Helping Clients Come ‘Back to the World of the Living’

Medhanye Alem is a counselor at CVT Ethiopia, Mai Tsebri.

What does a counselor do when your client hides to avoid going to her first session? In my work as a counselor for Eritrean refugees who have survived trauma, many of them children, I am always ready for surprises. And we continuously look for ways to engage children, as well as trauma survivors of all ages, in the counseling process. For the very young clients, most of them unaccompanied minors in the camps, we have many child-friendly techniques that we use and that we adapt as the needs of the children change and as the demand for counseling grows.

Before I took my position at CVT, I was a counselor in a private school in Addis Ababa. I enjoyed working with the students, but I was also very interested in working with refugees, especially people who had been through traumatic experiences. I spoke with friends who told me about CVT’s work and how clients  who went through CVT’s counseling sessions were able to change their lives after the experience of torture. They told me the counseling helped them regain hope. I wanted to help, to contribute my knowledge and skills.

I moved to CVT, and today as a counselor I engage in many different activities that provide care for Eritrean refugees who have experienced trauma. One of the first things I do with the community is to conduct psychoeducation sessions and sensitization events. These events raise awareness about traumatization from torture and provide people with stress coping strategies. During these engagements with the community, we also look for potential clients.

I also facilitate the weekly group counseling session with people who have experienced torture or trauma – this is the most important thing about my work. And it is very rewarding work, especially when I begin to see people’s symptoms mitigating and see them beginning to function well. They become engaged in many parts of their lives again, doing things they had stopped as a result of their traumatic experiences.

In one of our recent adult women’s groups, this was the first time the clients had ever been in this kind of group session before. I watched over the weeks as they built relationships with the other group members, relationships which continued once the counseling cycle was complete. After the sessions, they continued to meet on Sundays to share coffee. The group keeps getting together just to cope and support each other. I also am encouraged when I see clients find employment and get hired after they’ve gone through the counseling. Some become workers, taking jobs with other organizations and gaining experience.

We assess clients during an intake process and assign them  to groups based on a number of factors, including age and gender, so I work regularly with minor’s groups. When one young client of mine first came to CVT, he had been behaving aggressively with his dorm mates and friends. We did individual counseling and group work with him. It did not take long before he became a very good client. He showed up regularly and took on different activities we organized. He noticed this change in himself; it made such a difference for him. He now engages in sports in the camp. I feel proud when I see this.

In group sessions, we help the clients process their trauma experience. They work on their difficult moments, difficult memories. When they first come to CVT, many of them have been keeping themselves alone, isolating themselves from the community. They often have no self-esteem. The counseling sessions help them process their trauma, and they begin to build their self-confidence – this is very rewarding to me.

Especially when we first meet clients, they tell us they feel very hopeless. They feel worthless. But by the time they have completed the counseling cycle, they are talking to their neighbors and making friends. All these services helped. They’re hopeful. Now they have someone to talk to – that’s CVT. One client told me “I have come back to the world of the living.”

We also do three- and six-month follow up check-ins with former clients, so I learn how they are doing long after they have finished the counseling. I find that some of them stay in the camp instead of going on a secondary migration; some plan to stay longer. They are building lives. This is the work of CVT.

I spend much of my time working with children, and I am the focal person for child-related issues for CVT in Mai Ayni camp. In addition, in August 2016 I took part in Nairobi's especial child protection project workshop which was organized by UNHCR. This workshop shared information about CVT’s work with unaccompanied and separated children since we start operating in Ethiopia. We were applauded for our contribution, particularly in intervening in suicidal cases because we managed to reduce the incidents through our continuous psychoeducation programs.

Our approach to counseling is totally different for children. They have difficulty processing their experiences of trauma. Often they feel isolated from their family members – this leads them to feeling depressed.

As counselors, we come up with child-friendly methods, things that will capture and hold their attention and help change their attitude about counseling. We have them play indoor games and other activities. We have to draw from a different plan for children so they become interested. Otherwise, they can’t speak openly. They aren’t ready to share.

The minor girls often have a lot of difficulties. They don’t want to attend group sessions at first, and that is when some of them hide when it’s time to go to counseling. They’re not interested. For the girls, we have activities they do with nail polish and lotions. We also have them work on crochet. For the boys, we do indoor games in a circle, with different types of balls – sports activities they can engage in with each other. Once we introduce them to the crafts and games, the problems go away.

Over every counseling cycle, I see so many improvements in the children’s well-being but also in their perception of CVT and of counseling. But we always try to come up with new and different techniques. And we are always working to have more sessions for children – there is more and more demand all the time. There are simply so many referrals. It’s very difficult to reach every child who needs help, so we try to always come up with different techniques so we can help even more.

CVT’s work with Eritrean refugees in Ethiopia is funded by a grant from the U.S. State Department’s Bureau of Population, Refugees, and Migration.