The Benefits of Group Interventions in Building Self‐esteem and Resilience in Children and Adolescents living with and affected by HIV Chilombo Olawoye, Program Manager, Dorothy Odhiambo, Family Support Coordinator The Teresa Group OHTN Conference Nov 21, 2016
The Teresa Group • Mission : to advance the dignity and well‐being of children and families affected by HIV • Serve families throughout the GTA with care and support programming including practical supports, therapeutic groups for children, peer support groups for parents, tutor/mentor program, Summer Camp • Province‐wide infant formula program to prevent vertical transmission of HIV • Most clients are from ACB communities, predominantly refugees from countries in Africa • www.teresagroup.ca
The Teresa Group clients We serve over 350 families • Active clients (Children) in the past two years: • Approx. 40 children under 14 living with HIV • Approx. 20 adolescents living with HIV • Approx. 350‐400 affected children under 14 • Approx. 60‐70 affected children 15+ Focus on working with the family from the prenatal stage throughout high school graduation
Children living with and/or impacted by HIV exhibit: Purpose • Increased symptoms of stress/anxiety • Depression • Low self‐esteem • Behavioral Issues
Children/adolescents living with HIV • Transition to adult care • Sexual health and relationships • Communication and conversations in families • Feelings of blame and guilt between parent(s) and infected children, when child doesn’t know full story behind parent’s infection, situations of trauma and violence. Dynamics, anger and behavioural issues • Treatment adherence – pediatric formulations, emotional issues, daily reminder, “long‐term survivors”/”aging” with HIV in your teens • Disclosure for children and teens – many complex issues • Children managing secrets when siblings don’t know – making up stories about medications • Teens wanting to address stigma and be more open vs parents who are afraid
HIV‐affected children • Survivor guilt, protectiveness of parent(s), children taking on parenting roles • Impact of non‐disclosure to children – trust, relationship with parent (especially if told as teens), impact of secrecy in the family and how children grow up, mental health impacts in adulthood • Social isolation parents who self‐select children out of programs, friendships and other community engagement opportunities – impact of stigma and fear
Issues for parents • Disclosure to children, conversations about sex, trauma, violence • Treatment adherence challenges with a new infant • Being and staying “undetectable” • Family separation and unification • Coming to terms with own diagnosis and managing your child’s • Relationships between women and their male partners – trust, men not getting tested, men as unstable partners in women’s lives • Children who want to be more open and disclose • Family support for HIV+ women – differences in parenting styles, confidence and mental health between women who have the support of family and friends and those who don’t
Leading the Way • Leading the Way (LTW) is a therapeutic group that is divided into two components • LTW for undisclosed children, ages 7‐9, runs for 7 weeks in the fall and 7 weeks in the spring • LTW for disclosed youth, ages 15‐18, runs for 7 weeks in the winter and 7 weeks in the summer • Both groups are facilitated by Teresa Group staff and external facilitators
Leading the Way‐ Undisclosed • For undisclosed children: Creates an environment of mutual support, cohesiveness and practical skills to deal with complex emotions, fears and challenges children may be facing at home or in school • Themes are explored through play‐based therapy, discussions, individual and group activities (art, cooking, sport, puppet shows) • Children are given techniques and strategies for dealing with emotions, such as safe ways to express anger or frustration and ways to deal with stress, such as belly breathing, the stress stoplight
Leading the Way‐ Disclosed • For disclosed youth: Creates an environment of mutual support that allows youth to share their experiences, worries, fears and personal experiences of stigma and discrimination • For many of them, this is the only space they can openly have these discussions • Some themes explored include healthy relationships (familial, friendships, romantic), HIV stigma in various parts of the community (i.e. school, media, workplaces), disclosure and are explored through informal discussions, videos, news articles, and music
Camp Mandala • The Teresa Group offers a summer camp experience for children and youth between the ages of 9‐18 • This one week program, located at Camp Moorelands in Dorset Ontario, allows children and youth impacted by HIV a chance to connect with their peers • They have opportunities to build supports, learn life skills that will empower them to live self‐sufficient, independent, productive lives and most importantly have fun
Counsellor in Training • The CITs (who are disclosed to)participate in camp‐ wide activities as well as shadowing counsellors and participating in their own programming related to stigma and discrimination • CIT program mirrors Leading the Way and interlinks the youth who participate in both programs • Camp has 20 volunteer camp counsellors, some who were campers, CITS and Leading the Way youth themselves
Impact of Programs • Improvements in developing interpersonal relationships • Build peer support • Learning independence from being away from home • Gaining skills and confidence • Learned to respect others • The importance of being kind and caring, and the value of “talking things out” • Counselors felt the top benefits to campers were in personal development, positive social interactions, and new experiences • Parents were impressed with their children’s personal advancements, including improvements in responsibility, independence, leadership, and self‐confidence • Children had opportunities to engage in new activities independently.
Impact on family • LTW and Camp help the family deal with issues at Teresa Group as part of a continuum of services • Help with disclosure: by building on child and youth’s resiliency, emotional capacity and self‐confidence, creates a space for parents to work on disclosing to child/youth • Works with family from prenatal to 18 years, consistent support in every stage of child development • Works with children into young adulthood and provides leadership opportunities (many of LTW youth end up being CITs and then counsellors at Camp)
Conclusion • Teresa Group programming, specifically Leading the Way and Camp are shown to positively impact children and youths’ lives by building supports, improving life skills, and allowing children and youth to have fun. Leadership programs, and group activities in a camp setting serve to develop children’s self esteem and resiliency in the face of HIV‐related stigma. • They also help parents integrate in continuation of services and work with their children on issues of disclosure and stigma • WHERE TO NEXT – Expanding our reach through Partnerships – Addressing Disclosure in a digital age – Building connections within families
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