> Claudia Herrero is a General Services Counsellor and an Intake and Assessment Clinician.

Background
Farid, a 13 year old Afghan young person, was referred for counselling by his school counsellor. Farid was initially referred to STARTTS because of symptoms indicative of chronic grief and clinical depression. His school counsellor noted that Farid was isolated at school; experienced disturbed sleep patterns; flat mood; and showed symptoms of sadness and hopelessness. Farid also had quite disruptive behaviours at school, often getting into trouble. Farid’s behaviours were related to multiple traumatic events experienced in Afghanistan, including loss and grief surrounding his parents’ death and having to move to a new country.

During assessment, Farid’s history and family background revealed he had arrived in Sydney in 2007 with his two brothers. He lives with his siblings and an aunt and uncle he had not seen for many years. Farid’s major traumas are related to the death of both of his parents, and brutal violence in Afghanistan and Iran. Realising the difficulties that Farid and his siblings were facing, his uncle in Australia took the role of guardian and sponsored the three brothers to migrate here and live with his family. In 2008, Farid was injured in a car accident: he was hit by a car and was transported to hospital. Presently, Farid has transitioned to High School and continues to live with his relatives in Sydney.

Intervention
At the beginning of treatment, Farid presented as an intelligent, quiet and very creative boy, who enjoyed being praised and given focused attention. He engaged well during therapy and happily participated during sessions. At the beginning of treatment, supportive counselling was applied to establish trust and build rapport. During therapy, an eclectic approach was primarily utilised with the aim of decreasing his depressive symptoms,( in particular issues around loss and grief), increase his self-esteem, address life goals, and develop better interpersonal and social skills.

During the course of treatment, counselling focused on CBT and was used to help Farid work and recognise his emotions and thoughts and how these affected his behaviours, and to find better and more effective ways of dealing with problem-behaviour situations. The use of projective therapies were used, including art therapy, play therapy and the use of feeling cards to assist in identifying emotions.

An important achievement in therapy was when he, being led through the treatment sessions, developed A Global Life Line – which covered important events in Afghanistan, Iran, Australia, School and Counselling – in order to identify emotions and how he has dealt with experiences. During therapy, he encountered another difficult (and traumatic) event, when he was involved in the car accident. He was able, however, to critically analyse what had occurred and was able to talk about the accident in counselling, with the use of art and feeling cards. Despite his traumatic experiences and the many losses in his life, Farid demonstrated that he was quite resilient: with some encouragement he was able to make very effective improvements.

When Farid became too emotional – or when the memories seemed too intense or vivid – Farid was encouraged and reminded that he was in control and that it was normal to experience such feelings. Through this, Farid learned to better express his feelings, to share them with others appropriately, and to increase self control. He was better able to tolerate others and understand that they may be experiencing similar emotions to his. This built his capacity to deal with present and future issues.

3 Major Learnings
The clinician learned the following through her work with this client:

• The value of the therapeutic alliance. Developing rapport, trust and a safe environment for the client was crucial before he could engage in exploration of traumatic events and feelings.
• Despite multiple risk factors, some clients appear to be inherently more resilient than others – and this seemed to be the case with Farid. Nevertheless, it was still important to actively reflect to Farid his many strengths, so that he was aware of them and learned to recognise them.
• For refugee young people who struggle with verbal communication skills, the use of different media (art, play therapy) can help to strengthen resilience because the fear of failure associated with speaking is diminished. The alternative expressive therapies allowed Farid to communicate in a safe context, identify new skills, and strengthen self-perception.

> Claudia Herrero
Claudia is a General Services Counsellor and an Intake and Assessment Clinician. She completed a Bachelor of Arts with a major in Social Psychology and Social Research and is currently completing a Post Graduate Degree in Psychology. She has been with STARTTS for the past 5 years.