A BALAY Perspective on Psychosocial Work
The concept and practice of psychosocial intervention have gained attention in a number of relief agencies, humanitarian organizations and development-oriented service providers with the resurgence of armed hostilities in Mindanao. Trauma, debriefing, defusing, counseling, therapy and other terms and approaches usually employed by mental health professionals, social workers and community counselors have became new buzzwords. Some of these found their way to the language of a number of survivors of war who have recovered from trauma through the intervention of caregivers and counselors. However, a lot remains to be done to make clear what psychosocial rehabilitation is, and to bring it to the mainstream of responding to the rights and welfare of survivors of armed conflict and internal displacement.
A clinical definition of psychosocial rehabilitation was offered by the World Health Organization (WHO) as a process that offers the opportunity for individuals who are impaired, disabled, or handicapped by a mental disorder to reach their optimal level of independent functioning in the community. But working with victims of the Mt. Pinatubo eruption in Central Luzon, Lourdes Ladrido-Igancio and Antonio Perlas illustrate a more practical understanding of psychosocial intervention. Writing for the International Journal for Mental Health in 1995, they said: "The most basic issue in psychosocial intervention following a disaster is to transform those affected from being victims to survivors. What differentiates a victim from a survivor is that the former feels himself (sic) subject to a situation over which he has no control over his environment or himself, whereas a survivor has regained a sense of control and is able to meet the demands of whatever difficulty confronts him. A victim is passive and dependent upon others; a survivor is not --- he is able to take an active role in efforts to help his community and himself recover from the disaster."
From the WHO perspective, psychosocial intervention is seen as a part of the curative regimen for addressing a mental illness or a disorder away from asylums and other mental institution. The experts on disaster management. meanwhile, regard people who are emotionally and psychologically affected by an extraordinary, if not life threatening, event not as mentally sick individuals, but as people traumatized by a disaster, hence needing psychosocial intervention
It is likely that there are other ways to define psychosocial intervention and rehabilitation, depending on which discipline or perspective one tends to explain and practice it. But based on numerous literature written on the subject, as well as direct experiences and observations made by Balay counselors working among internally displaced persons, a number of elements shape psychosocial work, whatever way one chooses to define it.
Psychosocial rehabilitation is a comprehensive process and not just a technique. It involves resolving the emotional, mental and behavioral effects of a traumatic event by helping those affected to harness their internal and external coping resources. It also involves both improving individual competencies and introducing environmental changes.
The strategies of psychosocial rehabilitation vary according to a person's needs, the setting where the rehabilitation is provided, and the cultural and socioeconomic conditions in which it is undertaken. Housing, education, skills development, employment, livelihood and social support networks are all aspects of psychosocial rehabilitation.
The main objectives of psychosocial rehabilitation are the empowerment of an individual, family or community; the reduction of discrimination and stigma, the improvement of individual social competence, and the creation of long term system of social support.
Psychosocial intervention is one of the components of comprehensive community-based rehabilitation. Psychosocial rehabilitation enables many individuals to regain practical skills needed to live and socialize in the community, and teaches them how to cope with the disaster that have caused their trauma.
The primary goal of the psychosocial-oriented worker is change --- change that may take place in persons, groups, families or situations. The nature of the change sought is related to the potential of the individual or community partner in psychosocial rehabilitation, the goals and attitudes for which a person, family or community is striving, their values and aspirations, and the resources available to the individual or group.
Psychosocial Well-being and Advocacy
Appreciating the concept of psychosocial rehabilitation starts from the understanding of the human person as having the mental and physical endowments, as wells as emotional and spiritual entitlements. But nobody is an island, as the adage goes. And as a social being, it is natural for people to find meaning and fulfillment in their existence by associating with others --- their family, relatives, friends, community. Thus people are to be understood as products of the interaction among their biogenetic nature, the effects of significant relationships, the impact of life experiences, and their participation in societal, cultural, and current events.
Whatever a person does creates a ripple of effects to himself or herself and to the social and natural environment. In the same manner, changes in the family, community or society produce an impact to an individual. The web of psychosocial continuum could either contribute to the well being and development of a person or community or, if left shattered, could also lead to discord, stress and trauma.
Balay considers the individuals, families and communities that it served within an optimistic framework. Those traumatized by the crossfire and forced into exodus are essentially good people caught in the midst of impoverishment, discrimination, oppression and violence. Nevertheless, they are endowed with the gift of life and dignity that must be protected and nurtured, regardless of their ethnicity, culture, gender, age, creed, economic status or political beliefs. Whatever their situations in life, Balay believes that they are entitled to development in a manner and direction that they commit for themselves as individuals, and as a people. They have the right, as anyone else, to determine the satisfaction of their goals and objectives within a social, economic, cultural and political context in which the interests, goals, and aspirations of others are acknowledged and accommodated.
To be able to do this, conditions must exist so that they may be free to influence their developmental course and choose their alternatives. For Balay, psychosocial work would necessarily require advocacy for social justice, the protection and respect of human rights towards the development of a culture of peace. In addition to mitigating distress and rehabilitating traumatized victims of internal displacement, psychosocial work should also contribute to the prevention of traumatic event, such as internal displacement, from taking place in the first place. As the Special Representative to the Secretary General of the United Nations puts it:
"It is abundantly clear that unless ways can be found to counteract the withholding of, or outright violations of human rights, unless there is more sharing of resources, more restraint and tolerance, the granting to everyone regardless of race, religion, membership of a particular social group or political party the right to belong -- or alternative to move in an orderly fashion to seek work, decent living conditions and freedom from strife -- the world will continue to have to live with the problems of mass exodus. This problem, if left unchecked, will increasingly pose a threat to peace and stability."