It also
encouraged social interaction as other women came to their houses
to have clothes made.

Mental health versus psychosocial problems
Only a small percentage of a population will have psychologicalor mental health disorders requiring professional psychologicalor psychiatric treatment, as mentioned in the chapter on setting
the context. These people need to be identified and referred to86Planning and Implementation Psychosocial interventions

appropriate services for treatment. However, psychological andmental health disorders are often accompanied by psychosocial
problems. In fact people with psychological or mental disorders
should be included in psychosocial activities, as participation is
likely to benefit the treatment and recovery progress. Participationin community activities also encourages also a more positive
understanding of mental health issues by others, reducing stigma
and discrimination.

Holistic and integrated approach
If a particular subpopulation in a community is targeted,remember to regard them in their entire social and ecologicalcontext, as illustrated in the diagram below. If the primary focus ison planning and implementing activities for children, for example,
then their caregivers, teachers and others in the community who
have influence on their well-being also need to be involved in theplanned response. Working holistically brings benefits not only
on the individual level, but also for the community, encouraging
social cohesion and building resilience. Interventions may
therefore involve community members at different levels of social
interaction – individuals, households, different subgroups in thecommunity, whole communities.
s and service pr
ion
ov
t
is
itu
unity supp
t
m
i
s
or
m
o
t
C
e
t
net
wo
edia
m

rk

Im

on

In

Socialecologicalmodel

Source: Adapted from
Bronfenbrenner, 197987

Psychosocial interventions Planning and Implementation

What activities are appropriate in a
psychosocial response?
Preparatory activities
A psychosocial response begins as soon as questions relating to
psychosocial well-being are included in the very first assessment
following a critical event. The information gathered through theseassessments usually point to immediate activities needed in theemergency phase of the response, such as psychological first aid.
Red Cross Red Crescent National Societies’ programme staff andvolunteers commonly have to undergo initial training, unless a
trained psychosocial team is available. The initial preparatory
activities, following assessments, are therefore usually training
activities. Detailed information and recommendations for training
in psychosocial responses is given in the chapter on Training.
The Sri Lanka Red Cross Society

Community mobilisation
The affected population should
be involved from the onsetof the psychosocial response.
Both initial assessments andidentifying the appropriate
interventions are activities thatneed to be included in plans
Community meetings are usually the first step inand budgets. The time andmobilising community participation
effort to enable and support
full community involvement should not be underestimated.
Activities mobilising community participation and involvement
might include individual meetings with community leaders, larger
community meetings and community events.

Community-based psychosocial activities
Once assessments have provided adequate information on theneeds and resources of the affected population, it is time to begin
working with the communities to identify relevant psychosocial
activities. Deciding which activities are beneficial will be a balanceof meeting identified needs and a realistic appraisal of resources

88Planning and Implementation Psychosocial interventions

available, both of the affected community and of the Operating
and Participating National Societies. It is important not to plan
activities that cannot be carried out, as this risks the developmentof feelings of inadequacy, disappointment and failure for both
implementers and beneficiaries.
There are many important things to consider when planningappropriate activities. Some of these include:
International Federation of Red Cross and Red Crescent Societies

Meeting basic needs
Most people will not be able to take partin psychosocial activities, if they are
hungry, cold, have nowhere to live andare struggling to survive. It is therefore
critical that the planned psychosocial
response is coordinated with responses
relating to health and care, water andsanitation, food security and nutrition,and education. It should be possible toinitiate some psychosocial activities atthe same time as basic needs are being
met, but fulfilment of basic needs must
be a priority.

Entry point to the community
The first communication with a community is often the mostimportant and paves the way for a successful future interactive
relationship. Make sure that the targeted communities areapproached respectfully and appropriately. In many communities
it is fitting to first approach the community leaders, and with theirsupport, trust and participation of others is gained easier. Find out
the best way to enter the community through consultation withpeople who are familiar with the community.
The target group and the planned activities will also determine
where activities will take place in the community.

89Psychosocial interventions Planning and Implementation

Best practice

The role of schools
Schools have been found to be ideal settings for psychosocial
responses in many countries, both as the entry point to thecommunity and for assisting children following a crisis event.
As an entry point to the community, schools are often centrally
placed accessible venues and as institutions are highly valued incommunities. Teaching staff are usually highly respected and their
engagement in psychosocial activities frequently mobilises theparticipation of parents and other community members in thepsychosocial response.
Ulrik Norup Jørgensen /Danish Red Cross

As an activity in a
psychosocial response,
enabling children
to return to school
is a crucial part ofnormalizing life after acrisis event. It restores
some predictability ofdaily routine, reconnects
children to peer networks
and provides a context
within which children can process the experiences they have justbeen through. As teaching staff may often be burdened by dealing
with losses and disruption in their own lives, it is good practiceto help them too, which in turn will enhance their potential tosupport their students.
In Yogyakarta, Indonesia, teachers reported that the training andsupport they received as part of the psychosocial intervention,
run by Palang Merah Indonesia after the earthquake in May 2006,
helped alleviate their own sense of distress, whilst also improving
their relationships and interactions with students.

90Planning and Implementation Psychosocial interventions

Awareness raising and psycho-education
Regardless of the specific activities that are implemented, successful participation and understanding of the activities will always
benefit from raising awareness in the targeted communities on:• the Red Cross and Red Crescent Movement and how it operates
with particular explanation of the work of the Operating
National Society. This explains both mandate and intention,
reducing suspicion.
• psychosocial responses including the meaning of the terms‘psychosocial well-being’ and ‘psychosocial support’• what activities are planned and why• who is involved in the response and in the community-based
activities• how activities will benefit target groups• how community members can be actively involved in activities
Raising awareness can help to decrease any potential stigma that
may arise, since the word ‘psycho’ in psychosocial can easily be
misunderstood, if not explained well. There is prejudice in many
countries against people who have psychological problems.
Here, once again, it is important to raise awareness of the normal
reactions that arise in connection to abnormal events.
Yoshi Shimizu/IFRC

Methods of raising awareness on relevant issues vary from country to country91Psychosocial interventions Planning and Implementation

Indonesian Red Cross Society: Palang Merah Indonesia

There are many ways to raise awareness.
Popular methods include using themedia, such as radio and television, as
well as the production of informationand education communication (IEC)
materials such as leaflets, booklets
and posters. It is vital that all messages
and images are sensitively presented,
culturally appropriate and also
consciously target the right age groups
with the right messages. Awareness-raising opportunities can also
be used to highlight key messages that are relevant for the positivewell-being of the target group. For example, if targeting teenagers,
include key messages on drug abuse and teenage pregnancy.
There are many examples of good IEC materials developed as partof psychosocial activities responding to the Indian Ocean tsunami.
It is important that the use of all communication materials ismonitored and evaluated.
WWW

PS Centre site on Indian Ocean tsunami psychosocial response
Best to avoid

Letting children watch live television
In the Maldives, live television programmes continually featured
distressing footage of the Indian Ocean tsunami and the devastation
it had caused, not only in the Maldives but also in neighbouring
countries. These images frightened many of the children much
more than their own personal experiences. This type of insensitive
media reporting was taken into account by the American Red Cross,when they were planning psychosocial activities with the children.

92Planning and Implementation Psychosocial interventions

Best practice

Adapting leaflets
In Banda Aceh, Indonesia, after the Indian Ocean tsunami, Palang
Merah Indonesia and the American Red Cross adapted leafletsthat had been used in a psychosocial programme in India. They
featured illustrations that were culturally appropriate of families
and their reactions to the tsunami. Their aim was to educate adults
on normal reactions to what they had experienced. However,the first reaction to the leaflet was negative, as the adults felt the
pictures were cartoon-like and that they were condescending totheir level of intelligence. The materials were redone following
consultations with community members and were eventually asuccess.

Source: Indonesian Red Cross Society: Palang Merah Indonesia

Phases of psychosocial recovery
Psychosocial needs are dynamic and change according to the stagesof psychosocial recovery. These changes have to be consideredwhen planning psychosocial activities. The diagram on the next
page gives an example of how different recovery phases affectchanges in activities, and how this interrelates with the processes
for planning activities.

93

Psychosocial interventions Planning and Implementation

Emergency

Recovery – long term			
Activity planning
Immediate 	Long term 		Regular review and adaptation according to
response
programme design
findings of ongoing monitoring and evaluation
			
Recovery phases
Root shock	Realization	Acknowledgement	Adaptation				 Activity examples
				Psychological First Aid	Support groups	Youth clubs
Need and resource mapping	Home visits		Drama activities
Drama activities				Regular play groups with children					Memorial activities

CriticalEvent

3 mths6 mths1 year

2 years

3 years
Source: PS Centre, 2009

Gender and age
Make sure that activities are specific and appropriate for the genderand age groups of the targeted population. It would, for example,
be incorrect in some contexts to assume that the same activities are
suitable for boys and for girls. Appropriate activities also vary forchildren of different ages, as they are at differing developmental
stages. Be sure to budget for the development and/or adaptation ofage- and gender appropriate materials.
Pernille Hansen/PS Centre

Psychosocial activities should always be specific according to the targeted group94

Planning and Implementation Psychosocial interventions

Best practice

Youth programmes for children
Red Cross youth volunteers in Costa Rica, in collaboration with
UNICEF, a local university and other partners, run a psychologicalsupport programme called ”Return of Happiness” with children
affected by natural disasters. They perform puppet shows and playwith the children to help them overcome shock after a disaster.
This youth programme complements the work of the Costa Rica
Red Cross. The approach of “with, for and by youth” has greatly
improved the quality of the services to children. In the past, they
were often silent victims and therefore particularly at risk.

In many countries
religion influences what
activities are appropriate
as psychosocial interventions. Be sure to consider what role religious
beliefs and practices playin the lives of the target
group, and plan theactivities accordingly.

Li Zheng/IFRC

Religious affiliation

Differences in mourning rituals should always be respected

Protection
Crisis and post-crisis environments are unfortunately often
marked by an increase in violence and abuse especially againstchildren and women, but also against other vulnerable groups
such as people with disabilities or older people. Always be awareof special protection needs of particular groups and integratethese needs into the plans and design of interventions. It is the
responsibility of all National Societies to protect vulnerable groups.
Use all opportunities available to ensure that protective measures
are in place in the targeted communities.

95

Psychosocial interventions Planning and Implementation

Best practice

RespectED: Violence & Abuse Prevention and Be Safe!
Education is a vital key in the prevention of abuse, bullying,violence and sexual exploitation. The Canadian Red Cross is in
the forefront on issues of preventing child abuse, implementing aseries of prevention education programmes throughout Canada,
promoting healthier relationships and safer communities. Over
2.6 million Canadian children and youth, as well as more than
900,000 adults, have been educated by prevention educatorsand volunteers on the prevention of different types of childabuse, neglect, harassment, relationship violence and bullying.
The programmes are designed for children of different ages andadults, with appropriate messages, information materials andactivities. An example is c.a.r.e (Challenge Abuse through Respect
Education), a personal safety programme designed for children
from ages 5 - 9 which combines story telling, puppetry and otherhands-on activities.
The Canadian Red Cross is sharing its expertise and successful
experience of the RespectEd: Violence and Abuse Prevention
programme in Guyana, where Guyana Red Cross has developed
a programme called Be Safe! in collaboration with local andinternational child protection agencies. The main objectives of thisprogramme are to teach the children:• about body ownership• that bodies are private• that touches can be safe or unsafe• that secrets about touching should
never be kept
• about safety rules: Say “NO!”, Get away
and tell someone you trust – keep
telling until someone helps you.
WWW

96

RespectED: Violence & Abuse
Prevention program on the site for
Canadian Red Cross Society
Source: Guyana Red Cross Society

Planning and Implementation Psychosocial interventions

Best practiceProtection measures in camps
Following the Indian Ocean tsunami, thousands of people weremoved into internally displaced people’s camps. In some countries,
it was not long after relocation into the camps that incidences ofabuse, both of physical and sexual violence, were reported. Smallbut effective interventions were implemented to address this. One
example was ensuring that bathrooms or water-collection points
were close to the homes, and that there was adequate lighting
by these facilities. Another was holding community meetings toreinforce public knowledge on abuse.
Protection folder

CD

Short-term versus long-term response
Short-term responses usually address essential needs immediately
after a critical event. Long-term responses also address psychosocial needs that develop in the recovery phases, when communities
are adapting to the resulting situation. A number of issues should
be considered regarding short-term versus long-term responses.
Psychosocial well-being is an outcome of both individual emotionaland social factors. It often takes a long time before an improvementin psychosocial well-being is experienced as a result of implemented interventions. It is therefore advisable to plan for long-term
interventions when planning psychosocial activities if at all possible.
If it is clear from the beginning that resources are not available
to support a long-term intervention, consider partnering withother stakeholders that have these resources. This means thatthe affected population will have access to psychosocial activities
if needed, after the Red Cross Red Crescent implemented
programme has expired. Be sure to plan the short-term response
activities well; activities should not be started that will leavepeople more vulnerable if they are discontinued.

97

Psychosocial interventions Planning and Implementation

Psychosocial activities differ in the emergency response and therecovery phase. Useful and relevant activities in the emergency
response phase are not the same as those relevant in the recovery
phases. Make sure that adequate monitoring and evaluation of
the intervention is undertaken to confirm that activities are still
relevant and address real needs. If a programme has been funded
for several years, be sure to include both adequate time and budget
to regularly review and adapt the approach.
Although activities change and adapt according to changing needs,
it is still important to retain a link and sense of continuity between
different activities. This will encourage the trust and participationof beneficiaries, and in this way increase the chances of improving
psychosocial well-being. This can be done, for example, by involving
beneficiaries in identifying new or adapting old activities and byretaining the same volunteers and staff.
Long-term psychosocial response activities should be coordinatedwith other areas of response in reconstruction and development.
The Sri Lanka Red Cross Society

Empowering thecommunity

Psychosocial interventions aim to empower
communities to take care of themselves

98

Today there is a huge numberof international agencies
and bodies that want to help
when a country or an area
has been affected by a crisis
or critical event. This can be
overwhelming for the local
government, implementing
partners and most of all forthe affected population.
There is always a risk that
excessive external assistancewill encourage dependency
and decrease communities’Planning and Implementation Psychosocial interventions

motivation to help themselves. Psychosocial activities can playa positive part in empowering communities with the strength
needed to rebuild and recover from a critical event or crisis. It isvital to plan activities that rely on the strengths and potentials
that lie in the community. This is empowering and helps thecommunity to rebuild their resilience.
Best practiceLong term support at community centre
Turkish Red Crescent Society

Immediately following
the Indian Ocean
tsunami, Turkish
Red Crescent Society
sent a small team of
psychosocial delegatesto Aceh, Indonesia, toassess psychosocial
needs and initiate an
emergency responsein collaboration with
Palang Merah Indonesia
and other Movement
partners. Already in the initial phase of response, Turkish Red
Crescent Society committed to building and furnishing a needed
community centre, which could be used for long term service
delivery of psychosocial support. The Sultan II Selim Aceh
Community Centre has since been used for a vast variety ofactivities including training, art classes and competitions, sports
and fun activities for groups of all ages, community meetings,
support groups, etc. The centre continues to improve the coping
capacity of individuals, groups, families and communities during
times of disaster, and now provides services in cooperation withgovernmental agencies, local authorities, universities, nongovernmental organisations, as well as volunteers.

99Psychosocial interventions Planning and Implementation

Examples of activities in a psychosocial response
Examples of activities that have been undertaken in various
psychosocial interventions are given here to stimulate ideas. They
will naturally need adaptation for the specific context and affected
population. Some of the examples are specific to emergency
responses, recovery activities, conflict or HIV and AIDS scenarios,
whereas others are relevant for use in all settings and phases.

Emergency response activities
0 to 6 months
Chaos often follows in the wake of crisis. Every effort should bemade to encourage the restoration of order as soon as possible incoordination with others, allowing families to establish some senseof normality to their every day life. In the immediate aftermath ofa critical event, most people need active and supportive listening;
information about normal reactions to the event; and support
to engage in the natural coping and healing mechanisms of thespecific context.
Gene Dailey/American Red Cross

Supportive communication is key immediately after a critical event has taken place100Planning and Implementation Psychosocial interventions
Sho Huang/IFRC

Family tracing plays a critical role following a crisis.

Concrete psychosocial activities include:• psychological first aid• support groups for different groups e.g. widows or widowers,
teenagers, children, older people• support to engage in appropriate burial ceremonies or grieving
rituals• distribution of psychosocial support relief items, like prayer
mats, toys and games for children• family tracing• safe spaces for children equipped with play-kits• collective community actions such as clean-up activities where
members of the community, both those affected and those who
were not, get together to clear debris etc; restoration of public
institutions, for example painting of schools, clinics etc; religious
ceremonies to commemorate the dead following mass burials;
community kitchens, where members of the community get
together and cook meals for those affected by the disaster
Also see the examples of general activities listed later, as many ofthese are also relevant to this phase of response.

101

Psychosocial interventions Planning and Implementation

What is psychological first aid (PFA)?

Psychological first aid is about providing basic, human support,delivering practical information and showing empathy, concern,
respect and confidence in the abilities of the individual. It is offered toindividuals immediately after a critical event.
Those affected should be met with compassion, listened to andprotected from their surroundings. They will need help with practicalneeds and problems while gradually becoming stronger and better
able to care themselves.
Basic steps of PFA:
• Establish contact by introducing yourself and your role in offering
assistance• If at all possible, remove the person from the stressful situation;
limit their exposure to sights, sounds and smells; protect them frombystanders and the media; provide adequate food and fluids but
avoid alcohol• Make sure that someone stays with the person at all times• Ask what happened, how they are doing and let them talk about
their experiences, concerns and feelings, without forcing anyone
to talk if they are not ready to do so• Reassure the affected person that their reactions are normal• Assist in decision-making if necessary• Ask them if they have a place to go. If they do not, help them findshelter. Also ask if they have someone to look after them orsomeone to talk to after getting home. If not, assist in establishingcontact to significant others• Provide factual information about where and how to seek specificassistance

Recovery and development activities
3 months to 1-3 years
Recovery and development activities should be based on adetailed needs assessment. Psychosocial needs change rapidly
from the emergency to recovery stages, and therefore need carefulassessment. Activities in the recovery stage may address needs
arising directly from the crisis, but may also relate to other societal
factors that affect psychosocial well-being.

102

Planning and Implementation Psychosocial interventions

Wilda Anggraeni/American Red Cross

Concrete activities that
could be established in
the long-term recovery
and development phases
are listed below. Also see
the examples of generalactivities listed later as
many of these are also
relevant to this phase of
response.
• Children’s clubs andSuccessful livelihood initiatives contribute to psychosocial
youth clubs
well-being• Informal schooling• Life skill activities, such as raising awareness of sexual andreproductive rights of teenagers and young adults; basic hygiene
practises; parenting skills• Collective memorial ceremonies, such as lighting of candles;
listing of names of the deceased; saying prayers together; postingof pictures or photos of the deceased or missing• Group activities combined with livelihood initiatives, such as
handicrafts, baking, cooking• Training for future disaster preparedness as part of a crisis
response plan, such as simulations of evacuations, risk andresource mapping

Conflict situations
Conflict situations present specific challenges to psychosocial
well-being. There is often an accompanying high risk for feelingsof mistrust, fear and hostility towards others, as well as reactions
to losing loved ones and the disturbance of one’s daily life patterns
that are common to other crises. Specific psychosocial activities
that have been used in conflict settings are given overleaf. Also see
the examples of the general activities listed later, as many of these
are also relevant to responses in conflict situations.

103

Psychosocial interventions Planning and Implementation

Jakob Dall/Danish Red Cross

Rebuilding the ability to trust through play is a useful activity for children living inconflict situations• Role play with children and adults on tolerance and respecting
differences• Education and training in non-violent conflict resolution• School-based activities designed for children affected by armed
conflict (CABAC)

Health emergencies
Health emergencies, such as the HIV and AIDS pandemic, avian
influenza and tuberculosis, present specific challenges, as families
are often aware of the imminent death of family members.
Examples of useful activities are listed below. See the examples
of general activities below, as many of these are also relevant to
responses in health emergencies.
• Home-based care
• Memory work
• Hero books• Will writing

104

Planning and Implementation Psychosocial interventions

Best practiceMemory boxes and hero books
The South African Red Cross Society is implementing a
psychosocial programme for orphans and vulnerable children.
One of the activities in the programme is making memory boxes,
where the children can keep precious things that remind themof their loved ones or of good experiences shared with them.
Although this activity is often used to remember someone who
has passed away, it is also a good activity for parents and children
to do together, either in the preparation for imminent death, or
simply as an activity of sharing. Another activity is making herobooks with children from about age 10 years. In a hero book, thechild / adolescent writes his or her own story, often identifying
the challenges they are facing. In the same process they also findpositive aspects and solutions to their story and they become thehero of the circumstance they have described. This activity has
proved an excellent way of working with older children, providingthem with the opportunity to talk through difficult situations, aswell as enabling the Red Cross volunteers to identify the children
who are at risk and vulnerable. Below is an excerpt from one
child’s hero book:
Tomas Bertelsen/Danish Red Cross“I’m Ebby. I live in
Knysna, near the field.
I am fourteen years
old. My [hero] book is
the shelter for otherchildren. And I think
my book will give asolution to those whohave problems likeme!!!”
Memory books help children retain good memories about
loved ones and special moments in their lives

105Psychosocial interventions Planning and Implementation

General activities
The activities grouped here can be adapted for use in any of thephases or contexts described above.

• Psycho-education

Information, education and communication materials

The development and production of information, education andcommunication (IEC) materials is integral to a psychosocial response.
These are a part of public psycho-education, and are effective waysof sharing the messages on normal reactions to the crises, how tocope with such reactions and where to seek help if needed. Lots ofsuccessful IEC materials have been produced by Red Cross and Red
Crescent Societies and other partners, and these can be adapted andused to suit other contexts.

The Sri Lanka Red Cross Society

Information, education and communication materials often carryvery simple but key messages, making them easy to understand byanyone who sees them. Common formats include posters, pamphlets,
leaflets, single page and hand-outs. They are often passed from hand
to hand in a community, and should therefore be appropriate foreveryone. Most IEC materials
include hand-drawn picturesof people who represent theaffected population, and not
photos of specific people. In thisway, anyone can relate to thedrawings, and no single person
is singled out as an example inthe community.

• Community mobilisation
See page 88 for examples• Training
See chapter on training for more on this• Individual and community recovery and restoration• Restoration of family links

106Planning and Implementation Psychosocial interventions• Return to school, work and normal daily routines• Provision of legal and practical support to refugees, those whoare displaced and families of those who have disappeared• Physical restoration and ecological activities• Support groups for specific groups as teenagers, adults, widowers
or widows, staff and volunteers• Community-based care for separated children and orphans• Recreational activities for children and adults• Cultural and sport activities• Religious and cultural ceremonies and activities• Drama, art and cultural activities• Activities that focus on management of fear

Building community resilience• Setting up mechanisms to protect the population from risks ofviolence or harm
• Risk and resource mapping and analysis• Disaster preparedness (contingency plans)
Activities folder

CD
Tomas Bertelsen/Danish Red Cross

Drama is both educational and recreational and can be used to initiate discussion
in group forums

107Psychosocial interventions Planning and Implementation

The importance of play

Many psychosocial interventions involve activities to encourage andstimulate children’s play. Play is a fundamental part of children’s
physical, psychological and social development. In post-crisis
situations, play can also serve as an outlet for children to express
their emotions and describe difficult experiences without having to
put words to them. In this way play is sometimes regarded as having
natural healing properties. Play is also a window to the psychosocial
well-being of a child. If a child is unable to play with others, isexcessively aggressive or displays other abnormal behaviour, thismay be an indicator that the child is not doing well and needs special
attention and care.

Source: Tolfree (1996)

Promising practice

GO ON Game
Helle Tholstrup and Anette Lybech

GO ON is an innovative game, developed
specifically for children affected by a crisis
event. It encourages children to help eachother and have fun together. It establishes
contact between the children and gives
them an experience of how a community
is strengthened, when people help one
another. GO ON is a very structured game,helping children feel a sense of normality inabnormal and chaotic situations.

Pilot testing of the game in Pakistan showed that the children:• gained confidence as they played the game• learned to be part of a group and play as a group• felt motivated to win• enjoyed the game from start to finish• had a chance to forget their sadness• learned how to make others understand through acting
Overall, playing GO ON was the first time since the crisis event that there wasan activity that “brought happiness” to the whole community, for the adults
watching and for the children participating. For more information on the GO
ON game, please contact the PS Centre.

108

Planning and Implementation Psychosocial interventions

Programme management
The following section looks at issues relating to managing a
psychosocial programme. It is not solely directed at programmemanagers as it discusses aspects of planning and implementationof relevance to all those involved in a psychosocial response.

What are the aims of the psychosocial intervention?
Good planning starts with defining the aim or goal and expected
outcomes and outputs of the psychosocial intervention. This is also
the basis to most, if not all, programme proposals and descriptions.
It helps in defining precisely what is going to be done and why.
Logical Framework Approach
A good tool for planning an intervention is a logical framework,
also called a logframe. This is based on the idea that certain
inputs will lead to specific outputs and outcomes or results, which
will eventually bring about the expected change. A logframe isoften used as the core reference document throughout the whole
implementation period of a response: planning and design,
implementation and monitoring, and evaluation of the intervention.
A logical framework should be developed with the full participationof all involved in the psychosocial response and then made available
to all who have an interest in the planned interventions.
The components of a logical framework may vary from one
National Society to the next, depending on the adopted
management structure and reporting requirements. At times theterminology and headings in a logframe may also differ.
Comparisons between terminologies

CDThe flow from overall planning to more detailed planning, tospecifying activities and expected outcomes is, however, usually
the same. Typical components of a logical framework are presented
below in the example developed for the Iranian Red CrescentSociety’s psychosocial programme in response to the earthquake
in Bam, Pakistan in 2006. The development and use of indicators is
explained in detail in the chapter on monitoring and evaluation.
109

Psychosocial interventions Planning and Implementation, / Overall objective
Goal
To reduce the suffering, and risks for development of severe trauma,of those who lost their family members and friends, promote socialand economic livelihood and mobilise own and community strengths,
and thereby increase the possibility of those affected, to regain own
capacity, to build up their life again.
Outcome/immediate objective
To extend and reinforce the Iranian Red Crescent Society’s ongoingprovision of psychosocial and basic relief support to the survivors of
the earthquake.

Output / results• Outreach of community-based psychosocial support programme
activities to up to 20.000 affected people in Bam and surrounding
villages• Capacity building of Iranian Red Crescent Society: 200 trained newvolunteers and staff in psychosocial support programme work andintegration of Iranian Red Crescent Society psychosocial support
programme activities and briefing/debriefing systems into Iranian Red
Crescent Society Disaster Response capacity and plans.

Examples of activities• Introduction course to the specific activities given to 200 alreadytrained volunteers. Volunteers will, when applicable, train beneficiaries
in psychosocial support programme activities.
• Psychosocial support programme activities for the children living in
the camps: drawing, traditional games, singing, physical activities andreassurance.
• Psychosocial support programme activities for the women/mothers in the camps: counselling in groups and individually, according toneeds. Assist and encourage mutual support in the communities.
• Tent visits are provided by Iranian Red Crescent Society to women
who are reported to display symptoms of withdrawal and depression.

110Planning and Implementation Psychosocial interventions

Indicators• Decrease in stress-related symptoms and decrease in the need forindividual consultations during the implementation period.
• Increased survivor knowledge and reinforce healthy coping
mechanisms in local communities.
Indicators• The project is run by the Iranian Red Crescent Society, thevolunteers and staff are conducting psychosocial activities and thebeneficiaries are participating in the activities.
• Monitoring and evaluation system has been implemented by Iranian
Red Crescent Society with minimum supervision by psychosocial
support programme consultants.
Selected indicators• 20.000 survivors in Bam and the surrounding villages have beenoffered and have participated in psychosocial activities.
• The beneficiaries regain the capacity to relate to others within thecommunity and/or families and have the will to work.
• Children regain desire and capacity to play, interact with otherchildren, adults and other specific aspects of childhood.
• Briefing and debriefing system is established for the 200 volunteers
working with the psychosocial support programme activities for thesurvivors, as well as training has been conducted for both volunteers
and staff working with psychosocial support programme in the
Iranian Red Crescent Society.

111Psychosocial interventions Planning and Implementation

CD

Guidance on developing a log frame is provided in the IFRC
PPP Handbook and in SIDA LFA-review

Flexibility
Good planning for psychosocial activities needs to incorporate
flexibility, particularly in relation to the time frame and to thebudgeting of activities:

Time frame
Although it is essential to plan a time frame for any given response,
allow a certain degree of flexibility given the need for community
participation. When planning activities ensure that there is ample
flexibility in implementation schedules to suit the routines of thetargeted group.
Best practiceFlexible activity implementation
Following some months of implementing community activities by
the Red Cross National Societies in both Sri Lanka and Indonesia
after the Indian Ocean tsunami of 2004, it was found that men
were not participating as much as had been hoped. The reason
was the activities were held during the day, when most of themen were out
working. The
activities were
rescheduled tothe evenings,
and maleparticipation
increased
tremendously.

Flexibility encourages wider participation

112

Planning and Implementation Psychosocial interventions

Activity planning and budgeting
If the response planned is long-term, it is unlikely that all activities
can be identified in the early planning days. The accompanying
budget therefore has to be flexible and able to accommodate thecreativity needed for later planning. Since psychosocial support
activities are very dependent on community participation, budget
spending is likely to vary a lot, with some periods of very little
spending, and others of high expenditure. It is not always possible
to predict when these fluctuations will take place. It is important tobe aware of the possibility of these fluctuations.
Jakob Dall/Danish Red Cross

If the psychosocial
response is fundedby externalsources, ensurethat a common
understanding isreached with thedonors in terms ofwhat is acceptableconcerning
programme
activities.
Identifying relevant activities is a gradual process
Although longterm activities may not be definable at the initial start of the
programme, there should be clarity on what is acceptable in termsof the funding agreement, right from the start, to avoid later
disagreements.
Be sure to include time and budget allowances for the management
and capacity building activities that are needed for a successful
psychosocial intervention. These may not be obvious activities
when planning a psychosocial response, but they are critical for
facilitating the actual implementation of the psychosocial activities
with the affected population.

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Psychosocial interventions Planning and Implementation

Best practiceFlexible activity planning
The first activities of the psychosocial programme in the Maldives,
implemented by the American Red Cross in response to the Indian
Ocean tsunami, were to mobilise communities. These included
social gatherings, sharing meetings, children’s activities etc. During
these meetings, communities were encouraged by psychosocial
programme staff and using IEC materials, to identify specificactivities that would contribute social cohesion and community
resilience. Examples were given, such as the construction ofbuildings or renovation of children’s parks, community centres
etc. Monies were set aside for atolls to plan their specific activities,
relevant for their particular needs. The communities were alsooffered assistance in developing a plan for their projects. The
programme funded the procurement of materials instead of
handing out cash. The programme resulted in a variety of small
projects that contributed to building community resilience andimproving psychosocial wellbeing.
Best to avoid

Programme locking
Following a critical event, a Red Cross Red Crescent Society had
included a set number of referrals to mental health institutions
as an indicator in the planned intervention. Reaching the endof the implementation term, the number of people who had
been referred was unexpectedly low. In an attempt to meetthe expected indicators anticipated by the donors, staff andvolunteers spent extra time searching communities for people
they could refer to mental health institutions. This proved to
be a fruitless task, and also gave a wrong impression of activity
outcomes. It was a learning experience for the Red Cross Red
Crescent Society to be careful when developing indicators andnot to commit themselves to unrealistic numbers which could
not be met.

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Planning and Implementation Psychosocial interventions

Avoid ‘programme locking’Ensuring flexibility with regard to time frame and activity
planning reduces the risk for programme locking. Programme
locking occurs when a commitment is made to a strict timeframe for implementation, together with specific activities thatare determined in the initial planning stages, and these are set instone with the donors and supporters of the programme. If it is
not possible to negotiate flexibility, there may be a risk of losing
funds or worse, it may force the implementation of activities thatare irrelevant and do not add value to the lives of the affected
population.

Exit planning
As the mission of the Red Cross Red Crescent Movement is toassist vulnerable people, it is often the case that when a population
has recovered and people are doing well, the Red Cross Red
Crescent Societies will move on to work elsewhere. Psychosocial
interventions are also usually time-bound, linked to a specificperiod of implementation by donor resources. Information frommonitoring and evaluation activities will be used to assess if
activities are needed beyond the planned time-frame. Planningwhen and how to stop an intervention therefore also needs
flexibility.
Till Mayer/IFRC

If evaluation indicatesthat activities need notcontinue, then National
Societies will usuallyphase them out, withthe full understanding
and involvement of
the communities inthis exit phase. It is
common to hold final
programme activities
as a way of rounding off

Community celebrations are often held in the final phaseof an intervention

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Psychosocial interventions Planning and Implementation

the intervention. This gives community members and National
Societies’ staff and volunteers a chance to bid farewell to one
another.
If, however, it is recommended that the activities carry on after
the planned implementation period, then all efforts should
be made to make this happen. It may be that the communities
themselves can continue with the activities independently. If not,other psychosocial partners may be in a position to carry on withpsychosocial interventions, if the Red Cross Red Crescent National
Societies are not able to do so.
If monitoring and evaluation results indicate that psychosocial
activities should be stopped earlier than planned, make sure that
adequate arrangements are made to accommodate this.
Best practice

Exit planning
Palang Merah Indonesia and the Danish Red Cross Society
implemented a two year school and community-based
psychosocial support programme after the Indian Ocean tsunami,in Aceh, Indonesia. When the two year implementation period
was reaching its end, an evaluation was carried out. Instead ofcontinuing with school and community based activities, it wasagreed that the Danish Red Cross would support further capacity
building of the psychosocial team of Palang Merah Indonesia(PMI). Given the high risk of natural disasters in Indonesia, it was
clear that there was going to be a need for psychosocial responses
in the future. This exit strategy was therefore an investment in
human resources, adding to the potential for PMI to respondindependently. Unfortunately, but not unexpectedly, PMI had
the opportunity to use their enhanced skills and capacity, when
responding to the earthquake in Benkulu that took place on 12
September 2007.

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Planning and Implementation Psychosocial interventions

Human Resources
Adequate capacity
It is unlikely that all members of a psychosocial team will have thesame expertise and training. All staff and volunteers should takepart in relevant training in psychosocial support and responses.
After initial training, some may be suited for further training. Also
ensure that the recruited psychosocial team has the appropriate
skills and knowledge to work with psychosocial activities, whilst
also fulfilling other programme requirements such as reporting,gathering data etc. One way of doing this is to prepare a detailed
and specific description of tasks for each staff position together
with essential competencies needed.
If there are plans to gradually scale up the programme, make surethat adequate staff provisions are made, so that existing staff do
not get overburdened with new and additional tasks they may not
be equipped to carry out. Make sure that accurate job descriptions
are developed for each new staff member that has to be recruited
for all stages and levels of the programme activities, for instance foradministration, field programme staff and the evaluation team.
REUTERS/Tim Cocks

Relevant training is important for staff and volunteers

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Psychosocial interventions Planning and Implementation

Pablo Salazar/Ecuadorian Red Cross

Local staff and volunteers are likely to gain the trust of the affected population withease

Local resources
Given the culturally specific nature of psychosocial activities,
efforts should be made to recruit as many local staff and volunteers
in the psychosocial team as possible. Explore resources in
the affected country or region before looking towards hiring
international staff, as local resources will have a greater in-depth
knowledge on the often sensitive, and appropriate, ways ofengaging with communities.

Staff and volunteer retention
A tough reality faced in all programme or activity implementation
is when staff members or volunteers decide to stop working with
the Red Cross Red Crescent Society for one reason or another. Thiscan be especially difficult if it is someone who has undergone a lotof training in the relevant field, and has developed an expertisethat is valuable for the implementation of the psychosocial
response. One way to minimize this risk is to encourage open
communication and personal planning with the team throughout
planning and implementation.

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Planning and Implementation Psychosocial interventions

Best practiceVolunteer motivation
In Myanmar, six months after cyclone Nargis, some Myanmar
Red Cross Society volunteers expressed disappointment at notreceiving recognition. They felt they were doing an enormous
task but that there had been no signs of appreciation expressed bytheir National Society. This was demotivating for them. In responseto this, a day in each district was planned solely for volunteers.
They were honoured with speeches; they played games and eachvolunteer was presented with a certificate thanking him or her
for their effort. This helped tremendously to boost enthusiasm,
motivation and continued commitment to their volunteering for
the National Society.

American Red Cross

Supervision
Althoughpsychosocial support
activities target
the majority of the
population who do
not need specialized
psychological interventions or services,the psychosocial
response team isstill likely to meet
Programme managers have a responsibility to take care ofand interact with
their teams
people who are facing
many challenges and finding it hard to cope. This is emotionallydemanding and the programme management therefore needs toensure that the response team has the necessary supervision andcare they need.
IASC Guidelines: Action sheet 4.4.

CD

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Psychosocial interventions Planning and Implementation

Staff conduct and ethical guidelines
The International Red Cross and Red Crescent Movement has clear
codes of conduct for all staff and volunteers. Every staff member
has to sign the code of conduct. Ethical guidelines for all workin a psychosocial response should be explained carefully to all
involved. The ethical guidelines on collecting data presented in thechapter on monitoring and evaluation, can be considered for all
aspects of work in the psychosocial response.
CD

Staff Code of Conduct 2007

Partnerships and relationships
Open communication
There is usually an asymmetrical relationship between
implementing and donor partners, simply due to one having
money and the other needing or requesting it. An imbalancein power always bears with it a heightened risk of conflict andmisunderstandings, especially if expectations are unfulfilled byeither of the parties.
To avoid such problems, make sure there is open and transparent
communication in the initial stages of a partner relationship.
Clarify at what level different decisions about the programme
will have to be made with regard to disbursement of funds andconcerning other roles and responsibilities. If budget amendments
are necessary during the life of the programme or activity
implementation, be sure to involve all involved parties, so thatsuch changes are made with full participation and understanding
all around.

Local authorities
National Societies support the local authorities in their own
countries and act as independent auxiliaries to the government
in the humanitarian field. Their local knowledge and expertise,access to communities and infrastructure enable the Movement toprovide the right kind of help where it is needed immediately.

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Planning and Implementation Psychosocial interventions

The Sri Lanka Red Cross Society

Partnerships with local authorities are critical to the work of Red Cross Red Crescent National
Societies

This relationship between the National Societies and the local
authorities should be considered in all aspects of planning andimplementing psychosocial interventions. Particular focus
is needed on empowering and strengthening government
departments, so they can contribute to or eventually take over
the responsibility of implementing necessary psychosocial
interventions.

Short-term to long-term transitions
If an extension of a short-term to a long-term psychosocial
response has been successfully negotiated, make sure that all
relevant partners are informed and involved as necessary. Local
authorities and government departments as well as coordinating
bodies should be informed of these intentions to extend a response
period.

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Psychosocial interventions Planning and Implementation

Advocacy issues
National mental health and psychosocial support policies
As psychosocial support is still a relatively new field globally,
there are many countries that do not yet have national policies
or guidelines on mental health and psychosocial support
interventions. This can affect a psychosocial response in a numberof ways, as indicated in the table below:
No national policy or
guidelines on psychosocial
responses can lead to:This can result in:

1. Poor coordination of psychosocial responses

Not all who need psychosocial
support are reached
Same populations are targeted bymultiple partners, possibly withdifferent approaches or expectations, overwhelming the beneficiaries

2. Lack of quality assurance of:• Training in psychosocial support and related skills

No standard approach to psychosocial support
Possible low quality of training
Psychosocial implementers as
staff and volunteers inadequately
prepared and skilled• Psychosocial activities andservice delivery

Inappropriate responses are
implemented• Poor monitoring and evaluation
procedures

Inappropriate methods of datacollection
Misinterpretation of collected
data and inappropriate activity
adaptation

Even if policies do exist, they may not yet be implemented due to alack of resources or other difficulties.

122Planning and Implementation Psychosocial interventions

Organisations implementing psychosocial interventions may
play an important role in advocating for the development or
implementation of a mental health and psychosocial support
policy at national level. Coordination groups may be a good place
to start or provide input for such policies.
David Chancellor/ IFRC

Advocacy helps secure appropriate national services

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Psychosocial interventions Planning and Implementation

Best to avoid

Lack of policy implementation
In Sri Lanka after the Indian Ocean tsunami, despite thedevelopment of a national policy on psychosocial responses
and the existence of guidelines issued by NGO consortia andmental health bodies, an influx of foreigners and international
aid organisations overwhelmed local coordination. Some
inappropriate responses to psychosocial needs were reported.
An example was the arrival of a team of psychotherapists fromabroad who quickly set up group therapy sessions with a number
of affected adults. The psychotherapists ran in-depth therapeutic
sessions for four days and then left the country again, withoutarranging for further service provision to the affected adults. Thiswas considered professionally irresponsible and had the potential
to cause harm. This approach could have been avoided with more
stringent monitoring of the existing national policy concerning
what was acceptable.

IASC Guidelines – an advocacy tool
The IASC guidelines on mental health and psychosocial support inemergency settings represent a consensus on minimum responses
reached by key esteemed stakeholders in the psychosocial field.
The IASC guidelines therefore serve well as an advocacy tool, bothin addressing gaps in planned interventions and in promoting
recommended interventions with Red Cross Red Crescent
Movement partners, as well as other partners. See the chapter onsetting the context for more on the IASC guidelines.

Information dissemination
Documentation
Besides the usual reporting requirements requested by donors,
there are definite benefits to documenting all stages of a
psychosocial response. Documenting the work well is both anexcellent planning and monitoring tool in itself. Sharing findings

124Planning and Implementation Psychosocial interventions

from assessments and evaluations also invites collaboration withother partners and in this way strengthens opportunities for
improved interventions. It also creates an opportunity for sharing
experiences with others. This adds to the ongoing improvementof psychosocial interventions, which will benefit the psychosocial
well-being of many in the future.
If possible, use opportunities to engage in academic researchwhilst implementing the psychosocial response, and highlight
Tomas Bertelsen/Danish Red Cross

Photography plays an important role in documentation

125Psychosocial interventions Planning and Implementation

other research areas that arise during the course of the response.
The psychosocial field needs more research, maximizing
possibilities for evidence-based responses. A commitment fromall psychosocial practitioners to engage in research as they work
will contribute immensely, especially if findings are published injournals, magazines and newsletters.

Audiences
There are a number of differing audiences interested in
information about psychosocial work. Information dissemination
should be tailored according to these audiences. For example,
the affected population should always be given the chance toreview and confirm findings and outcomes of an intervention. The
management and volunteers of the
Ethical considerations
Red Cross Red Crescent Societies
in sharing information
involved in a particular response
The ethical guidelines
represent other audiences. The
presented on collecting data,
outcomes of a psychosocial responsein the chapter on monitoringshould also be made available toand evaluation, also apply to
external stakeholders, including
sharing of information. Make
sure that all information that
donors, policy makers and others
is made public adheres tointerested in psychosocial work.
ethical principles and does
not jeopardise the safety or
integrity of any person.

126

TrainingTraining

Tomas Bertelsen/Danish Red Cross

training Psychosocial interventionsAs attention to psychosocial needs grows, efforts are being
made worldwide to strengthen and improve knowledge
and skills to respond to these needs. This chapter
considers why we need specialized training in a psychosocial
response, and looks at who should be trained, what they should betrained on and who is involved in training at various institutional
levels. Following standards and guidelines formulated by the Red
Cross Red Crescent Movement and at national and international
level is recommended. Building multi-sectoral capacity to respondto psychosocial needs is also discussed. The chapter concludes witha look at the different phases of a response in relation to training
needs, followed by consideration of training methods and training
materials. Throughout the chapter references are made to the PS
Centre training kit, which is a primary resource for all National
Societies planning to implement a psychosocial intervention.

Why is training needed?
Providing psychosocial support to individuals and communities
that are affected by crises and critical events requires knowledgeof reactions to such situations, and skills on how to help people
cope with the resulting challenges. Focusing on training as part ofpsychosocial interventions is important for a number of different
reasons:

Psycho-education
Without prior knowledge, people often associate psychosocial
support with ‘normal’ psychological approaches, such asindividual therapeutic interventions, linking the term ‘psycho’in both words. Community-based psychosocial support is very
different to this. It is therefore essential that time and resources are
spent on educating all those who are involved or have an influenceon psychosocial interventions in relation to the principles ofcommunity-based psychosocial support. Particular focus should beon relaying the notion of normal reactions to abnormal events andon good ways of giving support to both helpers and members of anaffected population.

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Psychosocial interventions training

Standardised training and quality assurance
It is likely that the Red Cross Red Crescent psychosocial teamwill come from many different walks of life. This enriches theresources to respond to psychosocial needs, but also means thatthe team should all have the opportunity to access standardised
training. This will confirm that they have the skills and knowledge
to carry out expected tasks and that everybody understands what
psychosocial interventions are acceptable and appropriate in thegiven context.
American Red Cross

Investment in the future
Empowering people with skills andknowledge on how to respond to
psychosocial needs is an investment in
the future well-being of a population,
and a resource for responding tofurther crises.

Planning ahead
It is important that training activities
are included in the planned response,
and that the different training neededat different stages is recognized. Make sure that budgeting and timeallowances include all aspects of the training process including
preparation, delivery, evaluation and reporting.

Training is an investment in the future
well-being of a population

What training should be done and for whom?
Red Cross and Red Crescent staff and volunteers are the twomain groups that require training in a psychosocial response.
The affected population may also need training in the form of
psycho-education, and representatives from partner organisations,
governmental departments and other stakeholders may alsoneed training to increase their knowledge and understanding of
psychosocial support issues.

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training Psychosocial interventions

Training the psychosocial teamTraining should be offered to Red Cross and Red Crescent staff andvolunteers in a psychosocial response, tailored to the needs of theaffected population and to the expectations and tasks set for the
specific persons or groups to be trained.

Mental healthinterventions require
mental healthbackgroundCounselling, targeted support
groups require extensive training
on specific topics

Psychological first aid, support to affected
population and implementation of activities
require first aid training and basic
psychosocial support training
Assistance to groups, addressing protection needs
requires awareness of psychosocial issues

Basic support to affected individuals does not require any training

HIGHER NEEDS ➔ MORE TRAINING

As the needs of those affected increase, so does the need fortraining for those responding

Source: PS Centre, 2009

The following training topics are examples of what might beoffered to teams. They would have to be adapted to suit the specificprogramme, context and resources and skills of the psychosocial
team. The modules highlighted in red are all included in thecommunity-based psychosocial support training kit developed by
the PS Centre.

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Psychosocial interventions training

Thematic
areas

Specific modules / topics

Psychosocial
knowledge

Crisis events and psychosocial support; stressand coping; loss and grief; community based
psychosocial support; community resilience;vulnerable groups (such as children, people livingwith HIV and AIDS, people with disabilities etc);
basics in mental health and psychological disorders
and local referral mechanisms and procedures;supporting staff and volunteers.
Psychosocial
skillsPsychological first aid and supportive
communication; children; community

mobilisation; facilitating community meetings;
identifying community needs and resources;
identifying psychological distress; conflict
resolution; implementing psychosocial activities
Programme
administration

Assessment skills; planning and programme
development; monitoring and evaluation; datacollection; observational skills; communication
skills; report writing.

Training of others Planning training workshops; adapting trainings

to participants’ needs and resources; participatory
facilitation skills; evaluating training;
Helping thehelperSupporting staff and volunteers; recognizing

signs of stress and burnout; self-help techniques;debriefing techniques
Other

132

Introduction to Red Cross and Red Crescent
Movement; national and international standards
and guidelines on psychosocial responses; advocacy
strategies and skills; refresher courses.

training Psychosocial interventions

The PS Centre’s training kit on community-based psychosocial
support should be used as the first resource by Red Cross Red
Crescent National Societies during a psychosocial response.
The kit contains a Participant’s Book, a Trainer’s Book andPowerPoint slides for the trainer to use. It includes modules oncrisis events and psychosocial support, stress and coping, loss
and grief, community-based psychosocial support, how to help:
psychological first aid and supportive communication, children
and supporting staff and volunteers.
Like all general guidance, the ideas and activities in the kit willneed to be adapted to the specific cultural context in which teams
are working. Any part of the training kit may be cited, copied ortranslated into other languages or adapted to meet local needs
without prior permission from the International Federation of Red
Cross and Red Crescent Societies Reference Centre for Psychosocial
Support, provided that its source is clearly stated.
Community-based psychosocial support training kit:
Participant’s book; Trainer’s book; Trainer’s slides

CD WWW

Helping the helper

Ea Suzanne Akasha/ Danish Red Cross

Participating in a psychosocial response, either as a staff
member or as a volunteer, can be very stressful and emotionallychallenging. In many cases,
staff and volunteers are
local and may therefore
be personally affected by
the crisis. Additionally,
the nature of psychosocial
support is that it aims to help
those who are not feelingwell or not coping with
their daily challenges to getbetter. Although rewarding,such work can also be

Training volunteers and staff to support one anotheris a key activity in helping the helper

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Psychosocial interventions training

tough and exhausting. It is therefore critical that senior staff takeresponsibility that measures are put in place to ensure the wellbeing of staff and volunteers. This includes training on self-help
techniques, how to support staff and volunteers, peer support andhow to prevent stress and burn-out.

Multiple benefits of training
Training in psychosocial support issues not only improves
knowledge and skills on how to help others, but can also havedirect positive effects on the psychosocial well-being of the
trainees. Learning about normal reactions to abnormal events
can break a negative spiral of self-blame, as trainees begin tounderstand their own reactions and behaviour.
Best practiceCaring for carers
In South Africa, volunteer caregivers provide the backbone toa home-based care programme and work with orphans andvulnerable children on an on-going basis. This work is very
demanding both physically and psychologically. Often thevolunteer caregivers work in the same communities in which theylive. This results in volunteers carrying a huge personal load. The
South African Red Cross Society has acknowledged the criticalneed for providing facilitated, safe spaces in which volunteer
caregivers can discuss their work and how it affects them on a
personal level. Within the psychosocial support project, debriefinginterventions and stress management workshops have been
initiated to assist with the alleviation of the stress that volunteers
experience. These interventions have also been designed to teachtechniques for coping with stress and promoting the well-beingof the carer. A national research study has also been conducted,
looking at the stress levels and coping mechanisms of carers inmore detail. It is hoped that future interventions will be based on
the outcomes of the study and the identified needs of carers.

134

training Psychosocial interventions
Brendan Bannon/IFRC

Capacity assessment
When planning training
activities it is importantto carefully consider
the current capabilities
and prior training ofeach trainee. As muchas possible, tailor the
training according to thisknowledge.

Psychosocial interventions should always include focus on support for staff and volunteers

Using available human resources

The disruptions that accompany crises can often lead to limited
human resources, presenting challenges in terms of planning andimplementing programmes. In some cases, this has led to the use ofstaff or volunteers who have been inadequately trained in the specificskills needed for carrying out required tasks and activities. They wererecruited simply because they had attended some form of training.

Example: In Bangladesh the Bangladesh Red Crescent Society hasa Cyclone Preparedness Programme that has around 42000 volunteers in the coastal areas specifically trained to do early warning andevacuation. Many times they also get involved in relief distribution.
Some of them have received very limited briefing on psychosocial
issues during other trainings. However, in the immediate aftermathof disasters they typically end up providing psychosocial support tocommunities.

Training external partners or agencies
Training external partners or agencies, such as representatives
from other organisations, government departments or sectors,
may bring benefits to the implementation of an intervention.
Widening participation can lead to an increased understanding of
psychosocial issues from different service and policy perspectives.
Any of the modules suggested above could be used, dependingon the specific intention of the training programme and theparticipants.

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Psychosocial interventions training

Best practice

Tiered training
American Red Cross developed a three tiered training programme
in response to the psychosocial needs following the tsunami:

Tier 1: The first level is training of community facilitators, to workwith the majority of the affected population, whose psychosocial
needs can be addressed through community based psychosocial
activities. This training is offered to community volunteers who are
deemed suitable for the training by their observed communicationand interpersonal skills, availability and willingness to be involved.
Tier 2: The second level is training of crisis intervention technicians, who have achieved the knowledge and skills to provide
psychological first aid and basic counselling to the smaller
population following a crisis event, who are at risk for developing
mental health problems. This training is provided to persons
trained on emergency response from Red Cross and Red
Crescent societies, as well as to representatives from government
departments (such as the governmental disasters preparedness
centre, fire brigade, armed forces personnel, district and divisional
level government authorities) and NGO’s. This tier functions as thefirst line supplementary support to the community facilitators.

Tier 3: The third level is training of crisis intervention specialists.
This training is offered to professionals who have previous
training and expertise in responding to mental health needs andpsychological problems. This level of training is only offered to aselected few of the psychosocial programme staff, based on theirprevious experience and training.
This three levelled model , shown in the diagram on the following
page, has proved very successful, ensuring that adequate capacity
and resources is in place to respond to the needs at the different
levels of severity of psychosocial and mental health needs.

136training Psychosocial interventions

Best practice

Example of tiered training
Training levels according to
psychosocial support needs
Psychosocial
program staff

First respondersof disaster(RC and non RC)
Community
volunteers

Impacts on population
due to crises
Severely affected

Crisisintervention
specialistis

At risk

Crisis intervention
technicians

Most of the
population

Community facilitators

Source: American Red Cross, 2008

National and international standards and guidelines
All training undertaken during a psychosocial response has tobe done in line with international and national standards andguidelines on responding to psychosocial and mental health needs.
The most recent international guidelines are the IASC Guidelines
on Mental Health and Psychosocial Support in Emergency Settings(2007). It is advisable to include training on these guidelines forthe entire psychosocial team, so that they are familiar with therecommendations.
IASC Guidelines – Action Sheet 4.3; IASC Guidelines Checklist

CD

Integrated response
Just as it is recommended that representatives from health andcare, water and sanitation, food distribution and nutrition andeducation, are trained in psychosocial support, it is also advisablethat selected representatives from the psychosocial team undergo
training in other areas of response. This will increase the scope fordeveloping an integrated response to a crisis.
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Psychosocial interventions training

Who does the training?
Local resources
It is most beneficial to use trainers from the local branch or to
recruit local trainers for training in psychosocial support, since
the notion of psychosocial well-being is deeply rooted in thelocal context. In some languages, there are no direct translations
for many of the concepts associated with psychosocial wellbeing and support. It is therefore necessary to have someone
who understands these concepts and is able convey them inthe local language, so that the meaning is well understood by
the participants. If the selected trainers are not members of
the psychosocial team, make sure that someone from the teamparticipates in all trainings to supervise the trainings and ensure
the content and facilitation fulfils expectations and requirements.
The IASC Guidelines suggest the following criteria for trainers andco-trainers (from Action Sheet 4.3):

138

Ulrik Norup Jørgensen /Danish Red Cross• cultural sensitivity and basic knowledge about local cultural
attitudes and practices and systems of social support• emotional stability• good knowledge
about psychosocial
responses, including
understanding thevalue of integrated andcollaborative responses• practical fieldbased experience inproviding psychosocial
support in previous
emergencies• good knowledge ofteaching, leading
to immediate andpractical interventions

training Psychosocial interventions

Best practiceUsing local resources for training
Due to the political conflict in Sri Lanka, psychosocial support
programmes and activities have been ongoing for many years in
the northern district of Jaffna. A reputable training institution,
Shantiham, has been training people in providing psychosocial
support since 1987. This valuable local resource provided
immediate locally appropriate training of Sri Lanka Red Cross
Society staff and volunteers in response to the tsunami.
In the Maldives, during the emergency phase implemented by
the American Red Cross, eight teachers were recruited for theschool component of the response. These teachers had experienceand in-depth knowledge of the school systems in the country,
and could both understand English and deliver trainings in
the local language. They were thus centrally involved in thecontextualisation of the training modules as well as delivering thetraining activities in the islands.
In Bangladesh, volunteer student trainers from the Departmentof Clinical Psychology at Dhaka University were recruited to
do training for Bangladesh Red Crescent Society volunteers at
the district as well as the community level in the psychosocial
response to Cyclone Sidr. This meant the trainings were done in
the local language and were in line with the culture and context of
Bangladesh.

Peer training
Peer training involves training between people with sharedcharacteristics or experiences. Trainer and trainee are usuallysimilar, often in age, so that they feel comfortable with one anotherand understand each other. For example, youth learn easily fromother youth, especially if they have something in common and canrelate easily to one another. Try to arrange as much peer training

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Psychosocial interventions training

as possible. This paves the way for peer support during programme
and activity implementation stages.

International and external trainers
At times it may be necessary to recruit external trainers from othercountries. This is especially relevant if the country affected by
the crisis has no prior history of psychosocial responses. In thesecircumstances, try to recruit trainers from neighbouring countries
with a good understanding of the local context and culture. If thisis not possible, make sure that the recruited trainers work closelywith local counterparts who can translate and brief the trainers on
locally appropriate norms, behaviour and examples to use during
training. The PS Centre can at all times assist with recommending
suitable trainers for training on community-based psychosocial
support.

Universities
More and more universities are including aspects of psychosocial
support in various degrees and training programmes.
American Red Cross

External trainers may be needed if a psychosocial focus is new to the affected
country140

training Psychosocial interventions

Best practiceDisaster leading to opportunity
At times crisis events can lead to positive developments andopportunities. In Indonesia, a country at high risk for natural
disasters such as earthquakes and volcanic eruptions, the interest
and enthusiasm for further training in psychosocial responses has
encouraged the University of Indonesia to develop a new Masters
programme on disaster psychology.

When should training take place?
It is strongly recommended
that training in psychosocial
responses is part of any
disaster preparedness
programme. Regardlessof what crises are being
prepared for, psychosocial
effects are likely to occur.
It is advisable to prepare a
psychosocial team for both
immediate and long-term
psychosocial responses.
Awareness-raising on
psychosocial effects of crises
should also be included in
the training of the rest of
the disaster response team.
Such awareness will enable
all teams to respond inways that can enhance andstrengthen psychosocial
well-being.

American Red Cross

Disaster preparedness

Children can play a vital role in disaster preparedness,and schools provide an opportune venue for suchtraining activities

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Psychosocial interventions training

PROMISING practice

Psychosocial support component
A psychosocial support component is presently being developedfor use in the International Federation Health Emergency
Response Units (ERU). During previous deployments, Health
ERU teams recognized that many of the affected population havepsychosomatic symptoms and may show distress, both of which
are natural outcomes of experiences accompanying many crisis
events. Addressing psychosocial needs in the ERU is based on
the premise that most acute stress problems during emergencies
are best managed without medication. This can be done by using
psychological first aid which involves non-intrusive emotional
support, coverage of basic needs, protection from further harm, andorganisation of social support and networks.
Carina Sørensen/PS Centre

The psychosocial support
component includes a kit
with toys and play items
for children, informational
material for awarenessraising among adults, a
training programme forpsychosocial support
delegates, as well as a
training programme
for volunteers which
includes an orientation toappropriate activities. These include play activities with children,which can take place whilst their parents are accessing healthservices at the ERU, and setting up support groups with specificgroups. Initially the psychosocial support component will be
used by the Norwegian Red Cross and it is anticipated that other
National Societies will be interested in using the concept.

142training Psychosocial interventions

Best practice

Respectful food distribution

Jose Cendon/ IFRC

Incorporating awareness of psychosocial well-being into
other areas of response can have lasting effects on the targeted
population. Following a crisis event where thousands of people
were relocated into internally displaced people’s camps, food
distribution volunteers
were made aware of
the importance of selfrespect and dignity for
psychosocial well-being.
Food distribution had
previously been chaotic;
the volunteers often had
to break up fights, as they
threw bags of rice andbeans into the crowds.
Following the awarenesstraining on psychosocial well-being, they changed their methodof distribution. They made lists of the entire camp populationand called each person up by name to receive their food package.
This simple change in behaviour calmed the crowds. Beneficiaries
reported they felt they were being treated with respect andhumanity. Before, they had felt like a pack of animals, fighting tosurvive.

Emergency response
Training activities are often some of the very first activities thattake place in an emergency response. It is rare that a full team ofstaff and volunteers will be available from the onset with all thenecessary skills to respond to psychosocial needs. If this is thecase, it would still be advisable to do some refresher training. This
will confirm that all of the psychosocial team have the necessary
knowledge and skills needed to initiate the psychosocial response.

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Psychosocial interventions training

Examples of training needs in the early emergency response
phase include assessment skills; monitoring and evaluation skills;
psychosocial knowledge and skills, especially on critical events,
and psychosocial reactions and on psychological first aid.
Given the urgency that is usually met in the immediate aftermath ofa crisis event, it is likely that some of the psychosocial team will beneeded to implement activities whilst others undergo training.

Example: In the Maldives immediately after the Indian Ocean

tsunami, personnel from government agencies and from non-governmental organisations, with some training and experience in counselling, were identified and sent out by the National Disaster Management Centre to the tsunami-affected islands. Here they provided
immediate psychosocial support on the basis of their previous basic
experience. Further training on community-based psychological firstaid was provided to this group thereafter, scheduled into the responseby the American Red Cross as a component of the programme.

Long-term recovery phase
Fully involving the affected population in identifying relevant
activities in a psychosocial intervention has consequences
for planning activities. This is a gradual process, involving
identification of needs and relevant responses; implementation ofactivities; monitoring of activities (and changing needs); review
and adaption of old activities, or adoption of new activities. Thismeans that activities relevant to later stages of the psychosocial
intervention cannot be identified in the beginning of the
programme. However, even if activities cannot be determined, thetraining needs of the psychosocial team can usually be identified
early on, and training activities can then be organized as initial
response activities. This will equip the Red Cross Red Crescent
psychosocial team with the knowledge and skills to respond to
psychosocial needs, and enable them to provide guidance andassistance to the communities whilst they start the processes ofidentifying relevant activities.

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training Psychosocial interventions

Early training
Basic training on the Red Cross Red Crescent Movement, inprogramme administration and other issues, like helping
the helper, should also be done as early as possible in theimplementation process. This will equip the psychosocial team inplanning monitoring, evaluation and all other programme tasks.

Ongoing capacity building
Training should be included as a regular activity throughout theplanned response. The benefits of investing in human resources
through ongoing training cannot be overstated! The National
Society benefits by gaining a qualified and competent team to
respond to psychosocial needs. The trained Red Cross Red Crescent
psychosocial team also benefits, as they gain new knowledge
and skills. Regular refresher trainings ensure that teams always
have up-to-date knowledge and skills, and staggered training,where participants attend improved levels of training, build more
specialized psychosocial teams.
Where possible, select those members of staff who have a longterm commitment to their work for ongoing capacity building, tominimize risks of lost knowledge by those with advanced training
leaving the programme.
Pernille Hansen/PS Centre

Learning from each others’ experiences is a critical part of capacity building

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Psychosocial interventions training

How to train in psychosocial support
Training methods
There are a variety of methods that can be used for training on
psychosocial responses. These will naturally depend on thecontent of the training module. Some examples of training
methods are given in the table below. It is good to use acombination of training methods, as this will motivate and interest
the participants.
Training technique: Presentations
Cons

Tips for training

Blackboard CombinesFor
spoken word
drawings,
with visual
key words,
feedback

Limited availability– usually only inclassrooms;
May lose contact
with group as
you turn to write;
Needs constantcleaning to be
used a lot

Prepare things on
the blackboard
beforehand;
Have a helper towrite, while you
interact withparticipants;
Write big andclearly;

FlipchartsFordrawings,
key words,
feedback

Mobile;Inexpensive;
Can beprepared
beforehand;
Notes canbe used at alater stage

May lose contact
with group as you
turn to write;
Long ‘lists’ may
become boring
and repetitive;
Handwriting may
be too small or
illegible;

Limit number ofwords on a page;
Keep flipchart forlater reporting

PowerPoint Prepared
For key
beforehand;words,
Includesstatements, speaker’s
photos,notes
diagrams
Capturesinterest
throughvisuals

Too much text isdifficult to read;Can be boring if
not well done andused all the time

Be creative, using
images to captureinterest;
Avoid reading theslide – elaborate
in your spoken
presentation

Tool used

146

Pros

training Psychosocial interventions

Training technique: Participatory methods
Tool used

Pros

Cons

Tips for training‘Visualization in Participatory
Processes’(VIPP)
cards
for brainstorming,
problemsolvingEngageseveryone;
Creates‘equality’;
Cards canbe usedresponsively
to needs oftraining
session;Stimulates
creativity
and is fun!

Takes time to
explain the ‘rules’

Write key words
on each card;
Take photos at
key stages during
training forreporting purposes.
(link to useful website on next page)

BrainstormingFor
generating
ideas

Emphasises
all ideas arewelcome;
Stimulates
free and creative thinking;Great way
to tackle aproblem or
introduce a
scenarioSomeparticipants
dominate

Stress that all ideas
are welcome, andthere is no right orwrong answer in abrainstorm

Role plays
For practising real life
situations,
gaining
insight andempathy

Practises
skills neededin psychosocial support;
Heightens
empathy

Can be overwhelming, if too
similar to own
life; OR may be
unsuccessful if
too distant fromown life

Carefully choose
scenarios thatreflect real life
situations, but are
not emotionally
overwhelming;
Debrief role players
after each session
Continues >147

Psychosocial interventions training

Training
Training technique:technique: Participatory
Participatory methods
methods Continued
Continued
Tool used

WWW

148

Cons

Tips for training

Group
Gives thework
opportunity
For in-depth for personal
analysisinteractionof topics,
observinginteractions

As facilitator you
miss out on small
group discussion;
Difficult to ensure
equal participationin groups;
Discussions cantake longer thantime allocated.

Have a team ofco-facilitators to sit
in on each group;
Collect information
on interactions
and discussions
at the end;
Encourage equal
participation;
Good timekeeping
is essentialGroup
activity
For participants towork out
challenges
together asa group

Encourages
cooperationand collaboration skills;
Gives insight
into individuals’ roles ina group andinto groupdynamics

If some people
are dominant andothers submissive
or non-participatory, few people
may benefit fromthe activity

Observe groups
and intervene toencourage fullparticipation.
Plan timing ofgroup activities
carefully andkeep to time!

Plenary
feedback
for reporting backsmall group
discussions
or findings
to the wholegroup

Opportunity
to hear main
findings or
discussion
points fromeach group

Can be boring,
if points are thesame;
Presentations
using flip charts
are often justreadings fromlong lists

Encourage creative
ways of presenting
group discussions,such as several
group memberspresenting insteadof one;Keep to time sothat all groups havethe opportunity to
speak

Pros

Link to more information on method of Visualisation in
Participatory Programmes

training Psychosocial interventions

Training materials
Developing and adapting training materials can take a longtime and can be expensive. However, it is always a worthwhile
investment to build the capacity of staff, volunteers and others on
psychosocial interventions. Adequate time and budget allocations
should be allocated in any psychosocial response for this activity.
Tip for training!
Icebreakers and energizers

Icebreakers are a great way for participants to get to know each otherand to make everyone feel comfortable about being active participants. They create a positive group atmosphere and help people torelax. Use these at the beginning of a training session. Continue to use
energizing activities in small breaks throughout the training period tokeep participants awake and alert. Encourage different participants toshare energizers they know, to encourage participation and creativity.

Learn by doing

Active participation in training is one of the best ways to learn new
knowledge. Include as many activities and opportunities for trainees
to actively participate in dutring training as possible.

Do not reinvent the wheel
Red Cross and Red Crescent Societies should first consult thetraining kit on community-based psychosocial support developedby the PS Centre. If there are training needs not covered by thistraining kit, materials already developed in the affected country
would be the most useful, or from neighbouring countries or
the geographical or cultural region. Despite the fact that thepsychosocial field is relatively new, a lot of excellent training
material has already been developed throughout the world. It
is worthwhile getting to know the material that is already out
there, and to adapt this to the specific training needs identified.
Remember to reference and credit other sources, when materials
are adapted and used.

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Psychosocial interventions training

WWW

Link to REPSSI who have training material for working withchildren and their families affected by HIV and AIDSCD

A number of examples of training manuals are included on
the CD in subject folders in the training section
Best practice

Sharing training materials
The International Federation Reference Centre for Psychosocial
Support collects training manuals and materials developed aroundthe world, mostly in English, but also in many local languages.
Recent training materials shared were in response to Cyclone
Nargis in Myanmar and the earthquake in Sichuan Province in
China (both 2008). All psychosocial practitioners can request
copies of training material relevant to the crisis event they are
responding to. This can then be adapted to their particular setting.

Government departments and national boards
It is recommended to align Red Cross Red Crescent training
materials with national educational institutions and /or the
Ministries of Health and of Education. If possible, develop training
materials through such departments, so that they are endorsed asnational training documents. This will contribute to a standardized150

training Psychosocial interventions

approach to psychosocial responses, and enable others to use thematerials effectively.

Monitoring and evaluating
Include mechanisms to monitor the effectiveness of the training
materials looking at various levels, such as

Trainers: Is the material easy to use and effective?
Participants: Is the training easy to understand? Is it relevant
and useful? Are they able to apply what they learn?
Members of the affected population: Is the training of staff
and volunteers having the desired impact on the beneficiaries?
Plan for regular reviews and possible adjustments to training
materials during the implemented response. This is a way ofIndonesian Red Cross Society: Palang Merah Indonesia

Review and update materials for specific groups

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Psychosocial interventions training

Tip for training!

During a training lasting
several days, include daily
evaluations of the training.
The trainers can then meetto discuss the events of the
day together with the evaluation results, and make any
amendments to the planned
training for the next day.

ensuring the quality, not only of
training, but also of the knowledge
and skills needed for the psychosocial
response.

Piloting materials

Unless the training materials havebeen used previously with provensuccess with the same population astargeted, try to pilot or pre-test all
newly produced material. This means
testing the materials first with a smaller number of people andchecking it fulfils the purpose intended.

Update materials
Try to regularly review and update training materials. The fast
pace of change means that training content a year old may alreadybe outdated. Remember this when printing training and IEC
materials to limit wastage on outdated materials.

152

Monitoring and Evaluation

Monitoring and
Evaluation

Jakob Dall/Danish Red Cross

154

Monitoring and Evaluation Psychosocial interventions

M

onitoring and evaluation are very importantmanagement tools used to keep a check on all aspectsof a response, and to assess if the implemented
intervention is having the desired effect. They are often linked
together in practice and in the literature, and the methods forcollecting data in both activities are similar. However, a closer lookreveals specific differences, especially with regard to intention andtime frames.
This chapter explains what monitoring and evaluation are and how
they are seen within the Red Cross Red Crescent Movement; why
we need them; and when the two processes are required. It gives
an overview of who is involved in both monitoring and evaluationand looks at how they are conducted, with special attention paid
to the ethical principles involved in data collection. Finally thechapter discusses how monitoring and evaluation can contributeto research in the field of psychosocial responses. Suggestions
for further reading are given, as monitoring and evaluation
requirements can be complex.

What is monitoring?
Monitoring is the regular and continuous process of collecting andanalysing data to assess progress and development. It is an internal
responsibility carried by whatever programme is involved and is a
way of keeping a regular check on the planned inputs, outputs andoutcomes of a response.
There are two distinct types of monitoring required in the Red
Cross and Red Crescent Movement. One is process oriented, where
the monitoring activities focus on the progress and development of
the response, such as whether• activities are being implemented as planned• problems have arisen which need to be dealt with and how thisshould be done
• opportunities for improving the psychosocial responses havedeveloped
155

Psychosocial interventions Monitoring and Evaluation• resources are being used according to plan, including money. If
not, monitoring can usually help to clarify the reasons.
The second is results oriented and measures direct results of theimplemented activities, such as whether• activities, present and planned, are relevant to the needs of the
population. Are the objectives of the response still realistic andrelevant or do they need changing?
• changes in the targeted population or the external environment
have occurred that affect the planned activities• new information is needed to enhance understanding of thepresenting situation
Both types of monitoring are useful and are required for reporting
purposes.
Stacey M. Winston/ IFRC

Monitoring helps to keep a regular check on whether a programme is still relevant to
the needs of the population

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Monitoring and Evaluation Psychosocial interventions

Why is monitoring important?
Responsibility and decentralised information-gathering
Red Cross Red Crescent Society programme managers havethe overall responsibility for the psychosocial response to theprogramme and branch staff, the beneficiaries and to the donors.
As crises often affect large geographical areas, it is not possible fora programme manager to be at all the sites where activities are
implemented. Responsibility for implementation at branch level
will typically be delegated to branch managers, or psychosocial
focal persons at the branches. However, they have to report backto the programme manager. Monitoring activities thus allow an
overview of the full programme or activity implementation.

Relevance
Monitoring enables the people who are involved in implementing
a psychosocial intervention to regularly assess if the activities arestill relevant, and if they are being implemented in an effective
manner. The information from regular monitoring can be used tomake decisions about activities, to ensure that they continue tobe relevant to their intended aim. This is especially important in a
psychosocial response, as psychosocial needs and well-being are
dynamic and change rapidly.

Accountability
The Red Cross and Red Crescent National Societies are accountable
to the affected population and to the donors who support theimplemented interventions. Results of monitoring activities should
therefore be shared with both beneficiaries of the psychosocial
response and donors. Donors typically require detailed reports on
activities, where decisions on actions are explained, and financial
statements and reports are included.

Who is involved in monitoring?
Overall responsibility
It is the programme management who have the overall
responsibility of making sure that monitoring activities are157

Psychosocial interventions Monitoring and Evaluation

undertaken regularly in a responsible and ethical manner. They
facilitate regular meetings to discuss monitoring findings and anychanges arising, and they regularly review monitoring outcomesthemselves.
Rodney Dekker/Australian Red Cross

Programme staff andvolunteers

Monitoring information is usually collected by staff
and volunteers working directly with beneficiaries

The Red Cross Red Crescentprogramme staff at branchlevel typically collectthe data for monitoring
purposes, through theirdirect interaction withvolunteers and beneficiaries.
Volunteers of the National
Society also assist branch
programme staff bycollecting monitoring data
about their work with
beneficiaries.

Targeted population
Monitoring involves collecting data on all implemented activities.
This includes collecting data from the affected population who
participate in psychosocial activities, as well as from others involvedin the response, such as Red Cross Red Crescent programme staff
or volunteers who may have participated in training. In terms ofmonitoring activities, the ‘targeted population’ is defined as all
those who have participated in activities in the intervention.

Other active partners
The ideal scenario would be to carry out monitoring activities
together with others who are working with the same populations.
‘Others’ could be external agencies or other areas of the Red Cross

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Monitoring and Evaluation Psychosocial interventions

Red Crescent response. Carrying out monitoring activities together
does two important things. Firstly, it prevents families andcommunities from feeling overwhelmed by monitoring activities.
Secondly it provides a much broader and more holistic analysis
of how the targeted population is doing. This kind of analysis
increases opportunities for an integrated response that can attend
to many varied needs of the community at the same time. Thisin turn contributes positively to the psychosocial well-being ofindividuals and the community.
It is, however, rare that monitoring activities are done together
with others. Logistical planning and the separation of response
areas by administrative and budgeting issues usually prevent
this. Do not let this be a deterring factor from trying to encourage
it! Advocate with other active partners for joint monitoring
activities as much as possible. One way to do this is to point out thepsychosocial benefits for the beneficiaries.

What is evaluation?
An evaluation is an objective assessment that aims to find out if
the implemented activities or programme has succeeded in doing
what it aimed to do. In this process it looks at what worked andwhat did not. It therefore looks at both the outputs and outcomesof a response. Evaluations measure to what extent the goals oroverall objectives of an intervention have been met, asking thequestion ‘did the change we aimed for come about?’
Evaluations are usually lengthy and costly exercises, as they
involve a lot of data gathering and analysis, and finally reportwriting with recommendations. They are used to inform thedonors, the programme implementers and ideally also thebeneficiaries of the intervention. They are particularly usefulin providing lessons learned for others planning a similarintervention.

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Psychosocial interventions Monitoring and Evaluation

There are different kinds of evaluations:

Real time evaluations
Real time evaluations can be conducted either by Red Cross and
Red Crescent National Societies or by the Secretariat of the Inter­national Federation. These types of evaluations are undertaken
early on in a response and aim to provide information for immedi­
ate learning and indicating changes where necessary. They differ
from mid-term and final evaluations in a number of ways as they
• are typically shorter in length, such as a few days instead ofweeks• are often done by internal staff instead of external consultants• focus on process rather than impact
Best practiceTwo rounds of real time evaluations (RTEs) were conducted by
the International Federation in the emergency response to thetsunami. The first was done a month and a half after the crisis
event and the second six months later. These RTEs focusedon progress of operational management, cooperation andcoordination. They identified solutions to problems and provided
recommendations to operational and participating National
Societies, the Federation and donors regarding management andcoordination, implementation and the work programme.

Mid term evaluations or reviews
These types of evaluation, also called reviews, are done aroundthe half-way mark of a long term project. They assess impact andaccountability issues, including budgets and administration. The
results are typically used to report to donors and to make anynecessary changes to the interventions in the remaining life of the
project.

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Monitoring and Evaluation Psychosocial interventions
Till Mayer/IFRC

Final evaluations
Final evaluations are conductedat the completion of a response
and are used to assess boththe impact and the processof the intervention. They areusually very detailed andcomprehensive analyses of all
aspects of the response, identifying key information regarding the
successes and challenges experienced in the response.

Evaluating impact
One of the most important roles of evaluation is to assess
whether an intervention had the desired impact on the targeted
population. What the desired impact is depends on the aspect of
the intervention and the activity. Training, for example, aims toincrease knowledge and skills, whilst community activities may
have the specific aim of strengthening social cohesion.
To evaluate the impact of an intervention, information is needed
before and after the intervention. Information before theintervention begins can be collected through a baseline study(introduced in the chapter on assessments). Baseline studies
are undertaken after the objectives of a programme have been
established, and data is collected using the indicators identified as
relevant for the psychosocial intervention. The results from thebaseline study are thus the first set of results which are then used
for comparison in later evaluations. A good baseline study provides
a basis for measuring the same things at the mid term and end of
the intervention.
It is therefore important to be consistent and measure the same
indicators from beginning to end of a response. However, if
monitoring results or a mid-term evaluation identify the need foradapting or changing an intervention, this may involve a change
in indicators. Such changes have to be noted in later evaluations

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Psychosocial interventions Monitoring and Evaluation

with clear explanations as to why these changes were made. This
information is critical to the process of learning that is achieved
through evaluations.
CD

The Good Enough Guide

Why is evaluation important?
Evaluations are essential for:7• determining the relevance of the response• assessing the efficiency• determining the impact• assessing effectiveness• assessing sustainability
Evaluation criteria
Relevance: Is the response appropriate to the specific psychosocial
needs and resources?
Efficiency: Are the psychosocial response activities successfully
implemented in the intended time-frame and at lowest cost? Has the
response been implemented in the most effective manner comparedto alternatives?
Impact: What has changed as a result of the implemented response?
Did the activities in the response having the desired effect?
Effectiveness: Are the set objectives achieved?
Sustainability: Will or did the benefits of the response continue
after the National Society exited the response.

Who is involved in evaluations?
External consultants
It is difficult to be objective about work that one has beenpassionately involved with. It is therefore advisable and often
required to use external consultants to undertake evaluationsof a psychosocial response. External consultants should remain
objective in relation to the Red Cross Red Crescent Societies andthe implemented intervention, in order to achieve an honest,
constructive evaluation.

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Monitoring and Evaluation Psychosocial interventions

There are strong benefits to using local consultants who havea good understanding of the culture and norms in the affected
country. This will ease communication between the consultant
and beneficiaries and promote openness and honesty. Monitoring
reports and any other documentation should be made available toan evaluation team. This will provide good background material
and will help in highlighting what other information is required.

Programme staff
The Red Cross Red Crescent programme staff are always involvedin evaluations in one way or another. If external consultants havebeen recruited to take the overall responsibility for an evaluation,
programme staff will assist with any logistical and practicalmatters the consultant may need. They are also an importantsource of information for the evaluator, as they have the firsthand experience of planning and implementing the response,and can identify eventual challenges that were met together withsuccessful experiences.
If external consultants are not recruited for an evaluation, theprogramme staff may conduct the evaluation and thus take on allaccompanying responsibilities.

As with monitoring
activities, participants in
psychosocial interventions
provide data for an
evaluation. This includes
selected representativesof the affected population,
as well as Red Cross
Red Crescent staff andvolunteers who have been
involved in the intervention.
Additionally, community

Joe Lowry/ IFRC

The targeted population

Members of the affected population are a primarysource of information in an evaluation

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Psychosocial interventions Monitoring and Evaluation

members who may not have directly participated in the psychosocial activities may also be included, since an evaluation may also
focus on the impact of the interventions on whole communities.
When choosing representatives of those involved, it is goodpractice to use objective methods of sampling. Staff or volunteers
from the Red Cross or Red Crescent Societies should not be
the ones who select the community members for interviews,
for example, as this could create bias due to their establishedrelationships with the community members. Instead, use othersampling techniques such as representative, quota or snowball
sampling. These sampling techniques are described in more details
on page 167 in the section on how to monitor and evaluate.

When to monitor and evaluate
Monitoring schedules vary in programme design, and also
depending on whether the planned psychosocial response isshort term or long term. In an acute emergency, immediately
after a critical event, monitoring may be needed on a daily basis,and then on a weekly basis. Later, monitoring may be planned
every month or even every three months. The most important
thing concerning the ‘when’ on monitoring is that it is plannedat regular intervals, and throughout the life of the programme oractivity implementation. To make sure that monitoring is done asplanned, the Red Cross Red Crescent psychosocial team should
hold responsibilities for carrying out monitoring activities together
with the time frames decided.
CD

Daily Reporting Form Example
Evaluations are not on-going regular activities like monitoring, but
are scheduled at specific times in a response. In some responses tocrises, the International Federation conducts real time evaluations
during the emergency response phase. These are broad andmulti-sectoral. Evaluations of a specific area of response, such as
psychosocial, are typically scheduled around the halfway mark164

Monitoring and Evaluation Psychosocial interventions

and at the end of an implemented response. The results of a
mid term evaluation can be used to make necessary adaptations
and/or improvement to the programme for the remaining
implementation period.
Monitoring and evaluation in a nutshell; Good practises in
evaluating psychosocial programming

CD

Planning for monitoring and evaluation
A key point in considering when to monitor and when to evaluate
is that this should be done in the initial stages of planning a
response. Monitoring and evaluating are quality assurance tools
and they are as important as any other aspect of the response. It istherefore critical that they are included in:

Planning procedures
Developing indicators and agreeing on methods of informationgathering takes time which has to be included in planning processes.
An example of how monitoring and evaluation activities areplanned in a long term response
Emergency

Recovery and development

Rapid 	Detailed	Baseline	Continuous
assessment
assessment study
assessment

Critical
Event

Regular monitoring with very
short intervals (daily/weekly)

Immediate
Response

Finalevaluation

Mid term
evaluation

Long term
programme
designRecommended
future activities
Activity review
and adaptation(or exit– cessationof activities)

Regular monitoring with very longer intervals (monthly or quarterly)

3 mths6 mths1 year

2 years

3 years
Source: PS Centre 2009165

Psychosocial interventions Monitoring and Evaluation

Time-based implementation plan
Decide upon the most useful regular intervals for monitoring
and whether a mid term as well as a final evaluation will be
undertaken. Also include regular meetings to follow up on findings
from both activities. When planning evaluations, make surethat the targeted populations will be available for the planned
activity. It is no good, for example, to plan a mid term evaluationof a school-based intervention during the school holidays, where
nobody is available for evaluation activities.

Training
Staff who are involved in monitoring and/or evaluation activities
have to be properly trained in those tasks, for example in collecting
the relevant data; reporting findings; and/or linking findings withplanned objectives and engage in necessary adaptations.

Budgets
Both monitoring and evaluation bear costs, during the processes ofdata gathering and analysis and in the administrative task of reportwriting.

Information sharing activities
Make sure that the results of monitoring and evaluations
are presented clearly and in an accessible format, so that thepsychosocial team members themselves and others can learn
from the implemented psychosocial response. Note, however,that monitoring documents are usually internal to Red Cross
Red Crescent National Societies, whilst evaluation reports areoften released as external or public documents so that otherstakeholders can also learn from them. At times evaluation reports
are prepared in both an internal and external version.

How to monitor and evaluate
Data collection
Both monitoring and evaluating are processes that involve
collecting data and analysis. The different methods used for

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Monitoring and Evaluation Psychosocial interventions

collecting data depend on the type of information that is required,either qualitative or quantitative. Methods for collecting these twokinds of data are described in the chapter on assessments (pages
62-63).

Sampling
Sampling procedures for monitoring and evaluation activities
differ from those for initial assessments at the beginning of a
response. In initial assessments broad sampling methods arerecommended, so that data is collected from as wide a populationas possible. This provides a holistic understanding of how anentire population has been affected. However, when monitoring
or evaluating an intervention, the sampling of the population isnarrowed to focus specifically on those who are directly targetedby the intervention. At times a limited representation of others
affected indirectly by the intervention may also be needed, but the
primary focus in sampling will be on the participants.
Sampling methods for monitoring and evaluation activities
include:Quota sampling where a specific percentage or quota of a subgroup is chosen according to proportions in a population.

Snowball sampling where selected individuals recruit others to
be interviewed from their own networks.
Deciding how many people should be included in a sample for
either monitoring or evaluation depends on a number of factors
related to the intervention. These include the number of people
targeted by the intervention, the number of identifiable subgroups within the targeted population, resources available forthe activities and requirements for sampling size stipulated by
the National Society or the donors supporting the intervention.
If there is a plan to use the monitoring and evaluation results
for research purposes, it will be necessary to investigate formal
sampling requirements in this regard.

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Psychosocial interventions Monitoring and Evaluation

Ethical principles to data collection
Certain ethical principles of conduct govern the collection of datain psychosocial responses. These have to be considered carefully
in both the planning and implementation of monitoring andevaluation activities:8

1. Well planned and justifiable: Make sure that datacollecting activities are necessary and justified with clearly defined
purposes that can be explained to all involved. Also confirm that
there is an adequate budget to make sure the activities are donein an ethical manner. If possible, return to those interviewed andshare the results with them.
2. Coordination: Coordinate data collection with other active
partners to prevent target populations from being overwhelmedby different people asking questions repeatedly and possibly about
the same things.

3. Clarify aims and procedures: Design all monitoringand evaluation activities well, with clearly outlined protocols,
including accepted methods and behaviour for collecting,analysing and using information.
4. Participation and collaboration: Ensure the data collection
is a participatory and collaborative process. Try to gather
information from as many represented subgroups as possible in
the targeted population. Make sure participation is voluntary.
Get informed consent from all participants. Confirm that theparticipants understand the aim and purpose of the activities, so as
not to raise unrealistic expectations.
5. Comparison groups: In a psychosocial response, it is not
ethical to deprive a group of people of psychosocial services for the
purpose of evaluating the impact of a programme or implemented
activities. However, comparisons can be made with groups in a
population that may be waiting for psychosocial services.

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Monitoring and Evaluation Psychosocial interventions

Best practice

Making psychosocial services available as soon as possible
One of the benefits of psychosocial responses is that earlyinterventions can prevent the development of severe psychologicalor social problems. It would therefore always be advisable toadvocate for making psychosocial services available to all affected
populations as early as possible. This may decrease chances ofcomparing data with ‘groups in waiting’ but increases chances ofimproving psychosocial well-being.

6. Conduct and consent: Consult with community members
on how to approach participants for information in an appropriatemanner, and make sure you always get full consent before
commencing any information-gathering activities.

7. Privacy and confidentiality: Respect privacy and confidentiality of participants. Assure participants of anonymity.

Thorkell Thorkelson/ IFRC

8. Anticipate adverse consequences: Interviewing people
about issues related to psychosocial well-being can result in strong
emotional reactions. Those involved in data collection have toknow how to deal withthis. Referral systems
and appropriate followup actions must beplanned in advance inanticipation of suchreactions. If the datacollection activities inany way threaten the
security or well-beingof the participants,
they should be stopped
immediately.

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Psychosocial interventions Monitoring and Evaluation

Best to avoid

Inadequate training and preparation for data collection
In Syria, 2006, after the Hisbollah – Israeli conflict, a group of National Society Red Crescent volunteers contacted the internationalteam responsible for assessing psychosocial needs. They requested
permission to conduct a survey amongst the displaced Lebanese.
The survey had been requested by a local NGO wanting to assist
the targeted population. Problems arose, however, as it appeared
the volunteers did not understand the questions they wereasking. They also did not know what to do when the people theyinterviewed were emotionally affected by the questions. They
did not have access to or knowledge of any referral procedures.
The assessment team immediately discouraged the volunteers
from continuing with the survey, and the responsible NGO wascontacted and ethics and support mechanisms were discussed.

Interviewing children

The difference in power between children and an adult interviewer
collecting data calls for very strict observance of ethical principles.
Extra considerations include:• Inform communities on your intentions and methods before
approaching children to interview them
• Get informed consent for interviewing children from their nearest
caregivers• Only approach children directly to interview them if the information
is not available from other sources• Interviewers approaching children should receive specific training
on methods of working with children

CD

Gathering information from children and adolescents

Indicators
Indicators are the criteria that are used to measure the datacollected. Indicators measure changes related to implementationof an intervention. They can be either quantitative or qualitative.
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Monitoring and Evaluation Psychosocial interventions

Examples of indicators:
Logical framework, Bam earthquake 2006, Iranian Red Crescent Society.
Goal / Overall objective

Indicators

To reduce the suffering, andrisks for development of severe
trauma, of those who lost theirfamily members and friends,
social and economic livelihood
and mobilise own and community
strengths, and thereby increase
the possibility of those affected,
to regain own capacity, to build
up their life again.

• Decrease in stress related symptoms anddecrease in the need for individual consultations during the implementation period.
• Increased survivor knowledge and reinforced healthy coping mechanisms in local
communities.

Goal / Overall objective

Indicators

To extend and reinforce the
Iranian Red Crescent Society’s
ongoing provision of psychosocial and basic relief support tothe survivors of the earthquake• The project is run by the Iranian Red Crescent Society, the volunteers and staff are
conducting psychosocial activities and thebeneficiaries are participating in the activities.
• Monitoring and evaluation system has
been implemented by Iranian Red CrescentSociety with minimum supervision by psychosocial support programme consultants.

Output / results

Selected indicators• Outreach of community based
psychosocial support programme
activities to up to 20.000 affected
people in Bam and surrounding
villages• Capacity building of Iranian Red
Crescent Society: 200 trained
new volunteers and staff in
psychosocial support programme
work and integration of Iranian
Red Crescent Society psychosocial support programme activities
and briefing/debriefing systems
into Iranian Red Crescent Society
Disaster Response capacity andplans:• 20.000 survivors in Bam and the surrounding villages have been offered andhave participated in psychosocial activities.
• The beneficiaries regain the capacity torelate to others within the community and/or families and will to work.
• Children regain desire and capacity toplay, interact with other children, adults andother specific aspects of childhood.
• Briefing and debriefing system is established for the 200 volunteers working withthe psychosocial support programme activities for the survivors as well as training
has been conducted for both volunteers
and staff working with psychosocial support programme in Iranian Red CrescentSociety.

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Psychosocial interventions Monitoring and Evaluation
Till Mayer/IFRC

Both monitoring and evaluation
typically require a combinationof qualitative and quantitative
indicators for the same aspectmeasured.
Indicators for psychosocial well-being

are likely to differ according to context
Choosing which indicators
should be used for monitoringand evaluation is a process that combines considerations of• initial information from early assessments on how the
population is affected• the local definition of psychosocial well-being• the goal, objectives and activities of the planned response

CD

Types of indicators

PurposeGoal indicators

Measure the extent to which the overall
programme goals are being achieved

Outcome indicators

Measure the extent to which the project/programme objectives are being met

Output indicators

Measure project/programme deliverables

Input indicators

Measure the extent to which the planned
resources – money, materials, personnel arebeing utilised

Indicators in relation to psychosocial programming;PWG Objectives and Indicators

Proxy indicators
These are used to give an indication of a situation where direct
measurement may not be possible. Assessing changes in theprevalence of behaviour which is not easily observable, such as
domestic violence, child abuse or drug abuse, may depend on
proxy indicators. An example of a proxy indicator is the numberof reported incidents of domestic violence to the police. This

172

Monitoring and Evaluation Psychosocial interventions

is unlikely to be the true number of incidents that occur, since
it is known that many such incidents are not reported, but it
nonetheless gives an indication of prevalence.

Measuring psychosocial well-being
Challenges of definition
One of the biggest challenges in this area is how to measure
psychosocial well-being. There is agreement that psychosocial
well-being is an interaction of psychological, social and culturalcontextual factors. However, people working with psychosocial
responses have struggled with developing definitions andaccompanying indicators of psychosocial well-being. There havebeen numerous attempts to use previously developed scales ortools of well-being from other countries. At times monitoringand evaluation has been hopelessly inadequate, based solely
on quantitative measurements of how many people have beenreached in a response.
Nana Wiedemann/PS Centre

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Psychosocial interventions Monitoring and Evaluation

Best to avoid

Measuring psychosocial well-being with clinicalpsychology tools
There was a tendency in the past to use clinical psychologicaltools measuring individual disorders associated with reactions tocrises, when planning responses. Typically investigations focusedon symptoms of post-traumatic stress disorder, severe depression
and different anxiety disorders. However, it is now understoodthat the majority of people affected by a crisis do not develop
such severe psychological reactions. Instead most people arereacting normally to abnormal events. Secondly, the behaviours
and symptoms that these tools measure risk creating a false
impression or are irrelevant. Different populations have different
ways of reacting to stressful events, and these tools do not measure
universal behaviour or reactions. Third, psychosocial responses
focus on communities and empowering communities to takecare of themselves and each other. These tools, however, have an
individualistic and clinical focus, and therefore should be avoided
in community-based psychosocial interventions.

Relevant indicators of psychosocial well-being
By far the best way of identifying indicators of psychosocial
well-being is through qualitative communication with theaffected population. Focus group discussions, interviews with
key informants and through observations of the community are
all methods of collecting this type of information. The affected
population can themselves best define how to recognize if
someone is doing well or not doing well, and how the community
is functioning.

Indicator categories
There are three typical categories of indicators in a psychosocial
response which all contribute to the measurement of psychosocial
well-being. These measure aspects of174

Monitoring and Evaluation Psychosocial interventions• emotional well-being, such as trust, hope for the future, senseof control• social well-being, such as the ability to interact; assist others;
solve problems actively• skills and knowledge resulting from participating in thepsychosocial activities, such as learning how to resolve conflicts;
gaining new skills
Best practice

Behavioural indicators to measure psychosocial well-being
In a school-based psychosocial support programme, implemented
by the Palestinian Red Crescent Society, specific behaviouralindicators of psychosocial well-being have been identified:
playfulness, trust and tolerance. The intervention consists oftwenty guided workshops with children in the school setting, runby the teachers and volunteers from the Palestine Red CrescentSociety. Prior to the first workshop, a selected number of children
and parents complete a self-reporting questionnaire. This isrepeated again following the last workshop, together with focus
group discussions. Each workshop also includes monitoring
activities, where the children are observed according to the chosen
indicators.

Jérôme Grimaud/ French Red Cross

Identifying such focused behavioural indicators has enabled thepsychosocial team to gather
very clear and precise
results on the intervention.
Additionally, it has led tothe teachers increasing theirawareness and focus on these
aspects of behaviour, andto an increase in parental
involvement in the child’s
activities in the schools.

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Psychosocial interventions Monitoring and Evaluation

Ayu Ovira/American Red Cross

Individual andcommunal
psychosocial
well-being
As there areboth individualand communal
experiences ofpsychosocial
well-being, it isuseful to develop
indicators of both,when working in acommunity-based
psychosocial response. An example of an indicator for individual
psychosocial well-being is the score on a self-reported
questionnaire that measures self-confidence. An example of an
indicator of community psychosocial well-being is the percentage
of community members who participate in a community activity
planned to increase social cohesiveness.

International guidelines
The IASC Guidelines and Sphere Standards include sample process
indicators for key actions that are presented in their action sheets.
These provide guidance for developing specific programme
indicators and encourage alignment with international
approaches.

Reporting
Most Red Cross Red Crescent National Societies have specificrequirements for monitoring and evaluation. These may, forexample, include focus areas that are included in the National
Society’s Strategic Plan or other strategy documents. Be sure toinvestigate any specific monitoring or evaluating requirementsthat are relevant to all of the Red Cross Red Crescent National
Societies involved in the psychosocial response.

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Monitoring and Evaluation Psychosocial interventions

Most National Societies also have specific formats for monitoringand evaluation reports. It is common that the same generalformatting is often used for all areas of response. This provides
consistency in the overall management of the National Society’s
response. To make sure that the data captured for monitoring andevaluating the psychosocial response is as precise as possible, effort
and time will have to be spent on understanding the reporting
formats so that all the necessary information is captured.
‘Monitoring and Evaluation in a nutshell’ provides examples
of monitoring and evaluation formats in the annexes

CD

Best practiceEnabling cross-comparison of multiple country response
Following the Indian Ocean tsunami, the American Red Cross
supported psychosocial responses in a number of countries
simultaneously. Although responses differed according to the contexts and specific needs and resources of the affectedpopulations, allof the psychosocial teams were required to follow similar overallmonitoring procedures and reporting systems. Although eachcountry adapted these to fit the context of the specific programme
implemented, the overall consistency in this management tool
enabled the Participating National Society to have a comparable
overview of the multi-country response. This enabled both crosscountry comparisons and opportunities for the psychosocial teams
from different countries to learn from each other.

Monitoring and evaluation as research tools
There is an urgent call for more research on psychosocial
responses. Although attention on psychosocial well-being has beensteadily increasing over the past twenty or so years, research inthis field has been surprisingly minimal. This is due to inadequate
monitoring and evaluation processes, as mentioned earlier which
are partly a consequence of the fear that rigorous methods of datacollection would lead to insensitive and non-ethical practices due
177Psychosocial interventions Monitoring and Evaluation

to the subjective nature of psychosocial well-being. However, there
is a growing understanding that committing to exact methods ofdata collection and analysis (such as baselines, comparison groups,
sampling methodology etc) heightens sensitivity, contributing toour understanding of psychosocial well-being. Developing goodmonitoring and evaluation tools is therefore a very importantinvestment, both for the implemented psychosocial intervention
and for improving responses in the future.

Documentation
To use the results of monitoring and evaluation findings in research,make sure that the data collected is complete and kept safe, and thatanalysis and reporting conforms to research standards.

Longitudinal researchWorking on a long term psychosocial response presents an
excellent opportunity for starting a longitudinal study. Thiskind of research follows the same population over a long periodof time, investigating changes in the behaviour and well-beingof the population whilst analysing the causes of the changes. A
typical three year psychosocial response may be too short fora full longitudinal study, but it can provide a starting point for
researchers interested in this field.

Sharing research topics and information
Throughout the implementation period of the psychosocial
response, be attentive to information that would be useful for thisfield of study. Monitoring and evaluation processes are ideal for
identifying information gaps which can lead to relevant topics
for research. If the psychosocial team is not in a position to begin
researching, be sure to share ideas for research with others. These
could be colleagues working with the same affected population, orother interested parties.
WWW

178

The Mental Health and Psychosocial Network is a usefulforum for researches to share information

Final Notes

Final Notes

Till Mayer/IFRC

final notes Psychosocial interventions

Reference Notes
1) IFRC Psychosocial Framework 2005-20072) W orld Health Organization (1948). Constitution of the World Health Organization.
3) T he Psychosocial Working Group. (2003) Working Paper. Psychosocial Intervention inComplex Emergencies: A Conceptual Framework4) Inter-Agency Standing Committee. 2007. Guidelines on Mental Health and Psychosocial
Support in Emergency Settings5) N ote that the IFRC VCA tool is also used for organizational development, to assessvulnerabilities and capacities of National Societies.
6) IFRC (2008) Guidelines for emergency assessment7) T hese criteria are the same suggested by the Development Co-operation Directorate,
where the following sources are quoted: The DAC Principles for the Evaluation of Development Assistance, OECD (1991), Glossary of Terms Used in Evaluation, in ‘Methods
and Procedures in Aid Evaluation’, OECD (1986), and the Glossary of Evaluation and
Results Based Management (RBM) Terms, OECD (2000). See http://www.oecd.org/docu
ment/22/0,2340,en_2649_34435_2086550_1_1_1_1,00.html
8) H orizons Program/Population Council and Family Health (2005) ‘Ethical approaches togathering information from children and adolescents in international settings: guidelines
and resources.’ http://www.popcouncil.org/horizons/childrenethics.html

181

Psychosocial interventions final notes

Bibliography
Bronfenbrenner, U., 1979. The Ecology of Human Development: Experiments by
Nature and Design. Cambridge, MA: Harvard University Press.
De Berry, J., Fazili, A., Farhad, S., Nasiry, F., Hashemi, S. & Hakimi, M. 2003. The
Children of Kabul: Discussions with Afghan Families. Save the Children Federation Inc.
Inter-Agency Standing Committee, 2007. Guidelines on Mental Health andPsychosocial Support in Emergency Settings. Geneva: IASC.
INEE, 2004. Minimum Standards for Education in Emergencies, Chronic Crises and Early
Reconstruction.
International Federation of Red Cross Red Crescent Societies, 2003. Psychological
Support policy.
Perkins, D. D. and Long, D. A., 2002. ‘Neighborhood sense of community and social
capital: A multi-level analysis’. In A. T. Fisher and C. C. Sonn (eds.), Psychological Sense
of Community: Research, Applications and Implications. New York: Plenum Publishers.
Prewitt Diaz, J. O. and Dayal., 2008. A Sense of Place: A Model for Community-Based
Psychosocial Support Programs. The Australasian Journal of Disaster and Trauma
Studies. Volume: 2008-1.
Segerstrom, E. 2001. ‘Community Participation’. In M. Loughry and A. Ager (eds.),
The Refugee Experience: Psychosocial Training Module, Vol. 1 (2nd edition).
Oxford: Refugee Studies Centre, University of Oxford.
The Psychosocial Working Group. 2003. Psychosocial Intervention in Complex
Emergencies: A Conceptual Framework. Working Paper.
The Sphere Project. 2004. Humanitarian Charter and Minimum Standards in a Disaster
Response.
Tolfree, D. 1996. Restoring Playfulness. Different Approaches to Assisting Children
who are psychologically affected by War or Displacement. Stockholm: Radda Barnen.
World Health Organization, Division of Mental Health. 1992. Psychosocial
Consequences of Disasters. Prevention and management.

182

final notes Psychosocial interventions

Glossary
Advocacy
The active support of a person, group orcause; actively speaking in support of aperson, group or cause
Assessment
The process of gathering data and analyzing it to create information, in this context
to establish the status of well-being of aparticular population
Baseline study
A descriptive survey that provides information on the current status of a particularsituation in a given population
Child abuse
All forms of physical and/or emotional illtreatment, sexual abuse, neglect or negligent treatment or commercial or otherexploitation, resulting in actual or potential
harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power (WHO
Report on the Consultation on Child Abuse
Prevention Geneva, March 29-31, 1999)
Community
A group of people who live together inan environment, or who share common
cultural, religious or other social characteristics. For example, those who belong
to the same ethnic group; go to the samechurch; work as farmers, or those who arevolunteers in the same organisation
Community-based approach
Involves community members in partnership, recognizing their resilience, capacities, skills and resources, and building onthese to deliver protection and solutions,and supporting the community’s own goals(UNHCR 2008)
Community mobilisation
Activities that encourage community members to participate in the various aspectsof an intervention. Examples are meetings
with community leaders, large community
meetings and events, forming an issuebased group.

Coping
The process of adapting to a new life situation – managing difficult circumstances,making an effort to solve problems or
seeking to minimize, reduce or toleratestress or conflict
Crisis
A critical event or series of events that leads
to major changes in the lives of the affected. It can be due to natural disasters (suchas floods, earthquakes, cyclones etc) andman-made events, (conflicts, population
displacements, large-scale accidents etc)
Critical event
A sudden, powerful event that is outside
the range of ordinary experiences and has
an impact stressful enough to overwhelm
the usually effective coping skills of either
an individual or group
Disaster
An unforeseen and often sudden event of
natural or human origin that causes widespread damage, destruction and humansuffering. A disaster overwhelms local capacity, necessitating a request for external
assistance at national or international level
Emergency
A sudden, usually unforeseen, event that
calls for immediate measures to minimize
its adverse consequences
Empowerment
Gaining control of the decisions that
impact one’s life, as an individual or as agroup. This is mainly achieved by setting
up structures that allow people to regain
control over some aspects of life, a feelingof belonging and of being useful
EthicalConforming or adhering to accepted standards of social or professional behaviour
Evaluation
An evaluation is an objective assessmentthat explores if the implemented intervention has achieved its goal. Evaluations lookat both the outputs and outcomes of a
response and measure to what extent the183Psychosocial interventions final notes

goals or overall objectives of an intervention have been met, asking the question ‘did
the change we aimed for come about?’
Exit planning
The process of planning when and how tobring an intervention to a close with the
involvement of all those concerned
Grief
A natural process of response to loss,
conventionally focused on emotional
responses but having physical, cognitive,
behavioural, social, and philosophicaldimensions
IEC materials
Information, education and communicative (IEC) materials are typically produced
to raise awareness of issues related to theaims of an intervention. Format may be
visual, audio or audiovisual
Logical Framework Approach
A method of project design that structures
project objectives and articulates assumptions affecting chosen strategies
Monitoring
An on-going observation system to verify
whether project activities are happening
according to plan
Pandemic
Epidemic over a wide geographic area
and affecting a large proportion of the
population
Pre-test
Preliminary testing of a measure
Programme locking
When objectives for a programme are set
rigidly with little flexibility for amendment
over the course of the intervention
Psycho-education
A method that focuses on strengthening
people’s capacity to understand their own
or family members’ reactions to distressing
situations

184

Psychological first aid
Assistance given to people affected bya critical event. The four basic elements
are to stay close; listen attentively; accept
feelings; and provide general care andpractical help
Psychosocial
Refers to the dynamic relationship between
the psychological and social dimension ofa person, where the one influences the other. The psychological dimension includes
the internal, emotional and thought processes of a person – his or her feelings andreactions. The social dimension includes
relationships, family and community networks, social values and cultural practices
Psychosocial support
Refers to the actions that address thepsychosocial needs of individuals and ofcommunities, taking into consideration
psychological, social and cultural aspects
of well-being
Psychosocial support programmes
Any planned programme or activity thataims to improve the psychosocial wellbeing of people. Progammes may be
stand alone or integrated within broader
responses
Psychosocial well-being
The positive state of being when an
individual, family or community thrives. It
is influenced by the interplay of human capacity (psychological and physical), social
ecology and culture and values
Psychosomatic
When psychological problems are expressed through physical problems or pain
Qualitative data
Non-numeric information, usually descriptive and in narrative format
Quantitative data
Numeric information including quantities,
percentages and statistics

final notes Psychosocial interventions

Recovery
The process of restoring well-being after acritical event or crisis
Resilience
A person’s ability to cope with challenges
and difficulties, and to recover quickly.
Often described as the ability to ‘bounce
back’
Risk analysis
To systematically identify threats and /or risks, estimating their probability andseverity and to decide on the appropriate
response
Stakeholder
A person, group, organisation or system
who shares interest in something, forexample, in a programme, initiative orcommunity

Vulnerability
A range of factors that may decrease anindividual’s or community’s ability to copewith distress experiences.
E.g. poverty, mental or physical healthdisabilities, lack of social network, lack offamily support, age and gender
Vulnerable groups
Used to describe groups of people livingwith health challenges (e.g. HIV & AIDS,
TB, diabetes, malaria, and cancer), people
with physical disabilities and/or mental
illness, children and adolescents, older
people, women, unemployed persons,people living in poverty, and ethnic minority
groupsStress
A normal response to a physical oremotional challenge which occurs when
demands are out of balance with resources
for coping. At one end of the scale, stressrepresents those challenges which excite
us. At the other end, stress represents situations where individuals are unable to meetthe demands upon them, and ultimately
suffer physical or psychological breakdown
Support groups
Forums where participants can provide
each other with emotional and practicalsupportSustainability
The ability to maintain something – in thiscontext a programme or intervention – into
the future
TraumaUsed commonly to describe either a physical injury or a psychological injury causedby some extreme emotional assault. In thiscontext, trauma is associated with severe
psychological and physical distress requiring specialised services

185

Psychosocial interventions final notes

Acronyms and abbreviations
AIDS

Acquired Immune Deficiency Syndrome

CABAC

Children affected by armed conflict

CRC

Convention on the Rights of the ChildERU	Emergency response unit
FACT

Field assessment and coordination teamHIV	

Human Immunodeficiency Virus

IASC

Inter-Agency Standing Committee

ICRC

International Committee of the Red Cross

IEC

Information and education communication (materials)

IFRC

International Federation of Red Cross and Red Crescent Societies

INEE	

Inter-Agency Network for Education in EmergenciesNGO	

Non-governmental organisation

PFA

Psychological First Aid

PMI

Palang Merah Indonesia (Indonesian Red Cross Society)

PPP

Project Planning Process

PS Centre

International Federation Centre for Psychosocial Support

RDRT

Regional disaster response team

SWOT

Strengths, weaknesses, opportunities, threats (analysis)

UN

United Nations

UNFPA

United Nations Population Fund

UNHCR

United Nations High Commissioner for Refugees

UNICEF

United Nations Children’s Fund

VCA	Vulnerability and Capacity Assessment
VIPP	Visualisation in Participatory Processes
WHO	

186

World health Organisation

final notes Psychosocial interventions

CD Contents
Introduction
Page in handbook

Name of File on CD

Full document title

Additional reading

Psychosocial interventions. A handbook

Psychosocial interventions. A handbook

Additional reading

WHO Psychosocial
Consequences

Psychosocial Consequences of Disaster. Prevention
and management.

Setting the Context
Page in handbook

Name of File on CD

Full document title

28

Psychosocial Working
Group Conceptual
Framework

Psychosocial Intervention in Complex Emergencies: A
Conceptual Framework

21

Sense of Place

Sense of Place: A Model for Community Based Psychosocial Support Programs

31

Sense of Place 2

American Red Cross. Sense of place - a guide basic
concept on scope of PSP activities

49

The Sphere Project

The Sphere Project. Humanitarian Charter and Minimum Standards in Disaster Response

49

CRC

Convention on the Rights of the Child50, 56, 83, 119,
137,

IASC Guidelines

IASC Guidelines on Mental Health and Psychosocial
Support in Emergency Settings

50

IASC Guidelines
Checklist for Field
Use

IASC Guidelines on Mental Health and Psychosocial
Support in Emergency Settings. Checklist for Field Use

51

IFRC Psychological
Support Policy

IFRC Psychological Support Policy

51

INEE MinimumStandards

Inter-Agency Network for Education in Emergencies.
Minimum Standards for Education in Emergencies,
Chronic Crises and Early Reconstruction

Additional reading

AmCross India
MHPSS pictorial

Pictorial Guide. IASC Guidelines on Mental HealthandPsychosocial Support in Emergency Settings.

Additional reading

Poster IASC Mental
Health Psychosocial

Poster. IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings.

Additional reading

WHO Mental Health inEmergencies

WHO Mental Health in Emergencies: Mental and Social
Aspects of Health of Populations Exposed to Extreme
Stressors

Additional reading

IFRC Global Healthand Care Strategy

IFRC, Global Health and Care Strategy. 2006-2010187

Psychosocial interventions final notes

Assessment
Page in handbook

Name of File on CD

Full document title

56, 63IFRC Guidelines
Emergency Assessment

IFRC. Guidelines for assessment in emergencies.

56

VCA folder

56

How to do a VCA

How to do a VCA. A practical step-by-step guide for
Red Cross Red Crescent staff and volunteers

56

VCA Lessons Learned

Vulnerability and capacity assessment. Lessons
learned and recommendations

56

What is VCA

What is VCA? An introduction to vulnerability andcapacity assessment

56

VCA toolbox

VCA toolbox with reference sheets

58

Children of Kabul

The Children of Kabul. Discussions with Afghanfamilies.

60

WHO Rapid Assessment Tool

TOOL. Rapid Assessment of Mental Health Needs ofRefugees, Displaced and Other Populations AffectedbyConflict and Post-Conflict Situations

Additional reading

FACT Handout

Field Assessment and Coordination Teams (FACT)

Additional reading

Alcohol, Substance
Abuse Rapid Assessment

Rapid Assessment of Alcohol and Other SubstanceUsein Conflict-affected and Displaced Populations: A
Field Guide

Additional reading

OVC Participatory
Situational Analysis

A Framework and Resource Guide. Conductinga Participatory Situation Analysis ofOrphans andVulnerableChildren Affected by HIV/AIDS:Guidelines
and Tools

Planning and Implementation

188

Page in handbook

Name of File on CD

Full document title

81

Working with
communities

IFRC. Working with communities: a toolbox

81

Participation by
Crisis-Affected
Populations

Participation by Crisis-Affected Populations in Humanitarian Action. A Handbook for Practitioners

81

Community
Participation

Community Participation. By E. Segerstrom (2001).
In Loughry, M & Ager, A (eds). Refugee ExperiencePsychosocial Training Module. Oxford: RefugeeStudies Centre

81

Managing stress inthe field

IFRC. Managing Stress in the field97

Protection

97

InterAction Protection
Paper

Making Protection a Priority

final notes Psychosocial interventions

Planning and Implementation
Page in handbook

Name of File on CD

Full document title

97

10 steps on protection of children

Ten Steps to Creating Safe Environments for Children
and Youth. A Risk Management Road Map to Prevent
Violence & Abuse

97

Unaccompanied andSeparated Children

Inter-agency Guiding Principles on unaccompaniedand separated children

97

NIMH Helping Children Cope Violence

National Institute of Mental Health. Helping Children
and Adolescents Cope with Violence and Disasters

97

All children deserve to
be safe

ALL CHILDREN DESERVE TO BE SAFE!

97

ICRC Children in War

ICRC Children in War

97

CSE Fact Sheet for
National Societies(English and French)

Creating safe environments: Fact Sheet. Integration ofchild protection as a cross-cutting issue

97

Child Friendly Spaces
UNICEF

UNICEF. A Practical Guide for Developing Child
Friendly Spaces

107

Activities

107

ECPAT Children
activities

Ideas Bank of Creative Activities forChildren at Drop-in
or Residential Centres(Low Budget Activities for Nonliterate Children)

107

Ideas for activities per
age group – tsunami

Basic Ideas for Activities with Children after the
Tsunami (Draft)

109

Comparisons between terminologies

Comparisons between terminologies of different donor
agencies for results/logical frameworks

112

IFRC PPP Handbook

IFRC. Project Planning Process Handbook

112

SIDA LFA-review

The use and abuse of the logical framework approach

120

IFRC Staff Code of
Conduct 2007

IFRC. Code of Conduct 2007

Additional reading

E-PSP Guidance Note

PS Centre. Guidance Note – Implementing Psychosocial Programmes (PSP) in Emergency-settings

Additional reading

Psychosocial Supportof Children in Emergencies

UNICEF. Psychosocial Support of Children in
Emergencies

Additional reading

IFRC CAP indicators

IFRC. Capacity Assessment and Performance
Indicators (CAP) IFRC.

Additional reading

List of Acronyms forInternational Services

List of Acronyms for International Services

Additional reading

JH Public Health
Chapter 5

Emergency mental health and psycho-social support.
Chapter 5 in ‘Public Health in Emergencies.’ John
Hopkins and IFRC publication

Additional reading

MSF Mental Health
Guidelines

Medecins Sans Frontier. Psychosocial and mental
health interventions in areas of mass violence, 2005

189

Psychosocial interventions final notes

Training

190

Page in handbook

Name of File on CD

133

PS Centre Training Kit

Full document title

133

Trainer’s book

PS Centre Community-based psychosocial support
training kit. Trainer’s book.

133

Trainer’s slides

PS Centre Community-based psychosocial support
training kit. Trainer’s slides

133

Participant’s book

PS Centre Community-based psychosocial support
training kit. Participant’s book

150

Generic Psychosocial Support training material

150

Post DisasterCommunity Based
Psychosocial Support

Cyclone SIDR Recovery Operations: Bangladesh. Post
Disaster Community Based Psychosocial Support. A
trainer’s manual for community level volunteers

150

Community based
psychosocial services

Community based psychosocial services in humanitarian assistance. A Facilitator’s Guide.

150

Crisis to recover

Crisis to recovery: the road to resilience. Disaster mental health and psychosocial care manuals. Number 6.

150

Helping to heal.
Trainers manual

Helping to heal. A Red Cross Methodology for psychosocial care. Trainer’s Manual.

150

Helping to heal. Volunteer handbook.

Helping to heal. A Red Cross Methodology for psychosocial care. Volunteer handbook.

150

Witnessing a majordisaster

University of South Dakota. Disaster Mental HealthInstitute. Coping with the aftermath of witnessing amajor disaster.

150

Normal reactions toabnormal events

PMI/DRC Community based psychosocial support
workshop material 2005. Normal reactions to abnormal
events. Training for volunteers and teachers.

150

Community based
PSP in a disaster

American Red Cross. PSP Maldives. For use by trained
community level Psychological First Aid workers in
disaster settings. Community Based Psychosocial
Support in a Disaster.

150

Child centered training material

150

Child-safe
Organizations

Child-safe Organizations. Training toolkit

150Children and disaster

Children and War Foundation. Children and disaster.
Teaching Recovery Techniques

150

Children and DisasterworkbookChildren and War Foundation. Workbook for the Children and disaster manual

150

Children and war

Children and War Foundation. Children and war. Teaching Survival Techniques

150

Children and War
workbookChildren and War Foundation. Workbook for the Children and war manual

150

Child Protection
Trainers Workshop

PowerPoint Presentation. Child Protection Trainers
Workshopfinal notes Psychosocial interventions

Training
Page in handbook

Name of File on CD

Full document title

150

Child Protection Trainers Workshop Outline

Child Protection Trainers Workshop Outline

150

Child Protection Volunteers Workshop

PowerPoint Presentation. Child Protection Volunteers
Workshop150Child Protection
Volunteers Workshop
OutlineChild Protection Volunteers Workshop Outline

150

Child Protection in
Emergencies. UNICEF

Introduction to Child Protection in Emergencies.
An Interagency Modular Training Package. Child
Protection in Emergencies Training and Resource CD:
Psychosocial Module

150

REPSSI Memory WorkREPSSI Memory / Life Story Work Manual

150

Identifying Psychological Distress inChildren

American Red Cross. PSP Maldives. School Psychosocial Support Program. Booklet 1. Designed for use bytrained community level psychological first aid workers
and teachers. Identifying Psychological Distress inChildren.

150

Psychological FirstAid for Children

American Red Cross. PSP Maldives. School Psychosocial Support Program. Booklet 1. Designed for use bytrained community level psychological first aid workers
and teachers. Psychological First Aid for Children

150

Volunteer-Staff Care training material

150

Psychological
Debriefing in CrossCultural Contexts

Psychological Debriefing in Cross-Cultural
Contexts:Ten Implications for Practice. International
Journal of Emergency Mental Health, Vol. 9, No. 1,
pp.37-45 © 2007 Chevron Publishing ISSN 1522-4821

150

Health professional
training example

Psychosocial Support Training Module For HealthProfessionals. Pakistan Red Crescent

150

Teacher training
examplePsychosocial Support Training ModuleFor Teachers.
Pakistan Red Crescent150

Self-Care for Disaster
Workers. Facilitator’s
Guide

Canadian Red Cross Society. Facilitator’s GuideWorker
Care: Level 1. Self-Care for Disaster Workers

150

Self Care for Disaster
Workers. Participant
Guide

Canadian Red Cross Society. Participant GuideWorker
Care: Level 1. Self-Care for Disaster Workers

150

Working in stressful
Situations

Turkish Red Crescent Society. Working in stressful
situations. A Guide for Humanitarian Aid Workers
andVolunteers

150

UNICEF peer support
manual.

Support to UNICEF staff following chronic and criticalstress. Guidelines for peer supporters

150

Self Care for Disaster
Workers

American Red Cross. PSP Maldives. Community
Psychosocial Support Program. Booklet 2. Designed
for use by community level workers. Self Care forDisaster Workers.

191

Psychosocial interventions final notes

Monitoring and Evaluation

192

Page in handbook

Name of File on CD

Full document title

162

The Good Enough
Guide

Impact Measurement and Accountability in Emergencies. The Good Enough Guide

164

Daily reporting form
exampleDaily reporting form

165, 177

Monitoring and evaluation in a nutshell

IFRC. Monitoring and evaluation in a nutshell

170

Gathering informationfrom children andadolescents

Ethical Approaches to Gathering Informationfrom Children and Adolescents in International
Settings:Guidelines and Resources

172

Indicators in relation
to psychosocial
programming

PS Centre. Indicators in relation to psychosocial
programming

Additional reading

Good practises in
evaluating psychosocial programming.

Children in Crisis: Good practices in evaluating
psychosocial programming.

Additional readingPWG Objectives andIndicators

The Psychosocial Working Group. Reflections on
Identifying Objectives and Indicators for Psychosocial
Programming

Additional reading

Behavioral Surveillance Surveys

Behavioral Surveillance Surveys. Guidelines for repeated behavioural surveys in populations at risk of HIV.

Additional reading

WHO Ethical andsafety recommendations

WHO Ethical and safety recommendations forresearching, documenting and monitoring sexual
violence in emergencies

Additional reading

Community Participatory Evaluation Tool

The Community Participatory Evaluation Tool for
psychosocial programs: a guide to implementation.
Intervention 2005, Volume 3, Number 1, Page 03 - 24

Additional reading

Examples of behavioural indicators

PowerPoint slide: Behavioural indicators. Emotional
impact commonly observed after crisis events

Additional reading

Examples of resiliencecharacteristics

Resilience Characteristics for Individual, Different
Groups and Community as wholefinal notes Psychosocial interventions

Links to useful websites referred to in the handbook
Page 26: http://www.youtube.com/watch?v=3bsabzx_gEE&feature=channel_page
Page 31: http://www.youtube.com/watch?v=5PeXf6jgHDc
Page 38: http://antaresfoundation.org/ and http://peopleinaid.org/
Page 48: http://www.un.org/Overview/rights.html
Page 49: http://www.unhchr.ch/html/menu3/b/k2crc.htm
Page 49: http://www.sphereproject.org/
Page 50: http://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf
Page 50: http://www.who.int/mental_health/emergencies/IASC_guidelines.pdf
Page 51: http://www.ifrc.org/Docs/pubs/who/policies/psychological-policy-en.pdf
Page 51: http://www.ineesite.org/toolkit
Page 60: http://www.ifrc.org/what/disasters/responding/drs/tools/fact.asp
Page 60: http://www.ifrc.org/what/disasters/responding/drs/tools/rdrt.asp
Page 92: http://psp.drk.dk/sw37505.asp
Page 96: http://www.redcross.ca/article.asp?id=294&tid=030
Page 133: http://www.ifrc.org/psychosocial
Page 148: http://www.southbound.com.my/Vipp/Vipp_AboutVipp_WatIsVIPP.htm
Page 150: http://www.repssi.org/
Page 178: http://psychosocialnetwork.net/

193

Psychosocial interventions final notes

7. Recommended reading

Some of documents listed below are included in the attached CD
Bamberger, M., Rugh, J. & Mabry, L., 2006. Real World Evaluation: Working under
Budget, Time, Data and Political Constraints. California: Sage
Bolt, P. and Tang, A., A new approach to cross-cultural function assessment.
Available at: http://www.who.int/mental_health/emergencies/2.2_key_resource_4_
bolton_article.pdf
Duncan, J. and Arntson, L., 2004. Children in Crisis: Good Practices in Evaluating
Psychosocial Programming. Save the Children Federation Inc.
Feuerstein, M., 1986. Partners in Evaluation: Evaluating Development and Community
Programmes with Participants. London: MacMillan
Hart, J. with J. Boyden, Armstrong, M. and Galappatti, G., Piloting methods for theevaluation of psychosocial programme impact in eastern Sri Lanka. Report for USAID.
Oxford: Refugee Studies Centre, March 2004. Available at: http://www.rsc.ox.ac.uk/
PDFs/rrpilotingmethods04.pdf
Save the Children, 2001. Children and Participation: Research, Monitoring and
Evaluation with Children and Young People. London: Save the Children UK.
Save the Children, 1995. Toolkits. A Practical Guide to Assessment, Monitoring,
Review and Evaluation. London: Save the Children UK
UNHCR, 2008. A Community-based Approach in UNHCR Operations.
Available at: http://www.unhcr.org/publ/PUBL/47f0a0232.pdf
UNICEF East Asia and Pacific Regional Office, 2007. The Participation of Children
and Young People in Emergencies.
Available at: http://www.unicef.org/eapro/the_participation_of_children_and_young_people_in_emergencies.pdf
UNICEF, 2008. Psychosocial Evaluation Guide – field testing version.
Available at: www.psychosocialnetwork.net

194

The International Federation’s Global Agenda
2006–2010

Over the next years, the collective focus of the Federation will be on achieving the following goals and priorities:

Our goals
Goal 1: Reduce the number of deaths, injuries and impact from disasters.
Goal 2: Reduce the number of deaths, illnesses and impact from diseases and publichealth emergencies.
Goal 3: Increase local community, civil society and Red Cross Red Crescent capacity toaddress the most urgent situations of vulnerability.
Goal 4: Promote respect for diversity and human dignity, and reduce intolerance,
discrimination and social exclusion.

Our priorities
Improving our local, regional and international capacity to respond to disasters andpublic health emergencies.
Scaling up our actions with vulnerable communities in health promotion, disease
prevention and disaster risk reduction.
Increasing significantly our HIV/AIDS programming and advocacy.
Renewing our advocacy on priority humanitarian issues, especially fighting intolerance,
stigma and discrimination, and promoting disaster risk reduction.

The International Federation of Red Cross and Red CrescentSocieties promotes the humanitarian activities of National
Societies among vulnerable people.
By coordinating international disaster relief and encouraging
development support, it seeks to prevent and alleviate humansuffering.
The International Federation, the National Societies and theInternational Committee of the Red Cross together constitutethe International Red Cross and Red Crescent Movement.

ISBN 978-87-92490-02-5

9 788792 490025