Summary

Cambodia's long history of war and violence has left many women physically and mentally fragile, suffering from mental disorders ranging from stress and anxiety to thoughts of suicide.

Due to the impact of the "killing fields" on men, women comprise 57 per cent of all adults in the country. However, many women find it difficult to cope with the additional responsibilities that they have to shoulder in the household and community. Development organizations find that the high level of mental stress and trauma is a serious obstacle to women's participation in development, which is vital for the reconstruction of the society.

Despite the grave need in the country for mental health care, Cambodia has neither the human nor financial resources to provide facilities or treatment. NGOs, temples and other community groups have had to step in to meet the need, often with inadequate resources and skills.

To assist, UNIFEM initiated a project, based in a Buddhist temple, for mental trauma counseling that built on traditional Buddhist knowledge while incorporating modern methods. The project trained six monks and four nuns and developed materials and an approach that can now be used in temples in other Cambodian communities.

Results

The overall impact of the project has been positive. The two weeks training in both Buddhist and modern methods of trauma counseling at Wat Phnom Andeouk enabled the monks and nuns to:

• enhance their understanding of Buddhist scriptures and apply Buddhist philosophy to mental trauma counselling;
• develop self-esteem and self-confidence;
• apply stories from the Teachings of Buddha to counseling methods;
• use simple language so that lay women could understand without a deep knowledge of Buddhism;
• link physical needs to mental well being and provide basic health care;
• use interview forms and case management to document and monitor cases;
• counsel more than 80 clients as part of the practical training; and
• understand the importance of human rights (particularly of women and children).

Activities

The project trained ten monks and nuns to use a combination of Buddhist meditation and modern psychological methods to counsel women with psychosocial problems. The training was conducted in a Buddhist temple, Wat Phnom Andeouk, in the northwest of Cambodia near Battambang. This temple was selected because the head monk had previously helped many people with mental problems by using Buddhist teaching and philosophy. According to Sopha Hang, the project clinical psychologist,

"Wat Andoeuk is a great place for healing. It provides basic human needs and also higher needs…, the needs for acceptance, belonging, sisterhood, brotherhood, and a sense of community."

The project hoped to replicate these counseling methods in other parts of the country. Community outreach was a sensitive issue for many monks and nuns, who believed that it was against the Buddha's teaching for them to become too involved with secular society. They considered the Wat as a place of refuge, to which people may come in order to reduce their suffering. Many did not regard community outreach as a valid role for monks and nuns.

However, the head monk taught that there was nothing in the Buddha's teachings to forbid monks and nuns from working in the community. Fortunately, some monks and nuns shared this interpretation and were willing to go to relieve suffering in communities.

Training

Training included:

• Buddhist philosophy and its application to psychoanalysis and counseling;
• Cambodian culture and religion to provide an understanding of the patients' background;
• meditation as a method of counseling and treatment for psychological problems;
• an introduction to modern techniques of psychoanalysis, counseling and treatment;
• integration of Buddhist and modern techniques of psychoanalysis, counseling and treatment;
• in-service training in mental trauma counselling;
• training in first aid, food and nutrition for physical and mental health; and
• conflict resolution.

Achievements

Project achievements include:

• an increase in the number of counselors at Wat Andeouk;
• enhanced capacity to counsel women and understand their specific problems;
• improved services for women through the involvement of the nuns (women clients were reluctant to tell their personal problems to a male counselor); and
• a training manual that can be used by other temples.

Dated: 14Jul1999