Why this manual 

In recent years, several manuals and guidelines have been developed in the field of gender based violence (GBV). Not so many have focused solely on the mental health of the survivors. We wanted to fill this little gap. The aim of this manual is to provide a very practical supplement to the existing literature. The manual suggests approaches and techniques that address the psychological needs of GBV survivors, which helpers can use when they assist and provide care to individuals who are exposed to this form of violence. It focuses especially on ways of understanding how trauma affects the lives of survivors. The approaches presented will hopefully be of value in work with people exposed to other forms of trauma as well.

This training has been developed for helpers who provide assistance and support to women who survive gender-based violence (GBV) and sexual trauma during disasters, conflicts and emergency situations, where access to health professionals with psychological or psychiatric expertise is limited.

This manual can be used in different ways. The manual is not a therapy manual, but a training manual that suggests approaches and techniques that address the psychological needs of GBV survivors. It may also supplement and deepen the understanding of health workers who already have knowledge and experience. The main purpose, however, is to be used in training of helpers, to strengthen understanding trauma and practical approaches to assistance. It may be a tool for helpers who train other helpers and for groups of helpers who need self-study materials. The manual can be read, studied and discussed, and the exercises it contains can be tested and applied in groups working with this subject matter.

The manual explores the psychological meaning of trauma and how traumatic events affect mental health. What are the signs of severe stress? How can these be assessed and understood? How does a helper approach a woman shortly after she has been through dreadful and violent experiences? How to deal with her distress and how to create safe spaces that permit supportive dialogues? What forms of contact can help survivors to recover and heal? How can reporting of violations be prepared and handled and how can the survivor’s rights and safety be ensured?

Human Rights and Respect are key values. Human rights may assist both in understanding the suffering and in finding ways to respond to it in a respectful and helpful way. Willingness to help and listen, allow survivors to control their own stories, and respect their self-determination, are important values that shape the way survivors should be approached. In addition, a helper needs to know how to manage closeness and distance, how to give positive support, and how to tolerate silence. The manual includes elements of theory but focuses on practical training techniques that directly assist survivors. We hope it may provide helpers with approaches and tools they may use to assist survivors of GBV to rebuild their lives and regain their sense of dignity.

The contributors

This manual is made by HHRI and has been written with the insight and knowledge of several contributors with extensive experience within the field of trauma and trauma treatment. Divided by all they have been working with survivors in 26 countries in war as well as post conflict and in times of peace.

Nora Sveaass is a clinical psychologist and Associate Professor at the Department of Psychology, University of Oslo, Nora Sveaass chairs Health and Human Rights Info and until 2013 was a member of the UN Committee against Torture. She has worked for many years with survivors of trauma and forced migration at Oslo Universitys Psychosocial Centre for Refugees, and is currently directing a research project on transitional justice.

Doris Drews is a specialist in psychiatry, who for many years has treated severely traumatised clients. In addition to working as a therapist and teaching, she is currently head of the emergency unit at a large psychiatric outpatient clinic near Oslo.

Katinka Salvesen is a clinical psychologist who works with trauma patients at the Modum Bad Clinic in Oslo. An experienced trainer, she has trained helpers working with survivors of sexual violence in Congo. A graduate in art and expressive therapy, she lectures at the Regional Centre for Violence and Traumatic Stress, Oslo, on mapping and diagnosis, training and specialisation, and relational trauma and processing.

Annika With is an actress and expressive art therapist with years of experience in trauma treatment and sensorimotor psychotherapy, as well as eye movement desensitisation reprocessing (EMDR) and narrative exposure therapy (NET). She is a skilled trainer, and runs groups for ethnic Norwegians and minority people in Norway. She also runs groups for and is doing individual therapy with dissociative patients at the Modum Bad Clinic, Oslo. A.With has developed teaching material and trained helpers working with survivors of sexual violence in Congo. She is one of two authors of “The Butterfly Woman: Handbook for women who live difficult lives”.

Solveig Dahl a psychiatrist, was one of the founders of the Rape Victims Services in an emergency ward in Oslo. Her doctorate thesis examined rape as a health risk. She was a Special Adviser to Norwegian Peoples Aid on womens projects during the war in the Balkans from 1993 to 1995, and Mental Health Coordinator for the World Health Organisations Rehabilitation of War Victims programme in 1995-1996. She has worked with traumatised refugees in Norway at Oslo Universitys Psychosocial Centre for Refugees.

Helen Christie is a clinical psychologist and special adviser at the Regional Centre for Children and Adolescent Mental Health, East and South (R-BUP). She has worked for many years with refugee children in Norway and children in war zones, on trauma, sexual abuse of children, and the effects of child sexual abuse in adulthood.

Josefin Larson has a Masters Degree in psychology. Her research focuses on culture and social psychology, especially in multicultural societies.

Elisabeth Ng Langdal is the Executive Director of Health and Human Rights Info. She has a masters degree in human geography and a bachelor in media studies from Oslo University. In addition to run the Health and Human Rights Info resource data-base on the consequences of human rights violations on mental health, she has for the last eight years been working within the priority area of gender based violence.

Plain Sense has given valuable input regarding pedagogical layout, editing, design and in finalising the manual.

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