The primary aim of all psychosocial support programs should be placing and maintaining children in stable and supportive family environments. Psychosocial care and support activities for vulnerable children should follow the principles of child and lifespan development.
Rather than being a stand-alone activity, psychosocial support programs should be integrated into wider systems, wherever possible, such as existing community support mechanisms, formal and nonformal school systems, social services and health services. Integrated services tend to reach more people and are typically less stigmatizing. (WHO, 2007)
What is psychosocial support?
Psychosocial support addresses a person's emotional, social, mental and spiritual needs - all essential elements of positive human development.
Psychosocial support builds internal and external resources for children and their families to cope with adversity. It supports families to provide for children's physical, economic, educational, health and social needs. Psychosocial support also helps build resilience in children.
Why is psychosocial support important?
All children need psychosocial support for their psychological and emotional wellbeing, as well as their physical and mental development. Some children need additional, specific psychosocial support if they have experienced extreme trauma or adversity or are not receiving necessary caregiver support.
Poverty, illness, conflict, neglect and abuse can all affect a child's psychosocial wellbeing. As a result of HIV and AIDS, children may experience multiple traumas such as the illness and death of parents, violence and exploitation, stigma and discrimination, isolation and loneliness, and lack of adult support and guidance.
How should psychosocial support be delivered?
Families and communities are best placed to provide psychosocial support to children. Interventions should work through families to keep children in supportive and caring environments and to strengthen families abilities to meet a range of children's needs. Psychosocial support should not be a stand-alone activity but part of comprehensive, integrated programming.
Effective psychosocial support builds on community resources and links families with existing systems of community support such as early childhood development programs, school programs, kids clubs, safe spaces for girls, peer support groups and health services. Psychosocial support can also be integrated into existing programs for nutrition, HIV prevention, PMTCT, and care and treatment. Participation in parent education groups, community caregiver and family support groups, peer and social support activities and mentorship programs can help children, youth and families to strengthen coping mechanisms and build resilience.
While most children are fairly resilient, when faced with extreme adversity and trauma, they and their families need extra support. Extreme, prolonged 'toxic stress' may lead to anxiety or depression and can have long-term, harmful effects on a child's health and development. In cases of extreme stress or adversity, children and families may benefit from family outreach programs such as home visits that provide counseling services.
Key Psychosocial Support Activities and Message
- Support Families to Effectively meet Children's Psychosocial Needs and Care for Children in Their Own Communities. Families and communities that love and care for children are best placed to provide psychosocial support.
- Integrate Psychosocial Support Activities into Existing Community and Health Systems and foster support groups for parents, families, community caregivers and youth (peers).
- Organize Community Caregiver Support Groups, through existing community resources and structures, to address caregivers' emotional and psychological needs. Research indicates that caregivers in support groups reported 'better family functioning, more positive feelings towards children in their care and less social marginalization' than those not in support groups (Thurman et al., 2012).
- Support Mentorship Programs for Children and Youth affected by HIV/AIDS. Mentorship programs can lessen grief and positively affect psychological outcomes, especially for children without an adult caregiver (Horizons, 2007).
- Address Specific Psychosocial Support Needs of Children Living with HIV. These may be different from children dealing with the impact of HIV/AIDS on family members. Psychosocial support must consider how children respond differently to adverse situations based on their age, gender and circumstances.
- Provide Psychosocial Activities that Support Young Children through Early Childhood Development Programs (ECD or preschool). Research shows that toxic stress in early childhood can have life-long, negative effects on a child's brain development, health outcomes, learning and behaviors. (Center on the Developing Child, 2007)
- Strengthen Social Welfare Services and Promote Community Child Protection Policies including Inheritance Rights. Community level support needs to be backed by external efforts of policy-makers.
- Develop an Evidence Base of Psychosocial Support Interventions that Support Child Wellbeing. Psychosocial support programs are difficult to assess as outcomes may not be clear for a long time. Currently, there is limited measurement of its impact on children.
Key Links for Psychosocial Support
Psychosocial Care and Counseling for HIV-Infected Children and Adolescents. A Training Curriculum (Revised Edition by Catholic Relief Services (CRS) 2009; First Edition by ANECCA Secretariat, 2008).
Population Council. See psychosocial support.
JLICA. Joint Learning Initiative on Children and HIV/AIDS.
Thurman TR, Jarabi, B, Rice J. (2012) Caring for the caregiver - Evaluation of support groups for guardians of orphans and vulnerable children in Kenya. AIDS Care.
REPSSI. A regional non-governmental organization working with partners to promote psychosocial care and support children affected by HIV and AIDS, poverty and conflict in East and Southern Africa.
Mental Health and Psychosocial Support Network. An online network for people working in the field of mental health and psychosocial support in emergencies and situations of extreme stress acrosss the world.
The Memory Work Facilitator's Manual. Developed as part of the international Memory Project, the manual is for trainers supporting parents, guardians and carers affected by HIV and AIDS. It is aimed at trainers with all levels of experience, but requires basic HIV and AIDS knowledge. The training can be delivered to people with varying levels of education and the manual can be adapted to suit local needs. It can also be used to train future trainers to deliver the course.
The Sinomlando Centre for Oral History and Memory Work. Based at the University of KwaZulu-Natal, South Africa, they have a Memory Box programme that builds resilience in vulnerable children and orphans affected by HIV/AIDS.