Update Report from Chennai, India - November 2005 - by
Dr Viswanathan and Dr Martinez
Following the Tsunami of the 26 th December 2004, many areas of
South East Asia were devastated. Dr Viswanathan through the local
organisation Madras Christian Council for Social Service (MCCSS),
made an initial assessment of the needs in the area of Pulicat
Island. The findings of this assessment revealed, that indeed quite
a number of residents were suffering from mental and behavioural
problems following the disaster. This particular area, even though
it had been stricken by the tsunami, as happened to quite a number
of areas, was not declared a disaster area, and this meant that the
provision of services for people living in the area was limited.
Due to its remoteness, access to the island was also difficult, as
it is 80 Km North of Chennai and a further boat ride away.
Following the initial assessment, a project proposal was written
up by Dr Viswanathan to set up a Trauma Counselling service which
would recruit 14 staff, however, the funding for this project was
not available, and both MCCSS and Dr Viswanathan arranged an
alternative project, which would work on existing resources and
staff, and the aim of the intervention would be to strengthen their
skills and to provide introductory skills in Cognitive Behaviour
Therapy (CBT). In response to a request by Dr Viswanathan, Dr
Martinez agreed to collaborate with the project for a period of two
weeks (28 th October - 12 th November 2005) to help to provide CBT
training.
Prior to the arrival of Dr Martinez, Dr Viswanathan delivered a
training workshop in the headquarters of MCCSS, which was well
attended by staff of the organisation, as well as workers from
other organisations. MCCSS and Dr Viswanathan arranged the training
schedule and venues for the CBT training, it was organised as a
2-day training workshop, which was delivered in a number of
settings, in order to keep the numbers in the groups low enough so
that there would be opportunities for interactions, role play and
to listen to the participants’ experiences. The settings where the
training was delivered included: The Madras School of Social Work,
Teachers of the Madras Diocese, Stella Marie’s School of Social
Work, and the Loyola College.
The training that was delivered, intended to build on the
existing knowledge of the participants, and to provide a framework
and some tools to work with their clients. The feedback that was
received by the participants was very positive, they felt that they
could use the techniques, and they found that using some of the CBT
tools would be helpful for their clients. The training focused on
very practical aspects of CBT, and the participants found the use
of the formulation particularly useful, as a tool to use with their
clients. During the training we used real cases that the
participants felt happy to discuss with us.
The participants also gave us some insight into their own
constraints in their work. One of the common difficulties expressed
was the work overload that they felt they were suffering. At
present, the number of people in need of mental health services
outnumbers the capacity of the workforce. The participants also
discussed that in many occasions, people did not receive help for
their mental health problems, unless these were very severe, as
they tried to keep things in the family as much as possible.
Participants felt that there was a great need to increase the
awareness of mental health issues.
In their placements, mental health workers were also facing the
difficulty of lack of supervision of their work, and in some cases
professional isolation. One of the unexpected successes of the
training was that an e-group was set up called “Ullaviyal Poonga”
literally meaning Mind Garden. The participants felt that this
would be a good place for them to share resources, network, and
discuss issues relating to their practice and professional
development. During our stay we met Professor Nambi, The President
of Indian Psychiatric Association to discuss the present state of
CBT practice in the Indian psychiatric scene.
We found that the participants in our training workshops were
very enthusiastic, and the scope for future interventions and
collaborations with the Royal College of Psychiatrists could have a
great potential. The receiving institutions where the training was
delivered were very positive about receiving training input; one of
the requests that was made specifically through the group trained
at Loyola College, was about the possibility of providing a more
formal training in CBT leading to a formal qualification, as at
present in India there is no formal training in CBT, and those who
are trained have received their training in the UK, or perhaps the
possibility of arranging further opportunities such as this one for
ongoing training, and the opportunity to receive formal supervision
for their cases. It may be that prior to exploring these options, a
consultation at a strategic level may help to tailor the most
adequate future interventions that will help maximise their
potential.
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