REGIONAL POST continues its series of interviews on psychological assistance and integration of those affected by the war. We interviewed US Armenian psychotherapist Arpe Asaturian who has extensive professional experience. She is the founder and director of the nonprofit organization Frontline Therapists in Armenia, delivering psychological assistance to soldiers who have had to suffer different psychological traumas.
Interview: Anita Mihaeljana
Apre, why did you decide to create your own organization that provides mental health services instead of joining existing, experienced organizations in Armenia?
During the war, I came to volunteer for a few weeks. Then when I started working, when I started asking questions about how they are doing with mental health here, the more questions I asked, I realized that we have to do something better.
What difficulties did you face when you started?
I am not local. I am young. I don't know what the rules are here. I don't know what the law is. This made it all very challenging to start. There were many problems with basic things.
In the beginning, what helped us when it comes to clients, we were volunteering inside the hospital, so we went to them. The problem with that was, they didn’t understand why we are doing this and why we are doing it for free. The constant question was why are you doing this? Because we have to help. That was kind of hard in the beginning.
We were in the military hospital and you have to get approval to be there. It took time. The doctor had to say yes before I could go into that section. First, it's like teaching the doctor about mental health, teaching what we want to do. Everything was very exhausting.
How big was the organization's team in the beginning and how many people are there now?
When I had the idea to start it, I started with me. I had another therapist who was going to help. Then I met Daria, she is our art therapist. It just kind of started blossoming.
In the beginning, we focused on bringing volunteers from outside to come to Armenia and help, so they could support the local therapists, and help train, add education here. We brought people from different places. Someone came from England, we had another person from America, we had people from Lebanon, Canada. All these different people came and volunteered in different places in the community.
As time went on, the soldiers were being released from the hospital, were going back to the army or home, then we decided to open this office. Last November, we opened this office so that we could invite them here, so that we could start treating them like civilians.
Our team has changed based on what we need. Now we have two therapists, an art therapist, and a social worker. They are staff. We are always open to volunteers joining us. For example, through Birthright, we have many wonderful people who joined us for different periods of time. They bring their knowledge and their background to help us in different things.
You are mainly treating war veterans and their family members?
The focus is war veterans, anyone who participated in the war, any family members of war veterans, as well as any people that were directly impacted, for instance, doctors who treated soldiers. Anyone who works directly with them or was here during the war and has the trauma because of it.
Do you provide assistance only in Yerevan or do you also go to the regions?
Our office is here, but want to make sure that we are accessible to anyone who needs help. We have been invited from different places to come for special training or we go out and do different workshops. We have been to different places, and people from different localities travel to Yerevan to see us. Now we are working on a new project to focus more on border villages. It will start next year.
Have you noticed a change in how actively soldiers are now seeking or willing to receive psychological help, compared to what it was after the war?
What happens with PTSD (Post-Traumatic Stress Disorder) is it affects people in different stages. You could be doing okay, six months later suddenly you are feeling worse. It could change throughout the course of your life.
Right after the war, we worked in a hospital for a long time, about a year. A lot of these guys were still in the hospital getting treatment for their physical health problems, so we kept going to them. As they were finishing their treatments, they were going back to the army or they were being released to go home. It started to become less, because they wanted to go home, move on with their lives, they didn't want to deal with it.
But once they go back to their lives, they see that they still have problems. They can't talk to their parents, they fight all the time with their girlfriends or friends, they can't keep a job, they can't go to school. All these things block them, and everyone around them says that they are different, changed. That's when they start to realize that maybe they need to go back and talk to somebody. It goes through these series. They think they're fine, they think they can handle it because people tell them so. They tell them they will get over it, they just have to go to work, get married. But when real life happens, they are not fine.
Does the organization currently have enough resources or do you need something more?
We definitely need more resources. It is difficult getting donations. We are founded through donations because we are non-profit, we do not make money, we do not charge for any services, we do not charge for any trainings, we do everything for free. We're always looking for donations and support so we can keep doing what we're doing and do more projects and reach more people.
What kind of feedback do you get after the sessions? What are clients saying?
Everyone is always so thankful when we provide them with any type of help. I think one of the biggest changes we see is when we just explain to people what their symptoms are and explain why they're feeling it and where it's coming from. It’s such a relief. We give them that understanding and that helps them calm down their fears and that helps them understand themselves better.
How do you assess the level of preparation of psychology students to provide psychological assistance? During the war, students were recruited to provide assistance.
It is not just about teaching classical theories. It is very important for students to have practice while learning to become therapists. In America, we call it a practicum or an internship. Because while you're studying, no matter how much you read a book, you won't learn it until you actually do it or see it. This is the biggest thing missing in the education system here. They don't have internships. Students don't have that opportunity to be in a setting like this.
They're not going to do the therapy, they're going to watch the therapist do it or how you interact with someone. Then they graduate, they have a diploma, they can go and be a therapist, but then they don't know how to talk to somebody, they don't even know how to say hello. This is very damaging. One, it's hard for them to get a job, obviously. Two, it's very dangerous if you're not prepared to go and do therapy with someone, because you can really hurt that person.
We need to understand that therapists providing mental health support is not like passing out some napkins, that it is very valuable, very difficult work. We have to start elevating what that title means, so we could have better quality of professionals doing that service. If we think that a student could come in and just do therapy, then that's really misleading. It’s reducing what a psychologist really is.
At the moment, a project is being worked on in Armenia, where a psychological service is being developed, which will bring together psychologists, priests and supervisors. They will try to reach all those people who need psychological help in the regions and villages. What do you think about such a project?
During the 2020 war, a lot of the priests were going around to the soldiers to provide them therapy. There is a thing called religious counseling. But you have to be trained in that. In America there are courses where people who are in a church, synagogue or mosque also take counseling courses and learn how to provide religious counseling to their practitioners.
During the 2020 war, they sent a lot of priests to counsel these young men. Those people are not qualified to provide counseling. They could provide spiritual guidance, but not counseling. Again, this reduces what therapy and psychology are. When you put priests in there as counselors, it's automatically going to be about the religion, not about that person and what they're going through. The conversation is about religion.
Religious figures can provide a lot of comfort and can provide a lot of help to people, of course they can. But we have to be careful when we say that they are the ones who will give psychological counseling because it is biased. It's not entirely fair to that person because this conversation won't be about that person, it's going to be about religion.
Since we are already using religious leaders as counselors, we should train them, because they are going to do it anyway. We should provide them with some guidance and ways they can support people.
Your organization is also active on social media. You are trying to raise awareness about mental health in Armenia in different ways. You also organized an event where you talked about suicide prevention.
I think that apart from direct care, public education, public awareness is very important for us. We need to start talking about the problems that exist in our community so that we can — one, understand, two, figure out how to solve it.
Suicides are happening. Talking about it doesn't make it worse because it's already happening.But if we talk about it, we could make it less. We did an event for World Suicide Prevention Day. Last year 191 people committed suicide and that's on record. It's probably more. We held an event, we talked about the suicide rate, we talked about how to talk to someone who is having these thoughts or feelings.
We try to talk about all the taboos, we try to challenge people's ideas, teaching people how to talk to each other. We teach how to talk to soldiers, so that we don't make them feel worse, and how to encourage them to get help. We teach how to talk to soldiers so that they feel that we still care about them, that we haven't forgotten them.
.jpg)
Have you noticed a change in society's attitude towards mental health?
Slowly, very, very slowly, I think it has definitely improved. More people are open to talking about mental health now than before. Especially after the 2020 war, people were more open to getting help and understanding what was going on. I'm glad people are at least more open to talking about it.
What are the future plans for Frontline Therapists?
We have a few different projects for next year. We are going to continue doing individual therapy. We keep having different types of group models, community events. We are going to be working on straightening mental health along the Armenian border, because they have been very much impacted since September. There are also soldiers that are positioned there, and that's why we want to support those communities.