Philadelphia Refugee Mental Health Collaborative BuildaBridge International report of Year 1

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BuildaBridge Year 2 Report Philadelphia Refugee Mental Health Collaborative

Mission – To connect newly arrived refugees to culturally and linguistically appropriate mental health care, including support groups, therapy, and community-building arts and education projects. Vision – All refugees have access to quality mental health supports, including a network of trained professionals committed to serving refugee populations, appropriate translation services and treatment centers who access these services and recognition of alternative treatment modules and funding for them.

BuildaBridge Narrative Summary During Year 2 of the Philadelphia Refugee Mental Health Collaborative (PRMHC), BuildaBridge continued to provide high-quality, culturally specific art therapy and therapeutic art-making groups in the community context to the Burmese and Bhutanese refugee populations living in South Philadelphia. The BuildaBridge ClassroomSM, a trauma-informed, hope-infused, child-centered replicable model that includes a restorative justice approach for working with youth served as the foundation of the art therapy groups. Built onto that foundation, the groups accomplished two goals: 1) Assisted refugee children in working towards mental health goals set by art therapists based on children’s identified behavioral problems and 2) Taught children key life lessons through art-making in one or more of the BuildaBridge ClassroomSM Model outcome areas (Artistic, Social, Academic & Character Development). Woven throughout each group, therapists used art and art-making as a metaphor for additional life skills and lessons. It is these elements that assisted refugees in identifying adjustment strategies based on the strengths of their communities in promoting success, strength, recovery and resiliency in a new culture. Personnel

Year 1 Year 2 Total number of artists engaged: 15

Creative Arts Therapists 5 6 4 artists involved for both years

Assistant teaching instructors 5 3

Total number of Artists 10 9

Outputs

11 Burmese groups 46 Burmese individuals - 44 Burmese children plus 2 Case Aides

18 Bhutanese groups 18 Bhutanese children

2 Bhutanese Family Art workshops 4 Bhutanese parents, 2 Case Aides, 3 siblings plus 8 regularly attending children

Total number of refugees 73

Art instructor Robert Kelleher and child dancing during a Bhutanese group, March 2013

Philadelphia Refugee Mental Health Collaborative BuildaBridge International report of Year 1

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PRMHC Goals and Outcomes The goals and outcomes for refugee art therapy groups are detailed extensions of three of the PRMHC’s original goals:

Building ethnic community capacity to recognize and address behavioral health needs in their communities

Development of culturally appropriate supportive groups for new arrivals to deal with resettlement and forced migration stresses in non-traditional settings

Increasing understanding of the adaptive strategies of new refugee populations

Art therapists identified Year 2 goals for their respective groups based on the previous year’s goals and assessments documenting children’s progress in addition to their observations of children during the first two groups of Year 2. Bhutanese Year 2 Goals 1. Help each child to express their thoughts, ideas, and emotions non-verbally through the creative process of movement and visual arts and verbally through language. 2. Create a sense of group cohesion and community; encourage bonding among children. 3. Identify significant emotional and/or mental health concerns that require recommendation to additional mental health services. 4. Increase impulse control; specifically (a) during transitions that require moving through space, (b) waiting for a turn to participate, and (c) gently touching others when invited and calmly choosing art supplies. 5. Encourage utilization of various art-making (such as movement, drawing, painting, and storytelling) for self-expression and growth both in session and in other areas of the child’s life. Bhutanese Outcomes 1. 90% of children exhibited growth in personal expression through art-making as evidenced by:

The increased length of time each child spends on their individual artwork or movements

The conscious choosing of art materials for texture, size and color

The decrease in direct copying of one another’s artwork. Children continue to share ideas but develop the ideas further to be personally meaningful.

Increased amount of narrative appearing in children’s artwork

2. 100% of children developed culturally appropriate group cohesion as evidenced by:

Children taking turns - allowing others to demonstrate their individual movements or sharing of artwork without interrupting

Children’s ability to transition between art experiences (lining up, cleaning up)

Children’s ability to welcome one another and visitors into the group appropriately

Children’s ability to navigate space appropriately during movement activities

Contributing to group murals effectively – children contributed their individual artwork to murals and created artwork in pairs or with the group for the piece

3. 100% of children exhibited understanding of BuildaBridge metaphors for life lessons as exhibited by:

Verbal responses to therapists’ questions regarding the metaphor

Children’s comparison of the metaphor to an experience in their own lives

Children’s artwork demonstrating understanding and comprehension

Instructor Julia Crawford engages in discussion with a child about his artwork

Philadelphia Refugee Mental Health Collaborative BuildaBridge International report of Year 1

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“It may be that children and mothers and grandmothers who are seeking refuge in a new country feel that no place in particular is home as they strive to integrate the values and rituals of the past with survival in the present, but it also may be that home can be felt for a moment in someone’s eyes when you are surrounded by people who want the best for you.” – Julia Crawford, Lead Therapeutic movement instructor for Bhutanese group

Therapists and Artists plan activities to include at least one or more of the BuildaBridge ClassroomSM Model Outcome Areas. The following concepts were taught through art-making during Year 2 of the Bhutanese groups. Artistic

Combining individual movements to create a choreographed dance

Knowledge of movement types with props and with children's own bodies (i.e. fast, slow, light, fast, etc.)

Isolation movements with body parts

Color recognition, mixing and differentiation (warm vs. cool and mixing red with blue to make purple)

Knowledge of music types and the respective movements for those types

Learning to paint with watercolors

Character Development

Building of confidence and public speaking skills (Motto & Rules)

Recognition of the resources in a child's life that will help them grow personally (family, community, school, love, etc.)

Helping children recognize themselves currently and a vision for themselves in the future

Social

Respect for the individual creativity of peers

How to work together as a group to accomplish a common goal

Respect for personal space and sharing of resources

Respect for teachers and adults

Group unity and cohesion among refugees

Academic

Science of a tree (how it grows, what it needs to grow, what it looks like and produces)

Advancing knowledge of feeling words, the variety and spelling of them

River flow

Creatures that live in rivers (mammals, fish, amphibians)

Children and therapists sharing their sea creatures in the river mural they created

Bhutanese Group Attendance Highlights (18 groups total)

Eight children attended at least 11 groups or more

One had perfect attendance

Two children attended 17 groups

Two children attended 16 groups

Philadelphia Refugee Mental Health Collaborative BuildaBridge International report of Year 1

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“It is great if we as therapists and Artists-on-Call can speak blessings to these children, but even better if we can teach them to do it to one another.” – Natalie Hoffmann, Lead art therapist for Burmese

Burmese Year 2 Goals 1. Have all students and Artists on Call learn everyone's names. 2. Use movement activities to build group cohesion and

encourage affect expression 3. Supply children creative and nonverbal outlets, both through

movement and visual arts, in order to express mood, affect, trauma, and life experiences.

a. Use a story book activity as a metaphor for children to tell their own stories, share their experiences through art, and build sense of identity, self-worth, and self-esteem.

4. Support positive social interactions with peers & Artists on Call Burmese Outcomes

1. 100% of children demonstrated the ability to speak blessings (positive affirmations of a person and their future) to their peers as evidenced by:

The compliments children gave each other on their artwork 2. 75% of children demonstrated understanding of a ‘Story’ as evidenced by:

The illustrated timeline of events in children’s story books 3. 100% of children demonstrated the ability to comprehend and express ideas non-verbally, through either movement or art, much better than verbally as evidenced by:

The increase in children following the rules throughout group because they attached movements to each of the five BuildaBridge rules

The increase in children’s willingness to share their artwork by showing it or passing it around rather than verbally explain it

Therapists and Artists plan activities to include at least one or more of the BuildaBridge ClassroomSM Model Outcome Areas. The following concepts were taught through art-making during Year 2 of the Burmese groups.

Lead Art Therapist Natalie Hoffmann leading children in the BuildaBridge Motto and Rules

Artistic Learned how to draw and then illustrate self-portraits

Character Development

Building of confidence and public speaking skills (Motto & Rules)

Helping children recognize themselves currently and a vision for themselves in the future

Social

Respect for the individual creativity of peers

Relating to peers and adult mentors with similar experiences can build bonds

Respect for teachers & adults

Academic

Components of a story – beginning, middle and end

Burmese Group Attendance Highlights (11 groups total)

Nine children attended at least 5 groups or more

Five children attended 6 groups Twenty-four new children joined a group when they re-started in April after having a break since the Fall

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Highlights Developing Leadership Skills P. is developing greatly in impulse control and is becoming a leader in the class. He lights up when he is asked to lead. He patiently waits his turn to read the lines of the motto and rules because he knows his turn is coming. He watches the therapist’s eyes intently and when she looks to him he often says, “it’s my turn” and then reads. He is wholeheartedly engaged in painting, often producing more than 3 pieces of art with each project. When he finishes, the therapist engages him in conversation about his work; it is clear that he has completed the piece the way he planned it. He also often dances with his whole body, doing a repetitive knee lifting jig that uses more of a range of movement than many of the other children use. This appears to encourage others to explore. – A therapist’s assessment of a Bhutanese boy (P.) in March 2013 Confidence in expressing feelings through movement The group has become confident in their feeling words; they do not hesitate to create movements or share what words they think go with a song. – Therapist’s assessment of Bhutanese group in February 2013 Individual creativity blossoms Narrative, expression, and even abstract mixing of colors are taking place in their work. They have not discussed what to paint before starting in the last two weeks’ they have just begun their work. Ideas about what to paint seem to come near immediate. No one has hesitated to start; they just put the brush to the paper – Therapist’s assessment of Bhutanese children and their artwork in February 2013 Art as a metaphor for life lessons

Therapists used metaphors of a tree and a river to teach Bhutanese children key life lessons during the Spring 2013 groups. These included: “Going with the flow is like a Goals for oneself - Therapist said just like the river’s goal is the ocean, she asked the children if they had goals. S. wants to be an architect, Su. wants good grades, R. to be a martial artist and B. to be an artist. Making something new out of something bad – Therapist led a discussion that even though the tree had a cut in its bark it was able to continue growing. R. and S. described that trees take in bad air and make it good air. The therapist asked children if they ever do that (take something bad and turn it into something good). R. responded by saying that he does that a lot and gave the example that if a toy car breaks, that if the wheel falls off you can use the wheel for something else and you can still play with it. The others agreed.

Hope for the future – The therapist instructed children to trace hands, cut out hands, and decorate the hands with the things they give to others and/or the things they hope for the

world. These cut-out hands would serve as the leaves on the group’s tree mural. Common themes were to stop cutting down trees, stop killing animals, trees help all living things, and plant more trees. All children were deeply engaged in this experience. Turning mistakes into opportunities - “Going with the flow is like a river because it keeps flowing through different obstacles.” Children learned how to turn mistakes on their artwork into something new; the same way one can make a mistake in life and turn it into a new opportunity. Children understood this lesson as evidenced by their responses, “You can work through it” or “You can change it into something else” and also by their artwork.

Bhutanese child adds images to the group’s tree mural

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Art-making allows children to externalize the internal without the use of words The topics and themes present in their books seem to speak to the child's desire to embrace American life and be "normal" children here in the US. It seems to speak to a need to fit in and connect with their American peers. When asked to speak about their artwork, the children appeared to struggle with the verbal component.-They were very engaged in their drawings, but had trouble speaking about them. – Therapist’s assessment of the Burmese children’s storybooks, May 2013 Artist mentors find shared experiences with children Children were very interested in Art Therapist's trip to Ireland. It appeared to better allow the children to speak verbally about their own experiences coming to the United States. They appeared to better connect with the Art Therapist when they knew that she too had been on an airplane to take a trip. – Therapist’s observations of Burmese children’s responses to a trip overseas, June 2013 Links Photo Album https://picasaweb.google.com/117182181509527732452/PRMHC?authuser=0&authkey=Gv1sRgCOKj7MOV3dfsWA&feat=directlink Project Website http://buildabridgerefugeeproject.blogspot.com/ Project Video http://vimeo.com/65112790 PRMHC website www.culturalcommunities.org

Therapist Jessica LaBarca shows Burmese children how to do their storybook

Bhutanese children engage in the movement activity of the day