The Center for Mind-Body Medicine (CMBM) is seeking support from partners to establish, over the next three years (2014-2017), its scientifically validated model of psychological self-care and mutual help as an integral and sustainable part of every major health, mental health and primary and secondary educational institution in Afghanistan.
With your support, we can ensure that by the end of 2017, Afghanistan will have a sustainable infrastructure of self-healing and group support for millions of Afghan men, women and children.
"This is a major problem," Suraya Dalil, Afghanistan’s acting public health minister, told a ceremony in Kabul on World Mental Health Day. "After thirty years of war more than 60 percent of Afghans are suffering from stress disorders and mental problems."
"There are only 200 beds for psychiatric services in the country, with only two psychiatrists in the country covering the entire population," said WHO representative Peter Graaff.
There is an urgent need to build the skills and capacity of the human resource to be used now and in the future for the treatment of mental illness and psychosocial distress. Lack of knowledge among health staff is resulting in inappropriate and irrational use of psychotherapeutic medication by health professionals certainly it is not restricted to mental health field.
This problem is not only threatening the health of people in the entire world, but also jeopardizes peace, security and stability of the globe. If sufficient attention is not going to be paid to this emerging problem, insurgency activities will be increased tremendously.
James S. Gordon, MD, a former researcher at the National Institute of Mental Health, a clinical professor of Psychiatry and Family Medicine at Georgetown Medical School, former chair of the White House Commission on Complementary and Alternative Medicine Policy and Dean of the Saybrook Graduate College of Mind-Body Medicine, founded CMBM in 1991. CMBM has already trained more than 4,500 health and mental health professionals, educators, and community leaders in its model.
Since 1997, through the Global Trauma Relief (GTR) program, CMBM and the professionals it has trained have used its model to successfully address population-wide psychological trauma among young children and adolescents as well as adults of all ages in Kosovo, Macedonia, Israel, Haiti, post 9/11 New York City, post-Katrina New Orleans and with US military returning from Iraq and Afghanistan and their families, as well as in Gaza. The techniques and approaches have been easily incorporated in clinical, classroom, and workplace settings. CMBM’s experienced international faculty includes more than 100 gifted clinicians and teachers. Its Board and Advisors include a number of the world’s leaders in psychiatry, medicine, psychological self-care and human rights.
In addition to various research studies on the CMBM model in peer-reviewed journals, CMBM has been widely covered in print and broadcast media. To date, the CMBM Gaza program has been featured in articles in The New York Times, The Christian Science Monitor, AP, The Jerusalem Post, The Guardian (UK), The Forward, The Psychotherapy Networker, and San Francisco Medicine, as well as on National Public Radio, and in broadcast and print media throughout the Arab world and in Asia.
The CMBM model includes culturally appropriate mind-body skills such as slow deep breathing to quiet anxiety; guided imagery to seek intuitive solutions to intractable problems; and words, drawings and movement to express and share feelings. These techniques and others such as meditation, biofeedback and genograms (family trees) are practiced in small groups (which we call Mind-Body Skills Groups) so participants can learn to lower stress and gain perspective on their trauma and their lives in an environment free of stigma.
This CMBM approach has been widely used in the U.S. and abroad for adults and children with chronic illness, teachers and children in schools, and medical students, as well as traumatized populations. The model not only works, it appears to give both children and adults tools they can use — to reduce stress, improve mood, enhance resiliency, self-assertion, compassion and productivity, and decrease aggression — on an ongoing basis. The model has also been effectively used by faculty and students in 18 US medical schools, including Georgetown, Duke, Johns Hopkins, Stanford and the University of Washington.
CMBM Founder and Director, James S. Gordon, MD, and CMBM Afghanistan Program Director, Mental Health Specialist Dr Najibullah, work closely with the Ministries of Health, Education and Social Affairs, the United Nations World Health Organization (WHO) as well as women’s and disability-focused organizations, to invite physicians, psychologists, nurses, teachers, school counselors and social workers, community health workers, and administrators to participate in the Mind-Body Medicine training cycles.
The Afghan Minister of Education asked CMBM to fully train and supervise all of its 300 school psychologists and school counselors.
The Afghan Minister of Health asked CMBM to develop a program to bring "self-care and a more humanistic approach" to its primary care physicians and nurses, and to medical, nursing, and counseling students.
Organize twice, a five-day training for 150 participants. These initial trainings offer an introduction to mind-body skills within the group context and focus on teaching participants to use these skills in their own self-care and to begin to integrate the approach and techniques in their ongoing-work. It includes extensive scientific material on the biology and physiology of stress and trauma and on the specific techniques used, as well as experiential work in an intensive, supportive small group.
Group Consultation sessions last two hours every other week for several months until the Advanced Training. The purpose of these sessions is to provide support for the integration of mind-body approaches and techniques into the lives and work of program participants.
Advanced Training teaches participants to use with others the approach and tools learned in the Initial Training. Participants have the opportunity to actually lead the same small groups in which they were trained a few months before. During this training, they also attend interactive panels on issues related to teaching mind-body skills, and receive individual and group consultation on their performance as group leaders, as well as individual guidance on how to implement the CMBM program in the schools, clinics and other institutions in which they work. In addition, two specialized 3-day trainings are organized for 30 of those who work with emotionally and cognitively challenged children, and 30 who are primarily focused on working with people with cancer and severe disabilities and on medical, nursing and counseling education.
Following the Advanced Training each participant assemble and lead one or more ten-week long Mind-Body Skills Group(s) – with school children, parents, the disabled, former prisoners, the chronically ill, and healthcare students. These 10 member groups meet for two hours once a week. Program participants also are integrating mind-body techniques into their ongoing work with individuals and families and in classrooms. This work is ongoing with most participants leading ten-week long groups each year.
Intensive weekly supervision by CMBM’s present Gaza Leadership Team begins immediately after the Advanced Trainings. The Leadership Team guides program participants as they lead groups and integrate their new skills in classroom, clinical and community settings. Supervision is offered two hours per week, each week. The Kabul faculty, which provides supervision, meet in consultation every week with local program coordinators. Dr. Gordon and Dr Najibullah provide overall guidance for the entire program.
After each Advanced Training, 30 of the most gifted and committed participants from the Ministries of Health and Education, the NGO community, and WHO are prepared to be CMBM Afghan Leaders in intensive 3-day trainings. They in turn provide ongoing consultation and supervision to their recently trained colleagues as they integrate the CMBM approach in Mind-Body Skills Groups and in their other clinical, community, and classroom work. The present CMBM Afghan Leadership Team of 20 work closely with the new Leadership Team and will provide continuous supervision to them as they in turn learn to supervise others. By the end of the third year period these new leaders ensure that the CMBM program is entirely sustainable within Afghanistan's health, social service and education systems.
The long-term sustainability of CMBM's work in Afghanistan in ensured in several ways:
Atlantic funding enabled CMBM to undertake and publish the study in the International Journal of Stress Management on the effects of Mind-Body Skills Groups on Afghan children and adolescents with PTSD.
In addition to measuring changes in PTSD and depression symptoms, these studies address other changes that are crucial to the health, wellbeing, and future of the population: hopelessness in children; aggression in adolescents; and “post traumatic growth”—which includes greater resiliency, appreciation for life, and connectivity to others—in adults.
CMBM focus primarily on relieving psychological trauma and the physical and emotional symptoms of distress. At the same time, the people served have become aware of their own integrity, resiliency, and capacity for autonomy. They are thinking and acting in new ways — less reactive and more responsive, more likely to question their own aggression and be compassionate even toward those whom they have regarded as the enemy.
These attitudes and behaviors are transforming their society and laying a foundation for educational and economic success, social comity, and respect of political, religious and gender differences as well as psychological well-being. We believe that a rigorous program of qualitative research will definitively and specifically demonstrate these changes. The changes assessed and examined include:
In order to determine how those trained are using the mind-body skills training and the numbers of people that are being reached in Gaza, surveys will be undertaken on all those who have been through the training and data will be collected on the interventions they provide for individuals, and in family and classroom settings as well as in ten-week long Mind-Body Skills Groups.
The cost for training and supervising 720 clinicians and educators and community leaders; integrating CMBM’s program for psychological self-care, mutual help and health promotion into public and private health and education systems in Afghanistan; ensuring independent sustainability of the CMBM Afghanistan organization; and providing definitive quantitative and qualitative research on the program – is USD $4.2 million over 3 years.
This cost includes: 5-6,000 ten-week long Mind-Body Skills Groups for children and adults; two training cycles of 150 new professionals each; intensive, ongoing clinical supervision of the total group of 720 trainees; Leadership Training for 60; and research, monitoring and evaluation of the entire program. This allow to: