Exploring the link between Mental Health and Psychosocial Support (MHPSS) and Peacebuilding in post- conflict context

Exploring the link between Mental

Health and Psychosocial Support

(MHPSS) and Peacebuilding in

post-conflict context

A systematic literature review on the evidence and treatment approach: possible psychological interventions towards social change

This thesis is submitted for obtaining the Joint Master’s Degree in International Humanitarian Action. By submitting the thesis, the author certifies that the text is from his own hand, does not include the work of someone else unless clearly indicated, and that the thesis has been produced in accordance with proper academic practices.

Author: Alfa Gasani

Year of Conclusion: December 2016

Abstract

The background of this study is based on the fact that there is a lack of deep investigations that is linked between mental health and psychosocial support (MHPSS) and peace building. In order to narrowing this gap, this research was conducted with the assumptions that there is possible bridge between both fields by doing systematic literature review and reviewing the evidence from academic (scientific literature) and implementations of (grey literature) from NGO documents. Review findings of scientific and grey literature has resulting in some interesting framework models such as socio-ecological model and aspects, linkage concept, cross-cutting issue that could be used to intertwined both fields such as trauma healing, forgiveness and reconciliations from community efforts and missing elements of both fields that can be used for further research suggestions such as mapping research. Despite of some limitations in terms of government support and same understanding goals of both fields, there are possible and promising suggestion in future where the practice are presented in an effort to show where peace building and MHPSS need to be strengthen from policy until implementations.

Table of Content

1.2 Psychosocial practice and social change ... 9

1.3 Aim and research objective ... 10

1.4 Relevance... 12

1.5 Methodology ... 12

1.6 Limitations ... 13

Chapter 2. Theoretical framework ... 14

2.1 MHPSS ... 14 2.1.2 Mental Health ... 17 2.1.3 Psychosocial Well-being ... 17 2.1.4 Trauma ... 18 2.1.5 Resilience ... 20 2.2 Peacebuilding ... 21 2.2.1 Reconciliation ... 24 2.2.2 Transitional Justice ... 26 2.2.3 Social Transformation ... 28 2.3 Socio-Ecological Model ... 28 Chapter 3. Methodology ... 32

3.1 Definition systematic literature review... 32

3.2 Search Terminology Used ... 33

3.3 Exclusion and inclusion criteria ... 35

3.4 Flow paper selection ... 37

Chapter 4. Analysis Result ... 39

4.1.2 Summary of studies identified (Grey-Literature) (attached in Annex 7) ... 39

4.2.1 Findings (scientific literature) ... 39

4.2.2 Findings (Grey literature) ... 38

4.3 Discussion ... 42

4.3.1 Framework Concept ... 43

4.3.2 Linkage issues ... 43

4.3.3 Cross-cutting issue ... 46

4.3.4 Findings regarding missing elements ... 58

Chapter 5. General Conclusion ... 62

5.1 Implications for the field ... 62

5.2 Limitation ... 63

5.3 Conclusion ... 64

5.4 Suggestion for future research ... 66

References ... 75

ANNEXES ... 75

ANNEX 1. Intervention Pyramid of MHPSS from IASC Guidelines ... 75

ANNEX 2. Galtung’s triangle of conflict, violence and peace ... 75

ANNEX 3. Peacebuilding wheels ... 76

ANNEX 4. Ecological Model of Bronfenberner (adapted) ... 76

ANNEX 5. Tailored quality appraisal tool used in systematic review (adapted)... 77

ANNEX 6. Summary of studies identified (Scientific) ... 78

ANNEX 7. Summary of studies identifed (Grey Literature)... 96

ABBREVIATIONS

APA Associations Psychologist of America CBO Community Based Organizations

CCTR Cochrane Central Register of Controlled Trials CFS Child-Friendly Schools

CFS Child-Friendly Spaces

COCH Cochrane Database of Systematic Reviews CMR Cochrane Methodology Register Database CRTJ Community Based Transitional Justice CVICT Centre for Victims of Torture

DARE Database of Abstracts of Reviews of Effects DSM Diagnostic Statistic Manual

FSC Family Support Centre

GPCYP Global Partnership for Children and Youth in Peacebuilding HLW Healing of Life Wounds

HTA Health Technology Assessment Database IASC Inter-Agency Standing Committee

IAHV International Association for Human Values ICD-10 International Classification of Diseases ICTJ International Centre for Transitional Justice ICTR International Criminal Tribunal for Rwanda

ICTY International Criminal Tribunal for former Yugoslavia IGD Inter-Group Dialogue

IJR Institute of Justice and Reconciliation LAWECE Lament, Welcome and Celebration MHPSS Mental Health and Psychosocial Support

MSF Médecins Sans Frontières / Doctors Without Borders NGO Non-Governmental Organizations

NHSEED National Health Service Economic Evaluation Database PBC Peace building Commission

PCI Peace Child Israel

PCS Project Counselling Services PCFF Parents Circle family Forum PFA Psychological First Aid

PILOTS Published International Literature On Traumatic Stress PTSD Post-Traumatic Stress Disorder

SGBV Sexual Gender-Based Violence

STAR Strategies for Trauma Awareness and Resilience TLEX Transformational Leadership for Excellence TRC Truth Reconciliations Commissioner

USAID United States Agency for International Development WHO World Health Organization

WISCOMP Women in Security Conflict Management and Peace

Chapter 1. Introduction

Nowadays, many people are affected by the widespread effects of armed conflicts, with war and violence resulting in humanitarian crisis. As a result, the impact of these events may be various from the level of the effects of exacerbated political violence on psychological well-being and the social fabric being torn apart are well-known and inevitable (Sonpar, 2015). In the aftermath, the causes of interpersonal conflicts might still exist and get worsened, reaching stages of social and infrastructural problems that are profound, cross-cutting and probably described as chronically embedded in everyday existence and meaning systems (Hamber et al, 2015). Furthermore, Wessells (1998) stated that the effect could affect psychosocial issues such as the experience of immense negative feelings as an effect of the conflict, rise in aggressive and violent attitudes and a lack of communal trust are also common. As a consequence, these negative experiences and psychosocial problems somehow will predispose on the well-being, dignity and self-empowerment of those affected by violent conflict (Wessells, 1998). In this case of post-conflict countries where many people witness violence in an enormous scope and also personal loss from disaster, destruction or displacement, the chance of the conflict most likely to occur again (Collier, 2003). The capability of both society and individuals to handle with such as immensely hurtful experiences and cope with emerging distrust and fear is very restricted, often leaves triggers of psychosocial trauma such as Post-Traumatic Stress Disorder (PTSD), depression and other mental health disorders (Jordan et al, 2012). The impact is not only on the individual level; Hamber et al (2015) he even describe that the escalations of the psychological impact of armed conflict affecting entire populations and communities. Thus, the effort of rebuilding the broken social fabric that binds and supports people within their own communities is noteworthy for those who have experienced severe traumatic events and feeling connected with other people. In fact, it is essential for sustainable peace and social change in the context of peacebuilding.

rise in the number of interventions specifically dealing with the legacy of armed conflict and developing a global and local awareness of the psychological victim due to modern conflicts (Galappatti, 2003) in the form of psychosocial support implemented by nongovernmental organizations (NGOs), local community based organizations (CBOs) or International Organizations such as World Health Organization (WHO) (O’Sullivan et al, 2016). The Inter-Agency Standing Committee (IASC, 2007) defines the words “psychosocial support” as ‘any type of local or outside support that aims to protect or

promote psychosocial wellbeing and/or prevent or treat mental disorder’. Therefore,

psychological and social support services are ubiquitous both during and after armed conflicts (Hamber et al, 2015). Nevertheless, the forms of those supports are somehow diverse in terms of approach as it is part of the interventions within the domain of mental health, for example psychiatric services, psychosocial counseling, providing and facilitating community based social supports, structured social activities (such as child friendly spaces), provision of information, psycho-education, and awareness raising (Tol et al, 2011).

Thus, this research will try to explore the possible link between MHPSS and peacebuilding in the field of humanitarians, especially in the post-conflict context by narrowing the gaps between both fields. In general, the structure of this research will be composed of introduction, framework theory, methodology, results and general conclusions. Afterwards, systematic literature review is the main methodology that will be implemented for this research. Therefore, the main purpose of the research is to synthesize and integrate implications from the theory to practice from both fields (MHPSS and peace-building).

1.2 Problem statement

Humanitarian workers have had many debates regarding how psychosocial support should be implemented (Tol et al, 2011) and commonly conducted as the response of emergency situations, which need quick response such as coping with secondary stressor and trauma after disasters or conflicts (Alfadhli, 2016).

conflict settings has been growing vastly from an extensively multifarious set of indivisible approaches towards a integrated approach that includes concern for the effects of collective violence on the psychological well-being of individuals and at the societal level, such as the failure of social support structures that support local communities and societies. Afterwards, a clear understanding between practitioner humanitarians has growing understanding that MHPSS activities in (post) conflict settings should not only focus on assisting individuals and families with ‘problems’ but should include interventions to strengthen the resilience and coping mechanisms of the communities and societies at large and to promote overall well-being of individuals and communities. Therefore, most of us understand the relations partially between psychosocial interventions in post-conflict situations could possibly affect long-term collective social processes of peacebuilding, reconciliation or social change (transformations) (Hamber, Gallagher, & Ventevogel, 2014). Peacebuilding is also part of social integration and transformation in post-conflict settings, which is prolonged remembering the process. To reach peace in society is a very long process, vast and involving many parties in the implementation (Ramsbotham, Woodhouse & Miall, 2011).

However, in real implementation, most MHPSS programs pay small concern to the effects of interventions on larger social transformation processes within societies recovering from armed conflict. Moreover, there is a significant gap between the discourses of ‘peace building and reconciliation’ and of ‘MHPSS’ (Hamber, Gallagher, & Ventevogel, 2014). In order to inquire further the involvement of the MHPSS in the society, recent research has been conducted in many countries throughout post-conflicts settings.

Furthermore, from all of the descriptions of problem backgrounds above, the formulated and emerging hypothesis/research question is that; Would it be possible to apply interventions MHPSS in the area of peacebuilding for greater purpose of social change or vice versa? If it is might exist, what is the example and the best practice in both fields and how any stakeholder should take a part to address this issue? Would it be possible for both fields to co-exist, supporting one and other in the field in the future?

1.3 Psychosocial practice and social change

political and religious conflict. In the end, he found how a better understanding of what happened in the past helped him to understand the other people and himself to cope with deep traumatic memory. Moreover, almost similar research in psychosocial interventions related to ethnic and religious divisions, Hart & Colo (2014) conducted a research on how psychosocial peacebuilding theory and practices are substantial to bring both social and relational change, ultimately leading towards reconciliation and social change in the aftermath of war in Bosnia and Herzegovina. In this specific Bosnian context, they conducted the focused research of psychosocial trauma recovery, building workshops on peacebuilding processes are vital and corporate emotional, psychological and identity factors mixed with economic development and some political shift. The result is both important for individual and collective healing and creating new relational, social narratives and structures (Hart & Colo, 2014). Another different context of psychosocial intervention implemented in South-East Asia, is discussed by (the paper of) Win (2014) who wrote about his personal reflection as Burmese refugee in Thailand and he describes how his involvement in psychosocial counseling has helped him to address a state of demoralization and given him new sense of empowerment. The last part is that the research that has been done by Eiling et al (2014) focused researching outcome impact of psychosocial interventions for children and young people affected by armed conflict in the Republic of South Sudan. The intervention called IDEAL (developed by War Child), in brief is a life skills intervention to ‘deal’ with their daily lives. The research itself was conducted using mixed methods focused on qualitative and participatory methods (group and individual exercise) and interviews with parents and teachers. Thus, the result was shown that the interventions improved relationships with parents and peers, positively changing children’s social coping skills and improving their emotional coping skills as well as classroom performance.

theory framework to the practice in the field and bridging them by and systematic literature review findings.

1.4 Aim and research objective

The overall aim of this research is to explore to what extent MHPSS and Peace-building are interrelated, and to what extent, which a specific program entailing MHPSS can contribute to the Peace-building sector. Afterwards, several sub questions are related: a first aim is then to investigate the theoretical model that has been used to link between MHPSS and Peace-building, what are the particular macro, meso and micro level contextual factors, which facilitate broader social change that psychosocial providence might contribute. The second aim of this research is to explore specific characteristic that have been built between intertwined models of MHPSS program in Peace-building. The third aim is then to determine which recommendations can be made to different stakeholders related to the contributions of MHPSS in Peace-building and best practice are there in the field of peace building and MHPSS to be addressed. The fourth aim of this research is to see how much effective the psychosocial interventions bring social change towards reconciliation or social change, discussed within findings of systematic literature research.

There have been several investigations on the systematic literature review to see the issue in related humanitarian issues such as providence of child friendly spaces (CFS) in the humanitarian context assessing the evidence based on outcomes and impact (Ager et al, 2013) and other research regarding psychological interventions for children and young people affected by armed conflict or political violence (O’Sullivan et al, 2016). Despite of some research that has been done in the field of MHPSS and peacebuilding aforementioned above, there is no systematic literature review that comprehensively investigates the issue and tries to address the gap between both the field for the future implementation and the field of policy making.

1.5 Relevance

This research is of relevance because as explained in the problem statement, the exact relation between MHPSS and the process of peacebuilding and other forms of social transformation needs further investigations. Systematic literature review in general, gives an understanding from empirical evidence based for any possible link between both fields. As the hypothesis stated in previous paragraph, it is possible that some interventions of psychosocial support in post-conflict settings that have been implemented are therefore both interesting and relevant: the potential contribution of such an MHPSS program to social change or transformation can contribute to the accumulation of knowledge concerning the possible link between MHPSS and Peace-building and how these two fields can strengthen each other. Finally, it can contribute to the development of best practice into the field of MHPSS, peace building and future intervention designs for humanitarian assistance in general.

1.6 Methodology

The methodology used to answer the research question is a systematic literature reviewing analysis. Sources used are academic literature, peer-reviewed articles, empirical research, reports and grey literature such as reports, guidelines, training modules from (I)NGO’s. The literature, research and reports are retrieved through the following data engines: Ovidmed, Medline/Pubmed, Socindex and PsycINFO. As this research is also part of the joint collaboration between both NGOs War Trauma Foundation (WTF) in the Netherlands and Institute of Justice and Reconciliation (IJR) South-Africa, the possible sources of database are more diverse from several universities such as Groningen, South-Africa and Columbia University.

1.7 Limitations

Chapter 2. Theoretical framework

The fact that the field of disciplines of Mental Health (MHPSS) and peacebuilding are quite abroad, this chapter is about theoretical framework that being used in order to identifying and defining relevant concepts in both fields. Most of the concepts below are generally tested and valid in the context of post-conflict situations. However, the main purpose is to have a common understanding to create same foundation for the ground rule of theory before start to analyse the findings of search for MHPSS and peacebuilding.

2.1 MHPSS

The word MHPSS is the mixed definition between psychosocial support and mental health. Psychosocial itself meaning the connection between emotional, mental, social, spiritual, behaviour including the relational, traditional and cultural concept of a being (Dandaura, 2012). On other words, psychosocial can be defined as a close connection between the psychological aspect of human experience and the wider social scope. Moreover, the scope is not only on an individual level but also more on community levels such as family or certain characteristics of a group based on gender, age or vulnerability category. Moreover, psychosocial support is an integrated continuum of care and support that influences individual and social environment where people live provided by the social support such as family members, neighbours, friends, care workers, community and support offered by specialized staff in psychological and social services (Resource park, 2009). The main aim is to empower resilience, enhance social connection, strengthen coping mechanisms and reduce stigma in reaching towards psychosocial well-being.

basis, weak interagency collaboration, trauma denial or over focus, ignored pre-existing problems, participation from population and social support being ignored and many weak programs that fit to be implemented in the field. At the beginning, it was guidelines to overcome these issues were published the IASC Guidelines on Mental Health and Psychosocial Support (MHPSS) in Emergency Settings. The purpose is simply to enable humanitarian actors to design, conduct and coordinate a set of minimum multi-sectorial responses to protect and enhance people’s mental health and psychosocial well-being in the midst of an emergency such as disaster or conflict setting. The guidelines have been used by so many (I)NGO and International organization throughout the world to provide psychosocial support. Nowadays, the IASC MHPSS guidelines is being used as a standard guide for implementation of the psychosocial programmes in the humanitarian field alongside with the Sphere project standards (IASC, 2007).

Figure 1. Intervention Pyramid of MHPSS from IASC Guidelines

in the design it is important to consider cultural sensitivity, transparency of monitoring and evaluation of the program and to keep an open mind (ibid).

2.1.2 Mental Health

Mental health can be defined from a clinical perspective with the minimum presence of mental disorder or symptoms of abnormality such as anxiety, PTSD, depression etc. based on Diagnostic Statistic Manual (DSM) IV from Associations Psychologist of America (APA) (1974) or another approach from another perspective such as from WHO. The World Health Organization (WHO) defines mental health as ‘a state of well-being in which every individual realizes his or her own potential, can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’ (WHO, 2016). The difference of the approach lies in which mental health is applied in academic and practical views of life. The definitions from WHO is more general and emphasize on social factors of the people with environment in daily life, not only inner individual well-being while clinical perspective stressed on the diagnosis and individual well-being.

Moreover, the context of mental health of an individual is also broader in the context of humanitarian and post-conflict situations, including a combination of many aspects of life for the individual such as physical, emotional, cognitive, and social factors (IASC, 2007). There are several contributing factors defined by IASC that can affect conditions of mental health such as first of all, existing problems before the conflict started such as extreme poverty, being part of a marginalized group, being the victim of political oppression, existing psychological problems. Other can include any kind of distress such as desperation and sadness in very difficult yet heavy situations. Secondly, conflict regarding social issues such as family separation, disruption of social networks, destruction of trust and of family structures and gender-based violence. Thirdly, humanitarian aid-induced social problems such as undermining of existing community structures or traditional support mechanisms.

2.1.3 Psychosocial Well-being

order to respond the challenges of prevailing events and conditions (The Psychosocial Working Group, 2005). Moreover, psychosocial well-being emphasizes five interconnecting aspects between individual and community that is understood to experience well-being from physical, material and knowledge resources, experience competence and self-worth, exercise participation in family, community, social and political life, build social networks and improving the wellness of both physical and psychological dimension. To add the common understanding, Sonpar (2015) described that psychosocial well-being is mediated by power, subject and identity to facilitate the influence of surrounding socio-political, institutions and cultural systems. In the implications, psychosocial well-being stresses the importance of environment factors of an individual in order to achieve psychological wellness. In the context of post-conflict situations like an exposure of an endless war with very intense violence, people can get a psychological impact such as distress, loss of family members or even daily social support system such as educations and access to work disrupted.

2.1.4 Trauma

Exposure to life-threatening or stressful events can be the main source trauma of an individual or community. A person who experienced a traumatic situation can experience a feeling of loss of meaning of life and predictability. The reactions of trauma can be expressed by certain emotions such as anxiety or feeling of helplessness and might be subjective depending on the interactions between individual factors such as characteristics, resilience and environment forces such as a certain level of violence or experience (de Jong, 2005). Clinical definitions of trauma, based on Diagnostic Manual Statistics (DSM) IV and the International Classification of Diseases (ICD-10) of the World Health Organization, refer to Post-Traumatic Stress Disorder (PTSD), in which trauma is seen from the symptoms and the reactions dimension. The diagnostic criteria are exposure to the traumatic event, presence of intrusion symptoms, persistent avoidance and numbing, negative alterations in cognitions and mood, marked alterations in arousal and reactivity, duration longer than one month and results in clinically significant distress. The reactions can be seen in cognitive, emotions and behavioural aspect of people (APA).

internal strong factors (coping strategy, spirituality or adaptation skills). This individual definition of trauma also emphasizes that trauma can develop other mental disorder but in fact, not all of the people who had traumatic experience had some mental disorder later on. Needless to say, this clinical western approach to understanding the context of trauma of an individual might be not necessarily always relevant (de Jong, 2005). In this case, de Jong (2005) states that “transcultural psychiatry” offers a useful and complementary approach to DSM in order to define PTSD for international settings. In briefly, it describes to find anthropological information and assumption of thought through certain cultural lens about the culture and community with epidemiological and psychiatric studies of ethology health and illness. That explains why people can experience the same types of psychiatric and psychological disorders worldwide but they experience and express it in various ways cross-culturally. This way, the approach can be very relevant to describing the serious and prolonged disturbances of individuals confronted with severe life events such as violence in the context of post-conflict settings.

with death as evidenced by drawings, dreams, and poetry, deterioration in morals and social values such as unwanted pregnancies, teenage abortions and child sexual abuse, poor leadership, dependency, passiveness, despair and short-terms goals in society. In brief, collective trauma can influence the relationship between communities and give emerging phenomena such as traumatic memory (historical trauma) for one community where further worse case of trauma can be transmitted to next generations. One of the researches by Duran and Duran (1995) suggest that historical trauma becomes attached in the forms of cultural memory and passed on with the same way by which culture itself is generally transmitted, becomes part of the culture itself. In the post-conflict context, often there is a higher rate chance of risk that both individuals and communities affected by traumatic events will pass their negative emotions such as anger, hate, and fear into the next generation, which can manifest new forms of violence and trauma.

2.1.5 Resilience

Resilience has many definitions, taken from de Jong (2005), resilience refers to an “individual or group’s capacity to restore a new balance and related worldview when the old one has become dysfunctional due to the confrontation with a traumatic event.” In other words, resilience shoes how self-help and control mechanisms of an individual can resist to a certain kind of pressure, hardships or massive disturbing events such as conflict and disaster. Related to the context of MHPSS, usually, resilience is a very important concept in the matter of emergency situations but nowadays more and more needed characteristic in post-conflict situations especially dealing with traumatic experiences in humanitarian crisis or prolonged violent conflict. Moreover, this concept is very relevant to the fact that many humanitarian crisis contexts in which beneficiaries find themselves are on-going; therefore it is more realistic to focus on coping and self-control mechanisms and to not only focus on symptom reduction but to use a more comprehensive view on human health (including psychosocial well-being) in order to alleviate social suffering and foster healing processes (ibid).

is such as fulfilment of basic needs such as water, housing, and good physical health, which might entail less stress and more ability to cope with the psychological problem. So a psychosocial program is suggested to address basic needs because, this could directly improve resilience for practical reason. Mental factors such as normal psychological coping mechanisms are enough for most people under normal circumstances in a relatively stable context; the coping process is the key, the sooner it starts the better are the outcomes related to factors such as self-help and a feeling of self-control for a certain environment. Social support in this context, plays the role in affecting health by mediating the adverse effects of the environment, internal and social pressure. Nevertheless, it is multifactorial and consists of subjective support; supportive behaviour for example from groups or participation in group activities and company such as partner, family, and friends. Furthermore, social factors such as a positive social recovery environment in the community such as acceptance of vulnerable people, caring behaviour, social order, and clarity of cultural and community roles could promote resilience better. For the reason of sense of predictability and sense of belonging although in some other case, sometimes pressure of social factors could have a reverse effect on resilience. Spiritual factors in some cultures might contribute to the level of resilience on a whole different level. Outside of the context of empirical evidence, a simple medical solution to psychosocial problems and mental disorders, strong spiritual beliefs or divine interventions and motivations are increasingly receiving attention among mental health research for the reason that these can help physical and psychological healing processes. Lastly, moral values can play a pivotal role in addressing heavy psychological effects of mass violence in the post-conflict setting by giving higher meaning towards negative experiences into positive thoughts (de Jong, 2005).

2.2 Peacebuilding

The aim of peacebuilding is to address the structural and relational proponents between conflicts and within society to establish long lasting peace.

Galtung, the father of peace studies, coined the term peacebuilding in 1975 with his definition as the ‘practical implementation of peaceful social change through socioeconomic reconstruction and development (p.282-304).’ This definition emphasizes the need to pay attention to the structural causes of violence, which are described as the existing social order that supports and condones violence. Peacebuilding was a process that was to transform the existing social order and structures that shape and form conflict. Peace building has also been referred to as the changing of destructive relationship patterns and in seeking systematic change (Lederach 1996).

Furthermore, the Peace building concept is multi-layered, and yet interrelated with cross-cutting issues for example related to the state-building concept from the conflict resolutions perspective and the aim is to reach sustainable social, economic and political structural and relationships at all levels in society (described in figure annex 3). In one hand, peace building can be seen as peace reconstruction or building peace from the perspective of the institutionalized view from the UN system definitions of a peace process in the context of post-conflict situations. Thus in a nutshell, from UN perspective peace building is merely seen in a narrow perspective, top-down initiatives approach and with the only negotiation between elites trying to reach a peace agreement leading to truce from the top layer part of the interventions. The example of this attempt is the establishment of the Peace building Commission (PBC) as the response to the failing UN system on peace agreement and agenda for peace in some case such as Somalia, Rwanda and former Yugoslavia in New York in September 2005 as an Intergovernmental advisory body within UN system, formalized by UN General Assembly Outcome document of September 2005 (Ramsbotham, Woodhouse & Miall, 2011).

peace agreement by elites but more importantly on the empowerment of communities that were being torn apart by war, including local actors and the non-governmental sector that are linked to local wisdom and/or knowledge. In this way, a wide perspective of the peace process can be defined as actions carried by civilian’s and/or enhance sustainable civil society not necessarily tending to achieve a peace agreement but contribute to more a participatory peacebuilding (construction) in public political spaces for the purpose of the growing society towards stability. The concept is based on the idea that the community is liberated from deep oppression and misery of profound violence. The main goal is to achieve structured peace (in Galtung’s terms of positive peace). This approach also promotes many cross-cutting themes and broad issues such as gender equality, indigenous empowerment (cultural sensitivity), human rights, sustainable society, transformations of social order. However, somehow this approach might have a difficulty to be implemented in some cases, for example, as was seen by structural local barriers in Sierra Leone (ibid).

conflict resolutions to understand peacebuilding initiatives and defines that the ultimate goal of peacebuilding is reconciliation, which can create social space for encountering facilitation and acknowledgment of the past, set a vision of the future and finally could possibly be re-framing the current conditions. Moreover, his framework provides useful directions towards grassroots activity and bottom-up approaches, which will then be transforming relationships and transforming social space, and structures for a long-term peace society (Lederach, 1997).

2.2.1 Reconciliation

Reconciliation may have many different definitions but in a nutshell, it can be seen as the ultimate goal of conflict resolution by restoring the broken relationships and learning to live with the past. However, sometimes reconciliation is also seen as a political process, even when an armed confrontation is still active (Ramsbotham, Woodhouse & Miall, 2011).

the former enemies become friends, building a new identity, transforming the community and building up self-confidence and trust (ibid).

According to Kriesberg (2007), there are four-core components of reconciliation that are vital for conflict transformation and peacebuilding in post-war societies, which are truth, justice, regards, and security. The mechanism in order for truth to emerge is that the state should create a truth commission and mandate because the dimension of truth is not solely politic but also factual, narrative and including moral implications towards people who are victims of the war. Justice is also an important aspect where reparations (restitution, a symbolic guarantee from repetition) of the victims who are suffering from oppression, and no impunity take a place as the compensation and punishment for the war crime perpetrator. Sometimes justice is difficult to achieve, as it contradicts with other aspects and political interests and lack of prosecution itself. Moreover, regarded by the members of a community is meant to acknowledge other people’s human rights and moving towards forgiveness, which is mostly difficult if the impact of the trauma is profound and had a huge effect on the psychological issues. Lastly, feeling a sense of personal security as the fruit of trust living together is very noteworthy for future constitutive reconciliation (Kriesberg, 2007). However, all these dimensions of reconciliation might be difficult to achieve at the same time due to many constraints from the side of leaders, or small groups who had other interest especially towards the implementation of the peace agreements (ibid).

Needless to say, reconciliation is a long process in the post-war reconstruction. As mentioned above, the reconciliation must take place not only at structural level but also at socio-emotional level between the individual and community through forgiveness and healing. The huge challenge of reconciliation is dealing with the past (trauma and atrocity) from all levels; individual, community and national (the interaction between all of them; individual, community and national) as well as between various vulnerable groups such as women, children, and even the combatants. This effort will be futile unless there is support from the government (such as through truth commissions, prosecutions, reparations programs, etc.) and from the community level.

2.2.2 Transitional Justice

reaching of transformative reconciliation and cultural remembrance (Fischer, 2007). Lastly, the third and current phase of transitional justice emerged in the early 1990s in a response to ethnic cleansing and genocide in the countries of Rwanda and former Yugoslavia, where the UN Security Council created an ad hoc International Criminal Tribunal for former Yugoslavia (ICTY) and Rwanda (ICTR) (Pham et al, 2010).

2.2.3 Social Transformation

Social transformation is a long process and continuum concept, which can happen in the context of conflict resolution in a post-war society. Conflict can automatically cause a huge change at the structural level of society as it impacts the disturbance of social networks and systems. Some impacts from social transformation will define new social, economic and political reality in general, which leads to shape new forms of value, identity, culture, and gender or even hierarchy status in society and the result can be unexpected. The process of social transformation can take a part in institutional patterns, state formations (including law), political changes, social reconstruction and movement, economic change. The most important part, social transformation changes, happens not only in the huge scope of society but also internally in the mind-set change of individuals, which is why this concept will be appropriately described by following the concept, Socio-Ecological Model (Meintjes et al, 2001).

2.3 Socio-Ecological Model

Ecological model of Bronfenbrenner (adapted)

Meso level: Interrelations within social groups and interaction between the three levels

(adapted model by Bubenzer & Tankink, 2015)

In this model, the way of behavioural change patterns working is not solely one-way or through straight lines, but interrelated or circular for each level so that the relations between individual and the other layers of the model are interconnected, which means each layer affected the others. It means, the different contexts of environment situations in the larger layer such as macro system, will affect the behaviour in the community and ultimately affect the individual (microsystem). Furthermore, the behavioural change in the individual will promote changes in the family. Then, community members react differently in order to respond to issues and address problems in society as coping mechanisms and eventually, stimulate people to consolidate these changes and vice versa. For example in the context of post-conflict, the violence that happens in the society will most likely change the pattern in the community and the individual level eventually. Prolonged internal conflict will change the social relations in all layers. For instance, the lack of resources and judicial structures at macro level will change the value drastically into a negative one such as mistrust and fear in society culture, the loss of the family member will create a dysfunctional family and other broken social networks (bonding), create an unstable community at the meso level, and will be disturbing individual psychosocial and mental well-being at last at micro level (Bubenzer & Tankink, 2015).

From this perspective, the whole environment plays a very crucial part in affecting individual behaviour and well-being. Damaged environments, for instance, could cause disruption and add to the psychosocial stress in families where the individual might be

Micro level

The individual (intrapsychic and neurobiological level), Notions of health, wellbeing

and violence

Exo level

Family and community members

Macro level

War effected population Public services (judicial, health & education) gender culture, belief systems, policies

Resources

exposed to the risk factors for the accumulation of mental health issues. In order to prevent from further damage caused by risk factors, several protective factors can be functioning as deterred from all levels, such as strong justice and reparation mechanisms on a macro level, supportive groups and psychoeducation in a community as meso level and local coping capacity and resilience of individual as micro level. Furthermore, the ecological approach puts strength emphasizing on the roles of community resilience approaches to shape the well-being of the individual in post-conflict settings. Thus, the approach of MHPSS and peacebuilding should not only be aiming at healing at an individual level but also, more importantly, healing community by helping families to strengthen resilience (protective factors) and reduce the risk factors such as retributive violence (Bubenzer & Tankink, 2015).

Chapter 3. Methodology

In this chapter 3, the focus of the discussion is on the methodology of the research, which is using systematic literature review methods. As mentioned in the chapter 1, this approach allows us to find the relevant existing approach of both field of MHPSS and peacebuilding in the context of post-war societies. The essence of this methodology is tried to link the findings of both academic sources such as publications in journals, and implementations of interventions in the field in a systematic way of research.

3.1 Definition of systematic literature review

This chapter is focused on the methodology of the paper, which includes the definitions and description of how the data was obtained. The main data obtained for this research is done through literature review, which can be defined as follows: a literature review is a method for identifying, evaluating, and synthesizing the existing body of completed and recorded work produced by researchers, scholars and practitioners (Baumeister et al, 1997). Literature review comes from the premise that one study is not enough to prove one phenomena and the main characteristic of literature review is that it covers completed, published works, secondary source type of research (doesn’t present new or original work) and the sources are used for evaluation and interpretation aiming to create a new perspective, in this case, an integrated approach of MHPSS and peacebuilding.

finding a systematic search process is to locate studies, which pinpoint a particular research question and proves in terms of formulating new perspective of both field, by synthesizing the findings and characteristics of the results from the search. Moreover, systematic reviews strong points are that they are objective, systematic and transparent and replicable. They are also using criteria for inclusion and exclusion, which has to be objective, explicitly stated and consistently implemented in order to reduce bias and allow readers of the review to assess the author’s assumptions, procedures, evidence and conclusions critically. Finally, this methodology also allows other researchers to update the review at an alter time in order to integrate new findings.

From July to October 2016, the authors undertook a systematic review of literature that documents (in theory and practice) examples of the interconnectedness between peacebuilding and MHPSS in the context of post-conflict situations under collaborations with both organizations War Trauma Foundations (WTF) and Institute of Justice and Reconciliations (IJR).

3.2 Search terminology used

The search terminology derived from the basic assumption and research questions: Assumption: for sustainable social and psychological change the fields of MHPSS and peacebuilding need to be integrated. Research question: Which examples of an integrated approach of MHPSS and peacebuilding are described, which theoretical model has been used and what are the characteristics of such an approach? Therefore, the search for examples of an integrated approach (intervention, support, program) of MHPSS and peacebuilding are broken down into the following categories in words searching:

1. MHPSS/Community:

1.1. MHPSS, mental health, psychosocial 1.2. Communities, families

1.3. Resilience, coping

1.4. Arts-based forms of interventions 1.5. Local capacity

2. Peacebuilding/Justice: 2.1. Peacebuilding

2.2. Restorative justice, human rights 2.3. Social change

2.4. Forgiveness 3. Approaches:

3.1. Intervention, support, program 3.2. Effectiveness

3.3. Evidence (evaluation, reviews, trials etc.) 4. Context

4.1. Conflict, organized violence 4.2. Genocide

4.3. Peace phase

4.4. War-affected population

5. Publication date: January 1992 - June 2016

6. Document type: journal articles, grey literature, books, programmes etc. Not: letters, reviews of books and such – perhaps make this filtering after the search.

Finally, the search strategy is using these concepts and finds variations etc. The structure will be: (1.1 OR 1.2 OR 1.3 OR 1.4 OR 1.5 OR 1.6) AND (2.1 OR 2.2 OR 2.3 OR 2.4) AND (3.1 OR 3.2 OR 3.3) AND (4.1 OR 4.2 OR 4.3 OR 4.4). 5 will be a filter.

Bibliographic databases

These choice of the bibliographic database are based on the premise and the nature of the field study, multidisciplinary field included such as humanitarian, psychology, sociology, and public health from various digital library such as Cogis Library (Arq, War Trauma Foundation) and University of Groningen:

 PsycInfo (Ovid)  Ovid Medline

 Evidence Based Medicine Reviews Full Text Multifile Database Guide (Ovid) o ACP Journal Club (ACP)

o Database of Abstracts of Reviews of Effects (DARE) o Health Technology Assessment Database (HTA)

o National Health Service Economic Evaluation Database (NHSEED)  PILOTS: Published International Literature On Traumatic Stress

The search results will be de-duplicated in Endnote.

Table 1. Search terminology used in academic review by core theme (attached in Annex 8)

Table 2. Resume of search results and de-duplication

The items will be deduplicated semi-automatically in Endnote.

Database Hits duplicates in Endnote In Endnote

PsycINFO 522 8 514

SocIndex 506 89 417

Ovid Medline & EBMR 131 72 59

PILOTS 88 46 42

Total 1247 215 1032

3. 3 Inclusion and Exclusion Criteria

complete – very slightly (0-19), very slightly – moderate (20-38), moderate – complete (39-57), which is the only included paper is very slightly – moderate and moderate – complete categories. To supplement this review of published sources, the author solicited ‘grey literature’ (unpublished agency reports and other documents) and reviewed them within the same inclusion criteria but without quality appraisal tools for the reason of non-peer reviewed document.

There are some limitations for the selections of the paper of inclusion criteria. Somehow, the decision to include paper can be subjective because the scope of MHPSS and peacebuilding is broad and a little bit vague. In order to reduce the effect of subjectivity, the author doing double check with other researcher from IJR South Africa team by re-checking the selections of the paper and for final judge to determine whether the paper should be in or out based on basic theory framework both fields.

Figure 1: overview of selection of papers during review process

Abstracts of all 1,032 articles were reviewed for relevance by the first author, which identified 78 papers as potentially fulfilling inclusion criteria plus additional 9 papers from relevant source. Full versions of these paper were obtained, detailed review of which led to three of these studies being confirmed as meeting inclusion criteria. To identify relevant ‘grey’ or unpublished literature, over several source of NGO who are active in MHPSS and PB in post-conflict context were searched in the official website of the NGO and search through Google. As additional, the source of the ‘grey’ literature is obtained through email relevant actors in this field such as Katie Mansfield (she is director of Center for Justice and Peacebuilding in Eastern Mennonite University for the program called Strategies for Trauma Awareness and Resilience) or Barry Hart (he is a professor of Trauma, Identity and Conflict Studies in the Center for Justice and Peacebuilding). As the results, they suggested some links in the organizations that might work in both fields. Interventions, presentation papers, manuals assessments, monitoring, or evaluations both implementations of MHPSS and peacebuilding in the

1373 studies identified through keyword search 74 documents provided by NGO contribution 341 duplicates excluded 1032 studies selected for abstract review

954 studies excluded 87 studies selected for full text review on the

basis of abstract

74 documents selected for full text

review

0 documents excluded

41 NGO documents excluded upon full

text review 42 studies excluded

upon full text review

45 studies & 33 NGO documents included upon full text review 9 additional studies

Chapter 4. Analysis Result

4.1.1 Summary of studies identified (Scientific) (attached in Annex 6)

In this sub-chapter, the summary of scientific findings of literature review is presented in the annex for more details. The main description is about tittle of research, objective, details research and or interventions, the concept that being used, conclusion and scoring quality with tools appraisals.

4.1.2 Summary of studies identified (Grey-Literature) (attached in Annex 7)

While in this sub-chapter, the summary of grey-literature findings being reviewed and presented in the annex for more details. The main description is somehow similar with scientific summary review, just slightly different in the tittle of NGO and without scoring quality tools appraisals.

4.2.1 Findings (scientific literature)

In this chapter, the results of the final full review journal are presented in the previous sections before being discussed in detail. At the beginning, the findings are divided between scientific and grey literature review for the purpose of comparisons of main features and how both approaches complement each other to understand the integrated perspectives of MHPSS and peacebuilding.

General characteristics research and interventions

categorized as not complete to very slightly (details category descriptions can be found in the annex 5) (Staub, 2013 & Dandaura, 2012).

Core elements and concept

For the core elements and concepts, most findings that are being used in the definitions table of Peacebuilding and MHPSS themes in scientific literature research are as follows: reconciliation (Mendeloff, 2009; Laplante, 2007; Lee, 2006; Pham, 2004 & 2010; Martin-Beristain, 2010; Richters, 2010; Machinga & Friedman, 2013), transitional justice like restorative justice (Park, 2010; Mendeloff, 2009; Martin-Beristain, 2010), social justice, reintegrations or reconstructions (Pham, 2004 & 2010; Pupavac, 2004), Disarmament Demobilization and Integration (DDR) (Taylor, 2016 & Theidon, 2009), Truth-commissioner (Staub, 2005) and social transformations (Staub, 2013) for peacebuilding sections (national or local level) (Hamber & Gallagher, 2012, Dandaura 2012, and Bhadra, 2013).

On the other hand, the concept mentioned for MHPSS sections: trauma healing in community (Laplante, 2007; Spitzer & Twikirize, 2014; Machinga & Friedman, 2013), PTSD or Trauma (Pham, 2004; Solomon & Levi, 2005; Weder, 2010; Somasundaram & Sivayokan, 2013; Touze, 2005), Psychosocial (interventions and well-being) (Pearlman, 2013; Sveaass & Castillo, 2000; Staub, 2005; Dandaura, 2012), Public health (WHO; De Jong, 2010), mental health awareness (Lee, 2006 & Taylor, 2016), Resilience (Mendeloff, 2009; Machinga & Friedman; 2013) and IASC layers explicitly mentioned in one paper (Somasundaram & Sivayokan, 2013).

issue such as gender-based violence and women empowerment, and intergenerational trauma or violence. To add some linkage the concept between MHPSS and peacebuilding, some concept also found and being discussed such as building trust, forgiveness and violence preventions.

4. 22 Findings (Grey literature)

In general, in terms of research feature, qualitative methods are still commonly used in the grey literature approach for the research (used in 13 documents from total 33 documents) compared to the other approach such as mixed and literature review. As for the feature of the interventions, mostly the intervention address layer 1 and 2 from the IASC levels (basic needs and community levels) of MHPSS (total 24 documents are using it). The format of the papers is various such as report, conference, assessment presentation, monitoring, and evaluations. Region of Interventions are the same with scientific literature as well, mostly in post-conflict settings country such as Middle East (Palestine, Israel, Iraq, etc.), Africa (Sierra Leone, DRC, Uganda, etc.), South East Asia (Indonesia, Myanmar, etc.) or Europe such as Serbia, Northern Ireland and Latin America (Colombia).

Findings regarding the framework used and interventions

Management and Peace (WISCOMP), Foundation for Universal Responsibility of His Holiness The Dalai Lama, India, etc. (Global Peacebuilders, n.d.). Furthermore, Many NGOs put strong emphasize on the intervention for the vulnerable groups of women, youth and children for initiated approaches of both fields such as WISCOMP, EMPROC for women, or Global Partnership for children and Youth in Peacebuilding (GPCYP, n.d.) for youth and children. To add some findings concepts in grey literature, the issue of peacebuilding is usually ‘contextualized’ with other issue and might be providing relevant linkage issues such as politics and historical context of peacebuilding (mentioned in 3 documents), economic reconstruction (mentioned in 3 documents) and education as agent of change (mentioned in 3 documents).

4. 3 Discussion

In this sub-chapter, the findings of both scientific and grey literature review will be discussed in 4 different sections, which are framework concept, linkage issue, cross-cutting issue and missing elements.

4.3.1 Framework Concept

In the scientific literature review, liberation psychology was first introduced by the Jesuit Priest and as the development concept from peace psychology division, which is trying to use holistic psychosocial healing as the concept of alternatives approaches to mental health recovery in post-conflict settings (Anckerman, 2005; Laplante, 2007). Liberation Psychology focus on raising consciousness, renewing people's dignity and sense of self-worth through empowerment and aimed for peacebuilding (Laplante, 2007).

Furthermore, the socio-ecological system model by Bronfenbrenner is also being introduced as a bridge between MHPSS and peacebuilding approach by emphasizing on the multilayer system approach (micro, meso, exo and macro system) of individual well-being and the environment (Somasundaram, 2012).

On the other hand, the public health and transitional justice concept had a common goal to achieve: promoting and protecting individual and societal physical, mental and social well-being by focusing on health preventions, cultural appropriateness, reaching social and political transformations for sustainable peace effort (Christiansen, 2015; Berliner; Dunphy, 2014; Pham, 2010). Gutlove et al (2007) state that health professionals have a special role to play in healing violence broken communities. One of the reasons is because they have a close association with people who have suffered mentally and physically, are often well educated, how have public stature and have access throughout a community. They can formulate a ‘bridge of peace’ between conflicting communities, whereby delivery of health care can become a common objective and a binding commitment to sustainable co-operation in both fields. At last, they might facilitate reconciliation after the trauma of war and conflict, through a healing process that restores relationships at individual and community levels. Both Berliner (2006) and Anckerman (2005) state that for this project health is being used as the entry point for a psycho-social and physical aspect to communities highly affected by organized violence. Berliner (2006) goes on to state that ‘the programme’s aim of increasing the overall functioning capacities of the participants in the community links the significance of ‘health’ to social and political transformation, meaning that the need for physical and psychosocial treatment may well be addressed through the engagement in processes of reconciliation, empowerment, and development.’

their role in promoting peace through creative initiatives for example, Syrian children (International Alert, 2016). The next example of psychosocial interventions that directly contribute to peacebuilding is Inter-Group Dialogue (IGD), which is trying to facilitate dialogue between the members of opposed groups within a structured setting, with the objective of working towards psychosocial healing and social justice (King, 2014). Meanwhile, the ethno-psychotherapy approach using socio-political counselling for communities emphasizes social support, recreating flexible family support and network system, increasing group cohesion (Nqweni, 2002). While transpersonal resilience is an approach to reach healing and reconciliation in Zimbabwe from the effects of political violence, which combines psychological and spiritual intervention mixed between Shona & Christian values aimed for individual and community healing (Machine & Friedman, 2013). To support this approach, there is initiation from NGOs (Alliances for Peacebuilding) that try to bridge neuroscience, spirituality, and peacebuilding with assumptions that the power of spirituality can contribute to transforming behaviors, attitudes, and relationships, and can, therefore, be harnessed to build peace. While from the peacebuilding theory perspective, the most popular attempt design to integrate both fields (MHPSS and Peacebuilding) is using cross-community peacebuilding. The effort of peace consolidation to achieve the access to justice and facilitate reconciliation in all layers should start from community levels and respected local wisdom. For the example, CRTJ (community-based transitional justice) is the effort of peace consolidation to maximize access to justice and facilitating reconciliation that takes a place from community level such as the Rwandan experience of local community-based trials called Gacaca, Fambul Tok (Family talk) in Sierra Leone, Photo Voice for Mayan Women in Colombia, People-to-People (P2P) peacebuilding approach (Park, 2010; Lykes, 2003; Weder, 2010; Martin-Beristain, 2010).

universal and culturally sensitive (IAHV, 2015). Socio-ecological model can be adjusted and adapted as the relevant as possible in the post-conflict setting by addressing interventions all layers from micro to macro system. The intertwined elements of MHPSS in peacebuilding need to be address within this approach remembering the complexity of the issue such as cultural construction of mental health, understanding local resources, dialogue for healing, gender issue, intergenerational transmission of trauma or violence within socio-ecological system model (Bubenzer & Tankink, 2015). However, the difference is lies in the theory of changed analysis approaches, they can be easily found in grey literature but are hardly find in a scientific literature review. Why are many NGO papers using this approach a lot? Because of the fact that the benefit of a theory of change in peacebuilding context can clarify project logic and tackle inadequate assumptions, identifies the appropriate actors to work with, identifies the gaps between local and national level changes and resulting concrete results from the perspective of behaviour change of the beneficiaries (CARE UK, 2012).

violence, greater responsibility in sexual relations and improved economic well-being (International Alert, 2013). Moreover, another example of psychosocial interventions is focused on children and youth is creative and interactive arts-based psychosocial educational approach. This approach is using arts-based therapy to establish child-friendly spaces and helping Syrian children aged 6-17 in dealing with trauma. The approach aimed to help them understand their personal and collective identity, and improve their relationships with themselves, those around them and the environment. It also sought to empower them to reject discrimination and better understand their role in promoting peace through creative initiatives although there are some difficulties to implement the program (International Alert, 2016). As the example for youth is peace projects, a youth sports programs and awareness campaigns that street art promoting messages of peace the article talk about the peace project which is focused on peacebuilding in Yemen with youth (CARE, n.d.).

One different findings of the approach to bridge MHPSS and peacebuilding in the NGO report are neuroscience and spirituality. The main idea and major hypothesis is that there are antidotes to the brain-changes that occur in times of war, violence, and crisis – antidotes that harness the power of spirituality – that can contribute to transforming behaviors, attitudes, and relationships, and can therefore be harnessed to build peace (Alliance for Peacebuilding, 2016). However, This concept is quite new and is still in the process of for follow up research. Thus, compared to the framework findings from scientific literature review, grey literature does not have that much variety of basic framework concept other than mentioned above.

4.32 Linkage issues

Linkage issue is trying to see the aspect of another approach that interlinked MHPSS and peacebuilding by addressing some relevant concepts in between. Both scientific and grey literature review have their findings regarding this and will be discussed in the following paragraph.

2014; Taylor, 2016), trauma healing in the community by enhancing individual and personal transformation towards social change (Hamber & Gallagher, 2012), social reconstruction such as gender issues like women involvement (Laplante, 2007 & Theidon, 2009) orientated towards social cohesion, reconciliation, truth and violence preventions from intergenerational trauma from the past (Pupavac, 2004; Hamber & Gallagher, 2012). While in grey literature, many attempts of an integrated approach of MHPSS and peacebuilding interventions presented by some NGOs most commonly use the linkage concept like trauma healing that can manifest in the interventions such as psychosocial support counselling, education that can manifest in the interventions such as such as child-friendly schools (CFS) (mainly promoted by UNICEF) and violence prevention (to re-occurrence) programs that usually focus on youth as beneficiaries.

Forgiveness

perspectives in the context of post-conflict and traumatized populations. We should bear in mind that forgiveness needs to be properly followed by responsibility and sincere expression of regret; otherwise it could be harmful. On the other hand, constructive forgiveness, in contrast, may help all parties (survivors and perpetrators) into a healing process (Staub, 2005).

Trust

Violence prevention

Education

Education in peacebuilding is mostly seen in the grey literature review findings. Educations in peacebuilding usually aimed for children and youth as beneficiaries and the agent of change for the next generations. Some of the examples are Child Friendly School (UNICEF, 2014), Early Childhood Development (UNICEF, 2012) and Peace education (International Alert, 2016) through multilevel education program (International Rescue Committee, n.d.). Thus, Peace Education's role in peacebuilding purpose is to reducing vulnerability and increasing resilience to recruitment by armed groups, promote peace through creative initiative & promotes psychosocial resilience and social and emotional well-being through education services well-being (International Alert, 2016).

In the context with socio-ecological perspective, peacebuilding education is then offered postulating that sustainable social transformation calls for multi-layered. Interlinked change whereby, for instance, micro-systemic change in the classroom and school is reinforced and embedded through structural and cultural change at the macro-systemic level while being affirmed by action at the intermediate (including community) meso-systemic level. Education for peacebuilding is transformative in focus and aims at cultural, social, political and economic transformation at all levels within conflict-affected societies by addressing the drivers of conflict (UNICEF, 2014). The study results then turns to the potential within system-wide child-friendly education for peacebuilding, with sections on the professional development of teachers and others, the use of situation analyses, multi-sector and multi-level partnership approaches, national policy development, national child-friendly school teams, and national-level monitoring and evaluation (UNICEF, 2014).

Trauma Healing