Seeking Safety: Art Therapy Curriculum for Displaced Persons and Refugees Kelley Hocking COUN 400- 7560 Advanced Research Department of Science, Health and Human Services Penn West University Dr. Carolyn Treadon April 29, 2024 1 “Art also offers refugees a way to communicate the unthinkable the unbearable to others. It allows them to convert their drama and loss into words, colors or movement so that their distress does not overwhelm them and destroy what is still alive in them.” (Lousa & Hughet, 2022, as cited in UNHCR, 2023, p. 815) 2 Purpose This Curriculum is designed to use Trauma Informed Art Therapy and the Seeking Safety model to address the trauma and cultural bereavement experienced by Refugees and Displaced Persons. 3 Justification • Globally 108 million people have been forcibly displaced. • 2 million people need resettled each year. • Ongoing and new conflicts have increased displacement globally, 2022 had the largest ever increase in years (United Nations High Commissioner for Refugees, UNHCR, 2023). • Most witness or experience traumatic events before resettlement. • Most experience cultural bereavement. Image source: UNHCR (2019) 4 Justification Researchers have reported various symptoms of PTSD and depression in trauma-exposed refugees, including separation anxiety, worrying, poor concentration, disorientation, flashbacks, nightmares, hypervigilance, violent outbursts, crying, anhedonia, suicide attempts and using substances for coping (Dupont, et.al., 2005, as cited in Bennet et.al. 2017). Image source: UNHCR(2019) 5 Terms • Acculturation-process of adjusting to a different culture. • Art Therapy-mental health profession that uses art. • CBAT-modality using art therapy and cognition used in the seeking safety curriculum. • Cultural Broker- a person who creates a bridge between two cultures. • Displacement-moving involuntarily from one’s home country. • PTSD -trauma experiences that impair everyday functioning. • Refugee– a person forced to flee their country. • Relocation- act of moving from one place and settling in another. 6 Literature Review • Global studies of AT and Refugees- AT has been found to be beneficial especially by bridging communication barriers of people who have experienced displacement. Art can transcend language barriers. • Challenges faced by refugees: • • • • • • Lack of legal standing in new country Lack of cultural humility by others Access to mental and physical health care Cultural bereavement PTSD Loss of family, friends, home 7 Literature Review • Hope Simpson Survey- Born out of WWII and the desire to track Russian refugeesoffers a blueprint for understanding the modern refugee crisis. • Art Therapy- Has been found to be especially useful when there is a language barrier. Particularly effective with vulnerable populations with severe trauma. • Art Therapy and ETC- Framework for art therapists to inform their therapeutic decisions. 8 Literature Review • Trauma Systems Therapy for Refugees- treatment modality using a multi systems approach based on bioecological systems model. • Positive Psychology- works with the systems that help produce the best functioning through positive thinking. • Art Therapy and Mindfulness- used to bring awareness to physical sensations and how how anxiety can affect the bodies response to that feeling. • First Aid Art Therapy - Therapy-develop resilience with intent to provide a space to experience peace in which cathartic moments happen. • Seeking Safety- curriculum model developed by Najavit (Bennet et., al, 2017) to learn coping skills to process their trauma and comorbid symptoms. 9 CURRICULUM Image source: UNHCR (2019) 10 Curriculum Design • To be administered by a Master’s level art therapist • 8 1-hour sessions (more time if needed) • Ages 18 and older • 8-10 people maximum • Cultural broker if available • Images of examples with a translation if a cultural broker is not available • Open group – due to transiency of this population • Materials are adaptable according to logistics • Based on CBAT from Seeking Safety Model by Najavet 2002 (Bennett et., al, (2017) 11 Sessions Format • Mini Mandala weekly check in - 5 minutes • Discuss goal(s)- 3-5 minutes • Experiential- 40 minutes • Closuren-10-15 minutes 12 Curriculum Session 1: Mini Mandala Session 2: Narrative Story Session 3: Recognizing Resilience Session 4: Grounding Session 5: Acknowledging Strengths/Creating Empowerment Session 6: Acknowledging Cultural Bereavement Session 7: Safe Place Session 8: Self Nurturing 13 Session 1: Introduction Goal: To promote participants sense of comfort and belonging. • The use of mandalas help to provide a form of control over a situation that feels out of control. • This group is meant to provide a safe space for the participants to share if they want to and to express their feelings depending upon their immediate needs. • Each session will use a mini mandala as a check in and to create a peaceful space. • Participants may keep their work after each session. 14 Session 2: Narrative Story Goal: To encourage self expression and bonding. • Giving this space to allow the client to tell a story about themselves can help to create attunement. • Story telling allows them to share a piece of their life that they want others to know. • Words and images may be combined to relay the meaning. • Sharing may help participants bond over their displacement. 15 Session 3: Recognizing Resilience Goal: To identify resilience in each person to be used to build strength during relocation. • Recognizing resilience can build self esteem to get through difficult times. • 4 types of Resilience; Physical, mental, social, emotional. • Identifying and writing down a resilient quality from each category can help solidify and integrate these qualities so that they may be attuned to them. • Knowing these qualities can provide more self assurance and offer strength. 16 Session 4: Grounding Goal: To learn how to regulate oneself with breathwork and the use of sensory materials. • Connection to the earth has a natural calming effect. • Breathwork can be used to center oneself and create calm. (Cleveland Clinic, 2023). • Creating a sculpture with found objects can help create calm and a connection to the earth and one’s surroundings. • Being in this moment of creating a sculpture– mindfulness- may help the client be attuned to the moment and not thinking about the past or the future. 17 Session 5: Strength & Empowerment Goal: To foster awareness to create calm. • Honoring positive aspects of self can build empowerment. • Trees represent strength & fortitude. • The tree and can represent self by filling its branches and roots with the strength, gifts and talents each posses. • Feeling confident in your abilities and sharing this may help to empower. • A sense of empowerment can help aid a person and give them strength during hard times. . 18 Session 5: Tree examples from different countries 19 Session 6: Cultural Bereavement Goal: To engage healing through self expression. • Culture plays an important role in our identity. • Music, food, clothing, stories language make each culture unique. • Creating art that represents a culture can help a person reflect upon and honor their culture. • The art can provide a visual for them to look upon and reminisce and to share with others. 20 Session 7: Safe Place Goal: To promote safety through self expression. Creating a safe space allows them to look ahead, maintain resources, and regain control. Whether psychological or actual safe places. Kim, S.-Y., Lee, J. S., & Choi, H. (2023). • Visualize a peaceful place, real or imagined. • Imagine this place and apply the five senses to this experience. • Create a piece that represents this space the represents safety. 21 Session 8: Self Nurturing Goal: Particapants will learn taking time for self can help promote emotional stability • Taking care of oneself is important for mental well being. • Anxiety and stress can worsen if time is not taken for self care. • Self Care can be done without material things or money. • Examples of non-monetary self care: Singing, stretching, meditation, being in nature, walking, massage, napping, yoga. • Focus on not feeling selfish about meeting their own needs. 22 Session 8: Self Nurturing Self care wheel template Roizen (2020) 23 Limitations • This curriculum has not been formally tested. • Supplies in refugee camps or other places may be limited. • Participants may not be able to keep their art due to the transient conditions. • Language barrier and or lack of a cultural broker. • Cultural barriers- some may not embrace therapy or know what it is. • Religion as a cultural barrier- may influence decision to participate. 24 Final Thoughts Refugees and Displaced persons can benefit from Trauma Informed Art Therapy which has been demonstrated in different locations around the world. Cultural humility is important so that the person providing therapy does not transfer their own cultural beliefs onto others and avoid causing any more harm. To help current and future generations experiencing acculturation adapt to their unfortunate circumstances more research is needed with different age groups, cultures, and environments to ensure best practices. 25 References Bennett, K., Ely, G. E., Green, S., Hartinger, C., Koury, S., & Nochajski, T. (2017). “I feel like I am finding peace”: Exploring the use of a combined art therapy and adapted seeking safety program with Refugee Support Groups. Advances in Social Work, 18(1), 103–115. https://doi.org/10.18060/21130 Cleveland Clinic (2023). How box breathing can help you destress. https://health.clevelandclinic.org/box-breathing-benefits Kim, S.-Y., Lee, J. S., & Choi, H. (2023). The effects of art therapy on anxiety and distress Korean– Ukrainian refugee: Quasi-experimental design study. Healthcare, 11(4), 466. https://doi.org/10.3390/healthcare11040466 26 References Lousa, T. V., & Hughet, M. (2022). Case study first aid in art therapy and its liberating role in Bosnia and Herzegovina Temporary Reception Centers for migrants and refugees. Arte, Individuoy Sociedad, 34(2), 799–816. https://doi.org/10.5209/aris.75542 Roizen, S. (2020). Easy care mandalas. Art Therapy Spot https://arttherapyspot.com/2020/10/23/simple-self-care-mandalas/ UNHCR (2019). Art Stands with Refugees. https://www.unhcr.org/dach/ch-de/aktuelles/ /art-standswith-refugees-en UNHCR, the UN Refugee Agency. UNHCR. (2024). https://www.unhcr.org/ 27