“So why did you end up volunteering for our ABLE program?”
Courtney, the newest member of the ABLE team, pauses for a brief moment before she answers:
“What impressed me most about the ABLE program was not only the excellence of the work they are doing, but their dedication to contextualize therapy and treatments for Cambodia, to have Khmer staff leading the program, and to incorporate the whole community into caring for these children.”
“I am excited about the vision to see the children grow into adults that are contributing members of their families and their society. There is a lack of services for young adults with disabilities in Cambodia. I am excited to be part of a program that builds on the potential of the kids we are working with. ABLE is designed to see them in community based care in the future. It aims to create a space for them to shine. And that’s pretty cool.”
The excitement about the ABLE program is contagious when you speak to Courtney. Her desire to see sustainable innovative care for the children in the program is evident in her face and tone. Courtney and her husband, moved to Cambodia 18 months ago with the intention of being orphanage “parents”. Seeing the daily workings of an orphanage upfront, Courtney soon realized that there must be a better way to care for children. She began researching issues around orphan-care, and family-based care. It was in the midst of this research that she happened to meet Lisa, CIF’s other ABLE technical adviser. The rest, as they say, is history. Over the last 6 months, Courtney has become a valuable part of the ABLE program, adding an occupational therapist’s view to the work done by our Physical Therapists.
Occupational therapy and ABLE
Courtney decided on a career in Occupational Therapy after witnessing the different forms of therapy accessed by her disabled sister. OT is one of the newest approaches to therapeutic intervention. It is incredibly flexible in its approach to working with clients. This flexibility is part of the key to creating sustainable interventions, according to Courtney.
An example of this is the routines-based interview that the ABLE staff do. This is part of the initial assessment process. Developed by another Occupational Therapist who worked with CIF a few years ago, the routines-based interview asks families what life looks like for them.
“For example, we have a child who is having trouble with feeding, sleeping and being occupied during the day. The routines-based interview allows us to identify which area is the family’s biggest stressor. We might think that the child needs help with feeding tools, or toys to keep his attention. But if the family complains the most about how long it takes to get the child into bed, and the struggle to keep them in bed in the evening, then the sleep routine is the first intervention that we need to work on.
“This assessment is great because we get to see what therapy tools are already in the home. The sand in the front yard becomes a tactile resource to play with, the bamboo stick a muscle strengthening tool. By learning routines and the family’s daily movements we can involve parents, siblings, neighbors and other foster parents. This creates a sustainable intervention for the child. It supports the child as they grow in their skills, and supports the family as they care for their child.”
Hopes for the future
But Courtney’s real passion is the cross-section between mental health support and occupational therapy. Khmer people’s experience and understanding of mental health is still under-researched. Many Cambodians experience Inter-generational trauma. For our children in foster families, the trauma of moving communities and schools is secondary to the traumas that led to their separation from their families, and to the loss of the family itself. Kids who have experienced severe trauma are the hardest to keep in families.
Courtney is keen to develop interventions that are accessible to our caseworkers, staff and families. She hopes that they can be built into family-routines, the way physical therapies are now. The aim is to build resilience and emotional healing into everyday life for these families. We want to see children grow into contributing members of their families and communities,, not just physically, but as people who know who they are and where they belong.
These interventions are still a while away, as Courtney learns more about the ABLE program and the understanding of mental health in this country. In the meantime, we at CIF are very grateful to have Courtney as part of the ABLE team. We are grateful for the alternative perspectives to our team, and models a real willingness to try new things. (For instance, you can see her being willing to try eating a fetal duck egg below!) Most of all, we are grateful for her love and care for our staff, and for the children and families at the heart of our work.