Six year-old David* lives with his mother and his sister in a low-income community in Kingston. On a warm Christmas Eve afternoon David is playing alone in his living room.

Suddenly, the front door bursts open and a tall, lanky man runs in breathlessly. When the intruder sees David, staring confusedly at him, he scoops him up into his arms. In the same instant, a police officer rushes in. He points a gun at the man, an escaped criminal, who is now holding little David hostage. The man holds David in front of his body to deter the police officer from shooting; David is his human shield.

But the plan fails and the shot is fired. The intruder is hit in the head and collapses to the floor, taking terrified David with him. Blood is splattered all over little David’s face and clothes.

Soon after the incident David’s behaviour starts to change. He can’t sleep at night because he is afraid. At school, he is sad, withdrawn and can’t concentrate. David is experiencing some of the symptoms of post-traumatic stress disorder.

There are many children in Jamaica, like David, who have witnessed violence in their home or community. But after the blood is washed away and the police reports are filed, the effect on the child’s mental state is often forgotten.

Fortunately, David’s teacher recognised the changes in his behaviour and referred him to the Violence Prevention Clinic located at the University of the West Indies’ Mona campus.

The Violence Prevention Clinic has been helping children like David since 1996. Dr Claudette Crawford-Brown, a lecturer in Social Work at the UWI, started the clinic as an outreach project of the Department of Sociology, Psychology and Social Work. It is as a part of the Centre for Population, Community and Social Change in the Faculty of Social Science.

The primary objective of the clinic is to prevent/reduce violence by intervening with children and families who are affected by violence in different forms. The rationale is that early intervention may prevent maladaptive behaviour that could lead to further violence later. Therefore children and adults who are victims of violence are helped to deal with grief, mourning and loss, as well as issues of abandonment and trauma. The clinic also deals with children who are perpetrators of violence or who are at risk for being involved in violent activities. Children have to be accompanied and referred by professionals in the education, social service or mental health system.

The counsellors at the clinic assessed David’s condition using art and play therapy. This helps him to express his feelings on his own terms, since he does not feel like talking.

The pictures David draws are not pretty. His first is a picture of him hiding under his bed and screaming “Don’t Shoot!” In the second, a man fires a gun and a dead body lies on the ground. In play therapy, David chases the other children around the clinic with a gun depicting his experience.

After coming to therapy sessions at the clinic every Tuesday for four months, the rambunctious little boy his family once knew is coming back. David is once again playing with other children at school, doing his schoolwork and is able to sleep through the night. Because David and his family received regular counselling at the Violence Prevention Clinic he was able to heal by sharing and expressing his feelings about his trauma.

There are thousands of children, like David, who require the kind of counselling the Violence Prevention Clinic offers.

“The clinic has the potential to extend its services to more children but is restricted by its lack of counselling tools. We can’t see as many young children as we would like to because we don’t have enough local puppets and therapeutic story-books,” says Dr Crawford-Brown. “This problem never affected so many young children before, so we are not prepared to deal with this new phenomenon.”

The clinic is part of a comprehensive programme whose scope is much wider than treating individual cases. The counsellors try to equip teachers, guidance counsellors and social workers with the tools they need to help the children affected by violence in their classrooms and communities.

The Violence Prevention Programme receives numerous requests from communities and schools to conduct training on how to implement effective interventions with traumatised children. However, because the programme has only a limited number of rudimentary training manuals, most of these requests cannot be fulfilled.

“There is a need for culturally relevant training material that can be easily replicated and disseminated by the programme in regional workshops across the island,” says Dr Crawford-Brown.