Mohammad Abu Yaman is a senior physiotherapist at CVT Jordan.
At CVT Jordan, one of the most powerful and successful things that we are doing on the physiotherapy team is the children’s group sessions. During my three and a half years as a physiotherapist at CVT, I have come to understand how important it is to include the parents in their children’s healing journey. In order to get the best results, at CVT we have modified our approach as we’ve learned from the children and their parents.
The children’s group sessions are specialist group services we created for children who are affected by the war and its consequences, in direct or indirect ways. These experiences may cause them to have physical and psychological symptoms similar to the adults we see. We also see symptoms that are unique to children and require a special approach; symptoms such as nightmares, social withdrawal, development regression and increased attachment to parents are common. Addressing these symptoms is particularly important because these children are the women and men of the future who will be part of rebuilding their communities. To achieve the best results in the future, they have to be in good psychological and physical condition. Therefore, CVT saw that those children could benefit from our interdisciplinary care.
The interdisciplinary team started the children’s program based on the model of the adult group sessions cycle, which takes 10 weeks. Each week includes one psychosocial counseling session which helps the children to deal with their psychological symptoms, such as fear, nightmares, stress, sadness, loss and anger. In addition, there is one physiotherapy session which deals with physical problems that they have, such as pain, balance problems, coordination problems, sleeping, body awareness or self-regulation difficulties. Physiotherapy also teaches coping techniques to deal with their psychosomatic symptoms.
After these sessions we found good results, but it was hard for the children to understand the link between the psychological and physical issues, and to apply the coping techniques for different feelings and symptoms. To deal with this, we came up with the idea of joint groups where the children attend eight sessions and receive integrated physical and psychological treatment. In addition to this, parents receive two education sessions where we teach them about the effects of trauma and explain how it affects them and their children.
Overall, in these sessions we found better results compared to the separated sessions, but on the other hand, we found that many children forgot some of what they learned. This was especially true with younger children, who also struggled to spend time away from their parents in the groups.
This led to the CVT interdisciplinary team’s next development: joint parent-child groups for our youngest clients, who are five and six years old, which we called Family Groups. At this age, we know that the relationship with the parent or caretaker provides one of the main sources of coping and comfort for the children, so we wanted to maximize this. The important part that we focus on during these sessions is the relationship between the parent and the child, and also the relationships within the family itself.
In these groups, we ask the parents to participate in the eight children joint sessions, in addition to two parent-only education sessions. We designed these sessions to make it more interactive between the parent and the child to work on the relationship, and at the same time to work on the psychological and physical symptoms. During these sessions, we were surprised with the continuous improvement that we saw and how these sessions helped the parents understand what is going with their children, and with themselves. We also heard feedback that these sessions helped parents improve the relationships not only with the child who attends the session with them, but also with their other children and spouse.
On a personal level, I also have a huge benefit from attending and facilitating these sessions, as I’m a husband and a father for a little girl. This experience helps me a lot to understand the family dynamic and how the woman feels, how the mother reacts to events, in addition to better understanding the development of children, such as how they behave and what is behind their behaviors.
I am proud of what we are doing in CVT, and how we help the refugee community not only as individuals but also as families. This has helped them to create a safe environment full of love and integration to raise their children in a healthy way.