This paper was drawn from a working report and a conference
paper prepared by the primary author for the Federation Internationale
de Football Association (FIFA) and the Swiss Academy for Development
(SAD) in 2005, on the subject of helping children overcome trauma
through sports and play programs. The author wishes to acknowledge and
thank these organizations for their past financial support of research
on this subject.
Robert Henley, Ph.D; University of Zurich,
Centre for Disaster and Military Psychiatry
Birchstrasse 3, Zurich 8057, Switzerland
Phone: +41 43 233 95 40
Fax: +41 43 233 95 44
A review of theories and practices pertaining to the possible
underlying dynamics of international community-based resilience
enhancing psychosocial sport and play programs, established to help
children and youth experiencing adversity in their lives. Sport and
play activities (with play being inclusive of any organized movement,
exercise, game or artistic activities) can have a stabilizing impact on
most children through supporting and encouraging their resilience
processes, with resilience being described as the process of, and
capacity for, successful adaptation despite challenging or threatening
circumstances. Psychosocial sports and play programs are a relatively
new approach to helping children manage adversity, so more field
investigations need to be implemented to establish best practices
methodology, and to discover the impact that sport and play activities
may have on the enhancement of children’s resilience. Additionally,
more funding must be allocated for research on the effectiveness of
these psychosocial sport and play programs.
rehabilitation, sport & play, resilience, youth, stress, trauma
In recent years, the United Nations, individual governments,
international non-governmental humanitarian aid organizations, and
sports corporations have been turning to psychosocial sport and play
programs as an innovative method to address numerous health and social
problems (with the use of the term “play” being inclusive of any
organized movement, exercise, game or artistic activities). Projects
are being initiated that use sports and play activities with children
as psychosocial interventions in a variety of situations, including
(but not limited to):
- In and after wars or conflicts to
provide opportunities for “peace building” between conflicted parties
- In response to pandemics to provide
healthcare education, support and services
- In response to social problems, such as
providing opportunities to help reintegrate homeless children and child
soldiers into society, or to address issues of poverty
- After disasters to help re-establish
social and psychological stability
II. The Role of Sport and Play in Development and Rehabilitation
Psychosocial sport and play programs aim to restore children’s social
well-being and psychological health within their community through
group-focused practices, tailored to fit the contexts of local culture,
traditions, needs and resources (Boyden & Mann, 2005; Duncan &
Arntson, 2004 ; Eisenbruch, 2004; Grotberg, 2001; Henley, 2007). These
programs hope to fulfil key healthcare functions in two ways: 1. By
offering the majority of affected children direct psychosocial support
via sport and play programs that also teach important values and
skills, etc., and 2. By helping to identify those children who are
unable to effectively participate in these programs due to the severity
of their stress or trauma, offering more individual psychological
attention through referrals to mental health specialists (Statham,
2004; Yule, 2000).
Play has long been understood to provide children with the experiences
they need in order to learn social skills and values. Through play,
children become sensitive to other children’s needs and values, learn
to handle exclusion and dominance, manage their emotions, learn
self-control, plus to share power, space, and ideas with others. At all
levels of development, play provides opportunities for children to feel
comfortable and in control of their feelings by allowing the expression
of emotions in acceptable ways. Further, sport and play activities
provide children with the opportunity to negotiate and resolve conflict
(Erikson, 1977; McArdle, 2001; Piaget, 1959; Winnicott, 1968). Thus the
concept behind psychosocial sport and play activities is that these
will assist children and adolescents address a myriad of social and
psychological challenges simultaneously in gentle and non-intrusive
ways through accessing the natural predilection to play (Bell &
Suggs, 1998; Henley, 2007).
Humanitarian and social crises are any occurrences that can cause loss
of human life or the deterioration of health and health services on a
scale that requires an extraordinary helping response from outside the
affected community. These events can result in the experience of severe
stress or trauma in any population, irrespective of their cultural
background (Dougherty, 1999). Trauma is defined as the direct or
indirect exposure of a person to a life-threatening event, and the
concurrent experience of intense feelings of terror or horror (APA,
1996). Fortunately, the ability of human beings to cope effectively
with traumatic experiences should not be under-rated, and traumatic
experiences rarely develop into psychiatric illnesses (Bonanno, 2004;
Bonnano, 2005; Creamer, Burgess, & McFarlane, 2001; Kleber &
Brom, 1992). In studies of Western populations, 60% to 90% of affected
people have been found to be able to integrate the traumatic experience
by themselves (Connor & Davidson, 2003; Kleber & Brom, 1992).
In this context, “integrating the experience” refers to an individual’s
ability to resolve its traumatic experience and return to pre-disaster
levels of functioning (de Jong et al., 2002). The ability of a person
to manage severely stressful or traumatic experiences has been
identified as the process of resilience (Alvord & Grados, 2005;
Boyden & Mann, 2005; Luthar & Cicchetti, 2000; Masten, 1997;
Enhancing Resilience Processes In Children Through Sport and Play
Resilience is understood to be the process that enables some survivors
of high-risk environments to experience social competence, empathy,
caring, problem-solving skills, critical and creative thinking, task
mastery and a sense of purpose and connectedness in the face of
adversity and distress (Connor & Davidson, 2003). It is believed
that successful resolution and integration of severely stressful or
traumatic experiences by children can even contribute to increased
resilience in response to future stressors (Alvord & Grados, 2005;
Apfel & Bennett, 1996; Boyden & Mann, 2005; Connor &
Research on resilience has identified key protective factors in a
child’s life that can buffer and prevent the impact of such risk
factors as severe stress or trauma (Markstrom, Marshall, & Tryon,
2000; Tiet et al., 1998). The most significant protective factor is the
child’s connection with and attachment to beneficial friends, family
and unrelated adults. For children particularly, experiencing caring,
accepting and encouraging relationships with family and non-family
adults (such as teachers, coaches and mentors) has a significant and
positive impact on their development. Even for older children and
teenagers who have already been exposed to and adversely affected by
long-term hardship, the late establishment of healthy adult-child
relationships can help intercept the child’s negative life trajectories
and prevent future exposure to high-risk situations (Alperstein &
Raman, 2003; Luthar & Cicchetti, 2000; Rutter, 1998; Wolff &
As children and adolescents benefit from quality role models (Boyden
& Mann, 2005; Ungar, 2005), group sports and play activities offer
important opportunities for them to be engaged by older members of a
community. These adults are the ones who can provide structured
activities that encourage the development of children’s sense of
self-worth, support their ability to communicate more effectively, and
help them have healthier relationships with peers - and having healthy
peer relationships is yet another significant protective factor. It
must be emphasized that a key aspect of the healthy adult-child
relationship is the role that adults play in teaching values such as
teamwork, fair play and ethics, and the social skills that support
these values (Boyden & Mann, 2005; Dumont & Provost, 1999;
Duncan & Arntson, 2004). Thus, the impact of the sport worker
in the psychosocial sport and play program is of crucial importance,
though it must be noted that coaches in psychosocial sport and play
programs must have skills beyond solely teaching sport and game
activities. These coaches should also be able to facilitate the
understanding of emotions and inter-personal communications between
children, and help children develop effective coping skills. These
teaching skills require special training, which will help the coaches
effectively intervene in many challenging situations, as well as enable
them to deal with any of their own unresolved issues that they may face
living in the same adverse conditions as the children they hope to
help. When adults give their support to children, and encourage the
children to help others, they are in turn helping to enhance the value
and resilience of the community, for engagement in and connection to a
community which is seen as another significant protective factor
(Moscardino, Axia, Scrimin, & Capello, 2007; Wolkow & Ferguson,
While many psychosocial sport and play programs provide children with
the chance to get involved with others through joining competitive
teams, the context of interventions are primarily focused on the
process of helping children restore their psychological and social
functioning in a cooperative environment. These programs offer children
the opportunity to learn new problem-solving skills in managing their
own emotions and behaviours, as well as to have healthy peer
relationships. Of note, these problem-solving skills have also been
found to be a strong predictor of improved resilience in children, as
improved problem-solving skills can enhance the possibility that life’s
challenges will be resolved successfully (Boyden & Mann, 2005; Fok
& Wong, 2005; Grotberg, 2001; Place, Reynolds, Cousins, &
O'Neill, 2002; Save the Children, 2004).
Implications and Recommendations
It has long been recognized that play is instrumental in a child’s
healthy development, and the ability to play is one of the signs used
to determine if a child is healthy or meets age-related developmental
requirements. Additionally, when a child is under extreme stress or has
been traumatized, this is often seen through symbolic repetitive
behaviors suggesting aspects of the traumatizing event through play.
Thus the use of psychosocial sports and play programs provide important
opportunities for trained sports workers to help enhance children’s
resilience, facilitating emotional and social stabilization, and the
acquisition of new skills and abilities.
While it is hoped that psychosocial sports and play programs can make a
positive contribution towards the enhancement of a child’s resilience,
this can only occur under certain conditions - a sport is often
mistakenly viewed as having some sort of intrinsic nature in and of
itself (either good or bad), but is actually a neutral or empty
practice that is filled with meanings, values, and ideas of the culture
in which it takes place, and influenced by the individuals who
participate (Guest, 2005).
There is compelling practical, anecdotal and theoretical evidence to
suggest that psychosocial sport and play programs can be helpful with
children who have experienced severe stress or trauma, but there is yet
little empirical evidence proving it. This is a challenge that the
initiators of (and donors to) psychosocial sports and play programs now
face. While their focus has been primarily on raising and spending
money on the development and implementation of programs, there has been
a significant lack of money being spent on collecting empirical
research data on short-term outcomes and long-term impacts. Empirical
data is crucial to ascertain which interventions are the most effective
in helping enhance resilience in children and adolescents, and thus
enable them to more effectively adapt in a post-crisis environment.
Empirical data can also be helpful in improving organizational
accountability, potentially increasing future fundraising abilities as
a result. Additionally, empirical field research of psychosocial sports
and play programs can help establish a comparable database to
facilitate the identification of best practices and the accurate
evaluation of different resilience-focused programs. These psychosocial
studies will then be comparable with classical psychological and
medical studies, and will thus become empirically competitive. This can
help both to map out the borders of effective psychosocial practices,
defining where and when psychosocial programs reach their limits, and
also identify when traditional forms of psychological and medical help
would be more effective and efficient.
Psychosocial research has unique challenges it must address in order to
gather useful data (Duncan & Arntson, 2004). The following areas
should be considered for future research on psychosocial sport and play
programs in international settings:
- Identifying stressors, and assess the
impact of these stressors on children’s behavior, emotional stability
and mental health.
- Assessing child and adolescent
resilience levels, particularly before and after their participation in
sports and play activities in order to identify any behavioral and
psychological changes that may occur.
- Using resilience measures in
international settings with children, to measure the reliability of
these tools to effectively assess strengths and difficulties (though
these tools will need to be translated into local languages, and then
- Observing the impact of psychosocial
sports and play activities on children’s behavioral and psychological
status over time, paying particular attention to whether certain sports
are more effective.
- Identifying changes in behavior and
progress in school during the time a youth is participating in sports,
to note the influence of participation in other areas of their lives.
- Assessing coach and child interactions,
and compare which coaching styles may be more effective in helping
- And in order to do any of the above
assessments, a project must identify practical, measurable outcomes,
both short-term and long-term, and evaluation of the effectiveness of a
program will require the inclusion of either a cluster-randomized
trial, or if that is not possible, then with the inclusion of a control
Psychosocial sport and play programs look to be an important
development in potentially helping children manage and thrive in the
aftermath of traumatic or severely stressful experiences, and it
appears that the “active ingredient” of these programs is in the
enhancement of children’s resilience processes. A crucial component of
any program will be the quality of relationships between the children
and the adults who work with them, as programs run by adults offer
children the opportunity to establish healthy attachments with them, to
teach children how to effectively manage the various challenges they
face in an effective manner, and offer encouragement throughout the
process. Furthermore, since sport encourages group participation in
community settings, these psychosocial sport and play programs provide
a predictable and structured environment where even communities with
histories of conflict can come together to play in a peaceful and safe
environment, thus encouraging community reintegration. Therefore, sport
may be utilized to support communication and self-sustaining
development for an entire affected community. Likewise, psychosocial
sports and play programs can provide the international academic
research community with the opportunity to gain a better understanding
of how to enhance resilience through psychosocial programs and
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