Being Trauma-Informed At Hagar


6F4A6853“Hagar’s trauma-informed approach is strengths based, endeavouring to empower students in their learning by providing an environment where they are ‘Safe, Welcomed and Supported’ I am passionate about trauma informed care. I want to see more counselors and partner organsiations understand what TIC is, and understand tools to best use it with clients.” – Raksmey Sanh

Definition of Trauma Informed Care

Trauma- informed care is an approach to engaging people with histories of trauma, recognising the presence of trauma symptoms and acknowledging the role that trauma has played in their lives.

National Center for Trauma Informed Care (NCTIC, www.samsha.gov/nctic, 2013)

Being ‘trauma-informed’ at Hagar

For more than a decade, trauma informed care has been at the heart of Hagar’s recovery services.

Hagar’s trauma-informed model was developed in 2004 and has since been implemented across every programme. Over the years, Hagar has also taught numerous organisations the skills necessary to ensure an effective treatment environment.

Hagar’s trauma informed care (TIC) was first developed by Sue Taylor, a New Zealand social worker, who has worked in the field of human rights in developing nations for over twenty years.

For over 11 years, Sue brought professionalism through her skills to shape counselling and trauma focused cognitive behavioural therapy (TFCBT) in Cambodia.

Until 2004, Hagar had only been delivering aftercare services to only a handful of individuals. Over the years, as client numbers grew, Hagar built a strong counselling team.

At Hagar, every staff member, regardless of their role, is expected to attend 4 days of training on trauma, providing ongoing supervision to Hagar’s case managers and counsellors who work directly with Hagar clients.

When Raksmey Sanh first joined Hagar, he assisted Sue Taylor in developing the TIC course. As she delivered the training, Raksmey would interpret, allowing him to gain expertise on TIC.  When translating the TIC workshops, Raksmey realized there were some words that needed clarifying to him and the participants. The Cambodian language did not contain psychology specific vocabulary. He used a book entitled “Understanding about trauma in Cambodia”- bilingual book on trauma- as a useful tool to translate and has contributed a lot to the trauma informed platform across Cambodia.

In 2012, Raksmey was promoted to become a project coordinator for TIC. The project evolved from TIC to “Psychosocial capacity building project” expanding the project to provide basic/ systematic counselling, crisis intervention, training on how to respond to suicide as well as TIC training. Since then, over 20 TIC trainings have been delivered to Hagar staff, with a further 15 training sessions delivered to partner organisations.

From Bun Heng working at Hagar Cambodia:

I think the training is very helpful and very interesting. I gain a lot from it. I learnt about the process to work with my client, improving and developing my profession, and I can help my clients to deal with their anxiety. I like the trainers. The trainers provide monthly supervision where I felt motivated and supported, and received more information. I have one client who told me – “I am really thankful to you that you do some activities to help me like genogram, stop think and do, problem solving, breathing exercise, and safety plan.””

From clients:

“I feel really happy to see you as I can play and express my feeling and family. I hope to see you next time.”

“After doing this activity, I know my clear goal that previously I have never dreamed or thought about it.”

“I feel happy and confident and have high commitment to study and follow my hero”

Background on Cambodia’s education system

Education has progressed slowly in Cambodia since its first high schools opened in the late 1930s, with higher education institutions following suit in the 50s and 60s. The gains in education disintegrated during the regime of the Khmer Rouge (KR) in 1975 to 1979, when schools nationwide were ordered to close and teachers were among the first victims of the KR regime; an estimated 90% of teachers were killed. The genocide under the KR regime was not only unparalleled, but by targeting educated adults it has created a vacuum in the middle-aged group in the current labour force, particularly in Cambodia’s educated population.

The devastating outcomes of the genocide and then the twenty years of international isolation that followed continue to have broader societal implications. Cambodia is a vulnerable nation for human traffickers and continues to be a source, transit and destination country for trafficking.

This vulnerability and the increase in human trafficking can be contributed to a number of factors including poverty and high-unemployment, increased tourism, a socio-economic imbalance between rural and urban areas and a lack of education and safe migration. Cambodia is one of the poorest countries in Asia with 28.3% living below the poverty line of $1.25 a day (UN, 2014). Child abuse and neglect are common, with research suggesting that abuse and ill-treatment are everyday features of life for many children. This needs to be seen in the context of Cambodian history and culture, the devastation of KR regime, intergenerational trauma and the current socioeconomic climate is a complex picture, which does not lend itself to a simple explanation.

Another consequence of the KR regime is the relatively high prevalence of post-traumatic stress disorder among survivors, with one national study citing 14.2% of the population continuing to suffer psychologically because of the trauma they experienced under the KR regime. Given that more than 60% of present-day Cambodians were born post KR regime, there is substantial evidence of secondary traumatisation in the offspring of parents linked to their experiences of KR trauma. Among those affected by trauma are parents, whose children’s attachment signals may trigger traumatic memories of their own childhood. This may interfere and compromise with their ability to effectively function as parents. As such, trauma interacts with Cambodia’s education system on various levels.