By Beth Toomey, MSW, RSW-Clinical Specialist

When watching the news is not enough

In October 2023, like many around the world, I watched the escalating violence in Gaza with shock and incomprehension. As a trauma therapist, I also carried a professional awareness: conflict brings more than physical devastation—it inflicts lasting psychological wounds. Gaza stands at the heart of the Palestinian struggle, and once again its people were engulfed in the disorienting fog of trauma. At the time, the war felt very far away, and I could not see how a rural Nova Scotian social worker might offer meaningful assistance.

In late winter 2024, a colleague contacted me about Healing for Gaza (HFG), a charitable, non-profit initiative fiscally sponsored by HEAL Palestine, a registered U.S. 501(c)(3) organization. HFG was founded in January 2024 as a non-political, non-religious emergency mental health initiative designed to provide accessible, evidence-based, culturally responsive, and trauma-informed psychotherapy for Palestinians affected by displacement, fear, and trauma.

Since its inception, HFG has delivered more than 1,500 psychotherapy sessions to children, parents, and frontline workers. What initially began as a handful of individuals has evolved into a global network of over 120 psychotherapists, psychologists, psychiatrists, interpreters, clinical coordinators, advisors, and volunteers responding to what international health organizations describe as an unprecedented mental health crisis. Patients are referred either through partner NGOs on the ground or can sign up directly through an online link shared via social media platforms such as Instagram.

When I was invited to apply, I gave the decision careful thought, contemplating the challenges of such a complex situation. Palestinians were living without reliable access to food, water, basic infrastructure, and health services. The need for trauma care was urgent, the scale of the emergency unprecedented. Despite the unknowns, I felt compelled to contribute. Over time, the experience has proven deeply positive—broadening my perspective and allowing me to learn and benefit alongside those I have supported.

Since joining HFG, I have received intensive training in cultural competence and in providing remote support in war zones. I have participated in regular supervision with international colleagues and conducted weekly sessions with clients. The work has been a steady reminder of how essential mental health care is for people living in crisis. There is no “post-trauma” in this context.

HFG is a structured and well-organized initiative, with patient safety at its core. Monthly supervision sessions bring together clinicians from around the globe to share expertise. Clinical coordinators, who serve as the first point of contact, play a vital role in matching clients with clinicians and interpreters, safeguarding confidentiality, and ensuring that therapy continues even amid bombardments, blackouts, and displacement.

For those of us providing care, the work extends beyond clinical intervention—it involves bearing witness to extraordinary suffering, grief, and loss, as well as to the resilience and courage that persist in the midst of soul-crushing devastation. To do this work, therapists must be able to both witness and hold space for unspeakable pain without being consumed by it. HFG leadership, under the direction of Dr. Alexandra Chen (founder & executive director), ensures that its clinicians and interpreters have the professional support, supervision, and internal resources necessary to accompany patients week after week through such profound encounters.

Clinical social work as an act of hope

Over the last 16 months, I have delivered regular psychotherapy sessions to Palestinians displaced to Egypt. They include students working to complete high school and transitioning into university, adults rebuilding their lives, and frontliners evacuated for life-saving medical care whose families remain trapped in Gaza. Arabic is their first language, and this has been my first experience delivering trauma therapy through a translator. Initially, I wondered whether clinical and relational depth could emerge in a three-person virtual setting across two languages.

What makes this possible are HFG’s bilingual connectors—clinically trained interpreters fluent in both Arabic and English—who enable non-Arabic-speaking clinicians and Palestinian clients to communicate fluidly, each in their own language, without losing the intimacy or immediacy of the therapeutic exchange. Unlike in many humanitarian contexts where interpreters rotate frequently, HFG assigns interpreters long-term to a specific clinician–patient pairing.

What surprised and encouraged me was how naturally a safe, collaborative therapeutic container evolved. Over time, trust has grown, communication has become fluid, and the interpreters became an integral part of the therapeutic alliance.

My clients experience a variety of trauma-based symptoms—but they also show remarkable resilience and insight. As a certified EMDR therapist and consultant, as well as a practitioner of Somatic Experiencing, I use an integrated, evidence-based framework. EMDR in particular has demonstrated measurable effectiveness in reducing trauma symptoms, even in this cross-linguistic, virtual context. With careful pacing and cultural attunement, relief is possible. These individuals are reclaiming agency and rebuilding their lives—even in the midst of genocide.

This experience reaffirms what I have long believed: clinical social work is a powerful tool for advancing both healing and social justice. It addresses not only psychological symptoms but also the systemic and collective wounds that shape human suffering. In our clinical social work practice, we can affirm both dignity and the right to heal.

Healing for Gaza marked its first anniversary in July 2025. Since its work began, the organization has provided clinical care to approximately 150 patients and has now delivered more than 1,500 psychotherapy sessions. A similar number of patients are still waiting to begin therapy as the humanitarian crisis deepens.

HFG continues to accept applications from qualified mental health practitioners who wish to support Palestinian children, adults, and frontliners in need. For those considering it, I can say that being part of HFG has been both professionally enriching and personally meaningful—an opportunity to make a tangible difference in people’s lives.

Beth Toomey, MSW, RSW-Clinical Specialist, is the founder and clinical director of East Coast Psychotherapy & Trauma Clinic Inc. in Cape Breton, Nova Scotia. She specializes in trauma resolution with adults and first responders, serves as a treating clinician and consultant within Unama’ki Indigenous mental health and addiction initiatives, and volunteers with Healing for Gaza.

Read more of Connection

• Healing in the crossfire: Clinical social work in a genocide
• Healthcare erosion: “Why didn’t you press the button?”
• Food, Body, and Bias: Why Your Words Matter
• 2024 NSCSW Annual Report
• Developing a standard of care for social work practice with people who use alcohol and drugs

To enhance the professional standards of social work, the Nova Scotia College of Social Workers (NSCSW) has adopted the Nova Scotia Regulated Health Professions Network’s Standards for Good Regulation as its measure of performance. Standard Ten requires that the regulator encourages quality of practice through continuing competence requirements to support registrants in meeting standards of practice.

As part of our continuing commitment to ensuring safe(r) social work practice in our province, NSCSW began a new quality assurance (QA) process in 2023. The College has now completed a QA review of professional development activities reported by members in 2023 and 2024,

The findings and recommendations that arise from our recurring QA reports will continue to inform the College’s development of member services and resources, as well as the improvement of policies and procedures related to professional development tracking and registration renewal. By prioritizing quality assurance, the NSCSW is paving the way for a future where social workers are well-equipped to meet the evolving needs of society, ensuring that individuals and communities receive the highest standard of care and support.

By Michelynn Touesnard, MSW

Waking up from my fourth procedure and second major surgery, I found myself medicated but still conversational. I remember pieces of my conversation with the nurse in my recovery unit, as I answered her questions and explained what I did for a living (well before all of this cancer stuff). She asked about trauma symptoms and the treatment experience, with tears in her eyes. When I said that people don’t have to suffer, they can and do get better, I remember the tears that were hanging on finally fell. Our hospital staff are burnt out. They want to provide care that the system does not currently allow. I will assume that this is causing all sorts of moral-based injuries.  

As a 43-year-old mother of four, middle class, masters educated, white woman, who has worked in healthcare for many years, I have still found it challenging to navigate a stage 4 colorectal cancer diagnosis in our health care system. Nova Scotia’s Quality and Patient Safety Framework (2021) aims for our province to provide health care that is safe, appropriate, people-centred, integrated, and accessible. With the risk of sounding ungrateful, though I assure you I am not, my hope is to bring attention to the gaps in care. 

In January 2023 I noticed symptoms that were concerning and went to see my doctor. I was referred to the GI clinic eventually as symptoms worsened. I was told by this clinic it would be over a year wait because I was not considered urgent. I had all the symptoms of colorectal cancer, but I was not over 50, had no family history and my bloodwork was “good.” By the time I was able to be diagnosed I was already stage 4, incurable. It took me nine months to be diagnosed, and it was not for the lack of trying. I went to emerge, I called the GI clinic in tears, I begged for someone to help me. The emerge doctor rubbed my back and told me he would send the clinic a note considering how anxious I was. I explained I had four children and two jobs; I wouldn’t have made time to be at the hospital unless I felt it was an emergency. Trusting the processes and the system after was difficult for me, and it still is if I am being honest. 

Amongst the amazing nurses and surgeons and care, I have experienced some very difficult things. 

• When I arrived to what I thought was my last day of chemotherapy I was told by my nurse that I was mistaken; I actually had three more months, they had just forgotten to tell me.
  How do you feel included in your care, when huge decisions like this are made without you? 

• I went through three oncologists within my first year of diagnosis as well as three GI surgeons.
  How do you build rapport and trust when your life is on the line, in these circumstances? 

• I had complications during a liver ablation that landed me in the Intermediate Care Unit (IMCU) and at one point asked to speak to the on call doctor because of some significant things that were happening; my PICC line was touching my heart and causing it to irregularly beat, and the nurse gave me a blood thinner just hours after I had been given a coagulant because my liver was bleeding. The doctor was visibly irritated with my questions and offered me anxiety meds. I often wonder:
  How would five minutes and some compassion have felt for me? 

• That same visit I had a man with dementia who had been sexually harassing the nurses all day try to sneak behind my curtain in our ward room around 4 a.m.
  Is there a way to more appropriately consider safety concerns when assigning patients to rooms? 

• In the IMCU where the ratio is two patients per nurse, my care was top tier. But during my bowel resection surgery my roommate’s nurse left used adult diapers in the sink in our shared bathroom on two different occasions.
  Is this a result of nurses with too many patients?  

• I had a male roommate post liver surgery who screamed and yelled and threatened physical harm to me throughout the night. I watched the nurses trying to deal with him and they all would leave the room looking defeated. My husband called the nursing station as soon as he found out and requested a security guard be put outside my door. When my husband confronted my roommate and told him not to threaten me anymore, he attacked. My husband then restrained my roommate until hospital staff arrived because a security guard was not put there. After this incident, I cancelled my lung surgery that was to be at the same time as the second liver surgery, because the thoughts of having complications and needing to stay in the hospital longer seemed worse than just waiting to get the surgery in a few months. When my surgeons heard about what happened to us, one of them said, “I’m surprised it doesn’t happen more often to be honest, the way they stack people in together”. When I explained this story, some friends asked:
  Why didn’t you press the button to get help?  

And I suppose it’s the same reason I didn’t write the complaints, or letters of feedback for the other issues. The system is so broken I didn’t believe there was going to be measures in place to keep me safe anyhow. The button is the metaphorical safety net of our entire healthcare system. A facade. Much like the zero tolerance posters hanging on the walls. 

My experiences in our system have, on too many occasions, not been safe, appropriate, people-centred, integrated, or accessible. When I think about myself with all of my resources and supports and how difficult all of this has been to navigate and manage, I have to ask: what is it like for people who are disempowered, who don’t work in healthcare, or who have socioeconomic barriers or language barriers?

I hope that talking about this will help people learn to advocate, question, and ask for better care. I hope healthcare workers recognize the gaps themselves, advocate for change on their end, and demand better for their patients and for themselves. 

I also hope that social workers find a role in advocating in order to promote safe, appropriate, people-centred, integrated, and accessible care, specifically by not getting caught up in the culture of apathy and instead speaking out and insisting on the need for change. The continued erosion of our healthcare system will lead people no choice but to bankrupt themselves seeking private options. We don’t need privatization; we need properly funded care that is available to everyone. We need to do better because everyone is suffering in our current system: the patients, the families, and the healthcare workers. 

Michelynn Touesnard, MSW, practiced clinical social work for families and members of the Canadian Armed Forces out of Greenwood/ Eleke’we’katik and Halifax/Kjipuktuk since 2012. The last five years had a trauma focus while being part of the Operational Trauma and Stress Support Centre team treating operational trauma injuries.  

Currently residing in Berwick with her four daughters and partner of 18 years, Michelynn has been on medical leave while going through cancer treatments; October 16, 2025, was the two-year anniversary of her cancer diagnosis.