Mailman School of Public Health, Columbia University, New York, NY, USA.
J Child Psychol Psychiatry. 2015 Jan;56(1):18-20. doi: 10.1111/jcpp.12367. Epub 2014 Nov 20.
The field of mental health and psychosocial support for children in humanitarian emergencies has been evolving rapidly. A decade ago, researchers and practitioners frequently took a deficits approach that emphasized problems such as trauma, particularly post-traumatic stress disorder (PTSD), in zones of armed conflict. Assessments focused on PTSD and typically led to the provision of curative responses such as Western psychotherapies as the first response for the affected population. Practitioners expressed diverse concerns about this approach, including its narrow, medicalized definition of the problem (mental disorder), the unsustainability of the programs it generated, the relative inattention to the context, the privileging of individual over systemic approaches, and the lack of cultural sensitivity. For these and other reasons, humanitarian practitioners have increasingly favored a resilience approach that features the agency of children, families, and communities and seeks to build upon existing assets or strengths. Already there is evidence of the effectiveness of numerous interventions that embody a resilience approach. Yet resilience approaches have been limited by a lack of conceptual clarity and ongoing questions about how to assess and measure it. In this context, Michael Ungar's Practitioner Review is an important contribution to practice.
儿童在人道主义紧急情况下的心理健康和社会心理支持领域发展迅速。十年前,研究人员和从业人员经常采取缺陷方法,强调武装冲突地区的创伤等问题,特别是创伤后应激障碍(PTSD)。评估侧重于 PTSD,并通常导致提供治疗性反应,例如西方心理疗法,作为受影响人群的第一反应。从业者对这种方法表示了各种关注,包括其对问题的狭隘、医学定义(精神障碍)、它产生的项目的不可持续性、对背景的相对关注不足、对个人方法的重视超过系统方法,以及缺乏文化敏感性。出于这些和其他原因,人道主义从业者越来越倾向于采用具有儿童、家庭和社区能动性的弹性方法,并寻求利用现有资产或优势。已经有证据表明,许多体现弹性方法的干预措施是有效的。然而,弹性方法受到概念不清晰和如何评估和衡量它的持续问题的限制。在这种情况下,迈克尔·昂加尔的从业者评论是对实践的重要贡献。