Proposal for Culturally Informed Art Therapy With Syrian Refugee Women

Using art tools with older Syrian refugee women to explore activated evolution

Children and Adolescent Mental Wellness Master, Damascus University, Trauma and Disasters Mental Health, Istanbul Bilgi University, Psychologist in Humanitarian NGOs, Turkey

Date of Spider web Publication

xxx-Jul-2018

Correspondence Accost:
Bayan Hakki
Gaziantep, Sahinbey, Ogretmenler Evleri Mah, Gunaydin Sok, Darici Apt, No.1, D10
Turkey

Source of Back up: None, Conflict of Interest: None

DOI: 10.4103/INTV.INTV_46_18

The case written report this field report is based on used creative art activities and a systematic approach through the framework of the circuitous circumvolve. Its aim was to assist Syrian refugee women between the ages of 55–65 to explore changes in their roles and their arduousness-activated development after fleeing Syria due to the current conflict. V psychosocial sessions were conducted, twice a calendar week, with a grouping of three Syrian refugee women living in Kilis, Turkey. A simplified version of the qualitative 'arduousness-activated development' filigree was used as a pre- and post-intervention assessment and results were analysed qualitatively. Findings showed that at the end of sessions women were expressing more positive feelings and realising positive role changes as well as continued sadness in terms of the separation of their families.

Keywords: Adversity-activated evolution, circuitous circle, creative arts, role changes, Syrian refugees, women

How to cite this article:
Hakki B. Using art tools with older Syrian refugee women to explore activated evolution. Intervention 2018;xvi:187-94

Introduction

Deep suffering is common among Syrian refugee women. This is partially a result of changes in activities from those they were used to in Syria and new activities/roles akin to those considered every bit masculine roles, such as heads of households (Buecher & Aniyamuzaala, 2016; Oxfam & Abaad, 2013; United nations High Commissioner for Refugees (UNHCR), 2014, 2015). These office changes are non limited to Syrian refugee women in Turkey, merely are also experienced by Syrian refugee women in Hashemite kingdom of jordan and Lebanese republic, with increasing numbers of women acting as heads of households (Keedi, Yaghi, & Barker, 2017). Additionally, separation of families across dissimilar cities and countries minimises back up from family members. This situation brings added responsibilities without the necessary support that women need to brand a successful transition (Care, 2016; Oxfam & Abaad, 2013).

In 2013, Oxfam and Abaad conducted an assessment on irresolute the roles of refugees from Syria, including both Syrian and Palestinian refugees. The assessment included older women and men. Reports from the field highlighted that the women felt threatened due to the changes related to their traditional roles, and the feeling of loss of their femininity. The assessment also highlighted ii further changes: (1) that women constitute themselves unable to provide the same quality of familial care due to lack of adequate facilities and infrastructure; and (2) they were forced to appeal to agencies for assistance (Oxfam & Abaad, 2013). Older women (and indeed older men) may, therefore, exist suffering more than other historic period groups due to lack of resources, social support networks and less access to support services from organisations (Help Age International & Handicap International, 2014; UNHCR, 2015). Older women may feel more stress equally they are unable to act every bit mothers and grandmothers due to family separation, and new responsibilities managing households. These issues (perception of threat, of losing elements of their femininity, of losing the role of grandmother/motherhood, feeling unsupported socially and lack of access to agencies) were all highlighted in the reports as very of import, negative and stressful to older women.

From the author'south own observations during working with women in Kilis, Turkey, several factors seem to bear upon the style older Syrian women are coping with these changes. Equally the author is part of Syrian community, it is important to highlight hither the first major factor: civilization. Syrian culture and gender roles vary according to a person's city of origin or cultural sub-group. The women from this particular area shared common roles of mother, grandmother or housewife.

A 2d gene is that health workers oft assume refugee women are victim. Most of the organisations working with conflict-affected populations prioritise working with women considering they are labelled a vulnerable population. Importantly, this puts women in a pre-identified position equally aid seeker or in demand of assist, reinforcing helplessness over empowerment. People go more than dependent and enter the 'victim-rescuer triangle' [Figure 1]. In this theory (Gkionakis & Papadopoulos, 2017; Papadopoulos, 2002), the help provider is the rescuer and the help receiver is the victim who becomes dependent on the rescuer to problem solve and provide assist to see their needs. Gradually each gets more accustomed to and involved in their roles, so they become harder to modify. (The perpetrator tin can be the situation, person or whatsoever other reason for the suffering of the 'victim'.)

Figure i: Victim–rescuer triangle (Gkionakis & Papadopoulos, 2017, p. 98) Click here to view

The third gene is that Syrian women are part of a community that has suffered for years from political oppression. Further, simply being a woman in Syria can create additional pressure and incur oppression.

In the light of these main points, the idea was to provide older women a infinite to allow them to discover their role changes and express related emotions and feelings through a procedure of therapeutic change. Group work was decided as the appropriate method for two reasons: (ane) because these function changes happen on commonage level; and (two) because women were expressing that a part of their suffering was related to social isolation.

'Instead of being surrounded by family unit and support, I am here facing hardship of life … alone' (Syrian women, aged approximately lx, living in Kilis).

Therefore, the study this field report is based on aimed to discover the utility of a group programme to see whether it tin exist practical or developed further for older refugee women or women refugees in general, and to inform field workers. It was further decided to base the field piece of work on providing creative arts activities to this target group. The work was exploratory in nature, to find whether a psychosocial support group using a systematic approach to providing artistic fine art activities can help older Syrian refugee women in exploring resilience and adversity-activated development (AAD) relating to experiencing major role changes in their lives.

xxA group approach with art and drama therapy tools

Grouping work can provide a supportive network, particularly to older women (defined herein as aged 55 and older) who endure more from isolation and tend to take less access to services and activities than younger women. In Kilis, at the fourth dimension of this example study, humanitarian activities were mostly targeting children and younger adult women. Interactions tin exist helpful to break down caused roles, explained higher up, using the victim triangle. They tin also assistance clients to explore AAD [AAD refers to 'the spectrum of responses to adversity, offering a framework for the various combinations of trauma effects across different levels and perspectives (positive, negative and neutral)' (Papadopoulos, 2007)], not only in terms of needing help from service providing agencies, but also to notice dissimilar aspects of changes that accept affected their office when they became refugees. Importantly, interactions within a group may too help refugees to 'get out of set roles and locate the temporary situation inside the context of a longer time calibration to reduce high risk of helplessness' (Gkionakis & Papadopoulos, 2017, pp. 99–100).

Some studies on refugee women provide dissimilar recommendations to ameliorate role transition. One such study recommends organising 'recreational and fine art-related activities depicting the perceptions and challenges of gender roles' (Oxfam & Abaad, 2013, p. 16), and that art and drama therapy may facilitate 'processes to achieve psychological growth and change' (Emunah, 1994, p. 3).

The use of expressive art therapeutic tools can help people to human activity as a whole, instead of only using spoken language, as occurs in classical therapeutic tools. Additionally, drama and art tools can help in distancing ones' self and facilitate expression, as Oscar Wilde said; 'man is least himself when he talks as his own person, give him a mask and he volition tell the truth' (Emunah, 1994, p. seven). When a refugee is already hiding their suffering behind psychosomatic symptoms, equally is usual with people who take faced traumatic events (Van der Kolk, 2015), and as the author has experienced with Syrian refugees in Kilis, it will be much harder to express suffering through words. Using expressive fine art tools tin facilitate the procedure and give suffering a voice.

'We seek to create a form − a story, a song, a movement, an artistic creation to hold and express our personal experience, emotional expression and deepest learning' (Atkins & Williams, 2007, p. 35). Further, this can then occur in a safe way and within an enjoyable environment; 'the deepest currents of images, feeling and meaning can exist explored tangibly and in symbolic means. Through expressive arts, we provide this essential play infinite so that fragmented parts can be recovered' (Halprin, 2003, p. 178). Acting and using fine art may exist considered by patients as less risky than expressing ones' self in real life (Liebmann, 2006) and presents an opportunity for self-expression (Atkins & Williams, 2007). Group oriented drama therapy specially focuses on grouping processes and group interactions (Emunah, 1994) and enables participants to experience others' lives and difficulties, while feeling safety (Liebmann, 2006, p. 73), which can all contribute to self-healing amidst refugees (Papadopoulos, 2002).

Group advice during drama therapy can be enhanced by structured and systematic rules for interacting. 1 such example is a 'complex circle', which was created by Schininà (2004) for use in drama therapy with communities in disharmonize settings. It uses a circle instead of a triangle to emphasise equality in interactions (Tucci, 2013). This allows participants in the group to proceed their differences and dialogue on an equal level, and gradually brings them together using games and activities to form a circumvolve that creates pathways of interaction starting from one's self and finally ending with multiple paths of interactions between grouping members. This facilitates a circle of advice, as shown in [Effigy 2] (Schininà, 2004).

Figure 2: Group interaction as described according to circuitous circle (Schininà, 2004, p. 55 or Yard. Schininà, Personal communication, June 17, 2017 refer text) Click here to view

This case study explores the use of 'Theatre of the Oppressed' (Besides) as an inlet to therapeutic change. ToO is theatre, in which all people involved are actors, including the spectators, or 'spect-actors' (Boal, 2002, p. 15). Information technology has iii main methods: invisible theatre, forum theatre and paradigm theatre. This case study used image theatre to reach therapeutic goals. Co-ordinate to Boal, image theatre allows participants to express themselves and uncover truths, without using words. The participants are engaged in making images that represent problems or aspects of their lives, and these images can exist created in dissimilar ways, for instance, using one'due south trunk or past using other participants' bodies, or by creating images using art materials (Boal, 2002), every bit was the case in this study. Both drama therapy and Likewise provide tools of expression and enables processing their lives on cerebral, emotional, social and physical levels.

More specifically, this case written report used materials from 1 of the near well-known puppetry shows called 'Karagöz and Hacivat'. This show and its characters were originally used during the Ottoman Empire and the early on Turkish republic in coffee houses to criticise political topics (Ozturk, 2006). Karagöz was an oppressed character who made fun of the power of guild and the social constraints that framed normal life at the time. This method is somehow metaphoric, enabling vulnerable or oppressed groups to express themselves using same tools that take been used to express and criticise political oppression for centuries.

Methods

Sample population

The participants of the creative arts activity group were v Syrian refugee women, living in northern Turkey outside of a camp setting. They were aged between 55–65 years old, were married and grandmothers, but separated from their extended families and living with their husbands just. They were chosen amidst women who had completed private therapy, but needed more back up regarding issues of social role modify. Due to Ramadan and the personal situation of one of the women, only 3 women attended the sessions.

Therapeutic approach

This applied case written report used creative art activities and a systematic approach using the framework of the 'complex circle' to help older Syrian refugee women explore the changes in roles and related AAD. To this end, a range of different tools were used during the sessions. The complex circumvolve was used to aid participants interact with each other in the group and to ensure each participant used her own voice and expressed her own feel. The sessions followed the wide construction of contact, contract, warm up, main activity, cool downward and feedback (Thousand. Schininà, Personal communication, June 17, 2017). There were five sessions in total, each session betwixt 90–100 min long, twice a week, and led by ane facilitator (the author). The main activities during the sessions were built on a game taken from the Too approach called 'What is the story?' (L. Opdebeek, Personal advice, Apr 14, 2017), using a shadow theatre technique. Participants fabricated images using art tools and selected puppets that represented parts of their story. They told their stories with characters that they designed, using their ain voice, and using puppets they selected to give life to their story.

In this style, the structured sessions (outlined in detail below) used several tools or approaches for storytelling, including personal storytelling methods, which means that 'one tells his/her own story, only using 3rd person instead to increment the distance and facilitate the procedure of disclosure and consciousness of life events and scripts' (Emunah, 1994, p. 235).

One major adaptation to the original programme for the sessions was to remove the movement and using the torso in theatre elements. The participants had refused this element of the sessions because they considered it culturally inappropriate for women of their historic period and considering they reported health and mobility bug that prevented them from existence physically agile enough to participate in movement theatre activities. This limitation was the main reason shadow theatre puppetry was used instead of mainstream theatre techniques.

Session i

Telling the personal story: subsequently greeting the participants, the contact was made through sitting in a circumvolve and one past one explaining in one discussion their feelings, followed past work in pairs (the facilitator participated this game) and asking each other's a variety of questions (such equally: such as the story of your name, who named you, and the meaning of the name) so each 1 introduced her pair to the group. So the facilitator made a brief introduction well-nigh the group. This was followed by the group being invited to create a group contract (what are the things needed in the group to feel comfortable and condom). The warm upwards was about sharing childhood stories, then the principal exercise was to share personal stories related to life and role changes, and how conflict and fleeing to Turkey affected them. The cool down invited them to share one wish they had at that moment. Then a pre-cess was conducted, and participants were asked to share how they felt about the day every bit feedback [[Effigy 3] and [Figure 4].

Session two

The puppet shadow theatre and stories of the by were shared: the contact was introducing the puppets, then participants were asked to play with them and talk about their feelings now (through the puppets). A small reminder was given about the group contract, and then the warm upward started by reminding the facilitator of the childhood stories they had shared in the previous session. After choosing a story, participants decided which character puppets would be used, so created the story as four silent images represented as shadow theatre. One sentence from the participants, who is interim with the puppets, was added to each character at the end of the images talk. The main do began by reminding the grouping most the previous sessions' discussion well-nigh roles in the past and the present, and then participants were encouraged to share their own stories virtually the past and their roles. They were then asked to recall about one specific twenty-four hours to represent the past and to split it into (3–5) silent images, as had been performed in the warm up. Finally, they were asked what characters these images included. Equally a cool down, participants were asked to draw the characters and prepare them for acting. Feedback included each of them sharing 1 matter they felt they needed to acknowledge and share information technology with the group.

Session iii

Deed the past and play with voice: the contact started by using puppets behind the shadow theatre and asking other participants how they are and how they feel today. So a small reminder about the group contract, and warm upwards through the boob giving a different mode of speaking. Each participant needed to produce four different tones (for each puppet) and say hullo and how are you in these tones. The main practise occurred later on participants finished working on the characters, when each participant was asked to share their images in a mini shadow theatre as silent, separated images. Afterward that, they were asked to add together one word or judgement to each character and to add together movement to the characters. The other participants were asked to reflect on the story. Each participant shared their story about the past. As a cool down, participants were asked to share their using storytelling methods through telling their stories every bit if they were the story of a tertiary person. Feedback was to share feelings nearly the day using the puppet they created [Effigy 5].

Session iv

Sharing stories of today: the contact was to enquire each participant in the circle to employ the puppets and to change vocalisation tones in a manner suitable to limited their mood, and share how they felt that day. A reminder was given near the grouping contract, and so warm upward included each participant using the four puppets to produce different voice tones for each puppet, and to add a different sentence to speak according to the character's personality. The principal exercise included each participant being invited to share their stories almost the present, changes, roles, war and life. After that, the facilitator asked them to think about a day they thought represented the present and how it could exist represented in 3–5 images, and about the characters in the images. The cool down was to create the character for the present play. Feedback was conducted in a circle with each participant maxim how they felt near the session, and then to share one new thing near conflict and fleeing.

Session 5

Interim the nowadays and closure ritual: the contact began with each participant in the circle sharing how they felt that day. A reminder about the group contract was given, so a warm up with each participant choosing one character from the puppets. They were given 2 min to recollect most the character of the puppet, and then to introduce the puppet to the group. The principal practise consisted of each participant asked to share their images about the present in a mini shadow theatre as silent, separated images and asked to add one word or sentence to each character. This was followed by adding motility to the characters, and the other participants were asked to reflect on the story. The present play was closed with each i sharing something she thought had changed in a negative style and ane matter in positive mode. As a cool down, participants were invited to share their stories about 1 specific day in the present through storytelling, using the third person. Then the mail-cess was conducted, followed by a closure ritual in which each adult female was asked to draw a fourth dimension line and divide it into past and futurity. She and so used a color that represented herself and located herself on the timeline where she thought she was, that is whether she felt herself living in the past or the present.

Adversity-activated evolution assay

To evaluate the changes that occurred, AAD was used as an assessment tool. According to Papadopoulos, the AAD grid can be divers as: 'a useful framework, a template to grasp the complexity, uniqueness and totality of the responses to adversity that, can enable one to focus better on more than than negative responses' (Papadopoulos, 2007, p. 304).

Within the AAD, negative, neutral and positive outcomes of adversity and trauma are recorded qualitatively. The pre- and postal service-assessment used the simplified version of Papadopoulos' filigree of outcomes (Papadopoulos, 2007) [Table 1], which was also used for needs assessment surveys in the Yola refugee camp in Nigeria in 2015 by International Organization for Migration (2015). As in the Yola needs assessment, this inquiry used the AAD grid of outcomes to analyse the emotions and factors that related to changing roles of women later the conflict in Syria. This assessment consists of grouping qualitative responses from participants into themes for assay.

These included suffering, which referred to what participant stated equally a negative result of what had happened or increased after conflict in Syrian arab republic, and related to their changing gender roles. This was divided into three levels (individual, family and community), and then participants could categorise each change they labelled as suffering into personal level (individual), family unit (if it was a negative change related to their role, but which afflicted the family as whole) and customs level (the negative results that they thought affected the customs). On the other side, participants stated which changes they considered as positive ones (resilience/response) using the same levels (private, family, community).

Equally in the Yola needs cess in 2015, the grid of outcomes had to be slightly adapted from the original version. The two categories of resilience and response were merged together and any negative qualitative feedback from participants was labelled 'suffering', to make it clearer for participants and more culturally appropriate. The assessment was made through group discussion and coding was effected for the group, as a whole. Participants were asked ii open questions and their answers were registered and coded according to the AAD grid: How did the role of women change in your family unit and community after conflict? How did your role change?

Results

While women were sharing their stories, there was often an atmosphere of sadness in the room. The three of them were remembering and describing what they called 'best sky and best days'.

Using the ToO technique, older women were creating their own oppressed characters which were acting in the manner of the well known puppet evidence characters Karagöz and Hacivat. They were telling their ain stories nigh oppression and and so thinking near possible changes that could be made, giving their stories a voice, grapheme and a chance for the change.

The minor grouping of women were from unlike economic and social backgrounds, but they shared that they were similar queens in their houses and used to their needs provided by their husbands. All of them were longing for the family unit events and memories they shared from earlier the disharmonize. All of them agreed that they had a full, daily schedule with housework and social interaction in Syria and that they struggle to integrate into the host community. In that location was a fast connectedness between them from the first minute of session one, as they were prepared for the sessions to start and had some pre-conflict experiences in common.

The pre-cess happened during the showtime session on 2017, June 1 and the post-assessment on 2017, June 13. By comparing the grids of outcomes from pre- and post-assessments, information technology was clear that in the postal service-cess that participants were more able to realise the positive changes that had happened on a community level and share them in the group. They were likewise more able to meet a wider range of results, instead of focusing simply on negative results.

For example, in the pre-cess, women were not able to mention any positive results that happened on either family or community levels. They were focusing on the deep loneliness they felt on an individual level. As i woman expressed it; 'if I were in Syria, I could be able to knock at my neighbour's business firm and meet or just go out to 1 of my sons or daughters' house. Simply now I am here in Kilis, and each 1 of them is in a dissimilar country.' (cry).

Ane of the women was seeing a positive aspect to the changes in her life, and while she was trying to express this, the other two women were resisting and focusing more on how much this modify was causing them pain and suffering. The one woman expressed; 'I experience more costless, I exercise non have to await for my children or husband to make things washed, I am doing them by myself'.

Another woman commented on this equally: 'I am not used to being responsible to the house and that makes me feel lamentable that I am not the women I used to be, I need to go out and do things at this historic period!'

In the pre-assessment, the women were focusing more on their victimhood: 'that what war made to us, changed our life'.

In the post-assessment, they were better able to run into and take that results tin be wider that they idea, they began to talk more near the conflict and changes that happened after equally an event that could have both positive, every bit well as negative, results. One mentioned that; 'perhaps if I was in Syria, I will not be able to go out lone equally I am hither, aye my husband is not happy about this, but information technology would be incommunicable if I was in the village'.

During the mail service-assessment, they started to compare and talk almost the positive alter examples they had seen inside the Palestinian community; 'I remember very erstwhile stories about the Palestinian community afterward displacement and how women became more effective and provided more than help to their families and community and I feel that [now,] Syrian women are facing the aforementioned'.

Too, they were better able to express positive feelings related to the changes they are experiencing on individual and family levels. Feelings of sadness and nostalgia were expressed again and the separation of family was a focus, but the difference seemed to be more than positive, for example in speaking well-nigh alternative communication technology that they are using to communicate with family unit and how they started to learn. One woman was laughing as she said; 'I started using smart phone to communicate with my family unit, I have learned something new, it is not easy, merely I tin can manage'.

Another notable change was that women mentioned the feeling of helplessness in the pre-assessment, but in the postal service-assessment they did not mention hopelessness on an individual level. They just mentioned feeling tired. Another shift from negative to positive pre- to postal service-cess was around the household. One woman said during the sessions; 'I do not take to await for my hubby or anyone to exercise things for me, yes I am tired, just I have learned how to go by [exercise things on] my own'.

Another woman commented on the new institute space that the conflict and new situation has given to women; 'one of the young girls in the family was providing help for her area by learning basic information about first help, which was [considered a] foreign [matter] before all this war started in their village'.

During the pre-assessment women did not feel that on community level there is positive change, but at the post-assessment, they included positive feelings nearly a skilful hereafter and hope, and they mentioned over again that women are able to do new things now.

'I am learning the linguistic communication, attend some trainings and workshops and I experience that I tin get out more and I exercise non have to wait for someone to do things for me. I am doing things'.

On the family level, women mentioned in pre-cess feeling lonely, which was coded equally suffering, but again in the mail service-assessment, it was not mentioned. They mentioned that they are learning new technology to communicate with the family and described themselves as independent, which was coded equally a positive outcome.

In the post-cess, women was talking more about the opportunity to build new networks with the host community; 'I am trying to learn the language then I tin communicate with woman next door, but even when we exercise not find words we use signs'.

Discussion

Overall, women in the postal service-cess started to describe their feel and changing the roles in a more positive manner. Despite mentioning negative feelings, negativity was no longer the only affair noticed by this group of older women. They were seeing that there are both positive and negative results of their experience, and that they are not the victims that they used to recall they were. They were able to see that they accept resources and can be function. There was also a change in the way that the idea of independence was discussed, and this is specially telling of role modify, because usually Syrian women avert using the give-and-take 'independence' when referring to ones' self and tend to limit its employ to describe a homo in a positive way (while women demand to exist dependent).

The trigger for change in the group was when the women establish the courage to limited their emotions and concerns regarding the changes that they were living. Women were not sharing this outside of the grouping to peers or during individual therapy sessions. Using the drama/art therapy workshops and the Besides enabled these women to have a vox, express emotions freely, to support each other and to process what was happening all effectually them, instead of suppressing it and experiencing these changes in silence. Drawing, storytelling, acting and using different tones of vocalism helped them to communicate their ideas, needs and emotions in different ways.

The practitioners who worked with the women felt that considering these women were living the alter in part collectively, a group process was more effective than one to 1 sessions. It seemed they enjoyed the sessions, equally they were motivated to the level that fifty-fifty through it was the month of Ramadan, they came early to sessions and did not miss any. It seemed they were comfortable to express their story through art tools, to scream and say or practise whatever they felt in a safe style. The puppets and fine art tools immune them to altitude themselves and feel less threatened within the group.

Limitations

This case study was with very small group of three people, which makes the information less reliable to apply to a wider population. Furthermore, with a larger grouping, the women may take benefitted more. In improver, the sessions were conducted over a limited fourth dimension, 12 days, so more time would exist needed to assess whether this plan resulted in any permanent changes in the group. Responding to each other'southward feelings helped the women to accept them and feel less lonely.

In this case, women did not utilise body motion theatre in the sessions. Perhaps with other groups it could be added to facilitate the therapeutic and creative process, for example, starting with storytelling, then objection through puppets and then role-play using the body in movement.

Another potential limitation was that assessments were made within the grouping with the group facilitator, which may have biased the women to report more positive ideas almost their roles because of pressure to conform to the group or please the facilitator. Information technology too may accept been more than accurate to practise the pre-assessment at the offset of session ane, rather than at the cease. The qualitative tool used for evaluation helped to reflect on the process and assess the change in the perception of roles, but perhaps a quantitative mensurate of change could benefit the research.

Conclusions

Using creative activities for older Syrian refugee women was a challenge in the sense of accepting a unlike style of working, just the distancing that the theatre tools offered helped them to better express themselves and sympathise their feel compared to talking and sharing stories one to one, or in a traditional group therapy setting.

The sessions helped in exploring mutual interesting topics for participants, such as: advice technology tools and isolation from/contact with family unit, as well as other topics, not discussed in this field report, such as relationships with host community and the differences and similarities they meet in their experience of role change, compared to other deportation experiences they heard well-nigh, such as from Palestinian women.

Futurity Directions

Women enjoyed the creativity of using shadow theatre, and this created a vision for further activities with this group and with other groups, such as continuing with puppetry shadow theatre, simply for unlike topics or further work on Likewise techniques. At the finish of the sessions, the group agreed to meet afterward 1 calendar month and discuss the possibility of continuing the grouping and perchance extending it with new topics, and check if participants would like to show a play to audience (whether staff, relatives or another called audience).

Financial support and sponsorship

Nada.

Conflicts of involvement

There are no conflicts of interest.[xx]

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19.	UNHCR. (2015). Culture, context and the mental wellness and psychosocial wellbeing of Syrians. A review for mental wellness and psychosocial support staff working with Syrians affected by armed conflict. Retrieved from http://world wide web.unhcr.org/55f6b90f9.pdf
xx.	Van der Kolk B. (2015). The body keeps the score: Heed, brain and torso in the transformation of trauma. New York: Penguin Books.

  [Figure one], [Figure 2], [Figure 3], [Effigy 4], [Figure 5]
  [Tabular array one]

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Source: https://www.interventionjournal.org/article.asp?issn=1571-8883%3Byear%3D2018%3Bvolume%3D16%3Bissue%3D2%3Bspage%3D187%3Bepage%3D194%3Baulast%3DHakki

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