"How are you?" asks Salah in Arabic to begin the session. "Mneh," replies Farid, waggling one hand in mid-air: "Alright." Farid was 16 years old when he narrowly escaped a bomb attack in Algeria, his home country – but two of his friends died. He has been taking pills to sleep ever since. After the episode, he became a critic of the regime and was persecuted, so he fled to Germany. Now he’s a patient of Salah’s, a psychosocial counsellor at the Soul Talk project who is a refugee, too.
Created by the humanitarian medical organisation Médecins Sans Frontières(MSF, or Doctors Without Borders), Soul Talk is the first psychosocial aid project of its kind in Germany. Since its launch in March 2017, it has been training new psychosocial counsellors who not only speak the same language as the refugees, but also share the same or similar culture and have experienced life as refugees themselves. The concept was originally developed for refugee camps in crisis zones, where MSF usually operates. But since access to psychological support for refugees is limited in Germany, MSFset up the project together with St. Josef’s Hospital in Schweinfurt. Since then, it’s been up and running at an accommodation center for newly arrived asylum seekers.
A Syrian teacher of English, Salah was one of Soul Talk’s first three counsellors. Now patients call him Doctor Salah. When he arrived in Germany, he had to spend his first months alone in a refugee accommodation, even though his wife and children were already living in the country. He knows how difficult it can be to deal with language courses and authorities when one’s problems, fears and sense of hopelessness are overwhelming. "I had to be strong," he recalls, noting that he would have benefited from the support that Soul Talk offers.
While Salah speaks to Farid, three new counsellors are being trained on another floor. The training lasts just three weeks, during which they learn how to become good listeners, support patients, provide techniques for stress management and maintain a certain distance when dealing with hardship stories. Everything else is picked up on the job – counsellors work closely with psychologists and learn what psychologists call "strengthening one’s own resources." Along with the patients, they discover which of their abilities can help them tackle difficult situations, or feel better.
That’s why Salah encouraged Farid, who speaks Arabic and French and wanted to help others, to consider interpreting for other refugees. He told him he should go out more, since he doesn’t know many people in Germany. Farid has also found support in group sessions with refugees, which are part of the programme. "They helped me to see that lots of people are going through exactly the same situation. It’s not good to always keep your problems to yourself," he says.
MSF estimates thathalf of the asylum seekers who arrived in Germany in recent years – more than one million since 2015 - have suffered severe trauma. They have been exposed to violence and their lives have been at risk – either in their homeland or while fleeing. As a result, they battle everyday with loneliness, fear for relatives back home, and constant uncertainty as to whether they will be able to stay in the country, which translates into sleeping problems, anxiety and depression. "But for us, it’s not about processing trauma," says Hannah Zanker, one of the two psychologists overseeing the counsellors’ work. "It’s about providing support where and when it’s needed, to help stabilise the patients."
After discussing each case with the counsellors, Zanker assesses which refugees are in need of more intensive support - those who may be at risk of suicide, for example. Those unable to be helped by the project are transferred to a psychiatric clinic.
Soul Talk is not a replacement for therapy. "It’s more about prevention. Refugees need to be supported through the difficulties they are experiencing so that they do not develop chronic mental illnesses," says Zanker.
For now, St Josef’s Hospital is covering all expenses, and a new site may soon be created through crowdfunding. But the programme’s long-term funding remains unclear – so far, it hasn’t had any financial support from the Federal State of Bavaria. And yet the project has been a success. More than 450 refugees have received at least one counselling session, and an internal survey has shown that they would like more.
Parisa, an Iranian woman who, like Salah, is employed as a counsellor for Soul Talk, considers the project a triumph. But at first, she recalls, patients were sceptical: "They were afraid we would deliver them to the authorities, even though we have a duty of confidentiality."
While psychosocial counselling is not necessarily well known or recognised in other countries, refugees in Germany have started to recommend Soul Talk to one another. "At the beginning, we were still knocking on doors and asking people how they were doing. Today, people come to us on their own," says Parisa. "I feel proud, it means we’ve done a good job."
Soul Talk was established in 2017 as a joint project between Médecins Sans Frontièresand St. Josef’s Hospital in Schweinfurt. It is a low-threshold psychosocial counselling option for refugees. It is based on a concept developed by Médecins Sans Frontières for crisis zones. People with personal experience as refugees, who share the same language, are trained as psychosocial counsellors over a three-week training period. Prior knowledge of psychology is not necessary, but counsellors work closely with two psychologists and participate regularly in additional training sessions. St Josef’s Hospital exclusively funds the project for now. Médecins Sans Frontièresis hoping that this model project will be replicated throughout Germany.