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Israeli trauma expert Moshe Farchi working with children affected by the 2013 typhoon in the Philippines. Photo: courtesy ISRAEL21c

Israeli trauma expert Moshe Farchi working with children affected by the 2013 typhoon in the Philippines. Photo: courtesy ISRAEL21c

Trauma expert Moshe Farchi’s model stresses the importance of cognitive communication to shift immediate attention from emotions to actions.

By Abigail Klein Leichman

When dealing with someone in psychological trauma, most people instinctively hold, calm and soothe the person.

That may be well-intentioned but it’s not helpful, according to clinical social worker and volunteer medic Moshe Farchi, whose counterintuitive approach recently was adopted as the Israel Health Ministry’s national model for psychological first aid.

Farchi is head of Stress, Trauma & Resilience Studies at Tel-Hai College, and is teaching and using his method in several other countries as well.

While serving as a reserve mental-health officer in the Israel Defense Forces over the past decade, Farchi noticed that the approaches used to help traumatized soldiers in the field simply weren’t effective. Then he began seeing new research showing the scientific reasons for that failure.

He determined to create a new psychological first-aid model based on the latest science and easily implemented by anyone on the scene, not only by mental-health professionals who aren’t as likely to be available immediately.

“I wanted to provide something the whole community could do,” Farchi tells ISRAEL21c.

The program he devised centers on six Cs: cognitive communication, challenge, control, commitment and continuity.

The Six Cs model calls for activating the traumatized person mentally and physically. Activating might mean assigning a task, asking the person to take a walk or giving them decisions to make. Often those in trauma aren’t hurt but have witnessed or otherwise been involved in a frightening situation.

But even injured people in psychological trauma can be given small decisions in order to feel in control, says Farchi. They can be offered a drink of water or asked to direct first-responders where to stand, for instance.

The success of the Six Cs model has been documented. For example, in the summer of 2014, residents of an Israeli town on the Gaza border who were traumatized by rocket fire did not develop post-traumatic stress disorder if they had been treated on the scene according to Farchi’s protocol.

90 seconds

The scientific underpinning of this approach is dozens of studies demonstrating that the brain’s center of emotions, the amygdala, has a seesaw relationship with the brain’s center of logical actions, the prefrontal cortex.

“Activating the amygdala by calming the person emotionally causes the prefrontal cortex to decrease its function, and vice versa,” says Farchi. “We need to reduce the dominance of the amygdala, so actually we should speak cognitively rather than emotionally.”

Emotional communication (“Of course you’re scared”) only reinforces the person’s feeling of helplessness, while cognitive communication shifts attention from emotions to actions.

“Instead of stabilizing the feeling of being scared, we activate the person. We might say, ‘Tell me how many people are around you. Can you count them? How many people are lying down?’ It takes about 90 seconds to shift the person from passiveness to a person who can be helpful to himself and others,” says Farchi, 55.

Since 2013, Farchi’s Six Cs model has been taught to every IDF soldier. In November 2013, Farchi led a delegation from his program at Tel-Hai College to work with victims of the Philippines typhoon in coordination with Israeli humanitarian organizations Brit Olam and Natan.

Moshe Farchi teaching his trauma-care model in the Philippines. Photo: courtesy

Moshe Farchi teaching his trauma-care model in the Philippines. Photo: courtesy

“People going through a traumatic event are very confused and cannot synchronize the event in logical order, and that means the endpoint of the event is also not synchronized,” says Farchi, who volunteers for the Golan Search and Rescue Unit in Israel.

“Subjectively that means the incident doesn’t end and that’s why we have flashbacks. A couple of studies showed that the window of opportunity to resynchronize the events is no more than six hours before the memory is stabilized. That’s why we should assist the person to synchronize the event and emphasize that the major threat is over.”

After a suicide bombing last May in Manchester, Farchi immediately flew over to teach community members his method and returned this summer to train first-response trainers.

He went to Argentina twice to train firefighters, and has taught his method in Haiti and in Germany as a member of Natan’s psychosocial team.

All Israeli first responders are now learning the method, and the Education Ministry will start training high school students in Farchi’s method too. “I hope in the next two or three years the whole population will know how to do this,” he says. Training takes only a couple of hours.

Family therapist and EMT Miriam Ballin, director of the United Hatzalah Psychotrauma and Crisis Response Unit, says that previously, training for the two-year-old voluntary unit’s 150 mental-health workers and 150 medics was based on World Health Organization (WHO) psychological first-aid protocols.

United Hatzalah psychotrauma team leader Miriam Ballin with Moshe Farchi. Photo: courtesy

United Hatzalah psychotrauma team leader Miriam Ballin with Moshe Farchi. Photo: courtesy

“We are happy to collaborate with Dr. Farchi through the Health Ministry to implement his protocol and we hope it will allow us to give a whole other level of care to the patients we meet in distressing circumstances,” Ballin told ISRAEL21c in early August.

She got an opportunity to use the Six Cs method not long afterward as part of her team’s work with  Houston flood victims in August 2017.

“We always like to advance our skill sets. We meet people on the worst day of their lives and want to do all we can to ease them through that crisis period,” she says.

Israel’s Radical New Approach to Psychological First Aid

Jewish and Arab high-school students come together to participate in  MEET. Photo courtesy MEET

Jewish and Arab high-school students come together to participate in MEET. Photo courtesy MEET

MEET is an intensive three-year program for Jewish and Arab high-school students to learn computer science and business from a team of students, graduates, and faculty from MIT. The goal of MEET, based in Jerusalem and Nazareth, is to nurture a generation of young leaders, based on models developed in one of the top U.S. technological institutions. The curriculum (conducted in English) is heavily project-based, with students working together on lab assignments that culminate in large software engineering projects.

For teenagers, technology is a natural common ground.
— Noa Epstein

MEET’s program was founded in 2004 by three MIT graduates: Anat Binur, her brother Yaron Binur, and their friend Assaf Harlap. As of 2016, more than 300 students have graduated from the program (as the MEET website proudly notes: “50% girls, 50% boys; 50% Palestinians, 50% Israelis”), and student recruitment takes place throughout the country. According to Noa Epstein, one of MEET’s CEOs:

For teenagers, technology is a natural common ground. They share an interest in technology development, in mobile applications, in all things innovative and new. Additionally, in the twenty-first century, regardless of if you are going to be a computer scientist or not, there is a basic set of technological skills that you need to have. We believe that by providing a medium and skill set that [are] useful for leaders, our students can go onto careers in government, the humanities or technology. No matter what they do, it is good for them to have this training.

L. Rafael Reif, the president of MIT, adds: “The genius of MEET is that it challenges Israeli and Palestinian students to work together to solve hard technical problems. And as they collaborate, they build a foundation of trust and respect that they can use later, to help solve the much, much harder problems that divide their people.”

Middle East Entrepreneurs of Tomorrow (MEET) >

 

MEET: MIT’s Program for Young Engineers of the Middle East

Educator Karen Tal.  Still from the film   Strangers No More

Educator Karen Tal. Still from the film Strangers No More

Karen Tal’s ideas about how to educate have taken hold in a far-reaching way, in Israel and beyond. Having led the Bialik-Rogozin school to solid footing, she was confident that the school would continue on its successful path when, in September 2011, she stepped into a new role as founding director of an initiative called Tovanot B’Hinuch (Education Insights). This program oversees and supports schools and principals throughout the nation, with a holistic view of schools as “educational, therapeutic, and social centers.” Funds and resources are located for creative new curricula, summer camps and classes, parent-education, youth centers, and volunteer mentoring programs.

Children are inherently good, loving, and collaborative. All we need to do is to foster and channel those qualities.

Among the many initiatives supported by Tovanot B’Hinuch are several geared toward strengthening the education opportunities for all in Israel. Recently, for example, it sponsored a Big Sisters program inaugurated at the ORT Arab High School for the Sciences and Engineering in Lod. In May 2016, Tovanot B’Hinuch was the centerpiece of a TedX Youth conference in Tel Aviv. The following month, a delegation of educators from Harvard University visited one of its affiliate schools: Almostakbal Elementary, in the Arab town of Jaljulia. To date, Tovanot B’Hinuch is linked with some 20 schools in Israel's urban and geographic periphery, with a total of 11,500 students. The schools include nine elementary schools, ten secondary schools (middle schools and high schools) and a K-13 campus. And Karen has no plans to stop at the border.

Karen Tal makes a simple presumption: that children are inherently good, loving, and collaborative. All we need to do is to foster and channel those qualities, and we might end up with a future of peace.

Tovanot B’Hinuch > 

 

Innovator Karen Tal & Tovanot B’Hinuch: Rethinking Education as a Tool for Peace

Johannes, an Ethiopian student learning Hebrew at Bialik-Rogozin school, South Tel Aviv. Still from the film Strangers No More

Teaching, learning, and questioning have always, of course, been integral to Muslim, Jewish, and Christian traditions and practice. Some of Israel’s earliest and most grounding enterprises were in the realm of education.

Education must be something deeper and more extensive than schooling.

The film Strangers No More tells the story of an extraordinary school named Bialik-Rogozin, located in the struggling Florentine neighborhood of South Tel Aviv, where children from dozens of countries, and of many ethnicities and faiths, gather to play, learn, and grow together. Former principal Karen Tal has won the Chalres Bronfman Prize for her work with the school. And Bialik-Rogozin itself was awarded Israel’s National Education Prize.

Bialik-Rogozin is a genuine tool for promoting peace—allowing youngsters to do what they do naturally—playing with one another, loving one another. The film takes us into the lives of some of the school's young students, many of whom are recent arrivals in Israel, as they encounter a new place, a new language, and new peers. It is inspiring to see how the school provides a community and a nurturing home for them.  

Directed by Kirk Simon and Karen Goodman and produced by Lin Arison, the film had a major impact, receiving an Academy Award for Best Short Documentary in 2011.

These film stills are from the film Strangers No More, available with the purchase of The Desert and the Cities Sing: Discovering Today’s Israel.

Strangers No More >

Bialik-Rogozin Instagram >

Tovanot Bhinuch >

The Film: "Strangers No More"

Still from the film " MICHA: A unique kindergarten for hearing impaired Jewish and Muslim children", courtesy the Jerusalem Foundation

Still from the film "MICHA: A unique kindergarten for hearing impaired Jewish and Muslim children", courtesy the Jerusalem Foundation

Just as certain topics seem to be of interest to young people across the board, there are difficulties and challenges that do not acknowledge ethnicities, creeds, or borders. MICHA (the Society for Deaf Children in Israel–National Council), a school and rehabilitation program for hearing-impaired infants and young children, operates in Jerusalem, Be’er Sheva, Haifa, and Tiberias; its principal purview is the sector of the nation north of Hadera, a population that comprises Jews (including new immigrants from the former USSR and Ethiopia), Muslims, and Christians.

Enabling hearing-impaired youngsters of any background or creed to enter Israel’s regular school system

Given this cross section of students, MICHA’s activities are conducted in both Hebrew and Arabic. Their goal is to enable hearing-impaired youngsters of any background or creed to enter Israel’s regular school system when they become of age. This includes educating parents about how to address the needs of their hearing-impaired children, and ensuring that they are aware of their rights and of new legislative developments as they arise.

MICHA > 

The film "MICHA: A unique kindergarten for hearing impaired Jewish and Muslim children", courtesy the Jerusalem Foundation

MICHA, Teaching Young Hearing-Impaired Students

HIPPY-trained mother working with her child. Photo courtesy HIPPY

HIPPY-trained mother working with her child. Photo courtesy HIPPY

HIPPY was founded in 1969 by Avima D. Lombard, an American scholar of education who emigrated to Israel. Lombard recognized that Israeli-born children of immigrants from North African and Asian countries were not achieving in school as well as their peers. Her proposal was to take a close look at the homes and family life of the children: “Perhaps we [can] find a way to bring changes into the home that would help prepare children to deal with the demands of school.” In focusing on the home setting, she understood that there were two major areas of concern: “the educational enrichment of the child, and strengthening the mother’s self-esteem through her activities as an educator in the home setting.”

A global institution, involved with thousands of families around the world.

The program that evolved from these observations is HIPPY (known in Hebrew as Ha’Etgar, meaning “The Challenge”). What started as a small pilot study with a handful of children in Tel Aviv’s Hatikvah neighborhood led eventually to HIPPY being sponsored by the Israeli Ministry of Education, the Hebrew University of Jerusalem, and other organizations. Today, more than four decades after Lombard’s initial idea, HIPPY has become a global institution, involved with thousands of families around the world, in the United States, Canada, South Africa, Austria, Germany, Italy, Argentina, New Zealand, and Australia. In 2015, the HIPPY International program was selected by the Lego Foundation as one of thirty pioneering programs around the world that promote play as an essential tool in learning.

HIPPY ISRAEL >  

HIPPY INTERNATIONAL >  

HIPPY on Facebook >

HIPPY: Educating Preschoolers and Their Families

LOTEM participants on a hike. Photo by Itai Aviran, courtesy LOTEM

LOTEM is an Israel-based organization that offers excursions, nature clubs, and creative workshops in nature to people with physical challenges and other special needs. It was founded by Amos Ziv, an enthusiastic outdoorsman who, while hiking in the Israeli countryside, encountered a group of visually impaired teenagers and realized how difficult it must be for them to enjoy outings as he did. He recognized that in order for special-needs hikers to be able to enjoy excursions and activities in rural environments, suitable guidance and trails were essential. In 1993 Ziv founded LOTEM, and soon after teamed up with Sorin Hershcu, a quadriplegic who was wounded during the IDF rescue of hostages in Entebbe in 1976. Today, the organization has centers in Jerusalem and the North of Israel, and serves more than thirty thousand special-needs participants—youngsters with physical challenges as well as women and children living in shelters—every year. Its motto: “Making Nature Accessible.”

Making nature accessible to people with physical challenges.

Among LOTEM’s programs are “Four Seasons” (activities for special-needs people in natural settings throughout the year); “Mother Nature” (outings for women and children who live in shelters); and “Integra-Teva.” This last program brings together Jews and Arabs from all parts of Israel to learn about organic products from the Middle East as well as about ancient agricultural techniques used in the region throughout the ages. Each year, more than six hundred children and adults—all with special needs—take part in Integra-Teva. Jews, Christians, Muslims, and Druze make pita bread over an open fire, grape juice in a wine press, and olive oil in an olive press (all specially designed to be accessible to people with physical challenges). Working together on a common task, despite differences in race, religion, or culture, can create bonds that might otherwise seem impossible.

LOTEM > 

LOTEM on Facebook >

Photo by Itai Aviran courtesy Lotem

LOTEM: Nature Programs for People with Special Needs