Programme reactivating human care
Most agencies working with children who have undergone extreme deprivation naturally focus on their physical needs. But keeping them alive is only the first step. It is now well known that unless a child has a caring adult to love him and teach him life skills, social behaviour and morals that he needs, his mental and emotional development will be impaired.Recent research suggests that normal physical development of the brain depends on proper interaction between a caring adult and the growing child. In normal circumstances such learning happens naturally. But when families are uprooted through social changes, migration, catastrophes, children losing their parents, or having been numbed by severe deprivation and emotional shock, this care often breaks down and has to be reactivated through skilled help. If children do not receive sufficient love and attention while they are young, the problem also perpetuates itself because later on they become inadequate parents. ICDP's focus, therefore, is on trying to break this cycle. It does so by reactivating the existing caring skills and network that have been overlaid by stresses related to extreme poverty, social uprooting, migration, war and disaster.
THE 8 GUIDELINES FOR GOOD QUALITY INTERACTION are the key messages of the ICDP programme.
Diagram showing the components of the ICDP programme:
The starting point of the ICDP programme is to explore with caregivers how they see their children, by promoting a positive image of their child and by reflecting about their role as caregivers.
The main message of the programme to caregivers is expressed in the “8 guidelines for good interaction”- these are 8 criteria which define good communication between caregivers and children and are used as topics for reflection in meetings with others and for personal application in daily routines with children.
How the main message is delivered to caregivers is just as important as the message itself. “The 7 Principles of Sensitising” are a set of pedagogic principles applied by the ICDP facilitator, i.e. the person in charge of facilitating the programme to caregivers, usually in group meetings.
THE AIM OF THE ICDP PROGRAMME
Based on recent research in child development, the ICDP psychosocial intervention programme aims to enhance and enrich the relationship between caregivers and their children. The ICDP programme is designed to identify and reactivate local cultural practices, in order to stimulate development that is authentic, sustainable and long lasting. The task of ICDP training is to sensitise, build competence and confidence in members of a community or an existing child caring system, so as to withdraw after some time and transfer the project to the local resource persons.
1. To influence the caregiver’s experience of the child in a positive way, so that the caregiver can identify with and ‘feel with the child’, sense the child’s state and needs and adjust her/his caring actions to the child’s needs and initiatives.
2. To strengthen self-confidence in the caregiver.
3. To give children the opportunity to be heard, listened to and responded to by opening up a space for meaningful dialogues with adults.
4. To give children opportunities to follow their own initiatives giving them support when needed, but without taking over the control of the situation from the children.
5. To promote a sensitive emotional-expressive communication between caregiver and child that may lead to a positive emotional and developmental relationship between the two.
6. To promote an enriching, stimulating interaction between caregiver and child that expands and guides the child’s experiences and actions in relation to the surrounding world.
7. To reactivate indigenous child-rearing practices and values, including the child culture of play, games, songs and co-operative activities.
The 8 guidelines are the message of the programme, but how it is conveyed to caregivers is just as important as the message itself. It is clear, both from our experience and research of others, that just giving lectures and verbal instructions to passive receivers is not sufficient in order to change the course of their habits, in this case interactive habits. An active experiential and communicative approach to training is required.
Only when there is a self-initiated intention or hypothesis that is being explored, tested out and evaluated through some kind of feedback either from the experience itself or from other people, will there be learning. This type of learning will become integrated as part of the person’s own knowledge and skills. Pure exposure to experience as such does not create this kind of personalised knowledge.
The aim is to bring to surface the caregivers’ inner resources, by creating a warm human environment, where people feel free to express themselves, reflect, explore, experiment, test out new ways of interacting and share personal experiences. The person facilitating the ICDP programme is trained to use certain pedagogic principles in relation to the caregivers they are working with, which are summarized below:
THE 7 PRINCIPLES OF SENSITIZING
1. Establish a contract of trust and warmth with caregivers.
2. Develop a positive conception in the caregiver of the child by:
· Pointing out to caregivers some positive features and qualities of their children.
· Re-defining positively what appear to be negative features of their children.
· Reactivating past good memories of a caregiver’s positive relationship with the child.
· Using exercises for caregivers to discover positive qualities and competencies of the child.
3. Activating caregivers in relation to the theme/guideline that was discussed by:
· Asking caregivers to make self-assessments of personal interactions with their child based on the 8 guidelines of good interaction
· Exemplification: asking caregivers to produce examples of their interactions with the children
· Giving caregivers observational tasks in relation to their children
· Asking caregivers to try and test out new ways of communicating and interacting with their children in order to find out what works the best
4. Confirming caregivers’ competence by pointing out at that which is already positive in their existing interaction with their child.
5. Using an inquiring approach to guide caregivers’ discussions about what is good interaction.
6. Encouraging sharing and attentive listening among caregivers in group meetings to learn from each others’ experiences.
7. Using two styles of communication in relation to caregivers:
- A personalised style of explanation, with examples from your own individual experience.
- An empathic interpretative style, i.e. describing how the child experiences the situation; comparing the experience of the child with similar adult situations.
IMPLEMENTATION OF ICDP
The aim is to implement the ICDP programme on a large scale, by integrating it, whenever possible, in an existing network of care. The first step is to train a team of professionals as ICDP qualified trainers who can implement the programme by training others in their community with a multiplying effect. There are different levels in training:
Facilitator level, qualifies participants to apply the ICDP programme with caregivers and children.
Trainer level, building on the experience at facilitator level, further training is offered which qualifies participants to start training others to become facilitators.
THE ICDP PROGRAMME CAN BE USED:
Families and children. To prevent neglect or abuse of children and promote peace and dialogue, through group meetings and home visits. It includes working with: families in general; families from ethnic minority groups; families in stress and poverty; families and children under protection; foster families, adoptive parents; parents in prisons.
- Vulnerable children and orphans. To develop minimal standards for human care within a child-care setting, when emergency situations arise due to war, migration, catastrophes, abuse and trauma, or abandoned street children.
- As an integral part of any primary health care programme, building competence and sensitizing caregivers about the importance of their role for the future development of their children.
- Directly in combination with any content-oriented pre-school programme, serving to enrich and increase the quality of interaction between adults and children, which is crucial for the development of children’s emotional stability, as well as for their cognitive development.
- In schools, both working with teachers and the parents to create a more positive inter-subjective climate in the classroom and to help create better communication between pupils and their parents.
- Children in institutions. To sensitize staff and improve their quality of care.
- Special needs children. To sensitize caregivers about the psycho-social needs of their children and build their confidence as carers.
In addition to the above, in several countries we have included ICDP at university level, by training professionals and students of relevant departments, such as the psychology and sociology departments, who then either do the field work themselves or carry out research studies evaluating the impact of our work, or in some cases they do both.
ICDP IN ACTION
Quote from the report of a person trained as ICDP facilitator in Buenos Aires, Argentina:
- During my second field work I implemented ICDP through the local community centre in the outskirts of Buenos Aires, where poor migrant families and their children receive free meals, and have opportunities to socialize with each other. I want to illustrate the meaning for me of ICDP through my recent experience with a mother who has 6 children.
In our ICDP meetings, this mother revealed that the only way she can get her children to take any notice of her was to punish them physically; she went on, and not without some pride, to describe in detail her 'methods'. She also told us how her husband left to her all the responsibility of dealing with their children, and how straight after work, he would go to meet friends and get drunk, then return home only to fight with everyone.
I listened to her expressing her pain, her suffering, her feelings of loneliness and impotence about her family situation. My attitude was of total acceptance and empathy; without judgement or criticism. I let her feel my appreciation for her concern and efforts to educate and guide her children the best she can, under such difficult circumstances. At our meetings this mother was treated with love, was shown understanding, received praise for any positive aspect we noticed. After sometime, I noticed that she started to change. She trimmed her hair, her facial expression changed, she stopped looking angry about everything.
During one meeting we danced the typical local dance 'cumbia' and this mother really joined in, evidently enjoying herself. Afterwards, she went home and made herself look nice, waiting for her husband to come home. When he arrived she offered him a beer and that day he stayed at home and didn't go to meet his friends to drink. They talked in a positive way and from then onwards their relationship started to improve.
This mother changed her behaviour with her children also. She stopped using physical punishments and found new ways of interacting which made gradually her children happier and which gave her happiness too, as well as confidence.
My example shows that the essence of the success of ICDP lies in our ability, as facilitators of the ICDP programme, to release our own ability for empathy and apply the 8 guidelines for good interaction in the way we relate to the caregivers we are working with. The sensitising exercises, the explanations, discussions, home tasks, role plays, analysis of interactive examples on the video or photographs, are all very important but for all that to work well and for an internal process of change to take place in participant caregivers, a change that is lasting and can have an effect on the rest of the community, we need to be an example of a patient, loving person ourselves. To put love in action is the essence of ICDP.