1. Trauma & Loss: the impact on children who are refugees or asylum seekers. A Practical Experience

2. 2 QPASTT: Queensland Programme for Survivors of Torture & Trauma. QPASTT was established in 1995 to provide a community based response to the needs of refugees in Queensland The service was developed in consultation with key communities and is part of a National Forum of Services for Survivors of Torture and Trauma (8 services nationally) It is a state-wide specialised service which aims to provide a range of flexible and culturally sensitive services to people who have been tortured, or who have suffered refugee related trauma, prior to migrating to Australia QPASTT main office is in Brisbane. We also service Toowoomba, Gatton, Logan, Gold Coast, Townsville, Rockhampton, Cairns. 2

3. 3 Potential Sources of Trauma witnessing death squads witnessing mass murder torture disappearances forced marches extreme deprivation – poverty, unsanitary conditions, lack of access to health care persistent and long-term political repression, deprivation of human rights and harassment removal of shelter, forced displacement from home perilous flight or escape separation from family members refugee camp experiences – prolonged squalor, malnutrition, lack of protection. deprivation of education and for children, deprivation of the opportunity to play 3

4. 4 Loss & Grief Separation of families, loss of parent/s. Loss of cultural identity & belonging. Loss of all that is familiar: food, songs, clothing, traditional forms of communication (how we greet one another), smells, centrality of religious expression. Impact on developing brain (Malchiodi 2008) Remembrance & Mourning (Herman 1992) Reconstructing the Story - from Paralysis to Transformation (Levine 2010) Transforming traumatic memory. 4

5. Trauma Stages of Recovery: re-triggering, hypervigilance, nightmares, anger, fear. Dissociation & Disconnection Grounding for a child: throwing soft ball, music, songs, storytelling, bubbles. Implicit or unrecovered memory. Shame Survivor guilt.

6. Saying hello Parents involvement Explanation of process of play therapy – words don’t quite do it! Importance of an interpreter for some children & less so for others. How much history do we need initially. Acknowledge the stress of waiting for a Protection Visa. Impact on child.

7. SandPlay as part of the Assessment Use of sand during assessment Cultural understanding Use of materials– sand, symbols, play doh/clay, paint, pastels, puppets/soft toys, swords. Imagination and role play Slowly, slowly, safety, safety.

8. Communication through symbolism Play is a child’s means of communication. Play, as an early means of expression is the singular central activity of childhood. By engaging in expressive therapy young people may lean to live in the symbolic world of meanings and in turn create their own personal meanings. Expressive therapy and play therapy supports the emotional healing of children and young people. It provides a different language and is thus less reliant on the language of words.

9. So why this method? It doesn’t rely on words, it encourages use of cultural symbolism which comes from the child not from the counsellor or therapist. Their understanding of their world is depicted through such medium as sand, painting, drama, imagination. It provides for a safe container in which trauma & difference can be addressed.

10. Self Care Importance of de-briefing Supervision Techniques for grounding for ourselves – eg mindfulness, play, family or friends, music, good night’s sleep, journalling. Switching off mentally EG of Babette Rothchild Switching off the news!

11. References Herman J: (1992) Trauma & Recovery. Pandora Landreth, G.(2002) Play Therapy: the art of the relationship. Brunner Routledge. Levine, P (2010) In an Unspoken Voice.North Atlantic Bks. Berkeley. Malchiodi C (ed) (2008) Creative Interventions with Traumatized Children. Guildford Uni Press. Rothchild, B, (2006), Help for the Helper: Self Care strategies fro Managing Burnout & Stress. Norton & G. NY. Sunderland, M. (2000) Using Storytelling as a Therapeutic Tool with Children. Speechmark.