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Mon, 08/05/2024 - 01:33
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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
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