Mental health and gender based violence; helping survivors of sexual violence in conflict – a training manual for helpers

by Nora Sveaas & Elisabeth Langdal
Health and Human Rights Info HHRI

Focus Summary

This training manual, developed by Health and human Rights Info (HHRI) aims at assisting helpers who provide help and psychosocial support to survivors of GBV during disasters, conflicts and emergencies. In these areas there is often a limited access to, or even complete lack of, health professionals with mental health expertise.

The manual offers a new contribution to the already existing material, by being a low intensity training manual that focus on mental health issues following GBV, using a therapeutic metaphor, grounding exercises and Human rights perspective, and other tools, in order to create better trauma sensitive helpers.

This support may empower the GBV-survivor. By understanding her own trauma reaction and by finding ways to deal with traumatic memories and trauma triggers the survivor can find new ways to cope. The goal is to assist the survivor to be in charge of her own life.

Key Insights

  • The strength of this manual is that it´s developed based on training that had been offered to personnel working with sexually traumatized women in Congo as well as clinical work with rape victims in war and conflict areas. It has also been piloted in 5 different countries around the world. Based on these experiences significant changes and developments have taken place in order to make it even more usable in different cultural settings.
  • The training uses a single metaphorical narrative to describe the experience and consequences of GBV. We explain the course that trauma takes in generic terms through the metaphor of the Butterfly Woman; it remains a story but at the same time it is clinically accurate.
  • The manual contains practical perspectives, tools and exercises that can be implemented in situations where the need to provide assistance is of essence. The use of the, The Butterfly Woman-metaphor, are described and illustrated. Through examples it is shown how such a story can be a shared point of reference between helpers and survivors, and a way of working with trauma in an indirect way. The trauma event, the reactions and ways to assist the survivor are depicted through the story, based on clinical as well as scientific experience and knowledge.

Key take-outs from the ISHHR 2017 Conference (industry feedback, networking, peer presentations)

During the questions and feedback from the audience there were questions regarding evidenced based research on the effects of mental health trainings. We would very much appreciate and support such research. Hopefully we will also be able to conduct such research in the future in cooperation with universities or research institutions.

Future goals — what’s next?

We would like to cooperate further with colleagues in the field, and would be happy to assist in any way needed to hold trainings or use the manual “Mental health and gender-based violence Helping survivors of sexual violence in conflict – a training manual”. Our goal is to disseminate the manual that is now translated to Spanish, Russian and Arabic, as much as possible. The manual is free of charge and be downloaded from our website or contact us by e-mail

How can local / national / international media better assist in bringing the vital issues discussed at ISHHR 2017 to light, and further encourage real, positive change and understanding?

Women living in conflict areas, or are fleeing such areas, are frequently subjected to extreme forms of violence such as, gender based violence (GBV) including rape. The mental health problems are often quite severe for those affected. Even so, the assistance available in such settings is often very limited, both in terms of health-, mental health care and legal aid.
It would be beneficial for our work if the media could focus more on how to prevent GBV, make sure that perpetrators are prosecuted and how to support the survivors and their communities. In this way we can strengthen the rights of GBV survivors.