MID-TERM ASSESSMENT
OF THE
COMMUNITY PSYCHOSOCIAL SUPPORT PROGRAM (CPSP)
USAID/WEST BANK & GAZA
Contract: 294-0-00-03-00221-00
12/09/2003
Prepared by
Management Sciences for Development, Inc. (MSD)
Ruth Sanchez-Way, Ph.D., M.S.W. 
(MSD)
Rabab F. Saab, M.A.
(Reda Internacional, Inc)
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Table of Contents 
Acknowledgements
List of Acronyms 
I. Executive Summary……………………………………………………………..........5
II. Background Statement………………………………………………………….........12
A. Mid-Term Assessment of the Community Psychosocial 
 Support Program (CPSP) …………………………………………......12
B. Historical Context of the CPSP ………………………………….........13
C. Psychosocial Context of the CPSP ……………………........................14
III. Findings and Lessons Learned………………………………………...……………..17
A. Appropriateness of Program ……………………………......................17
B. Effectiveness of Program Implementation ……………………...…….20
1. CPSP Outreach Component: Level I Activities ……………....20
2. CPSP Outreach Component: Level II Activities ……………...24
3. CPSP Outreach Component: Summer Camps ………………..26
4. CPSP Support Component: Training ………………………….27
5. CPSP Support Component: National Psychosocial Database 
(MIS) ………………………………………………………….29
6. CPSP Support Component: Research ………………………....30
7. CPSP Support Component: Support to Psychosocial 
Coordinating Board (PCB) ………………………………........31
C. Effectiveness of Program Management ……………………………….33
IV. Recommendations …………………………………………………………………..36
V. Annexes
A. Preliminary/Tentative In-Country Assessment Schedule
B. Assessment Review Tool 
C. Interviews Conducted
D. Sites Visited 
E. Key Documents Reviewed
F. The Ten Messages 
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Acknowledgements
Management Sciences for Development, Inc. (MSD), would like to extend our thanks to the
many people who assisted us during the course of this assessment. The realities of conflict were 
mitigated by the service and support provided by those with whom we interacted.
USAID/West Bank and Gaza must be commended for facilitating our efforts. We extend our 
thanks also to Save the Children and the CPSP team for their timely responses and thoughtful
input. Everywhere we sought information – from sidewalks to schoolyards, to courtyards, to
clinics – we were greeted by professionals and technicians with a genuine interest in
participating in the evaluation process. For this, we are thankful. MSD would especially like to 
thank Ibrahim Masri, Psychosocial Project Manager, Save the Children, and Cario Arafat, Ph.D.,
Director, National Plan of Action for Palestinian Children, for their help and cooperation in 
facilitating the on-site assessment. A special thanks must go to Veerle Coignez, USAID/WB&G
Cognizant Technical Officer (CTO) for her patience and guidance.
Finally, we extend our thanks to Elham-Eid Alldredge, Ph.D., for her technical assistance in
developing the methodology used to assess the impact of quality of life interventions on
vulnerable populations in conflict situations.
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List of Acronyms 
BCC Behavior Change Communication 
CBI Classroom-Based Intervention
CIDA Canadian International Development Agency
CPSP Community Psychosocial Support Program
CTCMC Community Training and Crises Management Center
CTO Cognizant Technical Officer
GO Government Office
IOM Institute of Medicine
MIS Management Information System
MoE Ministry of Education
MoH Ministry of Health
MoSA Ministry of Social Affairs
MoYS Ministry of Youth and Sports
MTA Mid-Term Assessment
NGOs Non-Governmental Organizations
NPA Secretariat for the National Plan of Action for Palestinian Children
PA Palestinian Authority
PCB Psychosocial Coordination Body
PCHRCD Palestinian Center for Helping Resolve Community Disputes
PNGO Palestinian Non-Governmental Organization
PRCS Palestinian Red Crescent Society
PTSD Post-Traumatic Stress Disorder
PWWS Palestinian Working Women’s Society
Save Save the Children Federation
TOT Training of Trainers 
UN United Nations
UNICEF United Nations Children’s Fund
UNRWA United Nations Relief and Works Agency
USAID/WB&G United States Agency for International Development Mission to West 
Bank and Gaza
WB&G West Bank and Gaza
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This is the report of the Mid-Term Assessment (MTA) of the Community Psychosocial Support 
Program (CPSP) that was conducted October 13 – October 24, 2003 in West Bank and Gaza. 
The CPSP is implemented by Save the Children Federation (Save), and nine NGOs/sub grantees. 
The aim of the CPSP is “to assist children and youth in dealing with the current conflict
situation, through appropriate psychosocial interventions, with a view to help them become
productive adults and citizens of the future.”
Save was awarded a $2 million Cooperative Agreement in May 2001 to undertake a Community 
Psychosocial Support Program (CPSP) in the West Bank and Gaza. The health and humanitarian 
situation in WB&G deteriorated in Spring 2002. There was increasing concern about 
psychosocial distress among the children. 
The original CPSP was limited to basic outreach using structured group activities. The program
expansion allowed Save to introduce more intensive in-depth psychosocial support. A $3.2
million expansion was formally approved in August 2002, bringing total program funding to 
$5,200,000. 
The CPSP is operational throughout all 16 governates in WB&G. 
This Mid-Term Assessment seeks to determine the following: 
· Overall Appropriateness of the CPSP program given the psychosocial needs of
Palestinian children; and to identify improvements for future planning and
implementation purposes;
· Effectiveness of Program Operations per program components;
· Effectiveness of Program Management of the Save/CPSP team.
The Evaluator, using a qualitative research design, gathered responses from the granting agency, 
partner organizations, NGOs/sub grantees, and beneficiaries. In addition, the Evaluator reviewed 
briefing documents, visited program sites, developed a standardized assessment review tool, and 
conducted on-site interviews in Arabic in West Bank and Gaza (WB&G). 
An off-site Subject Matter Specialist, who is a licensed clinical social worker, policy expert, and 
program professional supported the Evaluator. The Specialist provided state of the art practice
tools for measuring psychosocial interventions for children in conflict and assisted in the data
analysis.
Key findings can be summarized as follows: 
I. EXECUTIVE SUMMARY
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Overall Appropriateness of the CPSP program
CPSP as a Response to the Psychosocial Needs of Children in WB&G
The CPSP is an appropriate response to the threat posed to children in conflict environments. 
The tools and strategies provided to children and their caregivers are technologically appropriate, 
current, and functional. CPSP funds outreach and training to program beneficiaries through
Level I community-based intervention programs, and through Level II classroom-based 
interventions, and through summer camps, using a sub-grant mechanism. 
Effectiveness of Program Operations per Component
CPSP Outreach Component: Level I Activities
The Level I activities successfully provide strategies and tools to cope with dangerous
environments, however the absence of structure - specifically a program manual - makes it
difficult to implement quality control. 
This component was part of the initial CPSP project and sought (1) to provide basic support to 
children in conflict, and (2) to provide basic tools to caregivers, parents and teachers to support 
the children. Essentially, the program sought to enhance the Palestinian children’s capacity to
communicate with their caregivers and to express their opinions and feelings about their
changing needs. 
This Level I intervention was a good start in the right direction. The outreach campaign to 
introduce and promote the Ten Messages was launched with both print and TV components,
most of which were produced by NPA and were of the highest quality. Outreach tools include 
TV spots, a calendar, teachers’ agenda, activity poster, student workbooks, and children’s
journals. Parent meetings encouraged open communication in a social venue. Counselors 
followed their groups’ lead and adjusted the content of the sessions as appropriate. 
CPSP Outreach Component: Level II Activities
Level II activities, including classroom-based interventions (CBI), are well-designed and well￾implemented, and successfully increase the level of support to children in the aftermath of the
second Intifada. Strong support from government offices (GO) helps to ensure program
sustainability. 
The CBI is a stress management program for use with a broad population of school-aged 
children. This evidence-based program targets the prevention and reduction of psychological
trauma in youth following their exposure to life threatening events and ongoing stress. It is
designed to increase children’s social-emotional competence and reduce impulsive and
aggressive behaviors. Children and youth are taught coping and decision-making skills, risk
assessment and positive goal setting. The program promotes a safe school environment where
children can openly express their emotions without repercussions. 
The success of Level II activities is closely tied to the capabilities of school counselors, who
implement the program three times each week at their two assigned schools. Implementation of 
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Level II activities highlights the successful negotiations led by Save to ensure program
continuity through the end of the current school year, despite tensions between paid and unpaid 
CBI program implementers. 
CPSP Outreach Component: Summer Camps
The summer camp programs where CBI is implemented are largely successful in terms of
program quality and participation. However, coverage is inadequate when considered in the
context of the demographics of WB&G. Government offices report serving up to 40-60,000 
children every summer across the country, however, there are 434,000 12-16 year olds in
Palestine today. 
The objective of the CPSP summer camps is to help children learn to deal with the distress
resulting from the increased violence on a psychological level, and to provide a safe and positive 
environment. 
CPSP Support Component: Training
Through its training component, the CPSP successfully strengthens local capacity to address the
psychosocial needs of children. Utilizing the Training of Trainers (TOT) approach, Save and its 
sub grantees promote quality implementation of outreach and support activities. 
The CPSP training targets school counselors and camp leaders who interact directly with
children. In addition to signs of trauma, the trainers learn to identify dangerous behaviors and
signs of distress in children. Counselors learn strategies to address the outward signs of
psychosocial trauma. 
The lack of reliability in training schedules, uneven competencies of program participants, and
disparity in compensation between school counselors and government workers prove challenging
when implementing training protocols and threatens long-term program sustainability. 
CPSP Support Component: National-level Psychosocial Support Database (MIS)
As of March 2003, the MIS provides online the first ever list of Palestinian service providers by 
geographic location, services provided, and contact information. At this time, the MIS has
achieved most of its goals, is still working on a few goals, and has resolved to abandon some 
goals. The MIS effectively utilizes its database, reporting, and query functions. The system can
provide several types of administrative reports for Save and NPA. Although it is only partially
operational, it is widely used for its emergency contact information. 
The National-level Psychosocial Database is a CPSP program tool built to collect and
disseminate information on the nature and intensity of psychosocial services provided in the
Palestinian regions. The information provided by the MIS facilitates coordination among service
providers and decreases the likelihood of the duplication of psychosocial services in the same
region. The MIS is also designed to serve as a national information clearinghouse for providers 
of psychosocial support for Palestinian children and their caregivers. 
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CPSP Support Component: Research
The scientific research included in the publication: Psychosocial Assessment of Palestinian 
Children verifies and quantifies the existence of trauma, and provides a basis for interventions to 
address the psychosocial trauma of war. The publication documents the significant strain 
Palestinian children are under, as well as their resilience and their focus on self-improvement 
(Background Document, CPSP). The report appeared to be well received among program 
implementers. There was broad support for the view that Palestinian children are victims. The 
report quantified – and thereby verified the impact of war on Palestinian children. 
CPSP Support Component: Support to National Psychosocial Coordinating Body (PCB)
The PCB is critical for knowledge-sharing and institutionalizing lessons learned, for the CPSP
program as well as similar programs in the country. Even though various barriers initially
hampered the progress of the PCB, the conference brought all parties together, demonstrated the 
significance of scientific research, and presented various proposals on legislative policy.
The PCB was initiated by the NPA to promote a comprehensive and coordinated national
program for psychosocial support services in West Bank and Gaza. The goal was to catalyze and 
help manage the work of stakeholders in the field.
The PCB sponsored a Conference in September 2003, resulting in recommendations for
programs and research. As a result:
a. The conference showed the importance of in-depth research on the psychosocial needs 
of children, one of the three goals of the emergency plan.
b. It proposed ideas on legislation regarding mental health policies in Palestine; one of
these proposals was adopted from work submitted by a CPSP sub-grantee; and
c. It strengthened the role of the Psychosocial Coordination Body.
Publication of the Psychosocial Assessment of Palestinian Children, released in September 2003, 
and authored by NPA’s Dr. Cairo Arafat, and published by USAID and Save, partially achieved 
the second goal of the emergency committee. This publication identified needs, and provided
scientific research to support the existence of trauma in Palestinian children resulting from the
Palestinian conflict. Findings provide a basis to continue to implement projects, like CPSP, in
the region.
Effectiveness of Program Management of the CPSP
Save has demonstrated foresight, adaptability, leadership and responsiveness in managing the
CPSP. Save quickly anticipated increased needs following the second Intifada in Spring 2002 
and developed the Level II program to address the increasing needs.
Save enjoys several management successes in implementing the CPSP, including successfully
negotiating with government offices. In particular, the Save administration succeeded in
persuading the Gaza MoE to continue to welcome counselors from partner organizations to assist 
its counselors to implement the CBI program in their schools during school hours. Save
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successfully brokers the relationship between the NGOs and the NPA, and generally is 
responsive to the concerns of sub-grantees. 
Save is serious about monitoring and evaluation. The impact of the Level I intervention was
evaluated by a pre-post model where all children completed a survey with their Level I 
counselors that asked them questions about themselves, their schools, their families, and the
nature of their relationships and attitude towards incidents and people in their environment. 
Save’s failure to delegate to the regions sometimes caused work delays as sub-grantees waited 
for central office administrators to make field visits to address program and policy issues. In the 
meantime regional managers were available to do the work.
Key Recommendations
Based on our findings, the assessment team makes the following recommendations:
Appropriateness of the Program
· USAID/WB&G should consider expanding psychosocial services to parents in the long run,
as requested by parents. Parents are both victim and caregiver, and widely embrace strategies 
to improve the psychological health and development of their children. Strategies
particularly targeting parent caregivers would enhance the ability of the Palestinian people to 
withstand the impact of the insurgency. 
· USAID/WB&G should consider expanding the CPSP to develop and provide booster
sessions for program participants. Booster sessions built on the initial CBI program must be 
continued at periodic intervals beyond the 15 sessions. Prevention research has shown that
the initial effects of a prevention program can be enhanced and maintained over the long
term only if booster sessions are provided.
· Government Offices are encouraged to invest in self-sustaining community-based activities
for children that enable community centers participating in CPSP to remain open and provide 
outlets for Palestinian children. Special spaces - including permanent camps run by the
MoY, multi-purpose rooms, and sports fields - could be used to conduct CBI classes. 
· Individualized intensive psychosocial services and referrals to mental health programs need
to be strengthened within the CPSP program. These services are for children who have not 
experienced reduction in their symptoms or who are unable to sustain gains after completion
of the Ten Messages and CBI program. These are children who are especially in danger of 
developing misconduct or other behavioral disorders. 
Effectiveness of Program Operations
· The mass media campaign should continue producing and distributing communication
products. The use of TV spots, radio, community events, town meetings, group sessions
should be expanded as using several different channels of communication increases the
likelihood of reaching more of the intended audiences. The campaign should also increase 
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repetition of the message, improving the chance that intended audiences will be exposed to it 
often enough to absorb and act upon it. For these reasons, a combination of channels has
been found most effective in producing desired results, including behavior change. 
· It is important that the media campaign be expanded and sustained over the long term. Mass 
media campaigns are a tried –and-true communication approach. They have been conducted 
on topics ranging from general health to specific diseases, from prevention to treatment. 
Overall, research has demonstrated the effectiveness of mass media approaches. However, 
behavior change is usually associated with long-term, multiple-intervention campaigns rather
than with one-time communication-only programs.
· Save should launch an awareness campaign to raise awareness of MIS among partners and 
psychosocial providers. One idea is to send a leaflet informing partners again of the type of
reports that are available through the MIS system. Include step-by-step instructions on how 
to get to some sample reports. 
· Establish a means for sub-grantees and partners to communicate at the administrator’s level. 
Perhaps Save could utilize the MIS bulletin facility that already exists on the NPA site for
that purpose. 
· Key to enhancing the usefulness of the database is to make it an interactive tool that can be 
used by participating agencies to input data and facilitate data analysis; to ascertain regional
program needs as well as the extent of geographic coverage. 
· Establish an on-line space for counselors to use to seek information and share best practices.
· Expand program beyond current providers and implementers in order to increase pool of
beneficiaries. Currently, CPSP tools and training are limited. CBI kits, training manuals,
and outreach communication materials should be made available to nurses, seamstresses, and 
market women – particularly due to curfews and restrictions on travel. 
· The CBI should be implemented in the community especially in areas where schools are
frequently closed. The CBI appears to be a successful program in the schools in which it has 
been implemented but there are areas where the schools are often closed or at times
inaccessible due to curfews and closures. Implementing the CBI in community centers will
expand its coverage and benefit adults as well. 
· Save should eliminate space requirements for implementing CBI so that the activities can
take place, for example in the refugee camps, and in clinics – wherever children are found. 
To do so would also reduce the pressure upon counselors to increase the reach of the program 
to include more beneficiaries.
· Provide in-kind payments/incentives for CBI counselors. Currently MoE counselors do not 
receive additional salary for adding CBI sessions to their normal workloads, yet they work 
alongside CBI partners whose counselors are paid to implement the CBI. 
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· Teachers should be encouraged to set-aside an hour each week to discuss psychosocial topics 
with children. Likewise, some CBI program components should be integrated into health
and humanities studies. 
· Disparity in the background of trainees often reduces the attractiveness of training programs
for those trainers are highly knowledgeable and experienced individuals. Save should use
these professionals for the program’s advantage by asking them to deliver or lead part of the 
training sessions. 
· Develop TOT manuals in order to incorporate the experiences of the trainers for Level I.
Compile the activities that trainers say worked best for them. Expand existing Activities
Manual using information from counselors who worked in the field. Document what
worked, with which group of beneficiaries and the barriers they could overcome and how
they overcame them. 
· Post all training and activity manuals on the website. Keep them updated with new ideas that 
counselors send in. This would keep the counselors alert to changes and new ideas. Share 
this manual with other stakeholders. 
Effectiveness of Program Management
· Save should increase delegation of authority to regional centers in order to provide program
continuity during unscheduled interruptions. Managing from the center must continue, but
delegating authority on functional matters should go to the regions to facilitate the efficiency
and work progress in these regions. Only in that sense did Save not utilize its human and 
material resources in its 5 regional offices to overcome the restrictions on movement. 
· Save must work to increase the autonomy of PNGOs under the CPSP. In several cases,
concern was expressed about lack of PNGO representation in coordinating bodies. PNGOs 
expressed a desire to play more participatory roles in decision-making and coordination
activities. 
[v10]
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What follows is a Mid-Term Assessment (MTA) of the Community Psychosocial Support
Program (CPSP) implemented by Save the Children (Save) and partners with USAID/WB&G
funding. The CPSP program aims “to assist children and youth in dealing with the current
conflict situation affecting the West Bank and Gaza, through appropriate psychosocial
interventions, for the purpose of helping them become productive adults and citizens of the
future.”
A. MID-TERM ASSESSMENT OF THE CPSP
In August 2003, USAID/WB&G requested an independent third-party Mid-Term Assessment
(MTA) of the CPSP program. This assessment was conducted in October 2003 and is reported in 
this document. It must be noted that, due to security restrictions, routine traffic disruptions,
frequent checkpoint stops, and almost daily aerial bombings constrained travel into and around 
the West Bank & Gaza. 
Purpose and Scope of Work
The purpose of this evaluation is to provide USAID/WB&G with an independent Mid-Term 
Assessment (MTA) of the CPSP program. The evaluation will establish the following:
A. Overall Appropriateness of the CPSP program given the psychosocial needs of 
Palestinian children; and to identify improvements for future planning and
implementation purposes;
B. Effectiveness of Program Operations per program component;
C. Effectiveness of Program Management of the Save/CPSP team.
Methodology
In accordance with the purpose of the CPSP Mid-Term Assessment, the process evaluation is 
comprised of three major components: 
1) Collection and analysis of site-by-site data on program activities and their effectiveness;
2) Collection and analysis of project-wide data on Save’s implementation of the program;
and 
3) Collection and analysis of data on Save’s project management. 
The assessment called for gathering data from the granting agency, program providers,
beneficiaries, donor organizations and health organizations. A qualitative research design was
used as the assessment called for gathering reactions and impressions from small numbers of
participants, in each of the above categories, by engaging them in conversation.
II. BACKGROUND STATEMENT
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The evaluation plan called for data collection from a review of briefing documents received prior 
to the visit, development of a standardized Assessment Review Tool, on-site face-to-face 
interviews in West Bank and Gaza, on-site review of documents, visits to program sites in West 
Bank and Gaza and on-site debriefing meetings.
The Assessment Review Tool (Annex B) consisted of questions regarding the effectiveness of
program design, implementation, and management. Questions were grouped according to CPSP 
program components. A matrix was developed which correlated the questions with the three
major assessment components to ensure that all areas were adequately covered. 
The Assessment Review Tool was sent to Veerle Coignez, Cognizant Technical Officer (CTO), 
USAID/WB&G, for review and comment. On-site revisions were made to reflect the interests 
and concerns of the CTO. 
Major topic areas of the Assessment Review Tool were:
1) Program Implementation
2) Program Related Training
3) Program Evaluation
4) Project Management
5) Program Coordination
6) Administrative Training and Support
More than 42 interviews were conducted. On-site, the evaluator made judgments to adjust or 
rephrase the questions according to the person being interviewed, to seek further clarification, 
and/or pursue other areas of concern.
Interviews and focus groups were conducted in Arabic, which allowed for trust and ease of
communication between the interviewer and the person(s) being interviewed. Major interviews
were audio-taped with permission of the person being interviewed and transcribed for further
review. 
Site visits were conducted to the major regions in which the CPSP project is being implemented. 
The evaluator spent time in the community centers run by the sub-grantees. The evaluator was 
able to observe both the primary psychosocial support sessions and the classroom-based 
intervention (CBI) and even participated in a CBI session.
B. HISTORICAL CONTEXT OF THE CPSP PROGRAM
USAID/WB&G funds programs that are key to US efforts to achieve peace and stability in the 
Middle East. The five principal strategic objectives of the USAID/WB&G Mission are Health, 
Economic Development, Water Resource Management, Governance, and Community Services. 
Likewise, the Palestinian Authority five-year program: “National Strategic Health Plan for
Palestine (1999-2003),” articulates the need for interventions that promote improved health. 
The Health objective encompasses two intermediate results (IRs): IR1: Improvement in
Women’s Health and Nutrition; and IR2: Improvement in Children’s Health and Nutrition. 
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Under a transition plan developed by USAID/WB&G in 2000, a third IR was added to the health 
program: “Improved Capacity to Meet Health, Nutrition and Psychosocial Needs Arising Out of
the Crisis (IR3). The Transition Plan went into effect in January 2001 and remains valid to date.
Save the Children (Save) was awarded a $2 million Cooperative Agreement in May 2001, to 
undertake a Community Psychosocial Support Program (CPSP) in the West Bank and Gaza
(WB&G). The award was based on Save’s submission of an unsolicited concept paper in
December 2000.
The main aim of the CPSP program is to assist children and youth in dealing with the current
conflict situation in the WB&G area, through appropriate psychosocial interventions. The
interventions include (1) the implementation of psychosocial outreach programs by Palestinian 
Non-Governmental Organizations (PNGOs) through a “grants-under-grant” system; (2) the
development of a national-level psychosocial database; and (3) the development and piloting of
communication campaigns to promote behavior change. In order to facilitate the above, the
CPSP program also includes (4) a substantive training component for psychosocial support
providers, community groups, and educational staff, to ensure the implementation of appropriate
programs for children and youth; and (5) the establishment of a national psychosocial
coordinating body.
The health and humanitarian situation in WB&G deteriorated in Spring 2002. Reports of
increased exposure to death, injury, and violence raised concerns about the psychological impact 
of war on the Palestinian people, particularly the children. In addition to the violence, the support 
system was challenged by school closures, unsafe streets, and broadcast coverage of the
incursion. Children sought solace from parents who felt increasingly unable to protect their
families. In order to better meet increased needs for psychosocial support, Save submitted a 
proposal to USAID to expand the CPSP program. 
The original CPSP was limited to basic outreach through structured group activities (primary
psychosocial support). The expansion allowed Save to introduce more intensive and in-depth 
psychosocial support (secondary” psychosocial support). The other components were adjusted to 
accommodate the changes in the psychosocial outreach component. A $3.2 million expansion
was formally approved on August 15, 2002, bringing the total program amount to $5,200,000. 
The CPSP is operational throughout all 16 governates in West Bank and Gaza. Save’s 
implementing partners include the Palestinian “Secretariat of the National Plan of Action for
Palestinian Children” (NPA) and 8 local NGO sub-grantees. 
C. PSYCHOSOCIAL CONTEXT OF THE CPSP PROGRAM 
The following classification system – developed by the Committee on Prevention of Mental
Disorders of the US-based National Institute of Medicine (IOM)
i
-- may be used to understand 
the psychosocial support activities undertaken under the CPSP:
 
1 Cf. Reducing Risks for Mental Disorders. IOM, Washington, DC: National Academy Press, 
1994
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Mental Health Intervention Spectrum
Treatment
Prevention
Maintenance
Universal
Selective
Indicated
Case 
Identification
Standard 
Treatment
for Known 
Disorders
Compliance 
Long
With 
-Term
Treatment 
Aftercare 
(Including 
Rehabilitation)
Reducing Risks for Mental Disorders: Frontiers for Preventive 
Intervention Research. Copyright 1994, National Academy of 
Sciences. Courtesy of the National Academy Press, Washington, 
D.C.
· Universal interventions are targeted to the general public or a whole population group that 
has not been identified on the basis of individual risk.
· Selective interventions are targeted to individuals or a subgroup of the population whose risk 
of developing mental disorders is significantly higher than average.
· Indicated interventions are targeted to high-risk individuals who are identified as having 
minimal but detectable signs or symptoms foreshadowing mental disorder but who do not 
meet diagnostic levels at the current time. 
The above classification system -- which the public health community has adopted as a
framework to guide research and program planning -- recognizes the importance of the spectrum 
of interventions from prevention, to treatment, to maintenance. 
· Universal programs target general population groups. Activities may include mass 
media, mobilize and organize communities, provide information, facilitate attitude
change, develop positive peer norms, and provide opportunities for community
involvement.
· Selective programs target those who are at higher risk for behavioral problems.
Activities may include mentoring programs, development of youth coping/life skills,
provide parent/teacher support, increase youths’ bonding to school, reduce child and 
parent stress, and increase communication skills. 
· Indicated programs are aimed at individuals who may already display signs of 
behavioral problems and are designed to prevent the onset of regular or chronic 
behavior. Activities may include individual and family counseling, facilitate healthy
family interactions, restructure maladaptive behaviors, and enhance social and
academic competence.
Prevention programs may include activities and address target groups that fall under more than
one classification category. In practice, the boundary between the various aspects of prevention,
treatment, and maintenance is not as clear-cut as the classification system conveys. The IOM 
classification system is useful to assess the comprehensiveness and extent of the services being
delivered. 
Within this context, the CPSP program, and in particular its main components, are firmly located 
at the prevention side of the spectrum. The CPSP primary psychosocial support component, 
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based on the Ten Messages, can be characterized as a “universal intervention” and the secondary 
psychosocial support component, the so-called Classroom-Based Intervention or CBI program,
can be characterized as a “selective intervention.”
The primary support program, based on ten messages, focuses on changing the way children,
parents and caregivers relate by acknowledging children’s emotional and developmental needs,
their dependence upon their parents’ affirmation, and their need for positive reinforcement. It
helps adults enhance their parenting and teaching skills. The messages have been disseminated 
through community meetings, the media, and the distribution of materials such as posters,
calendars, and workbooks. Youth are encouraged to take an active role in their family and
community, which works well with Palestinian children, who have a strong sense of national
pride and want to contribute to the reconstruction of their community. 
The Classroom-Based Intervention (CBI) is designed to help children positively express their
feelings, teach them how to control their emotions, provide a safe mental and physical play
space, improve children’s school performance, and create a supportive school environment. The 
CBI is a 15-session program implemented in schools, community settings, and summer camps. 
It is not an intervention to prevent Post-Traumatic Stress Disorders (PTSD), but designed to deal 
with stress. 
The CBI program also provides limited small group and individual and family sessions for
children identified with more serious problems. These may be children who have experienced no 
reduction in their symptoms or who have not sustain gains after completion of the CPSP, and 
who may need more individualized services. When appropriate, these children are referred for
more treatment. 
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According to the recently￾released Report on 
Psychosocial Status of 
Palestinian Children, “an 
overwhelming majority (93%) 
of children reported that 
they did not feel safe and 
believed that they and their 
family were vulnerable to 
attack.” (September 2003)
Findings are presented according to the three tasks set for the assessment team:
A. Overall Appropriateness of the CPSP program given the psychosocial needs of 
Palestinian children; and to identify improvements for future planning and
implementation purposes;
B. Effectiveness of Program Operations per program component;
C. Effectiveness of Program Management of the Save/CPSP team.
In Section B, the general objectives set for each component are restated, with a brief overview of 
CPSP’s reported achievements. The assessment team’s observations are then presented,
highlighting both areas of strengths and weaknesses of the CPSP program, and for the
implementing agency. Recommendations are provided in Chapter IV.
A. APPROPRIATENESS OF THE CPSP PROGRAM 
General Assessment
The CPSP is an appropriate response to the threat
posed to children in conflict environments. The tools
and strategies provided to children and their caregivers 
are technologically appropriate, current, and
functional. CPSP funds outreach and training to
program beneficiaries through a Level I community￾based intervention programs, and through a Level II
classroom-based interventions, as well as through
summer camps, using a sub-grant mechanism. 
CPSP programs provide a respite for children – a safe place filled with positive images and
constructive activities. These programs provide children with limited opportunities to enjoy their 
lives unencumbered by violence and imminent danger. The availability of these services and the 
spaces provided for gathering offer psychological and physical refuge.
Save develops and implements high-quality psychosocial support programs made possible by the 
extraordinary commitment and resilience of its partners and sub-grantees. 
Impact Assessment
Program impact was determined through interviews and focus groups, through which
beneficiaries related their experiences with the CPSP program. The impact of the Level I
activities is more evident than that of the Level II program. The Level I year-long program
activities have for the most part come to an end, and an impact study has been conducted. By 
III. FINDINGS
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A 40% decline in 
behavioral referrals 
following implementation 
of CBI was reported by a 
school principal. 
“… we are better ”… “now 
I have him figure out 
his own solution.” 
 “Instead of hitting 
him…I went to school to 
see about the problem.”
Mothers’ Focus Group
contrast, CBI is still being rolled-out, and reports on its impact are anecdotal. An extensive
M&E program has been developed, however, and should provide evidence-based information
soon.
Impact of CPSP on Children
The Level I and Level II programs received unanimous positive feedback from parents, school
and Ministry of Education (MoE) officials. Reportedly, the activities based on the Ten Messages 
resulted in less aggression and anxiety on the part of children, as well as on stronger social ties. 
By the same token, the impact of CBI was reported to be immediately detectable and addressed a 
growing need to manage and prevent harmful behaviors. School officials also reported fewer
referrals for inappropriate behavior.
Data on the impact of CPSP activities on children were gathered from group interviews with
children who participated in both Level I and Level II activities, from mothers who participated 
in group meetings that included discussions and parent activities, and from teachers, principals,
and counselors who worked directly with the children. In interviews with MoE and MoYS
officials, the effect of the CBI on children in the classroom and in Summer Camps was also
discussed. 
Parents reported that their children were more positive,
cooperative, and friendly, as well as less secluded, and less 
aggressive with one another. 
Teachers reported that students were more focused and
available for learning, displayed less enmity and oppositional
behavior, and exhibited lower levels of violence in general. 
The CPSP appears to have made a positive impact in the area of gender awareness and gender 
rights as well. A sub-grantee program coordinator reported cases in which girls who participated 
in CPSP became self-advocates for education in the face of marriage arrangements imposed by
their parents.
Impact of CPSP on Parents
Mothers reported using the Ten Messages as a guide to better support their children, to improve 
their parenting skills, and to improve interactions with their children. In general, CPSP helped 
mothers break down emotional barriers that prevented them 
from having open communication with their families.
Thanks to the tools provided, mothers were able to
encourage openness on topics previously avoided. In so
doing, mothers became better able to provide
encouragement and promote self-esteem and confidence.
It can be argued that the tools provided to parents have 
resulted in cultural adaptations of traditional parenting
practices. The Palestinians love their children but see them as not yet deserving of rights. Yet, 
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the parents participating in CPSP activities see that children are entitled to certain freedoms, and 
these ideas are freely discussed when parents meet under the auspices of the CPSP. The result is 
home and school environments in which children are respected and their opinions sought; whose
friends are welcomed into a home free from stress-producing demands for decorum, and whose 
parents seek out opportunities for children to meet and play. The Ten Messages provided
solutions and structure in an uncertain environment. 
A limited consequence of parent trainings was empowerment. In Hebron, CPSP discussion
groups led to the creation of an unofficial women’s centers that serves as a focal point for small￾scale micro-enterprise activities. In addition, discussion groups with mothers expanded beyond 
the Ten Messages to encompass women’s health and nutrition concerns, and non-traditional 
issues such as early marriage for girls.
Impact of CPSP on Teachers
Teachers, too, reported more openness in communications with students. Teachers were also
empowered to provide creative latitude to students without feeling threatened. Teachers reported 
on the impact of the Ten Messages meetings in two separate focus groups, one held in Gaza and 
the other in Hebron. Three school principals attended the Hebron focus group and reported on
the observed impact of CPSP on teachers.
Teachers reported increased efforts to improve classroom environments by refraining from
corporal punishment, softening language, and providing breaks from rigid schedules. The Ten
Messages provide strategies for teachers to better manage classroom behaviors. Teachers
universally agreed that they faced fewer behavior problems from CBI participants. CBI 
significantly improved the quality of instruction and the learning environment in classrooms. 
Training imparted new skills which enabled teachers to grow professionally and increased the
demand for their services.
Impact of CPSP on Counselors
Counselors are trained to equip affected individuals with coping skills. Counselors reported
growing personally and professionally through the CPSP program. Counselors bear the twin
burden of victim and service provider. In Training of Trainer (TOT) workshops, some counselors 
engaged in activities designed for students. Many reacted emotionally and realized that
professionals are not immune to trauma of war. 
The program provided counselors with skills that could lead to well-paying jobs. Psychosocial
counseling is gaining the attention of international agencies in the area, trained counselors with
such skills are in high demand. 
Impact of CPSP on the Community
According to counselors in partner organizations, the CPSP like other psychosocial support
programs, has helped communities become more aware of psychosocial issues. In addition, as a 
result of continued high-intensity conflict and the subsequent widespread need for psychosocial
services, the stigma once associated with psychosocial distress was quickly lessened by the
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availability of services. Psychosocial support professionals are now more familiar to Palestinian 
families. Only a few years ago, according to a YMCA Coordinator in Beit Sahour, a NGO was 
rejected at the door and informed that there were no “crazies” in need of attention.
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B. EFFECTIVENESS OF PROGRAM OPERATIONS
B.1. CPSP Outreach Component: Level I Activities
Objective
Level I activities were a part of the initial CPSP project and sought (1) to provide basic support 
to children in conflict, and (2) to provide basic tools to caregivers, parents and teachers to
support the children. These primary support activities sought to enhance Palestinian children’s
capacity to communicate with their caregivers and to express their opinions and feelings. It also 
aimed to provide children with tools to manage their physical and emotional reaction to common 
situations. In addition, the program intended to enhance the caregivers’ capacity to address these 
themes with their children utilizing their improved communication skills.
Implementation
Save competitively selected eight local NGOs to implement Level I activities. The interventions 
took the form of (1) play and discussion groups and other activities for children; (2) activities
and workshops for parents; and (3) training for parents and volunteers, as well as for school and 
NGO staff. In addition to the group sessions organized by the eight sub-grantees, an extensive 
outreach campaign was mounted, including media materials and other communication products.
The development of the outreach materials was accomplished by Save and the NPA, and one 
sub-grantee.
All five West Bank partners were involved in identifying ten key psychosocial messages for
three target groups, children, parents and teachers. Meetings were held with the partners to
clarify program goals and objectives, as well as to identify target groups and measurable
indicators and tools. Each agency was asked to write the best ten messages that they believed 
were necessary to achieve the project’s objectives. Save and NPA received 240 messages, 80 for 
each target group. These were narrowed down to the ten final messages. Originally the messages
did not include fear, worries, and safety. At a later time, the messages were revised to
accommodate the escalation in violence. (See Annex F).
Achievements
· Through development of the Ten Messages, the program successfully provides strategies and 
tools to cope with dangerous environments. Most importantly, the Ten Messages help
children manage fear and guide children in seeking help. Parents are better able to address 
and accommodate their fears, and teachers are able to better identify and address behaviors 
resulting from psychosocial disturbances.
· Using the Ten Messages as a foundation, basic psychological support has been provided to 
over 20,000 Palestinian children through play and art activities, role-playing, dance and
music festivals, as well as a Children’s Parliament.
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· Over 4,000 parents, teachers and other caregivers so far have benefited from the group
sessions and training on how to meet children’s basic psychosocial needs.
Assessment Team Observations
· The primary support activities of the CPSP effectively validate the stresses that
accompany daily conflict, and provide an entry-point for beneficiaries to learn about
psychosocial disorders.
· Mothers are recruited to meet at community centers to participate in the CPSP program. 
They discuss child-rearing and parenting methods. In this venue, the Ten Messages are
introduced, discussed, and promoted. The group sessions are organized around games, 
role playing, drama, and other skill-building activities related to the themes of the Ten
Messages. The CPSP does not dictate how the messages are to be presented, but rather
encourages the incorporation of the Ten Messages in teaching and nurturing children. 
· The community-based approach to promoting the dissemination the Level I activities
make possible its wide spread acceptance. At the same time, there was little oversight
and coordination among the eight subgrantees. The evaluation reports from the field,
however, suggest that indeed the beneficiaries are embracing these Messages and
incorporating them into daily living activities. 
· The primary support activities succeeded in building a base of stakeholders in the CPSP 
program. The outreach program particularly reached women with a message to lessen the 
hardship of parenting children in conflict. Once beneficiaries accept that there is
something they can do to improve their coping skills, they broadened their interests to 
include other areas for empowerment. 
· There was no coordination among the eight local NGOs. The partners were unable to 
come together for structured training that resulted in each organization interpreting and
implementing the Ten Messages in the areas that it was assigned. The latter is not
necessarily a negative, and may be considered to be suitable to community-based, 
grassroots programing. However, collaboration among the various implementing partners
would have provided a unifying element that would promote pride in teamwork. In the 
face of closures, coordination could have been facilitated through fax or email or
messages that accompany the feedback on the monthly reports. 
· Three of the Ten Messages address fear, worries, and safety. This direct and thorough
coverage of these pertinent topics is quite essential. It tells children that it is permitted to 
look for a safe place to hide and to stay away from a dangerous situation. This is
especially true for young boys who may be ashamed of their fears. 
Group Sessions
· This Level I intervention was a good start in the right direction. Parent meetings 
encouraged open communication and brought comfort to the participants. They were 
social events were parents shared their problems with others who had similar concerns. 
Counselors followed their groups’ lead and in some cases, rather than focusing on the
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“Someone heard our 
problems and helped 
us.” (Teachers Group 
from Hebron)
Ten Messages, discussed other topics that were more relevant to the group at the time. 
The group sessions created an environment to listen and respond.
· As a result of group sessions, mothers reported that old
habits used in raising their children stopped – among
such habits: discipline by hitting, telling children to leave
the house to avoid the noise, prohibiting visits from
friends, or prohibiting children from venturing out to play
in response to parental fears for their 
 safety. 
· Teachers expressed a similar attitude as the parents following a focus group. “We were 
finally heard,” he said, referring to the Level-1 meetings. “They gave us extra skills like 
organizing our time, listening to our students and to improve our teaching approach.”
· Beneficiaries of CPSP also participate in the Student Parliament program, where they
took advantage of another platform for practicing and promoting the Ten Messages.
Children made guest appearances on television shows to discuss the Ten Messages,
participated in art exhibits. Among others, such activities enabled children to become
more aware and pro-active.
Outreach Campaign
The outreach campaign designed to deliver the Ten Messages into the community was launched 
with both print and TV components. Most of these components were produced by NPA and
were of the highest quality. In contrast, the few print and TV media items produced by a sub￾grantee in the North were of poorer quality. 
 
· TV Spots/Talk Shows: NPA wrote and produced four TV spots with themes varying around 
the Ten Messages. Each spot follows a three-part format: A situation develops in which a 
family is confronted with a problem and the parents act in a way that is not in the children’s 
best interest. Then two counselors appear and talk of the children’s need for reassurance and 
physical closeness, and the parents’ responsibility to assure their physical and emotional well
being in spite of their own understandable fear and concern. The counselors make general
comments and suggestions regarding the situation. The situation is repeated and the
counselors’ recommendations are acted out. 
This method of role-playing seeks to promote behavioral change. Not only do the TV spots
highlight negative behaviors, but they explain their effect on children and propose a solution. 
Favorable behavior is then demonstrated for the parents. The settings and actors are well
selected as they represent average families in everyday situations that make it easy for
viewers to identify with them. The message delivered is consistent, focused and clear: “Your 
children’s feelings matter and are affected by your behavior” this is a central theme the Ten
Messages. 
Finally, the proposed behavioral changes are developed that satisfy cultural values of the
Palestinian and Arabic society. The concept of parents as guides and guardians of their
children is emphasized. The concept of parents’ sacrifice is underscored.
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“The success of this calendar,” says the NPA media coordinator, 
“is reflected in its popularity. We ran completely out and this 
is October and we are still receiving requests for more.” 
The talk shows produced by a sub-grantee in the North were not as relevant to the Ten
Messages. They discussed social issues that confront young men and women today. It 
mostly addressed conflicts between the older and younger generation, very real issues that
are not within the scope of the CPSP. It is important to mention here that Save considered 
terminating the contract of the sub-grantee that produced the talk shows and the children’s
journal.
· Calendar: An attractive calendar produced by NPA was developed to communicate the Ten 
Messages. The calendar serves as a useful, entertaining, and educational tool. Each page
displays a cross-stitching pattern, and the crop, vegetable, or fruit in season to be planted or 
harvested during the month. Each month reinforces one of the Ten Messages. The month’s 
theme is stated in two lines of poetry delivered in a simple, straightforward message written
in local everyday rhyming language. The calendars were in evidence at most program
locations and appeared to be warmly owned by program staff and beneficiaries.
· Teachers’ Agenda: A high-quality teacher’s weekly agenda produced by NPA has been
distributed to teachers. Each page portrays a message with an example of how that message 
can be applied in a class setting 
· Ten Messages Activity Poster: NPA designed and produced a colorful poster with clear
high-quality multi-color drawings depicting illustrations of the Ten Messages. On the
reverse side is a poster version of the popular board game Snakes and Ladders. Inserted in 
some of the boxes that would send the player up a ladder or down a snake are ten message￾type statements that are either “good” or “bad” moves. A child playing with another would 
not notice these writings, but a parent would. This provides an effective way to deliver a 
positive message: the snake provides incorrect responses to danger while the ladder offers
correct responses. For example, when the child lands on the snake, the message may read:
“When a bomb hits, I will run to see what happened.” Conversely, the message on the ladder 
may state: “I talk to my parents about what scares me.” 
Adjacent to the Snakes and Ladders game is another activity that is also included in the
Student Workbook. Twelve settings presented in very clear colorful art: someone watching
TV, a burning house, a child hiding from a bomb, a child at a picnic, a bomb outside a child’s 
window, etc. At the top of the page are twelve cartoon faces labeled by their expressions:
anxious, happy, afraid, calm, happy, sad, calm, etc. The child is asked to copy the faces that 
he or she believes corresponds to each of the settings in the blank space provided next to it. 
Identifying these feelings is an important goal of this activity. Further, a game like this,
played with a counselor or a caregiver provides the opportunity to discuss and validate a
child’s feelings of anxiety and fear in dangerous situations.
· Student Workbooks: The workbook is full of thought-provoking games. NPA intended for 
children to complete the exercises with an adult. By completing these, children will be able 
to identify their strengths, their feelings about people around them, their needs, people they
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love, safe places, what is good for them, etc. The workbook contains activities adaptable to 
the needs of the child. 
· Children’s Journals: A sub-grantee produced eight issues of a Children’s Journal. Written 
and produced by children, the Journal was to contain articles and stories relevant to the Ten
messages. Eight journals were released in the last three months of the contract period. In
reality, the journals were poorly designed and produced, and they were ineffective as a
program tool.
B.2. CPSP Outreach Component: Level II Activities
Objective 
The CBI is a stress-management program for use with a broad population of school-aged
children. This evidence-based program targets the prevention and reduction of psychosocial 
trauma in youth following their exposure to life-threatening events and ongoing traumatic stress.
It is designed to increase children’s social-emotional competence and to reduce impulsive and
aggressive behaviors. Children and youth are taught coping and decision-making skills, as well
as risk assessment and positive goal setting. The program promotes a safe school environment 
where children can openly express their emotions without negative repercussions. 
Implementation
In response to the increased intensity of the second Intifada in the Spring of 2002, Save 
submitted a proposal to USAID/WB&G to expand the level of psychosocial support to children 
and their caregivers facing increased trauma. A plan was put into place to design and implement 
a classroom-based intervention and psychosocial program to be installed in the elementary and 
secondary public and private school systems of West Bank and Gaza. The CBI program was 
adapted from a program developed and tested in Turkey after the earthquakes which ravaged this 
nation. Revisions were made to it by Palestinian counselors, teachers and social workers to
make it culturally appropriate.
Save and the program technical advisor met with officials from the Ministry of Education (MoE)
to introduce the program. The MoE endorsed the implementation of the program in its schools
and made it part of the counsel curriculum. It is implemented in MoE, UNRWA, and private 
schools as well as in community associations. To participate in the CBI, schools must have a 
counselor assigned to their school and have a room large enough to accommodate the
implementation of the CBI sessions.
Compared to the Level I activities, the CBI program is quite structured. The program consists of 
15 sessions, with the first and last sessions lasting 90 minutes and the other sessions lasting 45 
minutes. These 45 minute sessions are divided into physical movement, an art activity,
discussion, and a game, and they end with more physical movement. The materials used in the 
sessions are an integral component of the program. A CBI kit comprised of a stereo, play mat, 
nylon parachute and art supplies was provided to the schools by Save. Culturally appropriate 
soothing and calming music is used to open and close each session.
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In West Bank, the YMCA was chosen to be the CBI implementing partner because of their
presence throughout West Bank and their expertise in working with traumatized children and
youth. In Gaza, the CTCMC and PCHRCD were selected as the CBI partners. The partners help 
deliver the CBI training program and train others to implement the program. 
In October 2002, a CBI training for social workers was held in Amman, Jordan. This Training of 
Trainers (TOT) was important, as it developed a cadre of people who, upon their return to their 
programs, could train others. The TOT also introduced the program to psychosocial support
professionals who could facilitate the acceptance of the program within their communities.
Participants were selected to implement the pilot phase of the CBI in eleven schools in the West 
Bank and three schools in Gaza. Based upon their comments, revisions were made to the CBI 
manual, which made it more relevant to the Palestinian culture. The large-scale training of
school counselors and volunteers who would be working with the CBI program in the schools
began in January 2003.
The YMCA in the West Bank also provides support services for children who have been
identified as needing more intensive help. These services are provided to children who exhibit
more serious or long-lasting behavioral problems. Additional support is provided through 
individual, group, or family counseling. Parents are brought in so counselors can work with the 
family as a unit. Parents and counselors share strategies and skills for working with their
children.
Achievements 
· A total of 617 CBI kits have been distributed in West Bank and 307 in Gaza.
· As of October 2003, the number of CBI rooms furnished in schools in the West Bank is 622;
in Gaza 233 rooms have been furnished. 
· The CPSP project provides training to camp counselors, provides equipment such as mats,
toys, caps, and tee-shirts, and other materials needed for the CBI sessions held in CPSP￾sponsored camps.
Assessment Team Observations
· The developer of the CBI program acknowledged that without the Level I activities,
especially the Ten Messages, the CBI program would not have enjoyed the open reception.
· The artwork and the discussions are thematic and depend completely on the counselor’s
knowledge, skills and ability to manage a large group of students in a limited space. 
Counselors were generally well-prepared, gave clear instructions, made eye contact, and
demonstrated utmost respect to the students. 
· The children were happy and attentive counselor as they willingly followed the counselor
through the warm-up exercises. 
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· The CBI has built-in flexibility for adaptation to the audience; for example, the girls schools 
had a shorter physical activity period. Likewise, lying flat was replaced with sitting up to
accommodate the preferences of young girls in the room. This is one of the first
modifications made by Save during the pilot, in an attempt to make CBI activities culturally
compatible.
· Art is an important tool in both Level I and II programs. Often children are unable to talk 
about or to describe painful details, but can draw a picture of a painful event with greater 
ease. 
· The capabilities of the counselor are critical to the success of the CBI. The evaluator noted 
the difference in capabilities between the resident counselors employed by the Ministry of
Education (MoE) and the visiting counselors from NGOs. The latter had more experience
with the CBI sessions than the school counselors who conducted fewer sessions. However,
the school counselor has other responsibilities in addition to the CBI program. When the 
CPSP project ends, the resident school counselors will be completely responsible for CBI
implementation, which may be a problem in some cases.
· The CBI is so popular program that one school that failed to meet the space regulations for 
participation in CBI removed all the desks from large classroom to hold the CBI session and 
returned them right after. 
· The lead coordinator at YMCA reported a great need for more intensive individualized 
services for children and families exhibiting continuing problems. A mother became so
depressed she could not get up to take care of herself or her family. The YMCA staff
member helped that after losing one of her children, the mother who, in turn, thanked the 
worker for helping her tend to her remaining children. Mothers need encouragement and
skills to help them guide and nurture children.
B.3. CPSP Outreach Component: Summer Camps
Objectives
The objective of the CPSP summer camps is to help children learn to deal on a psychological
level with the distress resulting from the increased violence, and to provide a safe and positive 
environment as well as a rare opportunity to relax and play and to express themselves in a
proactive and peaceful way.
Implementation
The CBI program has been successfully implemented in community centers and summer camps
over the course 2003. The Ministry of Youth and Sports (MoYS) organizes summer camps for 
children and youth every summer. According to MoYS representatives, every summer the 
Ministry can serve up to 40,000-60,000 children who are spread out across the country, including 
marginalized areas. However, these only represent a fraction of all the children and youth in
Palestine that are in need for this service. For example, there are 434,000 12-16-year olds in 
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Palestine today. To serve this large number of children, the sessions are shortened to 3 weeks to 
enable the rotation of several groups of children within the same camp each summer.
Save works closely with the MoYS to organize CPSP-sponsored camps. CPSP provides 
training and materials for these camps. Financial and human resources are needed to provide all 
Palestinian children the opportunity to participate in the MoYS Summer Camp program.
Achievements
· An estimated 45,000 children throughout the West Bank and Gaza benefited from 300
successful CPSP-sponsored summer camps in the summers of 2002 and 2003. (Background 
Document, CPSP). 
· In the summer of 2003, the CBI was implemented in most of the CPSP sponsored summer 
camps, benefiting over 18,000 children. [v50]
Assessment Team Observations
· There is a wide gap between the number of summer camps provided and those that are 
needed for children and youth. CPSP provides training and materials for these camps. 
Although the program should be provided throughout the summer months, the current
one is for only a 3-week period, leaving children idle for the larger portion of the
summer.
· International support for the summer camp program is widespread in Gaza and West
Bank. However, West Bank officials feel that CPSP program is under-funded and has 
too few incentives as compared to other donor-funded programs, especially UNICEF and 
other donor funded programs. 
· In Gaza, officials warned that MoYS’ inability to provide summer camps to all children
may force them to consider other alternatives including camps offered, by religious
groups. They expressed a concern that some of these camps may not be teaching themes 
of peace and tranquility.
B.4. CPSP Support Component: Training
Objective 
Training is a key component of both the Level I and Level II activities. Through training the
CPSP seeks to promote quality program implementation through training. Training targets
counselors who work directly with children, teachers and parents.
Implementation
Level I Training
Level I training targets community workers, schoolteachers, and others who work directly with
children under the CPSP outreach component. 
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The counselors recruited for Level I training had diverse skills and backgrounds; and a separate 
training was not possible. Experienced counselors, program coordinators and directors of partner 
organizations were trained simultaneously leading to frustrations. Most participants viewed the
training as unsatisfactory. 
A follow-up training session did not take place because of security restrictions. As a result, each 
organization prepared in-house training for its counselors that resulted in different program
activities among the eight sub-grantees.
While there was no Level I training session in West Bank, NPA and Save did follow up with the 
partners in one-on-one sessions in their offices and in the field. In Gaza, a follow-up session 
involving all the three partners with the support of Save and NPA regional offices took place in 
Gaza. Counselors from each organization compiled activities into a manual to be shared by all
counselors. Save later merged all three versions into a bound master manual. The West Bank 
sub-grantees were not interested in developing a similar manual. 
Level II Training
The Level II training targets counselors who will implement the CBI program.
The CBI training was conducted on two levels: first, a training of trainers (TOT) session was 
held in Amman, Jordan; and secondly, counselors were trained in their communities by the first 
group of trainers. The training of counselors is important aspect of the CBI.
In both the TOT and the counselor training activity, the original program manuals were later 
adapted. This allowed for a structured approach to implementing the CBI in classrooms and 
community organizations across the country, differing from the Level I implementation that
allowed more flexibility in its approach. Also helpful was the activities manual that counselors
kept and used for their CBI sessions.
Achievements
· Sixty-three social workers successfully completed the initial Training of Trainers (TOT)
course in Amman designed to prepare other counselors to provide psychosocial support
through the CBI program.
· As of October 2003, there are 692 CBI trainees in the West Bank and 329 trainees in Gaza.
· Approximately 1,200 school counselors and 1,600 camp leaders were trained in CBI
techniques.
Assessment Team Observations
· NPA notes that even though the second Level I training session never took place in the West 
Bank, NPA and Save follow on with the partners in one-on-one sessions. The NPA director 
said, “I do not believe that (the partners) acknowledged this input sufficiently….” She added 
that the results in the field very positive and that the counselors have succeeded in reaching
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the children and making a difference. These results would not have been possible without the 
guidance and support of all players. 
· The Level I manual was eventually developed by the three Gaza partners is a good example 
of what was originally needed. Even in the absence of systematic training, an activities
manual provides counselors with a baseline from which to work. Instead, the Ten Messages 
were interpreted and implemented independently by each of the partners in the West Bank 
and in Gaza.
· Upon their return from the CBI training in Amman, the Save team embarked upon a pilot 
project to modify some of the activities in the CBI activities manual to make them culturally 
relevant to Palestinian children. This was a worthy project and was approached scientifically. 
Pairs of counselors met weekly to discuss problems and document findings. All data
collected and Save compiled a book of modifications to “fit our cultural reality,” reported the 
Save project manager. 
B.5. CPSP Support Component: National-Level Psychosocial Database (MIS)
Objective
The National-Level Psychosocial Database -- also referred to as the Psychosocial Management
Information System (MIS) -- is a CPSP component designed to collect and disseminate
information about psychosocial services in the Palestinian regions. The information provided by
the MIS facilitates coordination among service providers and decreases the likelihood of the
duplication of psychosocial services. The MIS is also designed to serve as a national information 
clearinghouse for providers of psychosocial support for Palestinian children and their caregivers. 
Implementation
The MIS system can provide information on each CPSP project by geographical region and
locality, implementing partner, the stated goal of the sessions, the barriers to accomplishing that
goal and the number and type of beneficiaries. Other reports provide information on relevant
research, references, seminars, or upcoming conferences.
The MIS contains a unique listing of all psychosocial service providers in the country who can
be queried by district, organization, and target group, approximate number of beneficiaries, and
contact information. Especially useful is emergency contact information, e.g., hotline and
cellular phones numbers. The information was compiled by NPA and Save counselors who made 
several visits to each region and held meetings in order to get to know the service providers in 
each area. The organizations in attendance were invited to return the following week with other 
organizations with whom they were acquainted. In this manner, the circle of organizations
expanded considerably after several meetings during which the NPA representative complied the
needed information.
The MIS has reached many of its goals, several goals remain and a few have been abandon. For 
example, at one time, analyzing and reporting survey data was an important goal. It would have 
been used to report on the progress of projects by reporting on the changing attitudes of
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participants, for example, before and after intervention. This goal has been postponed. Instead, 
data is now entered and analyzed in a popular statistical software package (SPSS) then the results 
are entered and displayed in text format on a MIS report screen.
According to the NPA, anyone can access the MIS through the www.npasec.org web page to 
find information about the CPSP project; and about field operations, or to find research statistics 
about psychosocial trauma.
Achievements
· As of March 2003, the MIS provides online, for the first time ever, a list of Palestinian 
service providers accessible by geographic location, services provided and contact
information useful to both beneficiaries and service providers. 
Assessment Team Observations
· The database provides a partial list of non-CPSP psychosocial providers. However, the
listings are limited to organizations that responded to the request for information. [v63]
· At the grass roots level, CPSP staff and partners continue to rely on personal contacts and 
word-of-mouth for information on psychosocial operations, program capacity, and the
geographical areas in which they provide services. 
· According to the NPA, a vendor was hired to program the system per their specifications but 
has yet to meet deadlines or perform the needed services. NPA is continuing to address these 
difficulties. 
· The Evaluator was given a series of reports that the MIS system can provide users. These 
reports appeared useful not only to psychosocial organizations but in some cases would be
useful to university students, field providers, as well as beneficiaries and mental health
providers looking for organizations that provide specific services in specific geographical
locations. 
B.6. CPSP Support Component: Research
Objective
The CPSP includes an activity to assess the psychological well-being of Palestinian children
through interviews and surveys under a program implemented by field volunteers. The study
was undertaken to “learn what children have to say about their situation and to understand how
they are dealing with conflict. 
Implementation
In this study, 1,266 children were selected based on age and gender. Sites were selected from 
villages both West Bank and Gaza cities and camps and included areas that had and had not
suffered high levels of conflict in the spring 2002 incursions. Parents of selected children were
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invited to participate, as were teachers in the participating districts. As a result, 449 parents and 
70 teachers participated in the study.
Three surveys were developed for children, parents, and teachers in a focus group held by trained 
field workers. Focus groups were held separately for each group. The questionnaires asked
questions in three separate areas: The first focused on basic issues regarding health, nutrition,
service availability, educational practice, housing, and information and type of traumatic
experiences that had been faced within the prior year. The second section focused on the
respondents’ understanding of the situation, their feelings and beliefs. The third section focused
on factors within the respondents’ lives that they perceived to be protective, including the
availability of social support networks and the importance of maintaining routine in their lives.
Achievements
The publication of the Psychosocial Assessment of Palestinian Children, documents the
significant strain faced by Palestinian children. as well as their resilience and their focus on
(Background Document, CPSP). The publication included valuable recommendations to
continue programs that enhance a child’s positive outlook, support for parents, educators, and
educational institutions. 
Assessment Team Observations
The scientific research included in the publication verifies and quantifies the existence of trauma
and provides a basis for interventions to address the psychosocial trauma of war. The report
appeared to be well received among program implementers. There was broad support for the 
view that Palestinian children are victims. The report validates concerns about the impact of war 
on Palestinian children. 
B.7. CPSP Support Component: Support to Psychosocial Coordinating Body (PCB)
Objective
The PCB was initiated by the NPA to promote a comprehensive and coordinated national
program for psychosocial support services in West Bank and Gaza. The goal was to catalyze and 
help manage the work of stakeholders in the field
Implementation
The PCB is a coordinating body. Membership has evolved over time in response to complaints 
from various sectors. Membership currently consists of three Ministries, and one representative 
from the Palestinian NGOs, Save representing all international NGOs, UNICEF representing all
UN organizations, CIDA representing all donors, and NPA. 
When the second Intifada reached a higher level of intensity the PCB’s priorities changed to
address the imminent emergency crisis. The PCB became known as the Emergency Committee
(EC). The three main goals of the EC were to (1) document the availability of service using the 
MIS by compiling information on service providers and emergency contact information; (2) 
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conduct and support research on psychosocial needs of children; and (3) compile research on
children from the NPA service providers, and PNGOs.
Achievements
The PCB sponsored a Conference in September 2003, resulting in recommendations for
programs and research:
a. The conference showed the importance of in-depth research on the psychosocial needs 
of children, one of the three goals of the emergency plan.
b. It proposed ideas on legislation regarding mental health policies in Palestine; one of
these proposals was adopted from work submitted by a CPSP sub-grantee.
c. It strengthened the role of the Psychosocial Coordination Body.
· Publication of research authored by NPA’s Dr. Cairo Arafat, and published by USAID
and Save in July 2003, titled Psychosocial Assessment of Palestinian Children, partially 
achieved the second goal of the emergency committee. This publication identified needs, 
and provided scientific research to support the existence of trauma in Palestinian children
resulting from the Palestinian conflict. Findings provide a basis to continue to implement 
projects, like CPSP, in the region.
Assessment Team Observations
· The PCB is critical for knowledge-sharing and lessons learned, for the CPSP and similar 
programs. Even though various barriers initially crippled the PCB, the conference
brought all parties together, demonstrated the significance of scientific research, and
presented various proposals on legislative policy.
· Compiling the list of organizations and the emergency contact information is critical to
coordination among the service providers. Such a comprehensive list never existed until
NPA and Save staff physically made repeated trips to each of the various regions and
documented the information.
· Different sources provided conflicting information to the Evaluator on the relationship
between the PCB and the EC. While some reported that they were one and the same 
organization; others insisted that the EC was a separate organization that was formed for 
a purpose and now dissolved.
· Some Palestinian NGOs and their members raised over and over again the concern that 
there was an over-representation of government as well as international organizations 
(UN and donor organizations) on the PCB in comparison to the local Palestinian
organizations that have been active in the communities for decades. These local NGOs
said they felt marginalized, especially with millions of dollars in funding for programs. 
Palestinian NGOs enjoy a long term presence in communities with and without funding 
and to be unable to fully participate at this point was not appropriate. It can be debated 
that since the committee exists for the goal of effective coordination, it would be logical
that all players in the field of psychosocial work should be included. 
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C. EFFECTIVENESS OF PROGRAM MANAGEMENT
Save has demonstrated foresight, adaptability, leadership and responsiveness in managing the
CPSP. Save quickly anticipated increased needs following the second Intifada in Spring 2002 
and developed the Level II program to address the increasing needs. Save adapts the program as 
necessary, including revising the Ten Messages in response to changing environments. 
Likewise, Save changed the organizational structure of the CPSP in response to complaints from
NGOs about the requirement that they report to both Save and the NPA. Save successfully
brokers the relationship between the NGOs and the NPA, and is responsive to the concerns of
sub-grantees. 
Save enjoys several management successes in implementing the CPSP, particularly its
negotiations government offices. Save administration succeeded in persuading the Gaza MoE to 
allow counselors from partner organizations to assist MoE counselors to implement the CBI
program in schools during school hours. In addition, MoE Gaza agreed to allow partner
organizations in their schools through the end of the academic year, instead of December of
2003. The Gaza Ministry had requested that the CBI program be implemented after school
hours, as of January 2004 so school counselors would qualify for stipends from Save. 
Convincing the Ministry to agree to the new terms was a great accomplishment in light of serious 
threats to discontinue counselor visits from partner organizations in December. Carrying out the 
MoE Gaza threats would have eliminated Save’s contact with school children. 
Save did not coordinate the efforts of among the sub-grantees. When an important Level I
training session was cancelled due to curfews, one of the regions held its own training, providing 
an excellent example of how the regions could took the initiative in the absence of directions. In 
addition, Save declined to share the data of the Level I training. Save’s failure to delegate to the 
regions sometimes caused work delays and resulted in the underutilization of regional managers
who were available to work.
Achievements
· CPSP is successfully managed, with appropriate and effective implementation in a
dangerous and fluid environment. The selection and management of the nine Palestinian
NGOs is especially noteworthy. 
· Save successfully negotiated with the Gaza MoE a resolution to the impasse over the
availability of CPSP in the schools. 
· The Ministry of Education West Bank has embraced CPSP and included it in its
counseling curriculum. CPSP operations are no longer dependent upon donor funding. 
At this time, the MoE is seeking increased collaboration with Save and NGOs to ensure a 
reserve of volunteers to support counselor-led programs. Sustainability is more
problematic in Gaza, where the CPSP is denied access to schoolchildren. 
· The initial goal of the CPSP project was to deliver preventative psychosocial messages to 
the community. The program evolved into a more intensive intervention as a result of
heightened security threats.
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· Save adapted the program in response to changing beneficiary needs. The Ten Messages 
incorporated “fear” and “worry,” into a lesson that one of which was direct enough to 
advise children to seek safety when they were away from home when a bomb hits. This 
is a very important message that counters what older people do: run toward the bombing 
site to help the injured.
· Save has a strong performance standard on financial management. Very strict rules
govern its expenditures. Some of the sub-grantees welcomed about the structure that
these rules brought to their institutions, while others - especially large organizations -
were restricted by rules. 
Assessment Team Observations
· Save’s decision to continue to manage the project from its central location in the face of 
restrictions on travel has hurt the CPSP project in several aspects. Yielding partial 
control to the regional offices would facilitate the efficiency and work progress in the 
offices and release the regions from long waits for field visits or approvals from NPA and 
Save’s central office. Guidance from the central office will always be sought, and their 
support and presence welcomed.
· One of the most debilitating barriers to this project has been the restriction of movement 
imposed on all residents of West Bank and Gaza. As a result, meetings among the 
partners were not held and some training sessions were cancelled. This problem is 
largely insurmountable without delegating more authority to the Save regional offices.
· The role of the NPA is poorly defined, which resulted in double reporting for the sub￾grantees. However, Save was responsive to complaints from the field and the procedures 
were changed accordingly.
· Data collection and entry for Level I pre-post evaluation model is complete. Save would 
like the data analyzed before it is distributed to the partners, but most sub-grantees do not 
want to wait to see how their children have fared. This withholding of raw numbers has 
generated ill feeling among sub-grantees. 
· The implementing partners stated that they are only able to 
satisfy a fraction of the demand for psychosocial support
services. In some cases, training did not evolve with
increased demands. Manpower shortages also hampered 
efforts to reach more affected populations. While this
condition could be attributable to travel restrictions, it could
alternately be a case of resource allocation. 
· To sustain the progress made under the Level I program Save should not have 
discontinued the Level I activities when it sought funds for the Level II program. The 
grant proposal should have allowed for both programs to run in parallel as each program 
Three sub-grantees 
operating in Gaza 
report they do not
meet 2% percent of 
Gaza’s needs. 
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reinforces the gains made by the other. For long-term changes it is imperative to 
continue psychosocial support at multiple levels
· Save is serious about monitoring and evaluation. The impact of the Level I intervention
was evaluated by a pre-post model where all children completed a survey with their Level 
I counselors that asked them questions about themselves, their schools, their families, and 
the nature of their relationships and attitude towards incidents and people in their
environment. After the Level I intervention ended, children were asked to complete an
identical survey in order to measure progress made by the child.
Since intervention is ongoing, the Level II impact study is only in its preparatory state. 
Save has contracted to conduct a randomized study of 800 students, 400 control and 400 
others who will receive the CBI intervention. Students will be interviewed before and
after the CBI intervention to determine any effects the CBI may have had. The presence 
of a control group will enable Save to attribute any significant changes in the responses 
of the CBI group to the intervention. This is a step forward from the Level I study where 
such a conclusion could not be drawn. In addition, a director of one of the Gaza partners 
hopes to publish an evaluation of the work of the partners. 
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The Community Psychosocial Support Program is an important intervention on behalf of
Palestinian children, and provides tools and skills to help children cope with the stress and
destabilization of living in conflict. Save has developed and implemented a thoughtful and
responsive program that is well managed and sustainable. The following recommendations are
intended to strengthen and expand the CPSP:
Appropriateness of the Program
· Expand psychosocial services to parents, as requested by parents. Parents are both 
victims and caregivers, and widely embrace strategies to improve the psychological
health and development of their children. Strategies particularly targeting caregivers
would enhance the ability of the Palestinian people to withstand the impact of the
insurgency. 
· Develop and provide booster sessions for program participants. Booster sessions built on 
the initial CBI program must be continued at periodic intervals beyond the 15 sessions. 
Prevention research has shown that the initial effects of a prevention program can be
enhanced and maintained over the long term only if booster sessions are provided.
· Invest in self-sustaining community-based activities for children that enable community
centers participating in CPSP to remain open and provide outlets for Palestinian children. 
Special spaces - including permanent camps run by the MoY, multi-purpose rooms, and 
sports fields - could be used to conduct CBI classes. 
· The mass media campaign should continue producing and distributing communication
products. The use of TV spots, radio, community events, town meetings, and group 
sessions should be expanded, since using several different channels of communication
increases the likelihood of reaching more of the intended audiences. It also can increase 
repetition of the message, improving the chance that intended audiences will be exposed 
to it often enough to absorb and act upon it. For these reasons, a combination of channels 
has been found most effective in producing desired results, including behavior change. 
· It is important that the BCC and media campaign be expanded and sustained over the
long term. Mass media campaigns are a proven communication tool. Campaigns have 
been conducted on topics ranging from general health to specific diseases, from
prevention to treatment. Overall, research has demonstrated the effectiveness of mass
media campaigns. However, behavior change is usually associated with long-term, 
multiple-intervention campaigns rather than with one-time communication-only 
programs.
IV. RECOMMENDATIONS
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· Start a media campaign to raise awareness of MIS among partners and psychosocial
providers. One idea is to send a leaflet informing partners again of the type of reports 
that are available through the MIS system. Include step-by-step instructions how to get 
to access sample reports, in the event some users are unfamiliar with the Internet. 
· Establish a website for counselors to access information and share best practices.
· Establish a means for sub-grantees and partners to communicate at the administrator’s 
level. Perhaps Save could utilize the MIS bulletin facility that already exists on the NPA
site for that purpose. 
· Key to enhancing the usefulness of the database is to make it an interactive tool that can
be used by participating agencies to input data and facilitate data analysis; to ascertain
regional program needs as well as the extent of geographic coverage. 
Effectiveness of Program Implementation
· Expand program beyond current providers and implementers in order to increase pool of 
beneficiaries. Currently, CPSP tools and training are limited. CBI kits, training manuals, 
and outreach communication materials should be made available to nurses, seamstresses, 
and market women – particularly so in light of curfews and restrictions on travel. 
· The CBI should be implemented in the community, especially in areas where schools are 
frequently closed. The CBI appears to be a successful program in the schools in which it 
has been implemented but there are areas where the schools are often closed or at times 
inaccessible due to curfews and closures. Implementing the CBI in community centers 
would expand its coverage and benefit adults as well. 
· Space requirements for implementing CBI should be eliminated so that the activities can 
take place, for example in the refugee camps, and in clinics – wherever children are 
found. To do so would also reduce the pressure upon counselors to increase program 
participation.
· Provide in-kind payments/incentives for CBI counselors. Currently MoE counselors do
not receive additional salary for adding CBI sessions to their normal workloads, yet they
work alongside CBI partners whose counselors are paid to implement the CBI. 
· Teachers should set aside an hour each week to discuss psychosocial topics with children. 
Likewise, some CBI program components should be integrated into health and humanity
studies. 
· Individualized intensive psychosocial services and referrals to mental health programs
need to be strengthened within the CPSP program. These services are for children who 
have not experienced reduction in their symptoms or who are unable to sustain gains after 
completion of the Ten Messages and CBI program. These are children who are
especially in danger of developing conduct or other behavioral disorders. They are
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children who one would address through indicated interventions using the IOM
classification system.
· Disparity in the background of trainees often reduces the attractiveness of training
programs for highly knowledgeable and experienced individuals. Use these professionals
for the program’s advantage by asking them to deliver or lead part of the training
sessions. 
· Incorporate the experiences of trainers for Level I trainings. Develop TOT manuals for 
Level I. Compile the activities that trainers say worked best for them. Expand existing
Activities Manual using information from counselors who worked in the field. 
Document what worked, with which group of beneficiaries and the barriers they could
overcome and how they overcame them. 
· Post all training and activity manuals on site. Keep them updated with new ideas that
counselors send in. This would keep the counselors alert to changes and new ideas.
Share this manual with other stakeholders. 
Management by the Implementing Partner
· Save should increase delegation of authority to regional centers in order to provide
program continuity during unscheduled interruptions. Managing from the center must
continue, but delegating authority on functional matters must go to the regions to
facilitate the efficiency and work progress in these regions. Only in that sense did Save 
not utilize its human and material resources in its 5 regional offices to overcome the
restrictions on movement. 
· Save must work to increase the autonomy of PNGOs under the CPSP. In several cases, 
concern was expressed about lack of PNGO representation in coordinating bodies.
PNGOs expressed a desire to play more participatory roles in decision-making and
coordination activities. 
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ANNEXES
 A. Preliminary/Tentative In-Country Assessment Schedule
B. Assessment Review Tool
 C. Interviews Conducted
 D. Sites Visited
 E. List of Key Documents Available to Assessment Team
F. The “Ten Messages”
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Annex A
Week 1:
Saturday, October. 11 Arrival in Jerusalem
Sunday, October 12 Free
Monday, October 13 Meeting with Save and NPA
8:00-8:45 Introduction to Save the Children
8:45-12:00 Introduction to CPSP Program
12:00-13:00 Lunch
13:00-16:00 Meeting with the NPA Secretariat. General overview of the 
psychosocial support field in WBG; role of the NPA in 
general and within CPSP in particular.
16:15 Return to Hotel 
Tuesday, Oct. 14 Meetings in Ramallah
8:00-9:30 Meeting with Veerle Coignez, CTO, American Colony
10:30-11:30 Meetings with the MOYS. 
Focus on: CPSP and Summer Camps.
11:30-12:30 Meeting with MOYS. 
Focus on: Relevance of CBI for MOYS
12:30-13:00 Lunch at NPA
13:00-16:30 Meeting with the NPA Secretariat.
Focus on: MIS
Also on: Psychosocial Coordination Body, Mental Health 
Conference Outcomes Psychosocial Assessment.
17:00 Return to Hotel
Wed., October 15 Meetings and Site Visits in Ramallah
CPSP Mid-Term Assessment -
 Tentative Meeting Schedule
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8:30-10:00 Meeting with MOW
Focus on: CBI
10:30-11:30 Meeting with the MOH
Focus on: Role of MOH in psychosocial projects & CPSP 
coordination with MOH.
11:30-12:30 Lunch
13:00-14:30 Meetings with Palestinian Working Women Society 
(PWWSD)
Focus on: PWWSD primary support grant project form 
headquarter viewpoint).
15:00-16:30 Meeting with PRCS
Focus on: PRCS primary support grant project (from 
headquarters viewpoint). 
Thursday, Oct. 16 Meetings and site visits in North West Bank
7:00 Drive up to Jenin (back-up plan: Nablus or Tulkarem)
Morning Visit to CBI section
Meeting with school director and counselors
Meeting with YMCA staff
Afternoon Meeting with ECRC (back-up: Al-Lod in Nablus or PWWS 
in Tulkarem).
Focus on primary grant program.
Friday, Oct. 17 Meetings in Jerusalem 
Meeting with WHO
Meeting with UNRWA
Meeting UNICEF
Saturday, Oct. 18 Free
Saturday, Oct. 19 Meetings and Site Visits in Gaza
7:00 Departure to Gaza
Morning Meeting with CPSP coordinator to discuss CPSP 
implementation in Gaza.
Site visit to CBI Implementation (e.g., Beit Hanoun) 
Meeting with school director, school counselor, children.
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Afternoon Meeting with three implementing partners CTCMC and 
PCHRD and El Hanan. 
Focus: Discussion on CBI project
Focus: Primary Support Program
Week II
Mon, October 20 Meetings with Site Visits in Gaza
Meetings with MOE, MOYS, MOH, UNRWA
Tuesday, October 21 YMCA Beit Sahour and CBI
Morning Site visit to CBI school (meeting with school director a 
school counselor and children.)
Afternoon Meeting with YMCA staff involved in CBI 
implementation; evaluation of what has been done so far 
and next steps.
Wed, Oct. 22 Field Visit to South (Hebron)
Morning Meeting with PRCS and target groups of PRCS primary 
support program.
Afternoon Meeting with YMCA
Thu, Oct. 23 Site visits to Al-Quds
Morning Meeting with Al Quds, Abu Dies
Afternoon Meeting with Jumana Awdi, CBI, M&E project coordinator
Fri, Oct 24 Debriefing
8:30-10:30 Briefing to USAID/HHA
12:00-14:00 Briefing to Save the Children
Sat, Oct. 25 Departure to the United States.
Week III:
1 Week Later Draft Report, to be submitted within 5 working days from 
departure from Tel Aviv
1 Week Later Final Report to be submitted within 5 working days from 
USAID feedback from Draft Report.
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Annex B
Assessment Review Tool
Date of Interview:
Name of Agency:
Name of Person being interviewed:
Position Title:
PART 1 NGO’s:
I. Program Implementation
What is the geographic area that you serve?
 Central West Bank
 Northern West Bank
 Southern West Bank
 Gaza Strip
 All of the above
Briefly describe the types of services your agency is delivering under the CPSP grant.
How many and what kind of staff members and volunteers are assigned to the CPSP?
PROGRAM COMPONENTS
A. Primary Psychosocial Support Program (the 10 messages)
How did your agency take part in the development of the ten key messages? Is there consensus 
on the value of the messages?
How easily did you incorporate the 10 key messages into you ongoing program activities? 
How accepting are the parent and caregivers of the ten messages? 
What effects, if any, does (this CPSP program) appear to have on the children? 
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What effects, if any, does (this CPSP program) appear to have on the family members’ and 
caregivers ability to emotionally support their children?
B. Secondary Support Program (CBI)
What is your agency’s role in implementing the Classroom-Based Intervention? 
Do the schools have all the necessary program kits, parachute, programs materials, supplies and 
facilities to carry out the program? 
 Yes  No If no, what is needed?
How would you rate the training you and your staff received to implement the CBI in the 
classroom? 
 Excellent
 Very Good
 Good
 Fair
 Poor
Did the training distinguish techniques for younger and older children?  Yes  No
Did you or your staff believe you were confident to implement this program in your classroom? 
Did the training prepare you to modify your technique to fit your students’ particular needs?  
Yes  No
Are you experiencing problems implementing the CBI? If yes, What are they?
Do you have any suggestions as to what services or programs should follow after the CBI is 
implemented in all the schools? 
What other programs do you think are necessary to complement a project like CBI? 
II. Program-related Training
Did you receive any CPSP-related training from Save or NPA?  Yes  No
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Describe the training your organization received.
Did your staff receive the training before the program was implemented?  Yes  No
Was the training relevant to the CPSP program you are implementing?  Yes  No
Was it sufficient to carry out the program?  Yes  No
IF NOT, What other training would you have liked to receive? 
III. Program Evaluation 
Did Save or NPA provide your organization with clear criteria for you to measure the success of 
the psychosocial support activities? 
 Yes  No
If so, What instructions did you receive?
Has Save/NPA provided you and the other sub-grantees/partners with common data collection 
forms? 
How often are you to expected to report this data to Save or NPA?
Are the evaluation findings clearly reported back to you?
What other support did you receive Save of NPA to evaluate the program? How useful was it?
VI. Project Management (administrative relationship with Save)
Do you know the Save psychosocial coordinator who serves your program? How often does 
he/she visit your program? 
What barriers or problems have you encountered in implementing your program? 
What assistance have you received from the psychosocial coordinator, technical consultants 
and/or other Save staff in resolving these problems? 
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How do you submit the required information for the quarterly reports?
Has the reporting requirements been burdensome?
Do you receive helpful comments quarterly progress reports?
What do you like best about your relationship with Save?
What do you like least? 
V. Program Coordination
How often do you meet with the other sub-grantees under the CPSP program? What difficulties 
have you encountered in meeting together as a group?
Do you have a formalized system to network or exchange ideas with the other sub-grantees? 
What kinds of information do you share and how?
Have you used the MIS?
VI. Administrative Training and Support
What type of training has your administrative, financial and management staff received to 
monitor the CPSP program? 
How would you rate the quality of this training in terms of helping you implement your 
program? 
What kind of guidance on USAID rules and regulations have you been provided from Save?
Has this guidance been helpful to you?
How does Save monitor your expenditure of funds under this program?
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Have you received your funds on a timely basis?
PART 2 MAIN STAKEHOLDERS
I. Program Implementation
How did you come involved with the CPSP program? 
Does the CPSP help you in accomplishing your agency’s mission? 
Are the demands of the CPSP taking resources and time from your other responsibilities?
Are there services that should be dropped or added to the CPSP under its current resources?
Do the sub-grantees/partners have sufficient resources, financial, manpower and facilities, to care 
out their program activities? 
What are the psychosocial needs that were not being met by the Palestinian care system that the 
CPSP is addressing? 
What would you change to make to improve the CPSP?
How would you describe your relationship with Save and/or NPA? 
How would you describe the relationship of Save and the NPA?
PROGRAM COMPONENTS
A. Psychosocial Coordination Body
Are you an active member of the NPCB?  Yes  No
What role did Save/CPSP play in organizing the NPCB AND what continuing role does it play? 
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What role did NPA play? What continuing role does it play?
How useful is the NPCB in coordinating the delivery of psychosocial activities to the maximum 
benefit of the Palestinian people?
Do you see the NPCB continuing its efforts if and when the CPSP program is ended? 
B. Psychosocial Database 
An attempt has been made to establish a national psychosocial database. How useful would 
such a database be in helping you accomplish your agency mission?
Where do you think the database should be located? Would this allow you with easy access to 
the data?
How would you anticipate using this data? 
C. Psychosocial Outreach Activities
What was the impact of cancellation of the outreach campaign? 
Do you think the outreach campaign should be reconstituted and launched again? 
Should it contain a behavior change communication component that will continue to promote 
good child rearing, good teaching practices and safe living practices among children?
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Annex C
Interviews Conducted
USAID 
Veerle Coignez CPSP CTO
Save the Children
Jonathan Hodgdon Field Office Director
Ibrahim Masri Psychosocial Project Manager
Paul Thomas Assistant Project Manager, Psychosocial,
Jameel Abu El-A’ta Regional Manager
Wafa Regional Manager, South Gaza 
Government Offices 
Nabil Atallah MOYS, Director, Children’s Division (8-12 years old)
Ibrahim Abu El-Sheim MOYS, Director, Youth Division (12-18 years old)
Ruba Timhawi MOYS, Director, International Relations
Dr. Ahmad El-Yazji MOYS, Deputy Minister of Youth and Sports 
Mousaa MOYS, Director of Counseling Division
Ahmad Awad MOE, Gaza, Director, School Counseling
Abdullah Mune’m MOE, Gaza, Deputy Minister of Education
Zeinab El-Wazeer MOE, Gaza, Assistant Deputy Minister of Education
I’tidal Mua’mar MOE, Bethlehem, Counseling Officer
Bashar Nabulsi MOE, WB, Center for Counseling
Dr. Bassam El-Ashab MOH, WB, Director of the Center for Mental Health
Dr. Assa’d Rimlawi MOH, WB, Deputy Director General, Primary Health
MOH, Gaza, Director of Counseling 
Partners, Sub-grantees and NGOs
Cario Arafat NPA, Director
Nariman Naji NPA, Psychologist/Media Specialist
Mahar NPA, Computer Specialist
Shadi NPA, Psychologist
Nader Abu A’msha YMCA, CPSP Project Director
Nidal Abu Zuluf YMCA, CPSP Project Coordinator
Mona Zahrout YMCA, Counseling Officer
Shurunk, Aminah, Ibrahim YMCA-Nablus, Counselors/Trainers
Mustafa YMCA-Nablus, Director
Dr. Jumana Awdeh Happy Child Center, Center Director
Jazeel Awas Happy Child Center, Clinical Psychologist 
Reem Ziad PWWS, Public Relations
Itedal Al Jarery PWWS; Director
Dr. Najah Manasra Al-Quds University, Coordinator
Waleed Al-Salhi and Staff Al-Lod Society, Director
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Donors and Other International Organizations
Bradley Brickham WHO, Mental Health Project Officer
Rajia Abu Sway WHO, Assistant Mental Health Project
Lamis El-A’lami UNRW, Chief Field Education Program
Waheed Gibran UNRWA, Director, Center Educational Development
Nasser Mattar UNRWA, Director of Counseling
Other Health Stakeholders
Im Kifah and Sumoud Beneficiary (family lost a son)
Children’s Group Palestinian Red Cross 
Jamal Hmeid Al Tasamuh School, Principal 
Nahla Abu Roumyeh Girls’ School Gaza
Dr. Robert Macy Exec. Director, The Center for Trauma Psychology, Boston 
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Annex D
Sites Visited
1. Jerusalem
Save the Children (Save)
2. Gaza
Ministry of Youth and Sports
Community Center
Save the Children
Girl’s School in Gaza
El Hanan Benevolent Association
Palestinian Center for Health
Community Training Center
3. Bethlehem
YMCA-Main Office
Al Tasamuh School
Ministry of Education
4. Hebron
Family/Beneficiary
Palestinian Red Crescent 
5. Ramallah
National Plan of Action
Save the Children
6. Nablus
Boy’s School in Nablus
YMCA-Nablus
Al-Lod University
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Annex E
List of Key Documents Available to Assessment Team
1. Publication in English and Arabic: Psychosocial Assessment of Palestinian Children, July 
2003
2. The children’s Journal Farha, copies of the eight issues, as produced and published by Al￾Lod Charitable Society, a Sub-grantee in Nablus.
3. An activities manual for Level 1 Intervention Activities (Ten Messages) Prepared by the 
Three Save the Children Partners in the Gaza Strip District.
4. The “Sub-grantee Working Framework” that defines the staffing level, activities, 
locations, and budget appropriated to each of the 8 partners involved in the Level 1. 
5. A paper describing the Roles and Responsibilities of the Psychosocial Coordination.
6. Charts enumerating the number of Public, Camp, and Private schools in West Bank and 
Gaza during Academic Year 2002-03 and the corresponding number of trained 
counselors, kits distributed, and CBI rooms furnished by region.
7. Chart reflecting the number of community associations currently implementing CBI.
8. The CPSP calendar and the Ten messages Poster produced by NPA.
9. The CPSP Children’s Workbook
10. The CPSP Teacher’s Agenda
11. A theoretical framework of the ten messages, prepared by the Community Training 
Center and Crisis Management, with various techniques that teachers and parents can use 
to deliver these messages to children.
12. A report the Palestinian Center for Helping Resolve Community Disputes on the CBI 
session conducted between 3/23/03 – 5/1/03. The report includes quotes from student 
participants, pictures of activities, and some work the children produced.
13. Study materials including questionnaires, prepared by Dr. Vivian Khamis who will be 
evaluating the CBI intervention program.
14. Improving Children’s well-Being Now to Ensure a Better Future Tomorrow, a booklet 
published in preparation for the conference: “The National Workshop on 
Psychosocial/Mental Health Well-Being of Children and Their Families” that was 
coordinated by NPA under the auspices of the Psychosocial Coordinating Body. 
15. Summaries papers and recommendations of the conference “The National Workshop on 
Psychosocial/Mental Health Well-Being of Children and Their Families” that was 
coordinated by NPA under the auspices of the Psychosocial Coordinating Body.
16. Report on the number and location of summer camps held by the Ministry of Youth and 
Sports in Gaza by location, Summer 2003.
17. The outcomes of the National Workshop for the Evaluation of Summer Camps, 2000, a 
paper prepared by the National Committee for Summer Camps.
18. The qualifications criteria for Summer Camp Staff, 2003, prepared by the National 
Committee for Summer Camps.
19. The October issue of Massira, a newspaper issued by the Ministry of Education, West 
Bank/Gaza.
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20. All reports that can possibly be produced by the MIS system housed in the NPA offices.
21. Children’s books published by Early Childhood Resource Center a Sub-grantee in 
Ramallah.
22. Publication on Children’s Art in time of war by YMCA, a Sub-grantee in Beit Sahour.
23. Quarterly reports submitted by Save the Children to USAID for the length of the project.
24. Palastenian Code of Conduct for Psychosocial Interventions, a paper prepared by 
UNICEF currently in revision, provided by WHO.
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Annex F
CPSP’s KEY PSYCHOSOCIAL SUPPORT MESSAGES
Children Messages:
1- We are children, we have feelings like you, which we need to express, and we need you to listen to us 
and help us express ourselves.
2- I am a child with many physical, social, and mental needs to grow and develop, and as I get older my 
needs change.
3- We are children, we need to have friends to play with, go to school with, to talk to, and to share 
feelings and thoughts with.
4- I love my school and I do my homework, and I love to play with my friends.
5/1 When I am worried about shooting and fearful situation while at home, I like to be in a safe place 
beside my family.
5/2 When there is shooting while am out, I stay away from danger, and I go to a safe place and ask for 
help.
6. I overcome my fears and worries by doing many activities such as drawing, reading, sports, and 
listening to music. 
7. We children love to enjoy our holidays and weekends with our family and we do many beautiful 
things and activities. 
8. I am a child and I cooperate with my parents in organizing my time between study, amusement, and 
helping at home. 
9 When someone bothers me or when I have a problem, I do not let them harm me, and I try to solve 
my problem, and if I can’t I ask for help.
10 We are children with many skills and abilities, and we can do a lot of things, but sometimes we need 
the help of adults. 
Parents Messages: 
1- Our children need us to listen to them, give them quality time, and encourage them to talk and express 
their feelings (happiness, sadness, fear).
2- As parents we should be aware of children’s different developmental needs- for example, physical, 
mental, and social needs - that change with age. 
3- As parents we should encourage our children to establish new friendships, and be aware of, and 
follow up on, their relations with others. 
4- As parents we should encourage our children to learn, study, go to school, and doing their homework 
and we should establish positive interactive relationships with their teachers. 
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5- In shooting and fearful situations we should provide protection and safety to our children.
6- As parents we should control ourselves in crisis events and portray good role modeling for them, this 
includes allowing children to express their feelings.
7- As parents we should provide a relaxing and happy atmosphere at home, and to participate with our 
children in their activities. 
8- As parents we should help our children in organizing their time and let them participate in helping 
around the house.
9- As parents we should teach our children the appropriate skills to solve their problems and be a good 
role model for them in problem solving situation.
10- As parents we should enhance our children’s existing skills and abilities, 
 and help them develop new skills to do different activities. 
Teachers Messages: 
1- As teachers we should help students to express their feelings and support them in expressing them 
positively. 
2- As teacher we should be aware of the different needs in each phase of children’s development growth 
and treat them according to those needs. 
3- As teachers we should enhance the social relations between students at school. 
4- As teachers we should encourage the students to learn and study. 
5- In shooting we should provide a safe place for students in schools. 
6- As teachers we should control ourselves in crisis situations and to help students express themselves 
and to be a role model for them. 
7- As teachers we should realize the importance of different activities and to provide the possibility to 
implement them. 
8- As teachers we should participate with students in planning and implementing different activities in 
class and school. 
9- As teachers we should teach students the appropriate skills to solve the problems in class and to be a 
good role model for them. 
10- As teachers we should enhance the students existing skills and abilities and to build and develop new 
ones. 
 
i
IOM (Institute of Medicine). (1994) Reducing Risks for Mental Disorders. Washington, DC: National Academy
Press