psychosocial innovation in post-war sri lanka - The Taos Institute

L. Charlés/G. Samarasinghe Psychosocial Innovation in Post-War Sri Lanka

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PSYCHOSOCI AL I NNOVATI ON I N POST -WAR SRI L ANKA

LAURI E L CHARLES, PHD GAM EELA SAM ARASI NGHE, PHD

A Taos Institute Publication 1


PSYCHOSOCIAL INNOVATION IN POST-WAR SRI LANKA

BY

LAURIE L CHARLÉS, PHD TAOS INSTITUTE ASSOCIATE FACULTY, DEPARTMENT OF PSYCHOLOGY FAMILY, COUPLE, INDIVIDUAL PSYCHOTHERAPY (FCIP) PROGRAM & PSYD DOCTORAL PROGRAM OUR LADY OF THE LAKE UNIVERSITY, SAN ANTONIO, TX, USA U.S. FULBRIGHT SCHOLAR, FACULTY OF GRADUATE STUDIES, UNIVERSITY OF COLOMBO, SRI LANKA (2009-2010)

GAMEELA SAMARASINGHE, PHD

FACULTY OF ARTS, UNIVERSITY OF COLOMBO, SRI LANKA SENIOR TECHNICAL ADVISOR, THE ASIA FOUNDATION, COLOMBO, SRI LANKA U.S. FULBRIGHT SCHOLAR, MAILMAN SCHOOL OF PUBLIC HEALTH, COLUMBIA UNIVERSITY, NYC

THIS RESEARCH WAS FUNDED BY TWO TAOS ASSOCIATE GRANTS (TAG) IN 2012/2014

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ACKNOWLEDGEMENTS We extend our thanks to the dedicated staff and leadership of the Family Rehabilitation Centre and The Asia Foundation in Colombo, Sri Lanka. Special thanks goes to Marion Staunton, Amalka Edirisinghe, Niranjala Somasundaram, Lahiru Perera and Mihiri Ferdinando. The research was made possible by the Taos Institute—who funded the project over the course of several years—and we are incredibly grateful for that support. Our thanks as well to the psychosocial workers who participated in this inquiry: Your everyday work and your ideas about how to help families and communities in the aftermath of war continue to inspire us to innovate our own work. We hope that this study is a worthy reflection of your efforts. LAURIE L CHARLES. I first travelled to Sri Lanka in 2010. I had been awarded a grant as a U.S. Senior Fulbright Scholar at the University of Colombo (which is where and how I fortuitously met my co-author, Dr. Gameela Samarasinghe). I arrived in Sri Lanka after living in Cairo for a year. Sri Lanka was a jarring shift from Egypt—in language, in climate, in history—in absolutely every way. My arrival in Colombo marked 1 year since the end of the war; thus, I hadn’t known Sri Lanka in conflict. Yet, nearly everyone I met in Sri Lanka had had the opposite experience: They had never known their country in peace. Over the years, traveling to Sri Lanka for both personal and professional projects, I witnessed subtle and graphic shifts in the country’s efforts to recover. As I am a family therapist who often trains psychosocial workers in conflict-affected countries, I was endlessly fascinated with how narratives of well-being and suffering were being negotiated after the war. That curiosity is the origin of this study. Yet, it is only microanalysis of one aspect —the practice of mental and psychosocial support—in the country’ s rebuilding. The history of Sri Lanka, pre-war, and during the war, is out of the scope of this book.1 Sri Lanka is a state in transition. In this study we attempt to document a moment in that transition process, by highlighting the post-war work of psychosocial workers in the field. GAMEELA SAMARASINGHE. It was indeed fortuitous to meet Dr. Laurie Charlés. She was a Fulbright Scholar attached to the Department of Sociology, Faculty of Arts, University of Colombo in 2010 when I first met her. With her training in Family Therapy and her experience in training in conflict-affected countries, she was able to contribute to the Postgraduate Diploma in Counselling and Psychosocial Support at the Faculty of Graduate Studies and in the Program at the Asia Foundation. I have been studying conflict-related psychological distress for many years in Sri Lanka. When we started our association, the country was in a post-conflict situation. The war had ended. There were new issues to be explored with regards to psychological suffering and well-being. The timing for this study was important to gain a better understanding of how psychosocial workers supported their clients in a changing environment. 1

There is a great deal of material written about Sri Lanka—much of the best of it I found only in the country. However, for a detailed history of Sri Lanka related to the war and conflict, disasters, and efforts to increase the population’s psychosocial well-being, the reader is referred to Somasundram, D. (2014). Scarred Communities: Psychosocial impact of man-made and natural disasters on Sri Lankan society. Sage: NY.

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PSYCHOSOCIAL INNOVATION IN POST-WAR SRI LANKA LAURIE L CHARLÉS AND GAMEELA SAMARASINGHE

Copyright © 2015 Taos Institute Publications/WorldShare Books © 2015, Laurie L Charlés, Gameela Samarasinghe All rights reserved. All rights reserved. No portion of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, without permission in writing from the publisher. In all cases, the editors and writers have made efforts to ensure that the text credits are given to appropriate people and organizations. If any infringement has been made, the Taos Institute Publications will be glad, upon receiving notification, to make appropriate acknowledgement in future editions of the book. Inquiries should be addressed to Taos Institute Publications at [email protected] or 1-440-338-6733. Taos Institute Publications A Division of the Taos Institute Chagrin Falls, Ohio USA E-Book Format Only ISBN: 978-1-938552-41-0 WorldShare Book - Psychosocial Innovation in Post-war Sri Lanka, by Laurie L Charles and Gameela Samarasinghe, (PDF version 2015)

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Taos Institute Publications The Taos Institute is a nonprofit organization dedicated to the development of social constructionist theory and practice for purposes of world benefit. Constructionist theory and practice locate the source of meaning, value, and action in communicative relations among people. Our major investment is in fostering relational processes that can enhance the welfare of people and the world in which they live. Taos Institute Publications offers contributions to cutting-edge theory and practice in social construction. Our books are designed for scholars, practitioners, students, and the openly curious public. The Focus Book Series provides brief introductions and overviews that illuminate theories, concepts, and useful practices. The Tempo Book Series is especially dedicated to the general public and to practitioners. The Books for Professionals Series provides indepth works that focus on recent developments in theory and practice. WorldShare Books is an online offering of books in PDF format for free download from our website. Our books are particularly relevant to social scientists and to practitioners concerned with individual, family, organizational, community, and societal change. Kenneth J. Gergen President, Board of Directors The Taos Institute Taos Institute Board of Directors Harlene Anderson Mary Gergen Ginny Belden-Charles Sheila McNamee Ronald Chenail Sally St. George David Cooperrider, Honorary Jane Watkins, Honorary Robert Cottor Diana Whitney, Emerita Kenneth Gergen Dan Wulff Books for Professional Series Editor: Kenneth Gergen Taos Institute Tempo Series Editor: Mary Gergen Focus Book Series Editors: Harlene Anderson WorldShare Books Senior Editors: Kenneth Gergen, Dan Wulff and Mary Gergen Executive Director Dawn Dole For information about the Taos Institute and social constructionism visit: www.taosinstitute.net

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“PSYCHOSOCIAL INNOVATION IN POST-WAR SRI LANKA” FOREWORD The objective of this project was to highlight and document how psychosocial project delivery in a post-conflict country incorporates relational understandings in its training of mental health workers. Technical assistance in humanitarian mental health contexts requires increased operational awareness to the political, social, and economic causes of suffering. It also demands sensitivity to the personal and cultural systems of meaning and structure that sustain those in distress during a humanitarian situation. Thus, this project focused on how psychosocial workers and staff at Family Rehabilitation Centre, an NGO (non-governmental organization) in Sri Lanka, utilize relational understandings of suffering in their psychosocial programming. This objective addresses peacebuilding efforts in transforming a country that had experienced 30 years of conflict, terminating in the end of the civil war in 2009.

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TABLE OF CONTENTS

I. CHAPTER ONE: INTRODUCTION TO THE STUDY

P. 9

II. CHAPTER TWO: METHODS

P. 20

III. CHAPTER THREE: PRESENTATION OF THE DATA & ANALYSIS PROCESS

P. 35

IV. CHAPTER FOUR: DISCUSSION

P. 73

V. CHAPTER FIVE: INNOVATION IN PSYCHOSOCIAL APPROACHES AND PRACTICE FOR RECONCILIATION IN POSTWAR SRI LANKA – THE WAY FORWARD

P. 82

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“I’m very proud of myself to be a counselor, PSW. Because as you know in Sri Lanka our people are going through 30 years’ war, and they lost everything. They underwent many things. Now they are rebuilding their lives. While they are rebuilding their lives, they may need counseling and support. That support is provided by me. I’m happy to provide that support to the clients. I’m very proud of myself to be a counselor PSW.”

CHAPTER ONE: INTRODUCTION TO THE STUDY

The goal of this project was to better understand how psychosocial workers (PSWs) in the post-war state of Sri Lanka conceptualize, utilize and apply culturally appropriate systems of meaning and structure in their counselling process with individuals, couples, and families (Samarasinghe, 2009). The research presented here is qualitative inquiry informed by the naturalistic paradigm (Lincoln & Guba, 1985). Focused on understanding the direct experience of psychosocial workers (PSWs) who provide direct services to those affected by atrocities of war, the research was designed, conducted, and analysed in collaboration between the authors and two partner organizations in Colombo. It is our hope that by publishing this document as an open-access WorldShare book—in English, Tamil and Sinhala—the work of the PSWs will expand the allocation and distribution of content knowledge on psychosocial skills, abilities, and practice in a post-conflict country. By highlighting the work of PSWs, we hope to illustrate to a wider audience the ground initiatives in post-conflict country reconstruction. It is also our hope that by emphasizing this work, overseas development assistance in this area can become more effective, transparent, and relevant to practice in the field.

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TAOS INSTITUTE This project expands upon the work of Taos Institute while aiming at its core mission. The Taos Institute is committed to: (1) Exploring, developing and disseminating ideas and practices that promote creative, appreciative and collaborative processes in all aspects of society; (2) Working at the interface between scholarly communities and societal practitioners; (3) Developing ways in which scholarly research and professional practices can significantly enrich each other.” This project explores practices happening in the current context of psychosocial practice in Sri Lanka society. We wanted to study how relational understandings of suffering and healing are used to help communities in the aftermath of conflict. We take a social constructionist perspective to understand the phenomena. That is, we assume that people have multiple ways to explain and understand the world. Research in this tradition attends to the complexity of these views rather than narrowing or minimizing their meaning (Creswell, 2009).

Additionally, our assumptions in conducting this research are consistent with the suppositions inherent to Appreciative Inquiry (Cooperrider & Whitney, 2005). Appreciative Inquiry is a philosophy and methodology, often applied to organizations, business, and leadership. Here, we take that understanding and apply it to the work of mental health and psychosocial support in a post-conflict country. We believe that the PSWs performing this work have untapped and rich resources to share about their experiences delivering psychosocial services in Sri Lanka. We agree with Meyer (2003), who stated that “Rather than global experts with ready-made formulas for conflict resolution and post-conflict reconstruction, it is local people with an understanding of the 10


workings of societies and cultures who can mediate situations, provide solutions and analyses, and bring their experience” to others in similar situations. We want to highlight this work. This focus is meaningful for us; we want to contribute it as a way to balance the fact that so much of the literature on mental health and psychosocial practice originates in high-income countries (Sluzki, 2004).

INNOVATION AND MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT

Mental health and psychosocial support (MHPSS) practice is a specialized arena in mental health. Skills-based and practice-focused, mental health and psychosocial support practice is ubiquitous in places lacking in mental health human resource capacity, such as low and middle-income countries (LMICS) and in fragile, conflict-affected states (FCS). MHPSS practice is also a practical, efficient, and effective way to increase the allocation and distribution of mental health services (Patel, 2012). Further, it is an assumption of our inquiry that in countries where internal conflict and violence have been part of the everyday landscape, psychosocial practice is by necessity a constant innovation. Dynamics on the ground in a post-conflict state are fluid and challenging. The sustainability and relevance of psychosocial practice in post conflict states demands sensitivity to this fluid dynamic. These dynamics are knowable and best appreciated by people on the ground, those working in the field. It is their voices we focused on in this study.

In this inquiry we wanted to expand our understanding of how MHPSS is designed and performed in a post-conflict country. We are especially curious about the innovative nature of this type of work. Broadly, innovation in health care is defined as

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both “innovativeness” and also, the “capacity to innovate” that leads to more competitive organizational learning. (Tamayo-Torres, et. al., 2010; Rogers, 1995 as cited in Ramendra, Sonya, Hsu & Fontenot, 2012). Specifically, innovation could mean anything from “introducing a new good, opening a new market, acquiring a new source of supply, introducing a new method of production…” (Schumpeter, 1934). However, innovation also refers to how an organization adapts to change and how it applies those adaptations in everyday practice, in pursuit of its mission and goals (Damanpour and Even, 1984, p. 393).

Innovation is a very useful lens to look at how psychosocial workers operate in a post-war country. Innovation in a professional context refers to any development of a process that enhances its efficiency (Jacques, 2011). Everything PSWs are mandated to do in a post-conflict state is a response and adaptation to change; in Sri Lanka, the change in context is from “armed conflict” to “post-conflict” status. Psychosocial workers in post-conflict countries are not exactly ‘re-creating the wheel;’ however, what they are doing merits attention. That is because the wheels they have to work with are quite different. Their context is unique. In a sense, it demands innovation. In this study, innovativeness is a way we understood how psychosocial service delivery workers generate ideas to help their clients, and how they put those ideas into everyday practice with a population in post-war Sri Lanka. Often these organizations have no option but to be innovative in conflict situations—in order to endure or not to draw attention to the work they are doing (Samarasinghe, 2014).

It is our hope that the data illustrated will be used to gather and generate ideas

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about innovative practices in psychosocial work in a post-conflict country. We believe these innovations can be influential toward peace-building and conflict resolution. Further, we hope to show how one must work outside traditional ideas of westernized mental health to instead consider broader aspects of psychosocial well-being during the reconstruction process in a post-conflict state. In fact, we believe it is the very context of the post-conflict state that can inadvertently enhance the innovation process.

By placing emphasis on the application of current psychosocial practice in Sri Lanka, this work addresses the call of Tol, et. al. (2011) to integrate research practices and inquiry with actual fieldwork on the ground. According to these authors, such an approach should include “interdisciplinary and multisectoral collaborations and strong partnerships between government ministries, researchers, non-governmental organisations, health professionals, affected individuals or caregivers, and communities...” (Tol et. al., 2011, p. 98).

THIS STUDY We chose to design and conduct a qualitative inquiry to best understand the psychosocial training strategies used by psychosocial workers in post-war Sri Lanka. The primary participants included 13 psychosocial workers placed throughout different locations in the North and Eastern regions of the country. Focus group interviews were conducted in Colombo in November 2012. Formal analysis of the data, including transcribing the interviews and qualitative coding methods to discern specific themes and patterns, took place from January-September, 2013. In November 2013, preliminary results of the analysis—categories and themes from the interviews—were presented to

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the participants and other research stakeholders in a seminar we convened in Colombo. In this setting we conducted member checking and also refined our analyses. It was also recommended at that time by the stakeholders to publish the study in Tamil and Sinhala, and the authors sought and received funding for that purpose. Following the meeting in Colombo, a second phase of analyses was completed, to better clarify and make sense of the data. The work presented here is the result of those efforts.

CONDITIONS IN A POST-CONFLICT STATE The International Development Association (World Bank) defines “post-conflict countries” as those which have (1) suffered from a severe and long-lasting conflict (2) experienced a short, but highly intensive, conflict leading to a disruption of IDA involvement (3) or a newly sovereign state that has emerged through the violent break-up of a former sovereign entity. In 2009 a 30-year separatist conflict in Sri Lanka was defeated, decisively, by government forces. Post-conflict, the country is experiencing economic prosperity and an increase in foreign direct investment. There are new roads, new infrastructure, and a gradual reappearance of tourists. However, intrastate conflict in Sri Lanka has left a myriad of consequences on individual, family, and community life. The repercussions of forced displacement of families and children, the effects of torture, maiming, the changed livelihoods of survivors, and disappeared or unaccounted for family members, are but a few of these consequences.

Further, due to the intense movement of people during and after the conflict, Sri Lanka now has a revised demographic makeup. For example, in communities where there has been a disintegrated social support system, such as the North, there is a large increase in female-headed households. Combined with an increased presence of military personnel 14


and militarization in the region, sexual and gender-based violence is a consequence of the conflict (Samarasinghe, 2014). Other critical issues include the rehabilitation and reintegration of former combatants into communities.

Phama, Vincka, and Weinstein (2010) described the challenging circumstances in conflict-affected states quite well:

In addition to casualties, wars and violence destroy infrastructure and the institutions that sustain a society, such as rule of law, health care and the educational system. Violence also leads to long term physical, social and psychological effects among survivors who may have lost family members, those who no longer have the means to sustain their livelihoods, or who have experienced amputation, disfigurement, displacement, torture, abduction, sexual violence, malnutrition and disease (p. 98).

It is precisely these ‘long term, physical, social and psychological effects’ on survivors that inspire the work of mental health and psychosocial projects in Sri Lanka.

MHPSS projects are delivered within fragile, conflict-affected states in part because psychosocial needs are a part of public health and well-being that are seen as owed to every person as a result of international law (Cryer, Friman, Robinson, and Wilmshurst, 2007). Conditions in conflict-affected states tend to put citizens’ mental health and psychosocial support needs at risk. The increased efficiency and delivery of mental health services has the potential to benefit the overall economic potential of the

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country (Andrimihaja, Cinyabuguman, Devarajan, 2011), in addition to its stability and security. Yet it can thus be a challenge to identify relevant and appropriate needs in such settings, precisely because of their dynamic nature (Batniji, Van Ommeren & Saraceno, 2005).

THE ROLE OF NGOS IN A POST-CONFLICT STATE In the Westphalian era, states’ authority was unquestioned by external actors. Based on the integrity of a territorial border, security was about protecting those borders. Yet, the types of conflicts that are increasingly threatening to states today are very different than protecting the integrity of a border. In this era, states face challenges presented by “non-traditional threats” (Mathews, 1997). These non-traditional threats are often intra-state issues, which confront a traditional view of security being solely about sovereign protection. NGOs are not a new phenomenon. They have played a role in “developing international law and organization for more than 200 years” (Karns & Mingst, 2010, p. 231).2 Overall, NGOs’ mandates and expertise are broad. NGOs often fill an important vacuum in a post-conflict state; they can do things that the state has been unable to do. For example, they can provide expertise and services that states sometimes cannot or will not.3 NGOs tend to have: (1) Capacity to claim representation of vulnerable populations

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Among other tasks, NGOs “seek to change the policies and behavior of both governments and IGOs and secure changes in international laws, and to make a difference” (Karns & Mingst, 2010, p. 226). 3 As Mathews (1997) puts it, “NGOs are quicker than governments to respond to new demands and opportunities….[and] can outperform government in the delivery of many public services” (p. 63). According to Karns & Mingst (2010), “In a few unusual cases, NGOs take the place of states, either performing services that an inept or corrupt government is not doing, or stepping in for a failed state” (p. 224).

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or key issues, (2) Broad and deep levels of expertise and access to expertise; and (3) Flexible organizational nature of their transnational and cross-institutional collaboration. The sustainable presence and performance of an NGO’s expertise, be it medical, educational, or humanitarian, demands attention to the working relationship between and NGO and the state. The state is pressured to perform differently by the presence of an NGO. Similarly, NGOs cannot ignore the politics of governance; doing so may jeopardize their mandate. From a social constructionist perspective, NGOs play an important role in terms of transmitting both information and ideas that cannot be accessed any other way (Karns & Mingst, 2010, p. 252). NGOs are often also able to mobilize the public in ways that may be more efficient than states.4 This is particularly relevant when it comes to promoting psychosocial health and well-being in communities. Moreover, NGO’s unique organizational innovation—often performed across borders and alongside international organizations and other NGOs—are interdisciplinary and transnational, and thus, tend to operate in a less hierarchical form than governments (Mathews, 1997). Additionally, NGOs often are able to access, through their advocacy or transnational partnerships, people’s experiences on the ground, something states may struggle to achieve. NGO RESEARCH PARTNER: FAMILY REHABILITATION CENTRE (FRC) The mission of Family Rehabilitation Centre (FRC), a non-governmental organization (NGO) headquartered in Colombo, is “to provide holistic treatment and care to those who have been affected by trauma, whilst lobbying and advocating to prevent trauma in Sri Lanka.” FRC collaborates with non-governmental and governmental

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Traditional state-based actors are “caught off guard by the speed with which global civil society used the Web to effectively mobilize people” (Karns & Mingst, 2010, p. 220).

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organizations on the goal of rehabilitating those affected by trauma as well as those working towards the prevention of trauma in Sri Lanka. In fact, supporting and advocating those affected by trauma in Sri Lanka has been its primary concern since its inception in 1991. In post-war Sri Lanka, the goal of FRC has shifted to focus on the rehabilitation and prevention of trauma. FRC also has something of an illustrious history. It was started by Dr. Anna Donney and Dr Radhika Coomaraswamy in 1991. Dr Coomaraswamy would later go on to serve as the U.N. Special Rapporteur on Violence Against Women, and later, as the U.N. Under Secretary-General, Special Representative for Children and Armed Conflict. FRC’s mandate is specific. Yet, it is an NGO that takes a broad, systemic view of how the effects of trauma cut across the population and communities of Sri Lanka. FRC provides services and support to “All Sri Lankans irrespective of their ethnicity or religion; their sex or gender; their age or social status or their political affiliations . . . who have been subjected to physical and or psychological injury caused by violence and or acute stress in Sri Lanka or overseas [and] dependents and close relatives of Sri Lankans victims who are still suffering as a result of physical and or psychological injury caused by violence and or acute stress in Sri Lanka or overseas.” The populations served by FRC reflect the changing conditions during Sri Lanka’s periods of armed conflict, ceasefires, and natural disasters, such as the Boxing Day Tsunami. In 2010 many NGOs left Sri Lanka, and this also had a formidable effect on FRC’s work. At that time, FRC started their VTTP (Victims of Trauma Treatment) project with TAF Funding; the VTTP project was a follow up of RESIST program from 2005-2011. RESIST focused on reducing the effects and incidences of trauma.

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FRC’s support of Sri Lankans affected by trauma focuses very much on the context of armed conflict and internal violence in Sri Lanka. For example, FRC started as a result of the Janatha Vimukthi Peramuna (JVP) insurgency. Over its last two decades, FRC’s focus on rehabilitation for those affected by armed conflict has remained constant, as did a goal to provide holistic care and increase awareness in communities about these programs. Admirably, FRC remains conscientiously attentive to the larger context in the country. They have adapted their services to the needs of the population, throughout a very complex set of changing circumstances in the country over the years. For example, in 1995, FRC’s mission statement included a more explicit reference on addressing ethnic harmony in its goals; in 2008, they focused specifically on torture survivors and severe trauma. Throughout its history, FRC’s working areas have encompassed nearly all of Sri Lanka and FRC has been funded by many international organizations, including TAF, UNHCR, DRC (EU), CIDA, NORAD, UNVFVT, UNICEF, IRCT, DANIDA, CARE International, and USAID. Since 2011, FRC’s focus is specifically on the Eastern Region (Ampara, Batticaloa, and Trincomalee), the Northern Region (Jaffna, Kilinochchi, Point Pedro, Mannar, Vavuniya, and Mullaitivu), and Anuradhapura in the North Central region.

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CHAPTER TWO: METHODS Research design –the plan or proposal to conduct research—occurs at the intersection of philosophy/worldview, strategies of inquiry, and specific data gathering methods (Creswell, 2009). Qualitative approaches tend to have a constructivist worldview and may have an ethnographic design, including participant/observation. The goal of such an approach seeks to “establish meaning of a phenomenon from the views of participants” (p. 16, Creswell, 2009). The objective of this project was to highlight and document how PSWs in a post-war country describe their approach to working with individuals, groups, and families who have experienced the aftermath of conflict in the region of the country most affected by the war. To conduct the research, the equivalent of Human Subjects Approval was obtained from the administration of the Family Rehabilitation Centre, the Colombo-based NGO involved in the project. Permission to record the interviews, analyze content, and publish research findings was granted by the NGO, and signed by representatives of all stakeholders involved in the project. A NATURALISTIC APPROACH TO THE RESEARCH QUESTION The research questions guiding this project had to do with our interest in the specific strategies used by psychosocial workers in their efforts to help communities in post-war Sri Lanka. We were interested in highlighting how relational approaches are utilized in the aftermath of conflict, and in relation to the broader political and economic factors in the country. Specifically, we wanted to ask: What strategies did PSWs use to work with their clients? Did what they do in a session differ from what they were trained

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to do? What had they learned from their work with the population? We wanted to understand their process by asking about and listening to their descriptions of it. The methods we chose allowed us to comprehend, synthesize, and recontextualize (Morse, 1994) the data collected to answer these questions. The research approach we took to this project was informed by assumptions of naturalistic inquiry (Lincoln & Guba, 1985). In a naturalistic inquiry, the researcher explores meanings and experiences of people rather than on confirming a pre-existing hypothesis. Our questions were about understanding a process. A process is not a hypothesis that can be confirmed or rejected—it has to comprehended; it has to be understood. One way to refine this comprehension is through thick description (Geertz, 1973) of a phenomenon. The descriptions are best told by those emic to, or “inside,” the phenomena. How do the PSWs describe it? The process we were interested in understanding better was the process of PSWs’ work with their clients in post-war Sri Lanka. How do they describe their work on the ground with the war-affected population? Designing and carrying out a study to reach this goal required research methods that are contextually sensitive and that elicit descriptive information about complex interactions. Thus, a qualitative inquiry using specific interview methods was tailored to fit the research curiosity and the setting of the study. We used in-depth focus group and individual interviews as our primary data gathering method. However, aspects of participant observation, fieldwork immersion, ethnography and appreciative inquiry also played a part. In a broad sense, we were also interested in understanding, from a relational perspective, innovative practices that focus

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on psychosocial well-being in the context of a post-war Sri Lanka. Thus, methods of triangulation were used with the stakeholders and those who directly support the PSW work inside the country. This included collaboration between the authors inside and outside Sri Lanka, and ongoing dialogue with staff members of each partner organization involved, throughout the three years of this project.

QUALITATIVE RESEARCH A core assumption inherent to qualitative research is that people are experts on their own experience. The methods researchers choose to understand that experience are highly specific to the focus and goal of the research question. Further, in qualitative inquiry in the naturalistic paradigm, the researcher’s orientation is always inductive. The researcher tries to develop “concepts, insights, and understandings from patterns in the data, rather than collecting data to assess preconceived models, hypotheses, or theories” (Taylor & Bogdan, 1984). Qualitative researchers attend to meanings, not “facts” nor “causes.” The meaning that researchers are most interested in is that of the participants in the study. It is the perspective of participants that becomes critical to understand. Research in this tradition means the researcher becomes the instrument of the process. What is “discovered” is bound by context and is mutually shaped by the researcher and the research participants (Lincoln & Guba, 1985, p. 37). EMERGENT DESIGN Qualitative design in this tradition is “emergent” design. The research inquiry is structured and the design is prepared in advance; however, the researcher also has to be flexible in modifying the design as she learns more about the phenomena. The design is thus both structured and evolving. The evolving process is shaped as the researcher 22


interacts with the setting, the “data” and the people providing the data—i.e., the participants (Lincoln & Guba, 1985). Research in this tradition is thus recursive; the questions and data must be allowed to inform the design, and the design must be flexible enough to respect the fluidity of the process. Below, we will discuss the methods used, and describe the collaborative efforts we undertook to design and implement the research inquiry. DATA COLLECTION METHODS FOCUS GROUPS AND ETHNOGRAPHIC INTERVIEWS

Focus group discussions were the primary method of data collection. Focus groups are interviews with small groups of people on specific topics of conversation (Patton, 2002). They are particularly useful in cross-cultural interviewing or with marginalized populations, and have been widely used with ethnic minority communities (Yeh, Kim, Pituc & Atkins, 2008). Focus groups are a valuable way to collect information; participants have an opportunity to share ideas and opinions with each other, while developing social networks and peer interactions at the same time (Yeh et al., 2008).

In this case, when the interviews were conducted, the PSWs did not all know each other. Many new staff had been hired after a recruitment phase, and it was the first time this particular and specific group of PSWs had all been together. Thus, the time spent in focus groups was very much intertwined with their new and developing peer interactions. Focus groups were conducted in English by the first author, and translated in situ (as they occurred, in real time) into Tamil. Tamil speaking participants’ responses were then

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translated in situ into English during the actual interviews. Transcripts were constructed from the raw data of the verbally translated Tamil-to-English responses.

Ethnography (Spradley, 1979) also influenced the inquiry process. In this study we used focus groups as the main source of data collection; however, we augmented this with several ethnographic interviews. Ethnographic interviews are open-ended, unstructured, and ‘sacrifice uniformity of questioning to achieve fuller development of information’ (Weiss, 1994, p. 3). Ethnography is a method but it is also characteristic of a research stance, consistent with social constructionism and appreciative inquiry. As Spradley (1979) put it, “Ethnographers adopt a particular stance toward people with whom they work. By word and by action, in subtle ways and direct statements, they say, ‘I want to understand the world from your point of view. I want to know what you know in the way you know it. I want to understand the meaning of your experience, to walk in your shoes, to feel things as you feel them, to explain things as you explain them….” (p. 24).

The ethnographic interviews were an outcome of the study’s emergent design. They became very useful as a way to further understand meaningful information from participants about how they conduct their work. In this study, the interviews of individuals were added on after a participant had made a comment relevant to the research question in the focus group, which could not be, either for reasons of time or privacy, further discussed in the focus group.

TRUSTWORTHINESS

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A qualitative researcher strives to achieve trustworthiness by assuring that the study is accountable (Lincoln & Guba, 1985). In naturalistic inquiry, the researcher assures trustworthiness by addressing the study’s confirmability, dependability, credibility and transferability. Respectively, these four concepts are parallel to quantitative constructs of objectivity, consistency (reliability), “truth value” (validity), and applicability (Lincoln & Guba, 1985.) CONFIRMABILITY Confirmability rejects the notion of objectivity and rather, emphasizes accuracy of the data itself. How is accuracy addressed during the data collection, analysis, and documentation phases? Confirmability was addressed throughout the study; however, it was perhaps during the interview process that it seemed most evident. The interviews were conducted in English, translated into Tamil by a Sri Lankan fluent in English, Tamil, and Sinhala. The translator, Prashal, a staff member of the NGO, is a person familiar to both the 1st author and the PSWs from previous training programs and NGO projects. It was a huge asset to work with a translator who was so familiar with the group of PSWs.

In this study, confirmability was also very much tied to the collaborative research design. Although I (LLC) had worked with FRC before, most of my contacts in Colombo were in other organizations, and had been at the level of an international, rather than regional, NGO. In fact, when I designed the research project, I did not have a specific NGO in mind as a stakeholder in the project. Since 2010, I had worked with several different NGOs, and I knew there were many more of them in the country. One of the research stakeholders, TAF, supports several local NGOs in Sri Lanka. The type of

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support they provide is critical to the ongoing operations of local organizations that might be lacking in logistical or structural support to complete their mission and projects (Samarasinghe, 2014).

For the project to achieve trustworthiness—particularly confirmability—I knew I needed to be as inclusive as possible of local stakeholders in every step of the project. I also felt strongly that there was potential utility of the project for the participating organization. A research product that illustrates how PSWs describe and implement onthe-ground work with families who have survived the conflict could be very useful information for any organization working in MHPSS—perhaps even part of its “brain trust” and institutional memory.

DEPENDABILITY Dependability refers to the consistency of the study, rather than its accuracy. How does the researcher take into account “both factors of instability and factors of phenomenal or design induced change?” (Lincoln & Guba, 1985, p. 299). One way we addressed dependability was the collaborative process we established to study the phenomena of psychosocial innovation in post-war Sri Lanka, and how to conceptualize and plan the design of the project. At the time the first author received confirmation from the TAOS Institute that the research had been funded, I (LLC) was actually in Colombo, about to conduct a training program on “Self-Care” for psychosocial workers. It was a perfect moment to arrange a meeting with the potential local partners in order to implement the inquiry.

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In April, 2012, I met with the second author, Dr Samarasinghe, as well as a third colleague working at the time as Program Director at TAF (The Asia Foundation). We discussed the goal of the research, to document how psychosocial workers in the project describe and perform their work, considered a time frame for inquiry, and brainstormed how this might be a useful research product for some of the local NGOs focusing on MHPSS strategies in contemporary Sri Lanka. It was at this time FRC was suggested as a possible local partner, and after a meeting together with its Executive Director, Lahiru Perera, FRC agreed to participate in the inquiry. At this meeting with Lahiru, we also discussed the logistics of the interviewing process. FRC PSWs are located across the north and eastern regions of Sri Lanka; they are not based in Colombo, although that is the location of FRC headquarters. As FRC typically convenes a training program for the PSWs in November of each year, it was suggested that might be a good time to add on two days to conduct the focus groups. Helpfully, TAF agreed to pay the cost for the FRC PSWs to lodge and travel to Colombo from their fieldsites. As part of the agreement, I also agreed to provide a no-cost day-long training on a topic that the NGO was especially interested in offering to the PSWs. CREDIBILITY The credibility of a study refers to how the researcher shows that the data is representative of multiple constructions there are about the phenomenon and that the reconstructions (made by the researcher) are “credible to the constructors of the original multiple realities” (Lincoln & Guba, 1985, p. 526). In this study credibility was enhanced by prolonged engagement. For the first author, Laurie Charlés, engagement in post-war Sri Lanka and its unique form of mental health and psychosocial support involves time as

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both a resident and a consultant in Sri Lanka. Living and working there as a Fulbright Scholar and later as a consultant/trainer has allowed me time to immerse myself in the place and in the literature over several years. During this time I have also been able to have numerous conversations with practitioners, researchers, and professionals from a variety of sectors. For the second author, Gameela Samarasinghe, mental health and psychosocial support has been a critical part of her career; she is both the coordinator and the originator of the Post Graduate Diploma in Counselling and Psychosocial Support (PgD.CP), as well as a new PgD.CP master’s program at the University of Colombo. Gameela’s work has focused on the psychosocial dimensions of fragile and conflictaffected states her entire career, working and writing about this area both in and outside Sri Lanka. For both of us, visiting PSWs in the field and discussions with other MHPSS workers, trainers, and professionals throughout the post-conflict reconstruction period in Sri Lanka has helped us to explore “aspects of the inquiry that might otherwise remain only implicit” (Lincoln & Guba, 1985, p. 308). This type of engagement was a way to “identify and assess both ‘salient factors and atypical happenings’” (Lincoln & Guba, 1985, p. 307). For example, erroneous hypotheses or negative case analyses can be minimized by peer debriefing and member checking (participant validation), “whereby data, analytic categories, interpretations, and conclusions are tested with members of those stakeholder groups from with the data were originally collected” (Lincoln & Guba, 1985, p. 310).

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As a way to increase credibility, preliminary analyses of the focus group discussions were presented to research participants and stakeholders in November 2013. After discussing preliminary analyses and discussions between us as co-authors, I (LLC) gave a workshop to check out the responses from the participants, incorporate their feedback, hear their interpretations, and make corrections to the transcripts. Although there were no further interviews at this time, there were many informal discussions with the participants and stakeholders. This was extremely critical for examination of the reconstructed data. In addition, I (LLC) met with the ED and his staff a few days after the presentation, on November 29, 2013, to hear their feedback and discuss the form of the final research product. They were highly interested in the findings and surprised by many of the comments of the PSWs. It was at this meeting we discussed the necessity to translate the document in Tamil and Sinhala, in addition to English; I agreed to write a second funding request for this purpose. In addition, we made a plan for how to stay engaged in discussions about the research analysis and its eventual dissemination. TRANSFERABILITY Transferability refers to how we account for our reconstruction of the data. How does the researcher demonstrate accountability, both to the phenomenon under study and the methods used to study it (Lincoln & Guba, 1985)? In a sense, transferability is a way to make the inquiry process more transparent, such that it could be replicated. Transferability is best achieved by “thick description” of the phenomenon (Geertz, 1973). In this study, developing a thick description took fieldwork, peer debriefing with in-country experts and consultants, focus group and individual interviews

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enhanced by ethnography, prolonged engagement, and careful attention to self-ofresearcher issues. Janesick (2004) recommends reflection and self-evaluation exercises for researchers to processing experience can be a way to maximize reflexivity, that ‘‘capacity of the researcher to acknowledge how their own experiences and contexts (which might be fluid and changing), inform the process and outcomes of inquiry’’ (Etherington, 2006, pp. 31–32).

RESEARCH PROCESS IN THE FIELD

DESCRIPTION OF PARTICIPANTS Thirteen PSWs participated in the interviews, and seven focus group interviews were conducted. Each focus group averaged 1.5 hours in length. Many of the PSWs were new to the NGO, having been hired after their projects closed down and other NGOs left. However, this did not mean they were inexperienced. Several had been PSWs at other organizations previously operating in Sri Lanka, including MSF and WorldVision. They had a range of experience from 20 years to 2 months. They were all Tamil and Tamil was their primary language, although some Sinhala and English was evident in the group. They shared a wide variation in age, professional and personal experience, as well as Muslim, Christian, and Hindu religious backgrounds. Participants worked as PSWs in the following locations in Sri Lanka: Two in Kilinochchi; two in Point Pedro; two in Mannar; two in Vavuniya; one in Trincomalee; two in Batticaloa; and two in Ampara. They ranged in age from 26 years to 52 years with the median age 34. Five of the PSWs were men and eight were women.

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DATA RECORDING PROCEDURES Consent forms to have research data audio or videotaped were translated into Tamil by staff of FRC. At the time of the focus groups, the consent forms were distributed and signed by all participants. As the PI, I (LLC) kept the originals and gave copies of the consent to the local partner, Family Rehabilitation Centre, in Colombo. It was also at this time that the equivalent of an IRB—the mutual consent for research to be completed—was signed by the authors and administrators of the NGO. Interviews were conducted over two days in Colombo. All of the interviews were audiotaped using computer software on a Macbook pro.

Several months prior to the interviews, the authors brainstormed and refined a set of “grand tour” (Spradley, 1979) questions to organize the focus groups. These questions (below) were also shared with the NGO prior to conducting the focus groups. However, when time came to conduct the interviews, the questions we had prepared no longer fit in quite the same way. When the questions were designed, a different set of PSWs had been working with the NGO. Therefore, not all the participants could answer the questions. The order of the questions varied throughout the interview process, as happens quite often in qualitative research. In this study, the order was influenced by the interactions among the participants and with the interviewer, and also, by the changed makeup of the PSW group. Further, some questions became much more generative than others, and other questions generated data that required more exploration in an individual interview. Following are the initial “grand tour” questions we constructed.

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● Can you describe your role as a PSW in the current context of Sri Lanka? ● What tools/ideas/strategies do you use the most in your role as a PSW? ● What technical skills do you practice that you have found best help you in your role as a PSW? ● What do these skills help you accomplish? ● Does what you were trained to do as a PSW differ from what you actually do with your clients? How? ● What have you learned “on the job” as a PSW that helps you do the work? ● What is most surprising about your work as a PSW? ● Can you describe any strategies you have found help your work as a PSW? How did you come up with these strategies? ● What would you recommend to PSWs in post conflict countries, newly starting out, about the best skills they will need to do their work?

APPROACH TO ANALYSIS

In this study, the research philosophy, strategies of inquiry, and methodology strategy was operationalized in the way we best thought could glimpse the intimacy and richness of how PSWs describe their work with clients in post-war Sri Lanka. The analysis process was similarly multi-layered. In this type of research, data collection and analysis processes occur somewhat together; data collection and analysis are simultaneous (Creswell, 1994.) However, analyzing the data of the focus group and individual interviews did involve a different phase in the research. In the next section, we will discuss how the data were re-constructed and analyzed, and illustrate some of our

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interpretations.

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CHAPTER THREE: PRESENTATION OF THE DATA & ANALYSIS PROCESS

Qualitative research is a descriptive process; its nature as a form of inquiry requires that description be applied to both the interpretation of the data, as well as the manner and the means of the interpretation (Chenail, 1994). In this study, the next step after gathering data in the focus group and individual interviews was to transcribe and analyze the interview content.

When I (LLC) sat down with all of the transcripts, I used a method of coding consistent with Glaser & Strauss (1990), but in the contemporary tradition discussed by Kathy Charmaz (2000). That is, I coded data for themes, but often circled back to the context in order to try to make sense of them and their relevance to the research question. First, I focused on coding in the tradition of Glaser & Strauss (1990), who suggested the use of open coding as: "The process of breaking down, examining, comparing, conceptualizing, and categorizing data" (p. 61); axial coding as “A set of procedures whereby data are put back together in new ways after open coding, by making connections between categories” (p. 96); and selective coding as the “process of selecting the core category, systematically relating it to other categories, validating those relationships, and filling in categories that need further refinement and development" (p. 116). The coding was strongly influenced by Charmaz (2000) whose ideas supported

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my constant comparison method, allowing me to “systematically compare data to all other data in the data set” (O’Connor, 2008). By using a constructivist approach (Charmaz, 2000) to inform the coding process, I was able to overtly acknowledge and incorporate the social context that informed the work of the PSWs. I was also able to maintain a naturalistic approach and appreciative stance toward the inquiry. Thus, the coding was constantly negotiated in reference to the context in which it occurred. Charmaz (2000) describes a constructivist focus to this method by focusing on the researcher’s constructs throughout the process and how she accounts for “the study’s contexts and the researcher’s standpoint, priorities, and interactions” (Bryant & Charmaz, 2007, p. 10). My goal was similar to the way Charmaz (2000) characterized it. I could focus on the “mutual construction of knowledge by the research and participant and the ability to develop subjective understandings of participants’ meanings” (Charmaz, 2000, p. 510). CODING PROCEDURES: THREE PHASES After collecting data, researchers attempt to analyze and “code” it, using epiphanies, understandings, and impressions from the iterative analysis process to inform the presentation of the data. In this project, I often used coding as a way to circle back to incorporate and make sense of what the context was. The process of coding emerged in three distinct phases. The first phase involved my initial impressions of the data, but was very much informed by the participants’ responses to those impressions. This occurred at the time I (LLC) went to Sri Lanka in November, 2013 to present the initial impressions of the inquiry—which I called preliminary

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analyses—to the participants and stakeholders during the participation validation process in Colombo. After the participant validation process in Colombo, the second phase began. I returned to the data with the information and understandings provided by the research participants and stakeholders in Colombo, and revisited the data. I used these constructions to look again at all the interviews more in depth, for themes and categories that were repeated across the interview transcripts. In particular, I often came across specific, repeated words or phrases (such as “torture,” “capacitybuilding,” or “respect”); however, I also came across repeated ideas that were much broader. These included the role of religion and how it informed a PSW’s attitudes toward clients and others in society; how theory and training was useful only in addition to practical and personal skills; and what it was like for PSWs with various experiences of the conflict and violence to work with clients sharing that same category of experience. When I seemed to have a clear set of themes and categories in this second phase—words, phrases, and ideas—I began to analyze all in more depth by trying to organize them and understand their relationships to each other in a coherent way. This process involved several discrete steps. (1) Identifying the units of meaning; (2) Assigning categories to the meaning through labels (using direct words and phrases of participants); (3) Analyzing these reconstructed data bits in terms of their relationship to each other (Miles, Huberman & Saldana, 2013). For example, the numerous comments that mentioned torture could be organized in relationship to several areas—what it is like to work in a conflict-affected state, where torture has been ubiquitous, and, also, 37


strategies of innovation PSWs had learned to work with this presenting problem.

When challenges of understanding emerged—and they did throughout every phase of the process—I tended to go back first to the transcript and study it further. Sometimes, I also went back to the session recording itself to relisten and revisit it. I compared what I thought I had understood across other themes and categories in the data. I also went back to the research question(s) repeatedly as a way to stay focused on the inquiry questions. The goal of the inquiry was to view MHPSS work as it was described in ways that illustrated the nature of a fragile-conflict affected state. We were curious about the strategies, tools, and ideas that seemed “innovative” or demonstrated an “innovative capacity.” In this way, some things that at first seemed to be categories had to be ruled out of the presentation of the data.

I constructed a revised set of themes and categories in this second phase. Particularly, I focused on comments that were most relevant to the research questions, and the specificity of that comment (data bit) to the research question. When I was uncertain of its relevance, I went back to the research questions and asked: Does this excerpt tell me something about how the PSWs conceptualize and implement their work? Does it say something about strategies they use, develop, or innovate? Does it illustrate something about the uniqueness of psychosocial support in post-war Sri Lanka? Keeping this in mind as the criteria, I could more easily make consistent and informed choices about the data’s relevance and position.

In the third phase, I revisited the themes and categories in more depth, focusing

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on the coherence of their relationship to each other. In this phase it was also useful to return to the transcripts—and this is where the work of Charmaz (2000) was so useful. It allowed me to develop understandings of the social context in which the data had been gathered at this point in post-war Sri Lanka. Thus, in this phase I consulted often with the research team of stakeholders in Sri Lanka, and returned more to literature on Sri Lanka, its people, and the history of war and separatist conflict of the country. Sometimes, I listened again to the taped interviews.

In a sense I was asking the question Chenail (1994) had posed about the data analysis process: “Here’s what I am seeing. What do you think of my seeing?” In each of these coding steps, I gleaned a more in-depth and detailed analysis of the themes and patterns. Overall, this in-depth and detailed lens was a type of going “back and forth” process, by which emerged each time clearer and more refined patterns in the data (themes and categories within the themes), specific to the purpose of the research inquiry: Psychosocial practice and innovation in post-war Sri Lanka.

The themes are presented below, using exemplars to illustrate the categories in each theme. First, I describe how I approached the interview process. I discuss some ethical and data collection matters in this section of the findings, as the information I began to learn in the focus groups required me to circle back to emergent issues in the context that were unexpected, yet typical for this type of inquiry. The information I learned early on meant that I had to restructure the focus groups, given what I was learning in situ. That emergent process is described in the next section.

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DESCRIPTION OF INTERVIEWS

I conducted focus groups and individual ethnographic interviews with 13 psychosocial workers and two staff members of the organization partner. All participants signed consent forms to participate in the research, and although the organization is named in this book, the names of the participants have been changed. For the first set of focus groups I did, I divided the group of PSWs in half, creating two focus groups. It seemed that doing this would be a good way to ask about general questions about the experiences of each person, their descriptions of themselves as providers of psychosocial support, and also, information about their background (such as caste and religion).

The question about background seemed relevant for two reasons: (1) The group was extremely diverse; (2) The group had mentioned caste and religious background many times and in unique ways (unique for me) prior to the focus groups. According to Hussein, “casteism is deeply rooted and firmly entrenched in Sri Lankan society” (2013, p. 1). Hussein defines caste as

“a largely homogeneous group of people who are almost invariably endogamous and who claim descent from a common ancestor or a close association from the distant past. A caste also professes to follow a common hereditary calling. Since caste is hereditary and determined by birth alone, one cannot move out of it. Nor does one have any opportunity for social mobility. One’s place in the overall social structure is fixed, and it is this feature that distinguishes caste from other forms of social stratification” (2013, p. 1).

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I became curious about—and if—the PSWs diversity—in this case, identities

related to caste and religion, among other things, was reflected in their work as PSWs. I wondered if it had anything to do with their strategies, interventions, or how they conceived of their work? However, I could not really ask about this in an informed way until I had some more information about their specific background—caste, and religious identity—in the first place. Essentially, I was asking about their social location—or intersectionality.

It was in this first set of focus groups that I could see who and how to further divide up the participants for a second set of focus groups. I either noted a comment related to the research question, or noted something compelling that I wanted to understand better. For example, when it became clear in the first set of FGDs that three women were highly experienced PSWs –and had very similar but unique ways to talk about their work—it seemed a good idea to interview them as one focus group on the next day. Similarly, I had had many more male Sri Lanka PSWs in front of me than I had had at any other time I’d done work in the country. Perhaps I needed to do a FGD with them? This later FGD revealed information about a case of torture, in which the gender of the client/PSW dyad had had a significant implication for the treatment.

Further, there were some very compelling individual statements made in the first day’s general FGDs. I began to reflect on possible ethnographic, individually focused PSW interviews. In one of these later interviews, a male PSW talked about his experience during the time of the final battle in the war, in May, 2009. This comment resulted in my interviewing this PSW alone, to talk further about how he was able to perform his work

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with former combatants.

A CHAMELEON CHANGING ITS COLORS: THE ROLE OF PSYCHOSOCIAL WORKERS IN POST-WAR SRI LANKA One of the first things I was interested in clarifying with the PSWs was how they viewed their role? How did they define it? How would they describe, in their own words, what it means to be a PSW in post-war Sri Lanka? Further, I was curious how their descriptions would match up with what is written in the literature about MHPSS and its role in post-conflict countries. Tol, et. al. (2013) has pointed out there is a large gap between what is written about MHPSS practice in the literature, and how MHPSS is actually performed on the ground. Although Tol et. al. (2013) had not been published at the time of these focus groups, I had wondered about this gap as well in a previous project (Charlés, 2010). Further, it seemed like an obvious question to ask about caste, after I had learned a little bit about the group. Caste came up serendipitously in our discussions about their previous experience before working for FRC, and gave yet another dimension to my understanding of their identities as psychosocial workers in post-war Sri Lanka.5 Following is a summary of the PSWs responses to my query: “Can you give us your definition of what you see your role is as a psychosocial worker? “Works with the people who need psychosocial help.” “Also providing help to the people towards them. To strengthen them.” 5

It is important to note that the caste system is a prominent part of the Tamil Hindu culture in Sri Lanka. However, it is perhaps less so for Sinhala Buddhist, and Tamil & Sinhala Christian cultures in the country.

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“As a good guide for whoever needs help.” “The person who identifies the needs, the critical needs and the psychological needs of the people, and gives good guidance to them.” “I would say a person who understands the problem of the needy. If the person sitting in front of me, if I'm able to understand the problem and able to give support to them to overcome their problem, I can say I am a psychosocial worker.” “I think is a psychosocial worker to provide counseling to the client and through him to solve his problems.” “Also it can be to identify the real needs of the people who have been affected by war. Identifying their special needs and giving counseling and support to the people. This can be a psychosocial worker.” “Giving support to the needy without having any expectations.” “Provide professional help to their clients.” “Giving psychological support, advice, strengthening them to find a solution for their problems because those people have been affected psychologically, so they need the support to strengthen them to find a solution.” “According to me, everyone has a particular strength. During the distressing time, they forget that. Though as a counselor and other psychosocial worker, I am a tool to find those hidden strengths.” “According to my point of view, the person who is enrolling in the psychological field, the counselor or the social worker or the psychiatrist, they are like…they sacrifice and give light to others. Sacrificing and giving life to others.

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“The counselor is look like a mechanic, you know the mechanics is having one tool, and …………doing all the repair work, by using one key skill. …as the same the counselor is having 3 basic skills, like attending skills, and the good empathic response and questioning. So these 3 basic things. If a person he can do a good counseling so by using these three he can handle all kinds of clients, we can help all types of clients.” Suriya, a diminutive woman who had been quiet in the training program stated: “So I personally am feeling, I am a small part, but my motivation is big. I am little, but I am giving support to a lot of people. LIKE A CHAMELEON CHANGING ITS COLORS The responses to my question were quick and were very parallel in some ways. However, I was struck by some of the metaphors that were used by the PSWs. One in particular talked about PSW work as requiring flexibility and a wide skill set—an adaptability of sorts—“Like a chameleon changing its colors,” she said.

The chameleon metaphor was not the first thing the PSW had stated; rather, it was her response to a follow up question I had asked. The PSW had stated in her description of the work that this time in post-war Sri Lanka was an “ideal “time for people to come forward for assistance and psychosocial support.” Curious about that, particularly as it was relevant to the research questions but also because it seemed to indicate the PSW had a concept of timing for psychosocial support that I wanted to know about, I then asked: “You said that now is the ideal time for people to speak out, and even you were saying that timing really matters. So how long do they think this ideal time will last?”

My question is awkwardly phrased; in hindsight, it still seems to be incredibly

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unproductive to ask. Except, to my good fortune—or the research inquiry’s good fortune—the PSW answered a different question—a much better question—that I didn’t ask. Rather than discussing timing as something to put on a calendar, she talked about ideal readiness of PSS having to do more with her flexibility and multiple skills. It was perfect.

“According to me, I would say there is no time limit or timeframe. So whenever a client feels. So this is time I need to meet a counselor. I need to meet a counselor. I need to tell my problem to a counselor. That is the ideal time. But as a counselor, we cannot predict a time. So this is the time for counseling or this is the time for the psychosocial work, but when the clients think, this is the time for me to get counseling, that is the way. That is the right time. Yes. As a psychosocial worker, we have to be available at any time because we cannot say, ‘This is the available time. This is the time for counseling.’ The client has to say– the clients feel that this is the time for me to get the counseling, then the clients can approach us. We have to be available, and we have to take the different roles. I am a trauma counselor. I have to take people in droves at the right time. Like a chameleon changing its colors, my time—I cannot say that I can only do trauma counseling, but I would know the counseling to do the children's counseling, to do the family counselling. We have to have a multi-skill. So we have to have skills and knowledge about the problems, about the people.” We will discuss more of the multi-skills Anjalee refers to later in the chapter.

THE IDENTITIES I BROUGHT WITH ME: “SYMBOLS CHANGE

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BUT I GIVE THE SAME RESPECT”

PSWs had many a variety of experience levels and a variety of experiences they brought to their role within FRC. Roshine has been working for 6 years and as a PSW for 2 years. Varshika has been working in the field since 2005. Maraiyon has been in the field since 1996. Peter has been doing the work since 2005. Asokaya since 1996; Suriya has been working this field since 2005, but as a counselor for 3 months. One PSW had worked as a trainer (animator); another as a counsellor in Batticaloa for two years. Sange joined FRC 3 months earlier but before that, worked in another MHPSS program based in Jaffna for 2 1/2 years as PSW. Sima has been working as a psychosocial worker in FRC for 5 months but had worked as a psychosocial worker at the Center for Psychosocial Care for 4 years. Praveena recently joined FRC but has been working as a counselor, as the team leader, and as a program officer, since 2001. Anajalee has been working at an FRC district office since 1999 to 2007 as a field officer, then became a counselor and has been for nearly 8 years. Murali recently joined FRC, but before that worked as a psychosocial worker at nature center in another part of the country. Smail worked as a mental health assistant at a mental health unit for 4 years before joining FRC. THE IDENTITIES I BROUGHT WITH ME: “SYMBOLS CHANGE BUT WE GIVE THE SAME RESPECT” At this point, after introductions, I stated: “So one question I want to ask you before we go too much further is about your culture and background, because I remember some of you are Hindu, some are Christian, Muslim. I think everyone is Tamil,

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everyone speaks Tamil, but also some speak more than Tamil. Could you say just how you define your cultural background? Your religious beliefs? You called it caste yesterday.” PSW: I am a Roman Catholic, so I mostly pray my rosary. Where I go, I take it with me. So I believe it will be safer for me. PSW: I am also from the Roman Catholic, but I like to wear a sari. In the Hindu religion, people are always wearing sari. Even when I go to church and when I go out, I used to wear sari, and also I wear jewelry. [LLC]: Jewelry? PSW: Jewelry. [LLC]: Which is associated with any particular religion or–– PSW: But always is having this mark (refers to pottu). [LLC]: Yes. I forgot what it is called. Because you remember Karthika’s story about she took it off and on? The PSWs had discussed caste in our training day. As an icebreaker before the training, I had asked a question of the group: “Tell us one thing about yourself that no one here knows.” Karthika had talked about how she sometimes takes the pottu off and on, to change her identity or “pass” from one identity to another, as if she was crossing a border. Another PSW discussed how he practices respect and referenced this in terms of religious tolerance. PSW: Most of the time, I am respecting my leader, but at the same time, I am giving more respect to other leaders. Because I used to go to other temples and other religions’

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festivals. I attend the other religious festival celebration. I am giving more respect to other religions. The symbols of religion and caste were also part of the conversation: Female PSW: “Also in my culture, my mother always goes out. She goes with my father. It is my cultural identity, because it is the same way, I am also following them. If I go to my relative's house, I never go alone. I go with my husband. If I go alone, my relatives might think whether I have a problem with my husband. That is why I come along. That is why I go with my husband to my relatives. And also I am one of the Tamil ladies wearing the––[touches her necklace] [LLC]: Oh. You have a necklace. PSW: Also the Tamil, they are wearing rings also. [LLC]: Rings. Oh. That seems-PSW: That is part of our cultural identity, whether a particular woman has got married. PSW: And particularly I am Roman Catholic, but I did not bring any identities with me. [LLC]: What do you mean, “I did not bring any identities with me?” PSW: Like wearing the cross or––or also anything that is normally Christian. PSW: In my culture, we are following our parents and grandparents, what they observe. Even in our culture, we are observing many cultural events like we are observing fasting and we worship our gods, and every occasion we are following on that because of our parents, they are following. Even in a telephone conversation with my father in law also I am giving respect to my husband. § RESPECT

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[LLC]: How do your cultural identities or things you describe, how that might influence your work as a PSW in either a positive way or a negative way? PSWs: I have observed in my work experience the clients who are coming to us to get service are having yellow colored pottus6. People who got married, they are wearing the red color, but the woman who lost her husband is also wearing yellow or someone wearing black. But there is no bias, no differences. Even some ladies who lost their husbands, they are wearing the normal style, the color style, so there is not any big changes. But we respect them and treat them as equals. [LLC]: So the symbols changed–– PSW: Yeah. Symbols change, but the same respect. Although it is tacitly understood in most helping professions, especially the psychotherapies, that respect for clients is critical in order to best work with them, the way the PSWs in this study talked about respect was different. It was broad. It was inclusive of many aspects of their work a central part of their belief systems, enacted in relationship with others. Respect took many forms and was not only directed at clients in a two-way relationship. Rather, it seemed that respect was more of an internalized concept, a stance, a way of being. It infiltrated every aspect of their work and how they saw their identities as people as much as psychosocial workers. Many of them tied this position and practice of respect to caste and religion. “I am giving much respect to clients and then to my parents and my co-staff and my community. I am giving much respect to the clients.”

6

In Hindu traditions, a Pottu is a colorful dot that is placed on the forehead of women. The Pottu has social, cultural and religious significance. A red Pottu identifies a woman as married; a black Pottu is worn by young unmarried women. Traditionally, widows do not wear Pottus.

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“I respect the people I respect the job. Even though I love God, I respect the people and I respect my job.” “Our religions says don’t have judgment; be free of judgment; the same way we are not doing prejudgment of our clients.” PSWs put the respectful relationship between themselves and their clients very clearly in the category of equality, despite differing religious codes. They were able to extrapolate how religious respect transforms across their personal as well as professional relationships with others. In addition to the diversity of their experience, religious beliefs and caste, each of the PSWs were, of course, all Sri Lankans who had lived through the war themselves. Each of them had had a very different experience, sometimes very directly and other times very indirectly affected. As one stated: “We feel the same thing our clients are facing, so that is why we are able to give positive empathy to our clients.” However different their experiences of the war have been, the PSW in a post-war country brings many identities to the table. One PSW talked about his identity as a survivor as part of the strength he relies on to do his work. “According to me, I would say I have a good coping mechanism before I enter into this field. So after I entered it into this field, I extended those coping mechanisms so it is a factor for me… So after I became a counselor, I was improving my capacity. Now I am the person listening to others' problems, where earlier I was thinking I need to prioritize my problem first, because in the Vanni I lost my father. So I was worried and I thought I need to study and I need to find a job. I need to find work so I can take care of my family. So my thought was concerning my family. Moving into these cycles also I realized

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that…helping in another's life and taking care of another's life is improving my capacity to be a calm person.” Similarly, it was useful to hear how Maraiyon, a male PSW who had worked in a region where significant battles of the war took place, conceptualized his work today. Previously, like many Sri Lankans in the North and East, Maraiyon had at times found himself in the midst of the combatants and their activities. Yet today, he is a counsellor to former combatants. As he put it: “So my point of view, I understand the feelings and the feelings and the sufferings of the people who are suffering who are suffering because I was there. It is easy for me to understand the others' struggling. Easy to understand their feelings.” In a later individual interview, I asked Maraiyon about how he thought about his role as a PSW in post-war Sri Lanka, given his unique experiences during the war. [LLC]: “So I want to ask more questions about it. How can you—how do you be a PSW. How have you become a PSW to the excombatants?” “Because I respect the people I respect my job. Even though I love God, I respect the people and respect my job. … Working with combatants I have a hard time to bring their feelings out because still they are suspicious of others or since they have a pride or [inaudible], so they cannot express their feeling well. The difficult part for me to is to take out their feelings. So now the things are getting improved; the clients who are getting counseling already they are going to their village and bringing new clients. So they are telling, ‘this is what happened here. If you go there and you meet the person you can get the support.’”

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“WE ARE REBUILDING”: SPECIFIC PSYCHOSOCIAL SKILLS USED IN POST-WAR SRI LANKA The next category of themes is specific to the skill set that the PSWs named in different ways as most relevant to working in a post-war setting. In a sense, the quotes presented below are at the heart of this study. That is, they illustrate how what these PSWs are doing is unique not only because they are working in Sri Lanka, but because the people in Sri Lanka, the clinical population, has been affected by decades of armed conflict and war.

In the first exemplar, the PSW immediately names some of the effects of the war on his client, but also compares this with how different psychosocial support in Sri Lanka is from the body of knowledge about it. As Sluzki (2004) noted, most of this literature originates in high-income countries.7 The question I had asked was “What would I observe if I were to watch you conduct a psychosocial session in your village?”

“You can observe the differences between Western practices and our country. In our country, people are coming for counseling with maiming, who lost their legs or hands, and those kinds of people are coming for counseling. You can observe how these people are coming to counseling and how the psychosocial workers are providing counseling for them.”

7 “[T]he vast majority of influential publications and authors in the field of mental health worldwide are located in high-income countries” (Sluzki, 2004, p. 100).

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This PSW went on to talk about how FRC is distinct from other NGOs focusing on MHPSS in post-war Sri Lanka. Here, he describes what makes FRC different; however, he was not the only one to comment on the difference. “And also our focus is a holistic approach, so we are not only giving counseling. Also we are giving medical attention, physical therapy, and referrals, and networking, so we are giving all kinds of activities or services to the clients. We will be most helpful for the clients. But in other organizations, they are just giving counseling and not concerned about their medical physical therapy. Even we are giving and spending some money for medical checkups.” The fact that FRC has focused its mandate specifically on trauma directs their MHPSS efforts in very clear ways. Their services are meant to address trauma from a systemic and holistic perspective. As this PSW continued to note: “Also our organization is providing the counseling services for a specific target group. So say trauma survivors, right? But in other organizations, they are giving counseling for everyone. So there are specific groups, and we can give support to the specific groups.” OUR COMMUNITY NEEDS SUPPORT It seemed to me that these PSWs had some interesting ideas about how their work made sense in context of armed conflict and its aftermath. Curious both about the expertise of the PSWs—I have a tendency to see them as experts on their experience, which is part of both a research stance and my clinical orientation—as well as how their

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work might have relevance for other fragile conflict-affected states—I asked a question which, now nearly two years as I sit at my desk typing it up, seemed a bit prophetic.8 “You probably know you are able to––a country at war now, Syria––many other countries have a lot of conflict, war. So you are a PSW in a post-conflict country 3 years. So what advice would you give to PSWs starting out in another country about what you have learned that can be very helpful for communities?” “As an example, the war was going on, and during the past war situation, my district was affected, but the people who were living there were not experiencing much of the war. Because we were in ________the people that are displacing from the war zone, we are the 1st people to accept them. At that time, I got a chance to speak to clients, people who were fleeing from the war zone, and they said they had come through many difficult war events and they have lost many things and they were explaining their worries and their great loss. At that time I thought that people are coming from the war zone. They will not go back to that place. But within a few months very quickly, they went back to their original place, their home, and now they are in their original place and they are rebuilding their lives. The learning point is given to the other PSWs: the family culture. Because they are loving their original village, they are loving their people, because of that the people immediately go back home, their original place. Their resilience. They are resilient.” Working with a focus on supporting those affected by trauma due to the armed conflict, in direct and indirect ways, requires many skills but perhaps none more

8 As

I write this two years later, I am working as a consultant with the World Health Organization (WHO) to provide technical support to MHPSS teams in Syria. 54


important than a clear structure of how to approach the work. One male PSW, Sange, put it this way: “My working experience post-war context is that during a crisis, if the people are coming to us, we cannot do the counselling; we have to do the psychological first step, like addressing their basic needs and referring them to the appropriate places. So those are the things we have got to do first. Another PSW related his approach to PSS as one that acknowledged both the losses and resilience of the people in his community: “This is the ideal time to do counseling because not only are the clients bringing many problems, so they are talking out and speaking out and telling their problems to their counselors. Throughout my experience on the psychosocial field, I would say our community needs support, people had gone without homes, without clothing, because they were facing many problems and displacing and again going back, again displacing, again going back. So they were very resilient.” TORTURE One of the sequalae of armed conflict in a country is torture and its long-term effects on a population. In this study, the PSWs referred many times to different experiences clients had with torture. They talked repeatedly about how they worked with it in their sessions. In a sense, dealing with the aftermath of torture is a “typical” presenting problem among the PSWs’ mental health and psychosocial support clients. It is an issue for them because it was ongoing in Sri Lanka throughout the period of the conflict. In the next set of quotes, PSWs were responding to my questions about skills

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needed working in a country that has overcome war. Immediately, the first response had to do with torture. “There are a lot of clients we are meeting every day. Because we are working with torture survivors and trauma survivors, there are many people who have come through the war, so we are meeting these clients and they are saying during the sleep, during the nighttime, they’re suddenly woken up because they are experiencing terrible nightmares, and some of them, they are experiencing the part of the bodies hanging on the tree after the blast, and some of them are experiencing seeing their friend’s heads or parts of the bodies. So when they are experiencing these terrible nightmares, their body was sweating and increasing palpitation, so unable to sleep during the night. Anjalee chimed in about one of her cases: “Also I have a client who is a torture victim, a torture survivor, so for 2 years he has been getting treatment at the private hospital. He even went for treatment of the mental health unit, but he did not get proper treatment, so now we have identified him as a client, and he is sitting nearly 4 sessions, and within 4 sessions, the client feels he is improving on his psychological health. Even if he is having nightmares, if he sees the dark, he suddenly is remembering that he was kept in the dark room and he went through many types of torture methods.” I asked Anjalee if she was working with this client now, and what skills she was using with him. Many things are communicated in the quote below; however, one thing that merits attention is Anjalee’s focus on re-directing the client to the present moment. “I am giving empathy to him, and also I am listening to him, because while I am listening to him, he is talking and his openly talking about everything. Even he is talking

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about the torture method that he underwent. And also, when he says he is experiencing nightmares, I usually ask how frequently you experience this, and if you experience a nightmare, what did you feel? And what did you think about the nightmares? And then he speaks out. While he is explaining his experience as the nightmares, he feels uncomfortable, I say, ‘Focus on what we talk now. Can we have tea or coffee? And then we can start.’ So then he will be relaxed.” In the next exemplar, the PSW talked about his client’s experience of torture, and how the client had figured out a way to survive the memory of it. “Even I met the client who is a torture survivor. He underwent––Ah, excombatant. But also he underwent the torture methods. So one of the torture methods was falaka. Yeah. The feet. During this process of assaulting him, they said, “You will be affected after for 25 years. Still he has the mind, and even though he is telling, “When I was undergoing the torture method, they were telling me, ‘You will be affected after 20 years,’” but he is telling it with a laughing. He is not worrying about that. He is laughing. But what he feels is that particular person with the proper counseling or proper guidance on that period, he would be able to develop self-awareness or selfcontrol or resilience skills. So he is feeling the proper counseling or proper help can help you at the right time.” Working with people who have witnessed and experienced extreme violence is something every single PSW has to deal with. Another PSW added his comments to Anajalee’s—this time it is the effect of witnessing violence in the war zone among a 12 year old girl.

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“I had a child client, 12-year-old girl, they were in the war zone, and that time they faced many difficulties during the war. So now she is experiencing when she was sleeping, she felt someone come and knock the door. She suddenly got up, and she is thinking, did they really come and knock the door?” The girl was experiencing nightmares. In this case, the nightmares seemed to also have a debilitating effect on the family system. When the 12 year old would awake to answer the door, the family also became afraid—wondering if indeed something awful was going to happen. “Her parents also were lost during the war, so she is always remembering them, but the girl was really interested in singing all the new music, so the same way I did with her, and also I was doing some creative therapy to create something—I was teaching the girl to create something, some new music by using the natural things, like the glass, the bottles. I tap on the bottles …..Also she had a social phobia, so she would not come up to the society, so I was giving some counseling to overcome that behavior. So also I did for visits for her guardians and also gave awareness for them. Because the relatives are still thinking that when she says someone comes and knocks on my door, the family members believe that maybe it is true. In Sri Lanka former combatants are women as much as they are men. In the next excerpt, the PSW discusses how one female ex-combatant, a new client with a missing hand, seemed to be presenting quite well to others outside the MHPSS milieu. The PSW was not convinced. Below, she tells the story. “An ex-combatant was referred by the community volunteer to a counselor, a psychosocial worker. At that time, the ex-combatants was waiting on the veranda, and at

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that time, I was doing counseling for other clients, and after the counseling session, I came out and looked at the clients. This particular ex-combatant was talking loudly and laughing and very friendly. She was having pleasantries with others. At the time, she came in to the counseling room and I talked to her in the very first session. In order to build up rapport, I friendly talk to her and she observed she lost her hand and there were a lot of scars on the body, healing wounds and scars all over the body. She was really injured. And also then I talked to her and asked, ‘How are you feeling? Are you okay?’ ‘Yes, I am okay. I am happy. I have no problem.’ I observe her body language, even the facial expression, very, very well. She said, “I have no problem,” and so the psychosocial worker had problems whether I can register her, whether I can continue my counseling with her. Since she is so happy? Very well.” Above, the PSW refers to the structure of the MHPSS services. How can she register a client who appears to have no problem? Yet, Anjalee felt there was some support that she could provide to the woman, and also, that perhaps what she presented to others may not be fully expressing what she was going through with such a traumatic bodily injury. Anjalee knew she had to use a subtle way to approach her. Her quote, describing how she did this, continues below. And I thought, how can I talk to her, because community volunteers said she may have problems. If you talk to her only you can find out. The same time, the client said, “My mother has been worried about me.” Then I asked, “Has your mother been worrying about you? What do you feel about you? Do you have any problems?” She said, “No.” I observed the hands. She sits right. “Do you feel pain in your hands?” I ask. “Yes. I feel pain, but it will not be a problem.” So I said, “Okay. If I give you a date for

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next session, can you come?” She said “Okay.” At the end of the session, I said, “I am a psychosocial worker. I am doing this. I am talking to people who need counseling. Whoever needs particular help, if you feel you need psychological help, you can come to me for my next session.” She said, “Okay. I will come for the next session.” Anjalee summed up her view of this experience: “One of the learning points is because the beginning session, she was not showing any expression of worry. The second session when she came to the counseling room, I asked whether she had thought about her problem, and she said, “Yes. I am really worried about my hand. I lost my hand.” Then I suddenly realized, okay, even though they are not showing any worries, even though they are not showing any problem, they are people. They are having good resilience. Yeah. And I found many, many problems. We need to talk to the clients again and again. We can find out the problem. Otherwise, we judge the client when they're showing their resilience skills, we may lose a real client.” It is a very sophisticated skill to be able to balance a lens that appreciates a client’s resilience, as well as her challenges, in the aftermath of losing her hand. This is a necessary balance in a post-war country. § One unexpected topic was the role of gender in the work of the PSWs in Sri Lanka. Several of the PSWs (males) mentioned this, as did some of the staff members of FRC. In general, the organization tries to have two PSWs in each community, one male and one female. As one PSW put it, “There are needs for increasing male counselors because even though the male counselor’s doing counseling, the male clients are reluctant to approach the female counselors.” The male PSW had a specific case in mind

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from his experience. In his description below, he references his female PSW colleague, who works in the same office as he. This case also had to do with torture. Even in my office, Sima’s doing counseling, and some male clients are getting counseling from her. Sometimes they approach me and telling something else, something, a special problem. There’s a need for increasing male counselors. One example, Sima is the counselor for this male client. One time she wasn’t there and the client came to me. He said is getting counseling from Sima [inaudible], but this time to me he said the methods of the torture. He underwent many types of torture methods. One torture method was to apply the chili powder on his penis and also entering the sharp object into his penis. But he did not say everything to Sima.” This PSW comment brought up a very interesting discussion on gender roles in PSW work in post-war Sri Lanka. Although I had found the group of participants balanced in terms of gender, what matters is the balance that is there among them in their communities. Indeed, I was to learn later this is one of the current goals of the NGO—to work to have both male and female PSWs in each community.

“WE HAVE TO LEARN THE NEW THINGS FROM THE CLIENTS; THEY ARE GIVING US THE NEW TRAININGS” The ability to learn from one’s clients, to take a position that puts oneself in a deferential, learning relationship with the people one is meant to be helping, requires a willingness to let go of the idea of the therapist as expert (Goolishian & Anderson, 1988). This position, and its performance in practice, is impossible without a deep respect for one’s community and for people’s inherent resources and life experience. It is a position of humility. This humility can generate many actions. However, for the PSW in post-war

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Sri Lanka, it reflects their ability to appreciate the everyday lives of their clients, as well as their curiosity of how to implement practices that best support their clients’ well-being. “The learning is very important, so we can learn from the trainings we can learn from our supervisor we can learn from the trainers but uh apart from the trainings we have to learn the new things from the clients they are giving us the new trainings. We have to learn from them.” SKILLS LEARNED THROUGH OUR CLIENTS The war in Sri Lanka and all of its repercussions has affected the population in a myriad of ways. However, it is also critical to consider what is happening now in terms of reconstruction of their lives (Samarasinghe, 2009). Psychosocial work in this setting focuses on present issues of the community, but also has to be put into the context of how it is these issues are occurring in the first place. Things need to be done to support individuals and families in their community; however, redressing issues of trauma directly related to the war is a key issue for PSWs in Sri Lanka. The effects of working with individuals, couples, and families who have experienced atrocities in turn have implications for the PSW. Some of these implications are professional; PSWs have ample opportunities to learn how a client copes and some of them are able to focus on these client strategies and promote the strategies even further. As much as I could, I wanted as a researcher to find out about the process of the PSWs as they sat with a client. I was particularly curious about the difference—if any—between what they had learned in a training program, and what they had learned in the doing of the work itself. I asked: “Is there anything that you have learned in your work as a PSW that is effective with your clients maybe you did not learn in the training, but you learned

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from doing the work?” This question generated a lot of information about client’s coping skills, and how a PSW might use those skills in client-focused ways, to support their healing. As one PSW put it: “During the counseling sessions, I found the clients have their own working mechanism. One of my clients is worried, and she is having poor sleep, insomnia. So what she did, if she feels she cannot sleep well, she has to move her hand and legs everywhere, and then maybe she can sleep well, but the second session she did last week, she said when I felt poor sleep, I drink tea. So I took a cup of tea and I felt that I slept better. So he realized, okay, if you can have a tea before you go to sleep, you may get better sleep. And she followed that. So these kinds of skills learned through the clients, through our work.” Another stated: “Even though they have big problems, they are able to enjoy their daily work. So they will not sort everything out, but they can manage their problem, and they can enjoy their work. This we also can learn from them, and we can explain to others. Also we can learn resilience from the clients. For example, I can say one of my male clients when he was free from the war zone suddenly a shell was blasted, and the wife was there, and both children got an injury from that. One child's body was blasted. But now, even though he experienced those big traumatic events, he is able to enjoy his daily life and daily work. He is involved in daily work and looks after his child.” In the next exemplar, the PSW talks about how the balance between appreciating the fact that clients have come from war, but also, how that they are now planning their future beyond war.

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“I can observe many occasions during the counseling session there are people who come from terrible environments. Now they're focusing on their personal development. They're focusing on their children's education. They're focusing on their improvement of the community. The same way in the counseling also, the clients are coming and telling me they have experienced things that are terrible, traumatized even, but “I have a job. I need to do a job. I need to earn money. I need to look after my children. I need to look after my family.” Though these are the things that are happening in the community right now.” Another comment reflects how one PSW, despite living through the war along with his clients, also realizes he was not affected in the same way. “It is true. I have not been in the war zone, but clients have been there, and now they are coming to me and they're telling me, “Yes. I have lost my loved one. Even though I have lost them, I have to live now, or I have to increase my knowledge. I have to focus on new things.” But they cannot focus fully, but they are focusing on their development. They are focusing on their improvement. So I am able to observe those kinds of things in my clients. So after seeing my clients I realized.” § It is a highly sophisticated skill to listen closely enough to clients that you are able to use their words and ideas as information to increase their well-being and decrease their suffering. This concept is fundamental to appreciative inquiry, utilization and solutionfocused therapy. It can also be conceived of as a “position” or “posture” or “stance”; that is, a way of interacting with others. Relational in nature, the performance of this stance requires an ability to appreciate how even the most challenging experiences of suffering

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simultaneously offer opportunities to learn about a person’s resourcefulness. In the exemplar below, the PSW discusses how he used a client’s own solution ideas as a way to build an intervention. “There was a client, a female client, who was living with her sister before she married. She and her sister were displaced separately during the war. The sister was not visiting her, so she wondered why she does not visit me. She wondered if she was angry at her? She came to see me and I said, ‘Even though you are here, you can visit her, you can speak to her. If you visit her and you speak to her, she will speak to you.’ So she forgot her strength, her wisdom and I strengthened her to visit her sister and speak to her. Afterwards the client came and said ‘Okay one day I went to visit her and I went to speak to my sister so later on she visited me and she brought me some things. So strengthening what they have, the skills for diversity to find the solution for their problems is really important.” This PSW went on to describe how his work seemed to focus mostly on persuading the client to listen to her own ideas and use them as potential solutions: “I used that theme, when you displaced and come together, what did you feel? So why don’t you go meet your sister now? Now she is living separately, from her sister, she has a big need for her. So I just promoted the question.” Some of the most experienced of the PSWs—in the exemplars below it is the three PSWs Anjalee, Varshika, and Asokaya—accustomed to working as a PSW during and after the war, each had a sophisticated set of skills and interventions at their fingertips. They had attended many different types of MHPSS trainings and had had many opportunities to work with a number of techniques.

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TOOLS TO EXPRESS THE HARD THINGS AS WELL AS THE GOOD THINGS

One technique they talked about they called a Lifeline. They described for me the use of this technique in post-war Sri Lanka and how they have tailored it to engage clients. This tailoring is an example of psychosocial innovation. The way these PSWs described Lifeline was to incorporate art as a way to narrate a client’s story. Further, the PSWs have found ways to use the technique as a metaphor to talk with a client about his pain as well as his strength. It is worth noting that each of the three exemplars below illustrate how the PSW modified this intervention to accommodate the client. Varshika, Anjalee, Praveena and Asokaya are responding to my question: “What strategies or skills or tools do you use the most as PSWs?”

“Lifeline. Tools….is a lifeline. Is if a client has negative thoughts, telling me about his negative thoughts, with lifeline, he is able to tell the positive thing also….so what are the things that happen in his life? So once we introduce these tools, clients is telling me more positive things less negative things. Good to introduce the lifeline. So… if a client comes to me and saying, difficult to say positive things, if a client forgets what has happened, I will ask, ok which age you still remember? Okay can you write it down? If you, if you experience positive things, so you can draw a flower if you experience the negative things, or hard things, so you can draw a stone. So, a client is drawing from his age to now this what happens, many flowers and many stones are drawing, so when I look at the paper, it is ah really, an informative matter. Client to express the hard things as well as the good things.”

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Varshika jumped in at this point. Varshika discusses how she uses the client’s traumatic experiences to help her learn the client’s strategies for overcoming problems: “I use the lifeline methods to find more information about their negative side….so the clients feel, he cannot fully express his negative side, so I say okay you can tell your negative things, and then I ask, how can you overcome those negatives? Right, and then he will tell you, ‘Oh so this was very hard but I overcome by using this way….increasing my coping capacity…’ Okay! Can be used for many many life events . . ..”

In another adaptation, one PSW discusses how using images the client can draw will help her define how to look at the future in addition to the past.

“One client, she brought a drawing, she drew it. It looked like the sea, the river, sea, it’s going deep. She said, ‘if someone falling into that, they cannot come out…They can die there . . .” So I can ask the client are you coming out, or are you going to die? If you go into, again and again, they can also see, there are many ways to come out.” Some clients are not able to do this task easily or as easily as it might come to others. Sophisticated PSWs are able to turn this obstacle into a resource. Below, Asokaya describes how she uses the tool in such a case. When the client cannot do the drawing, Asokaya offers to be the artist for the client: “I am also using this tool if a client, uh, you will see cannot speak out, so I will say, ok, I would say if you remember cannot remember you can write up or you can’t tell add until I will write up and I will tell you. This what happened in your life [demonstrates]. Then they clients’ will tell [more]. And I will write up and then I show them the paper… “I see now.” So these are the things uh going on what was going on in

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your life, now you are in this state, it will be useful for the client.” In another example, she talked about when she leaves the client to do the lifeline on his own: “Client come to me and I was trying to speak with him, but he was not answering, open his mouth so what I did was give him a paper, a piece of paper….and I said ok now I am leaving but you can write…whatever you want, your life, and I say come out the client was there in the room and drew up tree and nest and three birds and also a ladder and came back paper oh okay nice picture and he elaborated and so she asked could you elaborate a little bit more what did you work he said oh it’s a tree and she asked him what is this ladder and it’s a nest and things and okay if it’s a tree uh the birds are coming in and they build a nest as a nest, the birds will lay eggs, if there’s a eggs they become small chicks, chicks and if there’s a nest on the tree the people can climb the ladder and see look at the things there and also the uh, okay, then after drawing these papers and elaborating a little bit more he got confidence to speak with me so after the first session or the 2nd session he came with big laugh, and confidence, smile, counseling session is going on, he can speak out and express in. I also think to ask, where are you now, which position are you in? Are you in the deep, in the middle, or in the beginning? If client says “I’m in the middle’ it’s easy for later….don’t go in deep….”

“MY NATURAL CAPACITY: BEYOND TRAINING, MORE THAN THEORY” “Capacity-building,” referring to strategies of technical support and training in mental health interventions, is a common aspect of MHPSS programming. One of the themes in the research data was how the PSWs thought about their capacity as professionals. The participants had many ideas about what informed their capacity as 68


PSWs. I began to ask about it after I heard it noted several times in the interviews. One, Sima, had used the phrase “natural capacity.” [LLC]: “First, Sima, could you say a little bit more about what you think about the natural capacity of the PSW? “We have to have a natural capacity and understanding of people's emotions and an understanding of people's problems. So these are the important factors. We have to have the capacity. So I've realized this after I joined this field. …. So you have to get to everybody. You have to give help to the people who need help. Earlier, before I joined this team, also there were many people that are only focusing on their community, or their friends, or their family. But after coming to this field, I realized that we cannot have that knowledge or that attitude. We have to change our attitude, only focusing on people's needs. That is when I realized that we have to build up our natural capacity.” It was hard not to notice all the people nodding with Sima in the focus group, and PSW2 added thoughts: “I do agree with Sima, because we cannot divide the people. Before this, in front of us, everyone is equal. So you cannot focus much on one group, and we cannot focus less just on other groups. So everyone is equal in front of us. As psychosocial workers, we have to have the same respect. So I do agree with Sima.” The discussion evolved into an analysis of theory and training. Referring to the training program we had just had a day earlier, this PSW noted how a role play in training, for example, was never quite the same thing as sitting with a client. In the real situation, the client would do something different. The PSW has to develop various ways

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to interact with a client. As he put it, “we have to develop our own skills along with the training.” The following comment illustrates a PSW making an important connection between the need to focus on local resources while appreciating the limits of theory. Theory, as noted earlier, tends not to fit the Sri Lanka context. “Even though we learn a lot of a lot of theories a lot of techniques, we cannot apply on our people. Because our people are very very traditional people uh, say, so we can’t say, we cannot play the empty chair technique. We cannot find the chairs even! (Laugh) but we can use small exercises, like uh breathing exercise and uh if we use the basic element, like uh say uh empathy response attending skills it is enough…” PSWs also fluently talked about content knowledge as different from skill set—what they could learn, vs. what they could do, as Varshika put it: “Whatever we learned so we can gain knowledge but our skills is important. We can learn the therapeutic knowledge but our skills is very important so I am using only my skills on my clients so one of my first teachers said whatever counseling you can do but you have to remember three things questioning, listening and empathy. So these three things are very very important while you are doing counseling. Even the beginning stage or termination stage these three elements are very important.” OUR CAPACITY MUST GO BEYOND THE DIPLOMA However, training and capacity building is only one part of mental health and psychosocial support. It must be augmented by time in the field. Asokaya’s comment summarized this idea: “Main thing is we cannot do by using theory. Theory is a part of the knowledge but using the skills and the practice things is very important.

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“Whatever we learned from trainings, we can apply to work in the field with a client. Yesterday we had a role-play. The client did one thing, but in the real life, client would do something else. So we have to develop our own skills along with the training.” In Sri Lanka it is now possible to earn university graduate diplomas in different forms and approaches to mental health and psychosocial support. In the next comment, the PSW talks about how this was something one must go “beyond.” She related this “beyond” to cultural skills, and her own experience crossing cultural borders while performing MHPSS in a community in Sri Lanka. “Even though we earn diploma or whatever thing, our own cultural skills and cultural backgrounds are in there. So as an example, I was working in an organization at that time. Me and another Muslim girl were working together … in communities that were very much affected by war, but they easily, they won't accept the people, especially from another community. But we are Muslim people. We went there. We worked there. So we have to have our own capacity. So I can go there as a psychosocial worker, not a Muslim person. I am giving opportunity to new people, so whatever on that I will learn, but we have to have our own capacity that came from our culture. So respect people and giving experience. It is not about us. It’s beyond the diploma.” This PSW then went on to talk about how she managed to be accepted by the community, where at first she felt like she could not. She focused on her role and her work, and the significance of clarifying what that meant for the community. “It has come from our own culture. Accepting people, respecting people, giving the correct definition of our work, and things. So we will are giving advice to the new people. As a counselor, we have to build up a good rapport with the people because when

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clients are coming to us, they don't know how this organization is helping us, and what are the services they are giving, and what is the benefit from this? But our first meeting, we have to very clearly tell them, “This is what we're going to do. So then they could realize that this is what is happening for me from this organization. So as he said, “First impression is best impression.” So if you build up a good rapport on our first session or first meeting, it will be helpful for us to do a follow-up for the clients and thereafter.” Several of the PSWs talked very eloquently about the role of clients and how experiences with clients—even the mistakes that are made—are capacity building tools. Varshika put it this way: “The learning is very important, so we can learn from the trainings we can learn from our supervisor we can learn from the trainers but uh apart from the trainings we have to learn the new things from the clients they are giving us the new trainings. We have to learn from them. And also I feel that however we make a mistake from that we have to learn, learn new things that’s very important.”

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CHAPTER FOUR: DISCUSSION At the end of the focus groups, I sat down and had a long interview with Dineli, a psychologist at FRC. I wanted to ask her similar questions about the work of the PSWs— their strategies, innovations, changes to the work after the war had ended—but also, I think I wanted most to talk to her as a method to triangulate what I thought I had heard from the PSWs in the focus groups. I also expected anything she would tell me could help to thicken (Geertz, 1973) the descriptions that the PSWs had shared with me. Although the quotes I present here could easily be distributed throughout the section above (they also fit the categories and themes of the PSWs’ discussions), I present them here in a discussion section. I think it is a good way to reflect on the interview content shared above. REBUILDING: HARMONY AMONG COMMUNITIES AND FAMILIES A critical aspect of mental health and psychosocial support in a country recovering from war involves rebuilding. Typically, rebuilding after war refers literally to the destruction that has occurred in war—brick and mortar destruction as well as destruction of the integrity of educational, health care, and financial institutions. However, NGOs that are delivering MHPSS also have a mandate to rebuild. Their mandate involves the rebuilding of communities and families—of lives—and as she put it in the quote below, “harmony.” [LLC]: “If you could describe in your own words, what the skills of a PSW is, in this context, with this organization and at this time in Sri Lanka, 3 years later?” “In this post conflict, FRC, we will I basically want the PSWs to increase quality, provide psychosocial support to people affected by the trauma that they went through,

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during the conflict, with increased quality. I would also like the PSWs to help the clients to reintegrate into the community. So it’s not just counseling, it’s not just referring people, it’s giving people the skills they lost during the conflict because what we see is relationships with the community with each other in the family…. people were lost for a long time, disappeared, and now they are reunited but they lost so many years. There were supposed to be relationships. It’s so difficult for the family to unite, to live in harmony with each other.” Dineli then relates this difficulty to the conflict. “Because the trauma that they have gone through, it’s due the conflict but each person went through different trauma.” [LLC]: In different places. Dineli: “Yes. Yes. So how they do relate all that and how do they reconnect with each other as well as the community. The culture is such in these areas, the culture was very very close before the conflict. So now, they are living on their own, each family, person living in their own but if they can get together and go back to the same culture that they used to have, then it’s something that they own, that they know so the PSWs are also help clients with regard to reconnecting with family members. It’s helping people in the society as well as the community to reduce the trauma or the traumatic feelings that they have, as well as to reintegrate them into society with a lot of quality counseling yes okay the quality.” Having watched some of the MHPSS projects develop across various organizations in the years since the war, and after having spent so much time with several

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of the PSWs—who I thought had extremely sophisticated ways of describing and approaching their work—I was very curious about the distinction Dineli had made. USING LOCAL RESOURCES TO ENHANCE THE QUALITY OF PSW WORK [[LLC]]: What do you mean by quality? Can you say something about that? “Okay, it’s in Sri Lanka the counseling is becoming fashionable sort of, the counseling. But the quality of these courses, all these things, are doubtful. We get all these concepts from the West. Everything we learn is from the West. But can we can we apply these things to our country? Can we apply these things in the specific culture the PSWs are working in? What I saw when I joined, is that they’re applying the western concepts to their counseling. When I did my first few clinical supervision sessions I keep on hearing Empty Chair Technique and all sorts of things and I’m like what is Empty Chair Technique. I mean I don’t know what is empty chair technique I mean I have heard of it but how do you do it? Can you explain how you do it because I want to know, if they have enough training to do some sophisticated technique like that. But often no, because our courses, the diplomas they’re only theory-based not practice-based.” One of the things the organization had done since the conflict—two things actually—was to develop a very clear assessment and intake form. They did this with the support of an organization in the U.S. that focuses on trauma treatment and how to measure the outcome of treatment. A second major change had been to drastically decrease the number of cases each PSW had. In the focus group interviews, several of the PSWs had mentioned a difference in their work when they went to a smaller caseload. Here, Dineli explains the reasoning for

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this process a bit further. She also talks about how she tries to promote more locallybased and locally-sourced psychosocial interventions with the PSWs. “A lesser number of clients is for the increased the quality as well as to help the client in a better way as well as to move away from all these therapeutic, the technical techniques to do a more culture-friendly counseling approach. Because our culture, culture is such that helping is there! People are always ready to help….so whey can’t we find something from this society, from the culture, from this community, things that are appropriate as well as things that they feel are their own without giving them something from somewhere else? Something totally new for them to learn? Something from the community itself? And give something to the person so that the person feels more comfortable?” I was curious what Dineli would say about skills or practices the PSWs might be using in their work. Was there something they had figured out that was a useful skill or intervention in the post-war setting and in the PSW’s working community? Dineli: “In one center, uh, in one center this was this PSW who actually went into the community tried to find out what they were doing earlier. And she came up with this proposal sort of a thing sort of have a community especially for the women, who had their husbands killed.” There had been a time in very recent memory in Sri Lanka that it was not feasible for women to gather, even to mourn and cry together—because such gatherings were considered suspect. “So this community uh sort of small gathering brought a lot of people together, where they were able to share things and we are a society a community where we share a

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lot of things people talk, talk, talk, talk, they let it out. Especially women, women get together and start talking. But it was, it was also like there was a Hindu who came, to talk to them, because their culture is so connected to the religion, um, figures of brought some some religion and then talked with them about it, they had discussion about it, so it was a it was a situation or a gathering where they were able to share things with the people, they didn’t feel upset, they didn’t feel stigma, all those things were taken out.” [LLC]: What role did the PSW have? Other than figure it out? “She’s the one who sort of facilitated it and uh, then, the whole process. It’s common to that culture, it’s a cultural thing I mean even strangers the neighbors also sit, they share the pain sort of by doing that, so it relieves they’re not alone.” Another innovation involved work with children. Here Dineli discusses how she tries to help the PSW consider and implement locally-based and resourced interventions and materials to support them. “Earlier when we were working with okay we don't work with children that much but even if we were working with children, they were working with children it was a …. Like using very sophisticated techniques that they were trying to work with children, but after going after changing the model, after understanding what we expect from them they started using things from the community itself. And started teaching the models of things that they can do with their children that are relevant to the community even making small toys, using things that’s available. Because if we go giving dolls giving all these toys then but when the child goes back to the house they don't have those toys they can play with those toys in the center but once they go home what will happen? So we don't’ have such things in our centers. It’s just things that you find and you make put things together like

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small doll using coconut shells, small mask using coconut shell and things like that you can find easily in the community.” COMMUNITY VOLUNTEERS Another practice that supports the work of the PSWs, and is also in the realm of innovation, is the use of community volunteers. Community volunteers are local villagers sought and compensated by the NGO, in order to do outreach and advocacy of the work the NGO is trying to accomplish. There is one in every community where the NGO works. As Dineli put it: “They are from the community. They are from the village itself so uh, they’re like our first link.” [LLC]: How do you find them? Dineli: “First we go and do an awareness session during that we inform them the people apply they send us CVs sometimes government officers give us names of the ___ and there are like ____ that they have they are aware of the people who can do that so they’re sent to FRC office and we interview them and it’s like a position. It’s a designated person.” MY (LLC) REFLECTIONS In reflecting on this study, many thoughts and ideas come to mind. However, one pattern of conversation I noted in the interviews, which was relevant to the study but not relevant as a code or category—was how the PSWs experienced the focus groups. Just as Yeh et. al. (2003) had pointed out, they had found the interviews very interesting and useful. They used them as a way to learn about each other and each other’s work. This was an incredible benefit, and an unexpected one.

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“I also, I am I am happy to be here today and yesterday because it look like uh peer support pretty much our sharing our experiences and skills and also we can learn from others so we are very happy to be here to sharing experiences and things.” One of the PSWs referenced the meeting in which I had had them all sign the informed consent to participate in research. After her focus group was finished, she reflected on what it had been like to do it. “Yesterday, when you gave the piece of paper uh agreement, when we look at that…..inside I wasn’t afraid because earlier I did this kind of research my colleagues that were in my groups, they afraid why they asking? So now the agreement is happy because we are sharing a lot of things and also we go the new learning points from the discussion.” Another PSW: “Thank you so much. This give us some promotion to share our experiences among the team, so it is a good learning point for us to talk about and learn about others’ experience and other’s feelings and beliefs.” Maraiyon talked about what it had been like for him to take part in the process. “I'm also happy because maybe sharing my experience will be helpful for others because you are making this study …. I’m happy on that.” INNOVATION Talking with Dineli about her work was extremely helpful as a way to reflect on what I had learned in the interviews with the PSWs. I didn’t realize what I might learn from doing this study, but I do remember thinking a lot about innovation in this context of mental health and psychosocial support in a post-war country.

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At the time I had conceived the study, I had been analysing innovation in financial markets. During that time I was also traveling back and forth to Sri Lanka and a few other countries several times a year—always to do training for MHPSS projects. Quickly, I began to think laterally about the role of innovation in the work I had seen in these fragile, conflict-affected states. What they were doing seemed to me it fit exactly the definition of innovation. In particular, it seemed that each country was (of course) implementing MHPSS in different ways. The differences often had to do with the nature of the conflict in the first place, and the relationship between state and civil society in the country. It was this observation that generated the study proposal—and it continues to be a curiosity that drives my work. I also think it was the environment in Sri Lanka—the people I had met, the work I had seen, the evolving process of reconciliation I was witnessing—that contributed very much to my thought process. I could not have had one without the other. MPHSS work refers to what are often intangible processes—conversation, change, psychosocial well-being—that are not easy to observe. One reason is that these are categories and labels that refer to more specific words or events (Bateson, 1972). The relationship between the two categories is something unique to the context. Another reason MHPSS processes are difficult to observe is that in a post-war context the process of “rebuilding” is happening in real-time, in situ, alongside other perhaps more tangible reconstruction activities that often get more attention. It is not easy to measure exactly how one builds harmony in a community after a war. Yet, just because it is not easy does mean we should not attempt to do it. In fact it is something perhaps most critical to the reconstruction process. In the final chapter, my co-

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author Gameela Samarasinghe will discuss the role of this work in the current context of post-war Sri Lanka.

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CHAPTER FIVE: INNOVATION IN PSYCHOSOCIAL APPROACHES AND PRACTICE FOR RECONCILIATION IN POST-WAR SRI LANKA – THE WAY FORWARD On 8th January 2015 while this chapter was being written, the Sri Lankan people elected a new President, Maithripala Sirisena. People gave their verdict at the Presidential election. They expressed their desire to end authoritarianism, corruption and nepotism of the Rajapaksa regime. This was also a reaction against the growing religious extremism, fear and intimidation in the country. There had been an opportunity for bringing peace and healing after the end of the war in 2009. Instead, the Rajapaksa government launched massive development projects and overlooked the grievances of the people and the need for reconciliation. Today there is hope for people as democracy triumphs. People are already talking with no fear. Victims of human rights abuses will seek redress. A sudden ray of hope has appeared after a long era during which a culture of impunity and disrespect of the rule of law prevailed. This change will necessarily encourage more victims of the war to seek psychosocial services and care in an environment very different to the one they lived in for more than 30 years. In addition there will be more people wanting to share their experiences of loss and suffering and seek justice and reconciliation. The psychosocial sector will need to respond with innovation, adaptation and creativity to this new development. It will have to play a very crucial part in future reconciliation initiatives, as the country looks to heal all those who have suffered. The research project for TAOS sought to understand how psychosocial workers in one organization utilized and applied culturally appropriate systems of meaning and structure in their counselling process. The research showed that psychosocial practice in

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this organization was by necessity a constant innovation, as it is often in post-conflict countries. Similarly a case study on Sri Lanka that was done a few years ago for INCORE, The International Conflict Research Institute, University of Ulster, UK, (Samarasinghe 2015)9 also looked into the working practices and the innovative interventions of four psychosocial programmes in post-war Sri Lanka. The study pointed out that the end of the three decades civil war in May 2009 brought on new challenges as well as opportunities for organizations working on rehabilitation with war victims. The changing context from war to post-war meant that a critical assessment of the current working practices and approaches were needed. It also examined whether issues of peace building, reconciliation and rehabilitation had been included when conceptualizing the psychosocial programmes after the end of the war. One interesting finding was that justice for and human rights of clients became “part of the organizations’ psychosocial interventions”. The organizations often wanted to ensure justice for their clients although at times such action could put the client in danger particularly if the abuser were to be connected to a group with political or military power. This led to the organization focussing on the clients’ immediate psychosocial needs such as their safety and security, what the organizations was more experienced at. When handling torture cases, one of the organizations that participated in the study stated that it created awareness among the police and society about the fact that people do not have the right to inflict torture on others although they mainly dealt with the client and his family in order to reduce trauma. All four psychosocial organizations that participated in the study had to some extent broader mandates of social justice, human

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rights and equality, though these mandates had not been explicitly stated in their post-war programming goals. In a post-war environment, psychosocial initiatives need to be innovative in order to deal with increasing numbers of affected individuals and communities and must also attempt to understand how to integrate notions of psychosocial care with those of justice and reconciliation. Whilst one would expect to observe numbers of torture survivors to decrease after the end of the war, psychosocial organizations have recently reported an increase in incidents of torture. They attribute this development to people previously being afraid to come forth with their stories. With the return of democracy, it is very possible that there will be a further increase of these numbers and also a wide range of other issues to respond to (i.e. female headed households, sexual violence, displacement etc.). The clients of these organizations, in addition to wanting to heal, would seek justice. In his first official speech after being sworn in as the President of Sri Lanka on 9th January 2015, Maithripala Sirisena said he wanted to “work towards reconciliation of all ethnicities and religions according to the recommendations of the Lessons Learnt and Reconciliation Commission (LLRC)” and that “the process of healing also needs to include the pursuit of truth, not for the sake of opening old wounds, but rather as a necessary means of promoting justice, healing and unity.” He clearly links a psychosocial dimension to justice, rehabilitation and reconciliation processes. With mounting national and international pressure to address past and ongoing violations, the Rajapaksa Government resorted to establishing commissions of inquiry as its chosen path towards truth and justice. However to date, the many commissions of

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inquiry that were set up during the previous government to respond to the grievances of victims have shown little or no signs of being sensitive to their psychosocial wellbeing. The most well known state initiative in post-war Sri Lanka was the Lessons Learnt and Reconciliation Commission (LLRC). “In its chapter on principle observations and recommendations10 the commission states that appropriate redress to the next of kin of those killed and those injured as a humanitarian gesture that would help the victims to come to terms with personal tragedy be provided. It recommends further investigations to be conducted, investigations into such specific allegations of disappearances after surrendering to the military and to prosecute and punish the wrongdoers, a comprehensive approach to address the issue of missing persons to be found and previous recommendations of commissions to investigate human rights violations to be implemented. It further recommends taking necessary measures to ensure that arrests and detentions are within the legal framework and to protect those arrested. It calls for prioritizing the needs of vulnerable groups such as women and women headed households in all the government’s developmental measures, to provide safety and security for those who are vulnerable i.e. women, children and the disabled, necessary legislative measures to be taken for the realization of the rights of disabled people. Devolution of power in a people centric manner, addressing the legitimate grievances of minority communities, implementation of the language policy, ensuring equality of access and opportunity and active

10http://www.priu.gov.lk/news_update/Current_Affairs/ca201112/FINAL%20LLRC%20REPORT.pdf

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measures towards reconciliation are important recommendations made by the commission11.” “The

LLRC was established as a mechanism for both accountability and

reconciliation. While the commission itself has been criticized and has limitations, the recommendations of the commission, if implemented, may provide the base for the long and arduous journey of rehabilitation and reconciliation. It must also be noted that the LLRC did, albeit minimally, provide a legitimate and official space for people to air their grievances, talk about their losses and for their loss to be acknowledged” (Samarasinghe, 2015). However difficult - physically, economically and emotionally - it may have been for many of them, civilians arrived from different parts of the country to attend the sessions and narrated their stories, which demonstrates their desire for redress and justice. The report in its whole does acknowledge trauma and the prolonged suffering people have faced. The commission recognizes that the suffering needs to be addressed through counselling, justice mechanisms, compensation and acknowledgment if reconciliation is to take place. But the LLRC failed to understand how emotionally difficult it is for people who have suffered the consequences of the war to come forth and talk about terrible experiences before the commission or any other such hearings. Even more people might have appeared before the commission if it had a comprehensive victim and witness protection mechanism and they had been offered psychosocial support through the process. Similarly, other commissions were established and reports were produced. None referred to the psychosocial wellbeing of victims participating and sharing their terrible experiences.

11http://www.priu.gov.lk/news_update/Current_Affairs/ca201112/FINAL%20LLRC%20REPORT.pdf

295-316

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The 2011 Report of the Secretary-General's Panel of Experts on Accountability in Sri Lanka was produced by a panel of experts appointed by the United Nations Secretary General BanKi-moon to advise him on the issue of accountability with regard to any alleged violations of international human rights and humanitarian law during the final stages of the Sri Lankan Civil War. In 2013 the Presidential Commission to Investigate into Complaints Regarding Missing Persons (COI) was established by the GOSL, seemingly to address the issue of disappearances. The Commission met an overwhelming number of affected communities but no mechanism was in place to support them before, during and after their appearance before the panel. THE NEED FOR INNOVATION TOWARDS RECONCILIATION Significant and distressing levels of loss and suffering are associated with the past decades of violent armed conflict, with people from all ethnic communities having had direct and/or indirect experiences of the conflict. In the Sri Lankan context it is sometimes difficult to use the term ‘Reconciliation’ since the term Reconciliation may not comprise of all options necessary to meet the needs of people who had experienced psychological suffering or human rights violations. It may also not be a term that is understood by people in general. Reconciliation as a word also carries nuances of compulsory forgiveness, forgetting and/or resignation, which may not be the appropriate framework within which to work when dealing with psychosocially distressed individuals and communities. Additionally, different processes may be involved in ‘reconciling’ within oneself, ‘reconciling’ amongst individuals and communities and ‘reconciling’ between communities.

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If we do use the term Reconciliation and link it with “Building peace”, this inevitably begs the question of what may be the most appropriate means of ensuring that people’s experiences of, and grievances consequent to, such human rights violations are acknowledged and given due recognition and redress. Appropriate and effective redress will significantly contribute towards helping people move on within their lives as well as towards helping communities to come to terms with and traverse their collective experiences. Repeated references to their desire for revenge by survivors of violence12 (for example, “even if they [the perpetrators] are cut up and eaten, it will not be enough”; “I will not rest until the truth prevails – those murderers must not go free”; “I feel so angry that I want lightning to strike them”) show how meaningful a role redress of human rights violations and psychological suffering can play in mediating the suffering people have endured and hopefully contribute towards a constructive peace dialogue. Given the extent and complex nature of suffering experienced by individuals and communities, it is imperative that the issue of reconciliation be continuously debated and evolved with relevant stakeholders. However, it is alarming to note that the discussions and debates have so far evolved without meaningful consultations with people to whom the models of reconciliation would most likely apply, i.e. the men, women and children who have experienced human rights violations and who have been significantly distressed by their direct or indirect conflict-related experiences. Over the past year, many talks, seminars and discussions have referred to the issue of redressing human rights violations and reconciliation and in doing so have brought up the different models used in different contexts such as South Africa, Chile, Argentina and Spain to redress human rights violations following armed conflict. 12 Samarasinghe,

2002

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Arancha Garcia del Soto goes on to note that “there is a general tendency to start institutions that promote a fast path to reconciliation which many times do not consider the psychological condition” of the persons who have experienced suffering and violation. This may be particularly harmful when reconciliation promotes forgiveness without acknowledging the need for justice voiced by the survivors. A process of supportive dialogue has to be undertaken with the relevant stakeholders, most importantly with people who have had distressing experiences related to armed conflict to ensure that their distress is not increased as a result of such dialogue. Of particular importance in this is the role of the psychosocial support community in ensuring that distressed individuals and communities are supported in articulating their needs regarding the form and framework of the desired process for redressing grievances and human rights violations and reconciliation, in ensuring that these processes are implemented and later in helping people access and go through the required procedures. To date in Sri Lanka, the psychosocial sector has been separate from larger political issues. As a means of providing services to all persons irrespective of ethnic, social or religious backgrounds, the psychosocial sector has chosen to be deliberately apolitical. Whilst this has been a helpful strategy for helping people to cope with the daily difficulties present in situations of protracted armed conflict, it has also had its drawbacks. Caught up in the task of providing the necessary services, psychosocial workers have not yet had to engage in a discourse on the development of strategies for addressing human rights violations (or justice issues in general) in a broader social framework. This has also meant that psychosocial workers have been excluded from significant decision-making processes (such as the one that shaped the Commissions set

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up for the task of ensuring human rights) much to the detriment to the persons who have used these services. Consequently, psychosocial workers are not always familiar with issues relating to human rights and human rights violations. This has meant that psychosocial workers entering this arena of research will require guidance from and dialogue with persons who have engaged in similar processes elsewhere. It is necessary for the psychosocial sector to broaden their scope of intervention by dealing with political issues of justice and reconciliation rather than simply supporting people experiencing psychosocial distress or psychological suffering. Thus, the psychosocial community has to be involved in developing acceptable models of redress and reconciliation in Sri Lanka. A reasonable place for psychosocial workers to start would be by exploring what individuals understand by terms such as truth, justice, restoration, reconciliation, redress, human rights violations etc. It would also be important to explore and understand cultural notions of guilt and responsibility. It is necessary to learn about how people articulate their ideas, thoughts and experiences related to restorative justice and reconciliation. This will also include their opinions on possible mechanisms for redressing human rights violations and psychological suffering. Furthermore, the recognition to suffering is important especially if no perpetrator can be identified for human rights violations experienced by individuals or communities. Possible options to be explored may include listening, giving recognition, and documentation even where no form of justice may be easily identifiable. Equally, one must not underestimate people’s understanding of the notions of justice and be open to different options put forward as possible mechanisms for redress

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before talking about reconciliation. Some people or groups may want community justice, others individual justice and yet others may require no justice. In addition, people with different experiences may bring up many different issues (e.g. rape, torture, compensation, land, prosecution, public naming and shaming, public acknowledgement and apology, loss of family members/limbs/property etc.). Different mechanisms may be necessary to address the different needs of different groups of people. Identifying existing mechanisms of redressing violations or suffering which may include cultural or ritualistic forms may also contribute towards developing acceptable forms of redress. Such an exploratory research process will be an extremely timely one for including the voices of significant stakeholders in the development of models of redress. Despite the need for such understanding and information, this is not an easy task and one not easily undertaken. Persons distressed by their experiences will require support to share their experiences and opinions. For example, people living in the various conflict-affected areas of Sri Lanka, even today, may find it unsafe to name perpetrators, to describe their experiences and to share their hopes for justice and reconciliation. Extreme caution has to be taken to ensure the safety and security of respondents when undertaking any attempt to access people’s hopes and aspirations for feelings of justice and for reconciliation following their experience of violation. In some cases, even changing names of respondents may not ensure adequate anonymity and security.

HOW CAN THE PSYCHOSOCIAL SECTOR CONTRIBUTE TO RECONCILIATION INITIATIVES? SOME INITIAL REFLECTIONS13

13

Excerpts from Localizing Transitional Justice in the Context of Psychosocial Work in Sri Lanka, Salih & Samarasinghe, published by Social Policy Analysis and Research Centre (SPARC), University of Colombo, October 2005

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The first step would be to agree upon a Psychosocial Framework for Understanding Responses to Human Rights Violations. One could perhaps start by examining the different psychosocial frameworks that have already been developed. The Psychosocial Working Group14 (PWG) has put together a framework that attempts to capture the different spheres in which people could experience or locate their responses to conflict (PWG, 2003). This would be a very useful framework for understanding reconciliation processes as well. “This psychosocial approach explicitly acknowledges the cultural, social, and psychological influences on wellbeing, in the context of economic, environment and physical resources. These different influences and contexts have been depicted as overlapping domains, titled human capacity, social ecology, and culture and values. The framework has been developed for the purposes of understanding responses to violent conflict and for planning appropriate interventions” (Salih & Samarasinghe, 2005). The framework is useful in understanding and intervening at individual and community levels. The PWG psychosocial framework does not acknowledge the importance of politics and material influences on wellbeing although psychosocial workers in Sri Lanka have pointed out their impact. They have explained how people living in conflict affected areas are primarily distressed by material and physical deprivation. Poverty, unemployment and economic problems are found to be the main sources of stress.

14

The PWG comprises five academic partners (Centre for International Health Studies, Queen Margaret University College, Edinburgh; Columbia University, Program on Forced Migration and Health; Harvard Program on Refugee Trauma; Solomon Asch Centre for the Study of Ethnopolitical Conflict and the University of Oxford, Refugee Study Centre) and five humanitarian agencies (Christian Children’s Fund; International Rescue Committee; Program for Children Affected by Armed Conflict; Médecins Sans Frontieres – Holland; Mercy Corps and Save the Children Federation).

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The framework enables the recognition of the diversity of responses to human rights violations and the specific context in which these diverse responses occur. The psychosocial framework can accommodate differing demands made by groups of survivors within its framework. For example, the economic demands made by the families of those who have been ‘disappeared’ can be psychosocially located within the proposed framework as can be their demands for legal provisions for punishment of the perpetrators. In addition, the framework is not time-bound allowing for short-term and long-term responses to human rights violations, the consequences of those responses, and the social, material and psychological consequences of the human rights violations. Furthermore, the framework can also be used to understand community-level responses, interdependent group responses, institutional responses, and individual ones. At the same time, the psychosocial framework offers a way of understanding the potential impacts of transitional justice mechanisms on wellbeing of individuals and communities. A psychosocial approach offers a way of working with individuals and communities affected by violence rather than the description of a set of concrete activities. The Psychosocial Assessment of Development and Humanitarian Interventions (PADHI) framework places social justice at its centre (PADHI, 2009). According to the framework, power, influence and identity mediate wellbeing whereas systems and institutions enable wellbeing. For wellbeing to be achieved, changes need to take place at personal, community and institutional levels. It is a dynamic process of becoming that involves the development of human capabilities. Both frameworks could be considered when developing a mechanism towards reconciliation.

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SOME ASSUMPTIONS

ABOUT

BENEFITS

OF

RECONCILIATION MECHANISMS

AND THE

NEED FOR A PSYCHOSOCIAL APPROACH It is assumed that Reconciliation will be beneficial for everyone as it is seen as therapeutic. Reconciliation implies sharing experiences to know the truth and coming to terms with it. However, there is little mention of the process being potentially further distressing to people who are asked to publicly share their traumatic experiences of human rights violations. They may re-experience the suffering and distress and may face social stigmatization and isolation after sharing their stories. However, as Hamber & Wilson (2002, p. 35) succinctly put it, “nations are not like individuals, in that they do not have collective psyches, that nation-building discourses on reconciliation often subordinate individual needs and that truth commissions and individual processes of healing work on different time lines.” It can also be argued that the very act of participation in truth commissions can in fact restore in people a sense of control over their lives, a reinforcement of dignity in their identities, an increase of options for responding to felt or actual losses, future threats and a sense of reconnection with broader society. Allan and Allan (2000) point towards theoretical justifications that transitional justice mechanisms can act as ‘therapeutic tools’ to achieve the benefits described above. It is also assumed that narrating distressing experiences provides the beneficial impact of emotional relief for people (Agger & Jensen, 1996; Galappatti, 2003a; Hamber & Wilson, 2002; REMHI, 1996; Promotion of National Unity Act No. 35, 1995)15. These people have not had previous opportunities to voice their distress publicly and it is 15

REMHI (1996) Guatemala: Never Again! The Official Report of the Human Rights Office, Archdiocese of Guatemala from the Recovery of Historical Memory Project. New York: Orbis Books Promotion of National Unity Act No. 35 (1995) Available at www.truth.org.za/legal/act9534.htm

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believed that the expression of their emotions in such a setting is therapeutic. The danger is that this intense moment makes the individual focus on a distressing situation but the situation remains after it has been shared publicly. Moreover, this may not be the first and only opportunity people have had to speak about their experiences. Often they have already expressed their distress to family members or when alone. Equally importantly, how those who experienced human rights violations are distinguished from those who committed human rights violations can also have significant impact on and consequences for their wellbeing. Borer (2003) and Sanford (2003)16 both offer the notion of the ‘gray zone’ in the classification of victims and perpetrators. Reconciling calls upon identifying perpetrators. The existing definitions of ‘victim’ and ‘perpetrator’ may not reflect the realities by which people are named victims or perpetrators. Truth is not always what people want to know although it is assumed that knowing the truth about what happened to missing family members is therapeutic. This is theoretically linked closely with the construct of ‘closure’ (Allan & Allan, 2000). The establishment of the truth is said to allow people to review their own explanations for their experiences and to sometimes accept other explanations made available through the transitional justice mechanism. These other explanations may cause people to change their self-perceptions or their judgments about their situations or the explanations they had used earlier, thereby creating less distressing emotions. But knowing the truth may not necessarily bring about closure or alleviate suffering. In some cases, people may actually feel more distressed when the truth is established because it requires or forces

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them to accept the death or disappearance of their family members or close friends. It may in some cases trigger revengeful feelings and bitterness after ascertaining circumstances of disappearances and deaths. It is also often assumed that sharing experiences reduces the sense of isolation and in this manner that people can collectively heal. However, knowing about the similar experiences of others does not necessarily change one’s situation. POTENTIAL RISKS

TO

WELLBEING

IN

TRUTH COMMISSIONS

AND

RECONCILIATION

PROCESSES After engaging in Truth Commissions, there is a potential risk of further victimization. The community identifies participants as either perpetrators or victims or as persons who named others. Truth Commissions can also be patronizing or intimidating spaces to people who share narratives. The persons listening to their experiences are likely to be distant from the social realities of those who have experienced human rights violations (Perera, 1999) resulting in a potential lack of empathy towards people providing the narratives. This can cause further distress and anxiety to victims of human rights violations. There is therefore a need to provide a supportive and less intimidating environment for people to share their distressing experiences. In addition, the members on these committees are likely not to be trained or equipped with skills to support persons emotionally through potentially difficult narratives. When intimidated and distressed, people often cannot relate their experiences logically. It is important to be able to support people through the process of narration to make sense of what they are saying.

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The Reconciliation mechanism must not only seek to achieve peace at a national level but also be designed to respond to individual suffering and support people at their own pace. Individual suffering must not be overlooked in the process of collecting testimonies. IMPACT OF A RECONCILIATION PROCESS ON PSYCHOSOCIAL WELLBEING There is little focus on how the process of truth seeking, justice and reconciliation -i.e. the conceptualizing, designing, setting up and implementing, analyzing and concluding mechanisms - may impact on the psychosocial wellbeing of the broader community and of those who ultimately participate in the process. Defining human rights violations for the purposes of justice and reconciliation is particularly relevant because of the wide range of human rights violations that have occurred in the different parts of the country involving different conflicts and communities. There will be a need to respond to all individuals or groups who have experienced human rights violations; whether in the north, east or south of the country, whether perpetrated by state, militant or paramilitary forces, whether it was statefacilitated political thuggery or facilitated by those who used the prevailing security context to settle personal vendettas. What do justice and reconciliation mean to people? In addition, timing is crucial. There has to be serious thought given when imposing time periods for reporting human rights violations, and for deciding on the inclusion and exclusion of different groups of people. The transitory nature of truth commissions (special courts and commissions set up for particular purposes) mean that they are valid for a limited period of time during which people seeking justice will have to come forward to share their experiences. Since some

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people may take longer than others to be ready to share their experiences or go through a justice-seeking process, the time limit makes it difficult to access the justice mechanisms at a time when one is ready to do so. As a result some people may suffer during the process because they may feel compelled to access the mechanism when it is available, even though their emotional and social state may not be the most suitable for them to go through such a process. Alternatively, people may choose not to go through the process because their social, economic and emotional states do not easily permit this at the time when the transitional justice mechanism is being implemented. This latter group of people may be required to entirely forego engaging in truth seeking and justice processes. When conceptualizing Reconciliation mechanisms, there is a need to take into account that people may have experienced multiple human rights violations. In Sri Lanka, a person may have not only lost their property and land during displacement but may also have suffered from landmine injuries on their return as a result of indiscriminate mining of unoccupied land by state forces or militant groups during active conflict. It needs to be recognized that for the person who has experienced these events, both issues (i.e. the loss of property and land and of personal injury caused by failure of state and militant groups to honor established land-mining practice stating that private land should not be mined) are most likely seen as a continued experience. The design of reconciliation mechanism may mean that first the multiple human rights violations are dealt with as separate issues, requiring people to go through multiple processes to redress the multi-faceted nature of their human rights violations before expecting them to go through a reconciliation process.

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Given that one of the purported objectives of knowing the truth is to seek accountability for the terrible experiences people have gone through, it is particularly important to recognize that the issue of accountability is closely linked to individual and social explanations regarding the causes of conflict, its related atrocities and the subsequent suffering. In order to achieve a sense of justification for all who have suffered human rights violations, it is necessary that people be punished for committing grave human rights violations. In the case of people who have committed human rights violations that have resulted in the suffering of others, it is important to consider how they are brought into the reconciliation process. Such a process needs to create an environment conducive for people to reflect upon the motivations for their behaviors, understand the context in which they acted, and consider the consequences of their actions on others. This may allow people to retain different identities other than that only of a ‘criminal’ or a ‘rapist’ or a ‘corrupt politician’. These other identities would be extremely important to help the person to readjust within mainstream society. A process in which these other identities are destroyed are weakened will create more challenges for people who have to go back to their communities and lives following punishment. To be named as a perpetrator or victim when this does not describe the way people feel about themselves or their experiences can be psychosocially distressing. This can be the case for a number of reasons. Firstly, because their self-perceptions have not been respected and acknowledged people may be confused about why a particular label has been assigned to them or they may resent the conferring of the term to themselves as

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it does not resonate with their own interpretations and experiences. Secondly, assumptions (perhaps wrongfully) have been made about people’s capacities and level of control over their lives, without considering the context in which people have acted. The process should not be oriented towards apportioning blame or guilt of people but rather towards developing a sense of personal accountability for their actions and acceptance of wrongdoing. At the same time, it is important that the process allows people who have experienced human rights violations to feel that adequate justice has been done for their suffering. Along with that, it is important that the process helps people who have committed human rights violations to identify alternate ways of responding to situations in a socially-sanctioned and just manner. Despite these measures to ensure a fair hearing for the perpetrators of violence, care should be taken to avoid homogenizing the suffering of the survivors and perpetrators.

CONCLUSION The psychosocial sector can indeed play a very important part in facilitating reconciliation processes. It is essential to first acknowledge the grievances of the people from all parts of the country and to provide psychosocial support while accompanying them in their pursuit of truth before commencing reconciliation efforts. The narratives collected by the psychosocial sector and the victims themselves can facilitate the design of comprehensive, culturally acceptable and meaningful reconciliation initiatives. They have to be active stakeholders in the process. As the new government has undertaken to “work towards reconciliation of all ethnicities and religions according to the recommendations of the Lessons Learnt and Reconciliation Commission”, there is hope for a better life for people in Sri Lanka and as

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Subha Wijesiriwardena so beautifully writes: “If someone says ’let’s forgive and forget, it’s time for a new Sri Lanka’, we should say to them: We can forgive but we must never forget; there is no new Sri Lanka without the old; we cannot build a future that does not acknowledge the past; we will not live in a nation in which we have not all, without exception, been given the chance to rebuild our lives, and the very luxury of the choice to forgive” (Wijesiriwardena, 2015 ). And then, may be some day, Democracy may become a ‘feeling’ for even those who suffered the consequences of the war.

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********************************************** Focus Book Series When Stories Clash: Addressing Conflict with Narrative Mediation, (2013) by Gerald Monk and John Winslade (also available as an e-book) Bereavement Support Groups: Breathing Life Into Stories of the Dead (2012) by Lorraine Hedtke (also available as an e-book) The Appreciative Organization, Revised Edition (2008) by Harlene Anderson, David Cooperrider, Ken Gergen, Mary Gergen, Sheila McNamee, Jane Watkins, and Diana Whitney Appreciative Inquiry: A Positive Approach to Building Cooperative Capacity, (2005) by Frank Barrett and Ronald Fry (also available as an e-book) Dynamic Relationships: Unleashing the Power of Appreciative Inquiry in Daily Living, (2005) by Jacqueline Stavros and Cheri B. Torres Appreciative Sharing of Knowledge: Leveraging Knowledge Management for Strategic Change, (2004) by Tojo Thatchenkery Social Construction: Entering the Dialogue, (2004) by Kenneth J. Gergen, and Mary Gergen (also available as an e-book) Appreciative Leaders: In the Eye of the Beholder, (2001) edited by Marge Schiller, Bea Mah Holland, and Deanna Riley Experience AI: A Practitioner's Guide to Integrating Appreciative Inquiry and Experiential Learning, (2001) by Miriam Ricketts and Jim Willis ********************************************** Books for Professionals Series Social Constructionist Perspectives on Group Work, (2015) by Emerson F. Rasera, editor. New Horizons in Buddhist Psychology: Relational Buddhism for Collaborative Practitioners, (2010) edited by Maurits G.T. Kwee Positive Approaches to Peacebuilding: A Resource for Innovators, (2010) edited by Cynthia Sampson, Mohammed Abu-Nimer, Claudia Liebler, and Diana Whitney Social Construction on the Edge: ‘Withness’-Thinking & Embodiment, (2010) by John Shotter Joined Imagination: Writing and Language in Therapy, (2009) by Peggy Penn

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Celebrating the Other: A Dialogic Account of Human Nature, (reprint 2008) by Edward Sampson Conversational Realities Revisited: Life, Language, Body and World, (2008) by John Shotter Horizons in Buddhist Psychology: Practice, Research and Theory, (2006) edited by Maurits Kwee, Kenneth J. Gergen, and Fusako Koshikawa Therapeutic Realities: Collaboration, Oppression and Relational Flow, (2005) by Kenneth J. Gergen SocioDynamic Counselling: A Practical Guide to Meaning Making, (2004) by R. Vance Peavy Experiential Exercises in Social Construction – A Fieldbook for Creating Change, (2004) by Robert Cottor, Alan Asher, Judith Levin, and Cindy Weiser Dialogues About a New Psychology, (2004) by Jan Smedslund For book information and ordering, visit Taos Institute Publications at: www.taosinstitutepublications.net For further information, call: 1-888-999-TAOS, 1-440-338-6733 Email: [email protected]

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