Psychosocial support, prevention and coordination

1Psychosocial support and child-friendly spaces

Most children recover when their routine, relationships and sense of safety are restored. The intervention pyramid (IASC) ranges from basic services and security, to community and family support, then focused non-specialised support, up to specialised care for a minority.

Child-friendly spaces offer a safe place, structured activities (play, sport, expression, learning), trained facilitators and protection messages. They are also used to identify children who need individual follow-up. They are accessible to children with disabilities and adapted to girls and boys of different ages.

2Preventing the worst risks

• Child labour: economic support for vulnerable families, access to school, awareness-raising among employers; priority to the worst forms (hazardous work, exploitation).
• Child marriage: it often increases in crises as a survival strategy. Responses: transfers to at-risk families, keeping girls in school, dialogue with religious and community leaders, case management for at-risk girls.
• Recruitment by armed forces and armed groups: monitoring, advocacy, programmes for adolescents, and, for released children, family, educational and economic reintegration in line with the Paris Principles. These children are first and foremost victims.

3Referring safely

Before any referral, know the available services through the service mapping and the agreed referral pathway. Referral is made with consent, through a safe channel, with the minimum necessary information, and you check that the child actually received the service.

If you are not a social worker and a child discloses abuse to you: listen calmly, believe them, do not ask detailed questions, do not promise absolute secrecy, explain what you are going to do and refer immediately to a trained caseworker.

4Coordination and mainstreaming in other sectors

The Child Protection Area of Responsibility, within the Protection cluster, is coordinated globally by UNICEF. It harmonises tools (forms, standard operating procedures), 4W mapping, referral pathways and advocacy.

Child protection also happens in other sectors: lit, sex-segregated latrines (WASH), priority queues for child-headed households (distributions), safe schools (education), screening for distress in health centres. Every sector can apply the CPMS mainstreaming standards.

5Designing and running group activities and child-friendly spaces

CPMS Standard 15 (group activities for child well-being) replaced the place-centred approach ("open a child-friendly space") with an outcome-centred approach: structured, age-appropriate activities that strengthen well-being, skills and social connections, and that can take place in a dedicated space, a school, a community centre or outdoors. The Guidelines for Child Friendly Spaces in Emergencies (Global Education Cluster, CPWG, INEE and IASC MHPSS Reference Group, 2011) and the operational toolkits published since by several agencies remain the operational references.

Set-up steps

1. Analysis and choice of location (week 1): consultation with children, parents and the site committee; a location within 15 to 20 minutes' walk, away from military areas, busy roads and distribution points; separate latrines for girls and boys that are accessible to children with disabilities, drinking water, shade, light fencing.
2. Recruitment and training (weeks 1 to 3): facilitators from the community, gender balance, local languages; safeguarding checks; initial training of at least 5 days (child development, structured facilitation, psychological first aid, identification and referral, safeguarding, disability inclusion), followed by monthly refresher sessions.
3. Activity programme (week 3): a weekly schedule by age group, combining free play and structured activities (expression, sport, music, life skills, protection messages), with a structured curriculum for adolescents.
4. Opening and monitoring (from week 3 or 4): attendance registers, weekly supervision visits, feedback from children and parents.
5. Transition (from the design stage): an exit plan provides for the gradual handover of activities to schools, community structures or municipal services.

Commonly used organisational benchmarks

Measuring well-being

Well-being is not measured by attendance figures. Age-appropriate, validated or contextualised tools are used: short subjective well-being questionnaires, tools measuring social and emotional skills, structured observations by facilitators, and indicators from the IASC Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings (2017, revised). The tool is tested, translated and administered at the start and end of each cycle, and the analysis is disaggregated by sex, age and disability. An improvement in the average that masks a deterioration among adolescent girls must be visible in the results.

Group activities are not therapy. They meet the needs of the majority of children (levels 2 and 3 of the IASC pyramid). A child whose distress does not decrease after a few weeks, or who shows warning signs, is referred to case management and, if necessary, to specialised services.

6Focused support: psychological first aid, identification and support to parents

Between group activities and specialised care, the IASC pyramid provides for focused, non-specialised support. The Minimum Service Package for Mental Health and Psychosocial Support (IASC, WHO, UNICEF, UNHCR, UNFPA, 2022) describes its priority activities, including psychological first aid, support for caregivers, low-intensity psychological interventions and referral to clinical care.

Psychological first aid adapted for children

Psychological first aid (PFA) follows three action principles: look (safety, urgent needs, serious distress reactions), listen (approach, introduce yourself, help the child feel calm, do not force them to tell their story), link (basic needs, information, loved ones, services). With a child, the helper gets down to their level, uses simple words, stays with them or makes sure they are with a trusted adult, and keeps siblings together. Save the Children's guide on PFA for children offers one- to two-day training courses for front-line staff in all sectors.

Warning signs warranting referral

Specialised mental health services must be identified in the service mapping: professionals trained in the WHO mhGAP Intervention Guide in health centres, psychologists, psychiatrists. If they do not exist, the MHPSS coordination group takes this gap up in its advocacy; a facilitator is never left in charge of a suicidal child.

Supporting parents and caregivers

CPMS Standard 16 recalls that the most powerful protective factor for a child is a stable, caring adult. Parenting support programmes (group sessions over 8 to 14 weeks, 10 to 15 parents per group) cover stress management, communication with the child, positive non-violent discipline and the prevention of local risks. Evidence-based programmes exist and have been adapted to humanitarian contexts, for example the Parenting for Lifelong Health programmes developed with WHO and UNICEF. They are all the more effective when combined with economic support to households.

Caring for staff

Facilitators and caseworkers are exposed to traumatic accounts. The minimum measures are: regular supervision, collective peer-support spaces, limits on the number of heavy cases, confidential access to psychological support, and training in recognising compassion fatigue. These costs must be included in the budget.

7Preventing child labour, child marriage and recruitment: operational methods

These three risks share root causes (poverty worsened by the crisis, school dropout, insecurity, social norms) and common levers: targeted economic support, access to education, community mobilisation, and case management for the most exposed children. Addressing them together in a single programme improves effectiveness and avoids families being approached by three separate projects.

Child labour (CPMS Standard 12)

The reference legal framework is ILO Minimum Age Convention No. 138 (as a general rule 15 years, 14 years for certain developing countries, with light work possible from 13 or 12 depending on the case) and ILO Worst Forms of Child Labour Convention No. 182 (slavery and similar practices, recruitment for use in armed conflict, sexual exploitation, illicit activities, hazardous work). Programmes prioritise the worst forms and the youngest children.

1. Identify: mapping of sectors (markets, mines, agriculture, domestic work), interviews with employers and adolescents.
2. Prioritise children: under-12s who are working, the worst forms, night work, domestic work for third parties.
3. Intervene: case management for children exposed to the worst forms; cash for protection; school enrolment or accelerated education; for 15- to 17-year-olds, vocational training and safe working conditions rather than an unrealistic ban.
4. Work with employers: market codes of conduct, working hours, removal of hazardous tasks.

Child marriage

In crises, families often present marriage as a way of protecting girls from violence or as a response to poverty. Effective interventions combine: cash transfers to the families of girls at risk, staying in or returning to school (the best-documented protective factor), safe spaces and life skills programmes for adolescent girls, dialogue with religious and traditional leaders, and case management for girls in imminent danger. For girls who are already married, the aim is not only to dissolve the union: it is to ensure access to health care, school, GBV services and legal protection, in line with their interests and wishes. Coordination with the GBV AoR is essential: services for adolescent survivors are often shared.

Children associated with armed forces and armed groups (CPMS Standard 11)

The Paris Principles (2007) define a child associated with an armed force or armed group as any person under 18 who has been recruited or used by an armed force or armed group in any capacity, including as a cook, porter, messenger, spy or for sexual purposes. The Optional Protocol to the CRC on the involvement of children in armed conflict (2000) prohibits armed groups that are distinct from the armed forces of a State from recruiting or using persons under the age of 18 under any circumstances.

A principle to be defended in all circumstances: a child associated with an armed force or armed group is first and foremost a victim. Detaining a child solely for association is contrary to international standards; if the child is prosecuted for other acts, juvenile justice applies, with detention as a last resort and for the shortest possible time.

8Worked example: referral pathway and cash for protection in Nordavi

The following case is fictional. It shows how a child protection sub-group builds a referral pathway and integrates a cash transfer component into case management, in a medium-sized town hosting displaced people.

The context

The municipality of Nordavi (about 180,000 inhabitants) hosts 26,000 displaced people, including 14,300 children, dispersed across six neighbourhoods and two collective sites. Five organisations work on child protection; two provide case management (total capacity: 9 caseworkers); one health centre provides clinical management of rape; the municipal social affairs department has 3 social workers. Monitoring reports an increase in child labour at the central market and in marriages of adolescent girls.

Step 1: service mapping

Step 2: the referral pathway

1. Any actor who identifies a child at risk (teacher, health worker, distribution staff, facilitator) applies PFA and refers the child to the case management provider for the area, with consent, using the common form, or by telephone for urgent cases.
2. For sexual violence that occurred less than 72 hours earlier, referral to the health centre is immediate and accompanied, while the caseworker is informed in parallel.
3. The caseworker assesses, develops the plan and refers to other services; access to cash for protection is only through the caseworker.
4. Each referral receives feedback from the provider (service received or not) within 7 days; the caseworker follows up if there is no feedback.
5. The sub-group reviews aggregated referral statistics (number, timeframes, feedback rate) every month and updates the service mapping every three months.

Step 3: sizing the transfers

The average daily income of a child working at the market is estimated at the equivalent of 1.2 monetary units, i.e. about 31 units per month for 26 working days. The cash working group sets the minimum expenditure basket at 140 units per household per month; targeted households already receive multi-purpose assistance of 90 units. The protection top-up is set at 35 units per month, to compensate for the child's lost income and cover school costs, for 6 months, conditional not on results but on adherence to the case plan (follow-up visits accepted). For 220 households, the cost of the transfers is 220 multiplied by 35 and by 6, i.e. 46,200 units, plus about 8% in transaction and management costs.

Step 4: monitoring results

The six-month analysis shows that results hold as long as the transfers continue; the sub-group recommends a transition to the national social protection programme for eligible households, and a gradual exit accompanied by income-generating activities for the others.

The decisive point: cash transfers are a tool serving the case plan, not an end in themselves. Without case management, they are absorbed into household spending; without transfers, case management comes up against economic causes it cannot address.

9Coordinating child protection and mainstreaming it in other sectors

In countries where the humanitarian coordination system is activated, the Child Protection Area of Responsibility (CP AoR) operates within the Protection Cluster, with UNICEF as lead agency and often an NGO as co-coordinator. In refugee situations, coordination falls under the Refugee Coordination Model led by UNHCR, with a child protection working group. CPMS Standard 1 and the AoR's Child Protection Coordination Handbook describe the expected functions.

Coordination functions and their outputs

What is expected of a member organisation

• Submit its 4W/5W on time and accurately, with no personal data.
• Use the common tools (forms, SOPs, indicators) and the shared information system.
• Report gaps and service interruptions, including its own (end of funding, withdrawal from an area), at least one month in advance where possible.
• Take part in joint assessments, technical working groups and project reviews for the response plan.
• Respect the information-sharing protocol.

Mainstreaming in other sectors: concrete actions to request

Successful mainstreaming is negotiated with precise, quantified requests ("light 40 latrines in zone B before the end of the month") and concrete support (training, tools), not with a general request to "take child protection into account".

10Common mistakes, contextual variations, interview questions and references

Common mistakes and how to avoid them

Variations by context

• Sudden-onset crisis: PFA and simple recreational activities in the first days, messages to prevent separation, then structuring of activities after two to four weeks.
• Protracted crisis: structured life skills and parenting programmes, integration into schools and municipal services, strengthening of community-based child protection committees.
• Camp: fixed spaces, close coordination with camp management, children's committees.
• Urban setting: mobile activities, partnerships with schools, youth centres and sports clubs; neighbourhoods targeted through vulnerability mapping.
• Insecurity and limited access: activities entrusted to trained community facilitators supervised remotely, radio programmes for children and parents, helplines, times and places adapted to the risk.
• Local partners with limited capacity: ready-to-use curricula, training of trainers, joint supervision visits, gradual handover of the running of activities.

What donors and evaluators look for

• Measured well-being outcomes, not just attendance.
• The link between group activities, identification and case management (how many children were referred, and with what feedback).
• The place of adolescent girls, children with disabilities and working children in the activities.
• Active participation in the AoR and use of common tools.
• Sustainability: transition plan, strengthening of local actors.

Interview questions

Key references

• IASC, Guidelines on Mental Health and Psychosocial Support in Emergency Settings, 2007.
• IASC, Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings.
• IASC and partner agencies, Minimum Service Package for Mental Health and Psychosocial Support, 2022.
• Global Education Cluster, CPWG, INEE and IASC MHPSS Reference Group, Guidelines for Child Friendly Spaces in Emergencies, 2011.
• WHO, War Trauma Foundation and World Vision International, Psychological First Aid: Guide for Field Workers, 2011; Save the Children, training guide on psychological first aid for children.
• WHO, mhGAP Intervention Guide and mhGAP Humanitarian Intervention Guide.
• ILO, Conventions No. 138 (1973) and No. 182 (1999); Alliance, resources on child labour in humanitarian action.
• UNICEF and partners, Paris Principles and Paris Commitments, 2007; United Nations, Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, 2000.
• Child Protection AoR, Child Protection Coordination Handbook.
• Alliance, Minimum Standards for Child Protection in Humanitarian Action, 2019, Standards 1, 10 to 12, 15 to 17 and 21 to 28.