August 4, 2018 Philip Holmes

Theraplay in Nepal

With a vital training input from volunteer consultant Debbie Mintz, ChoraChori has started using theraplay as a powerful therapeutic tool at its child trauma management centre in Kathmandu.

In the past week ChoraChori has admitted a ninth victim of child rape to its child trauma management facility in Kathmandu. The task of therapeutic management of children who have experienced almost unbelievable horrors, including at Indian “children’s shelters”, is a daunting one. Our local staff are very highly trained but remain open to new therapeutic approaches that can help them meet the challenge of restoring children’s confidence in themselves and in humanity. Accordingly, we have been delighted to receive the very timely British volunteer consultant support of Debbie Mintz who has trained staff in the technique of theraplay.

Theraplay is a proactive, intensive, relationship-focused therapy, modelled on the natural patterns of early healthy interactions between parents and infant; the kind that lead to secure attachment and lifelong good mental health. Theraplay is uniquely suited to the treatment of complex trauma in children because the model focuses on developing a secure base, strong attachments, concrete guidance, support and nurturing. These are the foundations from which a child can utilise natural reparative mechanisms, address their traumatic history, and have a restorative experience.

Whilst theraplay treatment is often carried out with children and their parents, it is very suitable for use with children whose primary relationships have broken down. With an attuned therapist guiding the child sequentially through phases of treatment, safety and security are first established in the relationship, allowing trauma to be addressed directly, and finally allowing social reconnection with others. Theraplay functions to create a sense of safety for the child by anchoring them in a nurturing, safe, and structured relationship, thus addressing attachment concerns first. Once children establish a sense of feeling connected to one important other, the trauma work can proceed with greater ease since the emotional foundation is set.

The benefit has been immediate and dramatic. Debbie writes:

I have been in Nepal for almost two weeks now and my experiences have not necessarily met my expectations. Teaching the therapists here to use theraplay as a part of their therapeutic model was a pleasure and easier than I expected. They have a natural warmth, compassion and intuition that makes them ideally suited to the attachment-focused theraplay model. Beginning theraplay sessions with the children has been deeply moving and has not taken the course I expected at all. The usual curiosity that I see in children in the UK is very much present, but the natural resistance that often comes with it is not. I will have to think more about why this is, but my initial instinct is that these children are so desperate for safety and nurture that having found physical care and security with the dedicated staff at ChoraChori, they have almost been waiting for the engagement and nurture of theraplay. We have already seen remarkable results. Within the first week children unexpectedly and spontaneously shared previously undisclosed traumatic experiences of the most severe nature to their trusted therapists. This seems to have come much more speedily than expected on the safe foundations that the close and attuned interactions of theraplay have provided.

ChoraChori is making a very strong start into an area of childcare where few organisations and charities wish to venture; it is just too difficult, too harrowing and too demanding of a long term commitment. But alongside our partner Unity in Health we are laying the foundations of a therapeutic service that is so badly needed in Nepal given the scale of the problem that we need to address.

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