Project Areas of Focus: Education, Program and Policy Development, and Leadership
Mission Statement: To explore attachment as it relates to child development and create educational materials to teach to caregivers of orphans in Kenya.
Vision Statement: To provide orphans with the opportunity to form a safe attachment with their caregiver to promote improved quality of life and occupational participation.
Prior to the start of my capstone project, I completed a Needs Assessment and Literature Review to understand the need for the project and the current research on the project's topic. Both documents can be found in the links below.
Research indicates the strong correlation between the lack of attachment and trauma on an individual’s development and occupational participation, demonstrating a strong need to address this area with the project (Becker-Weidaman, 2009).
Attachment is crucial to support development (Dye, 2018) and occupational participation throughout the remainder of an individual’s life (Cooper, 2000; Ayathupady & Arikkatt, 2020). Ignoring the need to promote a secure attachment between child and caregiver limits physical, social and emotional development in an individual and will thus be evident throughout the child’s life.
Occupational therapists have a unique opportunity to intervene in childhood and throughout the lifespan to address the deficits produced by trauma. With a trauma-informed approach and a holistic view, occupational therapists can work with caregivers of children, the children themselves, or adults to help promote an improved quality of life and well-being.
Part 1: Research and Curriculum Prep
Prior to writing the curriculum, I spent time in the current literature to collect evidence-based materials and best practice techniques. I wrote an outline for the material I wanted to cover during the training and based my research on that.
At the beginning of the project, I applied and was granted an approved IRB to teach the curriculum and collect data while in country to understand the effectiveness of the training.
I completed continuing education courses on topics like cultural humility and ACE's.
Finally, prior to writing this curriculum, I attended a 5 day training in Oklahoma City, OK with The Halo Project on trauma informed programing. Additionally, in preparation for my capstone project, I completed a 10 week (one week in-person intensive) course to become a Trust Based Relational Intervention (TBRI) Practitioner in July of 2022.
Once these steps were completed, I was able to begin writing the curriculum.
Part 2: Writing the Curriculum
After all of the information was collected, I began to write the curriculum that I would teach in Kenya. The manual included information on trauma, attachment, human development, sensory processing, self-concept, play, and self regulation. The manual contained seven sessions that included interactive activities and materials. The total manual was 132 pages with colorful graphics and images to help overcome the language barrier. Each participant would receive a "Caregiver's Guide" that they would refer to during the training. I wrote an additional "Leader's Guide" that contained more information and this is what I would teach from.
Part 3: Teaching the Curriculum in Kenya
The last and best part of my doctoral capstone project was traveling to Kenya and teaching caregivers of orphans the material I had prepared. I taught a 3 day training to individuals interested in being a caregiver or house parent at the children's home I was serving. The material was written and taught in English, but every word I spoke was translated into Kiswahili throughout the training. The training included lecture style lessons, interactive group discussions and activities that the parents would ultimately be using with their child who had experienced trauma.
On the first day of the training during our lunch break, I asked one of the participants how it was going for him so far. His direct words to me were this:
"I'm falling in love with this."
Before and after the training, each participant completed a quiz to assess any gains in their knowledge. They also completed a feedback form on what they learned and overall input for me as the presenter. After my return to the United States, this data was analyzed.
The most important piece of feedback I received is as follows. When asked what could be done to improve the training in the future, one participant wrote the following:
"Involve other departments that care for the children because my people perish for a lack of knowledge."
The need for the knowledge taught in this training can be summed up with that response. I left the training feeling humbled to have been the one to teach these wonderful individuals.
Project Longevity: The impact of the materials created will go beyond the individuals trained in Kenya. The curriculum I wrote will be used by my site, The Boaz Project, in their other partnering countries of India, Russia, Ukraine and other future countries. The discussion of trauma will continue with the house parents and the children will be impacted because of knowledge gained.
Future Implication for OT: Occupational therapists have a unique opportunity to step into the area of trauma informed care and help the most vulnerable of people every day. As holistic care providers, it is our duty and job to provide each individual with a whole-person approach and understanding. This includes understanding potential trauma in someone's history and how it ultimately impacts and changes their brain, body, behaviors and occupational participation. I hope to see more OTs learning about this topic and forming a new understanding of how to best serve people who have experienced trauma. The research and individual people support the need for OTs to join this practice area.
Additional Artifacts
I created sensory kits for each house parent couple to use with the children. The Boaz Project generously purchased all of the materials that I had requested for each parent to have access to.
I completed a DIY Weighted Rice Pack with the children when in Kenya. They LOVED this activity.
During the training, all lectures were recorded for The Boaz Project to access in the future. These videos were created for future leaders to reference and for sustainability purposes of the manual.
Connect with me!
Email: n.grady098@gmail.com
References
Ayathupady, S., Mohanan, & Arikkatt, R. M. (2020). Effect of attachment dimensions on life satisfaction of adolescents living in orphanages: The role of self-esteem as a mediator. Indian Journal of Health & Wellbeing, 11(4–6), 258–264.
Becker-Weidman, A. (2009). Effects of early maltreatment on development: a descriptive study using the Vineland Adaptive Behavior Scales-II. Child Welfare, 88(2),137-161.
Cooper, R. J. (2000). The impact of child abuse on children’s play: A conceptual model. Occupational Therapy International, 7(4), 259-276. https://doi.org/10.1002/oti.127
Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328