Do not forget culture when implementing mental health interventions for violence survivors

Bonilla-Escobar, Francisco J.; Osorio-Cuellar, Gisel Viviana; Pacichana-Quinayáz, Sara Gabriela; Sánchez-Rentería, Gabriela; Fandiño-Losada, Andrés; Gutiérrez, María

doi:10.1590/1413-81232017229.12982016

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…Research on mental health interventions in post-conflict contexts posits the need of trained psychologists who can support dissemination and implementation of evidence-based effective health care approaches (Murray et al, 2014). Further, some communities require community interventions that consider their cultural characteristics and their coping mechanisms (Bonilla-Escobar et al, 2017). In particular, post-conflict contexts require professionals who are prepared to work with culturally diverse populations, recognizing the victim's multiple local knowledges and cultural practices, and offering an empathetic and rigorous service (Osorio-Cuellar et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Social Impact of a Transformative Service-Learning Experience in a Post-conflict Setting

2020

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In the context of the 2016 Peace Agreement signed between the Colombian government and the FARC-EP (Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo), several challenges for society and academia have emerged: (1) overcoming the gap between the rural and urban settings, which has been one of the roots of the Colombian armed conflict, and (2) training psychologists and transforming traditional educational practices, which have not been designed to fulfill community needs in a post-conflict setting. One of the strategies from academia to overcome these difficulties is to create alliances with rural communities where students learn key competences to foster a horizontal approach while actively working with the community. In the region of Caquetá, Colombia, two Territorial Spaces for Training and Reincorporation (ETCR) were created in order to provide a space for former guerrilla members' reintegration to civil society. In the ETCR Héctor Ramírez, 27 students and two faculty participated in a service-learning project (2 weeks in December 2018 and two in June 2019) where they engaged in local daily practices and social projects based on the community's prioritized needs. The aim of this study was to analyze the learning process of undergraduate psychology students in this community psychology service-learning project in the context of peacebuilding in Colombia. This study is grounded in a Participatory Action Research (PAR) approach and data collected include reflective narratives and video diaries by students before and during the course, and two focus groups after the experience. Findings suggest that students who participated in the experience are in the process of developing cultural humility, through affective understandings and the consolidation of communities of practice that include the former guerrilla members and their knowledges. Preparing psychologists to lead peacebuilding and reconciliation processes is of importance to the field because the professional competencies gained in this context surpass the professional practice as they become part of the students' abilities as citizens. The social impact is twofold: the students learn to create partnerships where purposes are co-constructed and trust-based, while the community takes the lead of their processes creating alliances with an academia that recognizes their knowledge and practices.

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Section: Introductionmentioning

confidence: 99%

Social Impact of a Transformative Service-Learning Experience in a Post-conflict Setting

2020

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“…[6] There is limited information about displacement in Colombia including the average length of displacement, the different traumatic experiences suffered by victims of the armed conflict, or the effect of interventions on mental health of victims. [7–9] Previous research has shown that Afro-Colombian victims of violence experience symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. [9–13] Despite this, few psychosocial services are readily available for survivors of the conflict.…”

Section: Introductionmentioning

confidence: 99%

“…This was considered as the easiest way to access victims, promoting confident relationships between participants and LPCW. [7, 23–25]…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants’ survivors of systemic violence in Colombia

et al. 2018

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BackgroundExposure to violence has negative consequences on mental health. Armed-conflict in Colombia has widely affected Afro-descendants in the Pacific region. Evidence regarding effectiveness of mental health interventions is lacking in low-income settings, especially in areas with active conflict. The objective of this study is to evaluate an individualized Common Elements Treatment Approach (CETA), a transdiagnostic psychotherapy model based on Cognitive-Behavioral Therapy, for adult trauma survivors.Methods and findingsA referred sample of 521 adult Afro-descendants from Buenaventura and Quibdó, Colombia, experiencing significant sadness, suffering or fear (score>0.77 in Total Mental Health Symptoms), with history of traumatic experiences, and with associated functional impairment were randomly allocated to CETA intervention, standby group without intervention, but under monthly monitoring, or a Narrative Community-Based Group Therapy. CETA was provided by trained Lay Psychosocial Community Workers without previous mental health experience, supervised by psychologists, during 12–14 weekly, 1.5-hour sessions. Symptoms were assessed with a locally validated survey built based on the Hopkins Symptom Checklist, the Harvard Trauma Questionnaire, the PTSD CheckList–Civilian Version, a qualitative study for additional general symptoms and a gender-specific functional impairment scale. CETA was compared with the control group and the intervention effects were calculated with mixed models using intention to treat analysis. Participant completion of follow-up was 75.1% and 13.2% voluntarily withdrew. Reduction in post-traumatic stress symptoms was significant in both municipalities when comparing intervention and control groups (mean difference), with a with a moderate effect size in Buenaventura (Cohen's d = 0.70) and a small effect size in Quibdó (d = 0.31). In Buenaventura, the intervention also had significant effects on depression (large effect size d = 1.03), anxiety (large effect size d = 0.80) and functional impairment (moderate effect size d = 0.70). In Quibdó, it had no significant effect on these outcomes. Changes in Total Mental Health Symptoms were not significant in neither city.ConclusionsThis trial suggests that CETA, can be effective in improving depression, anxiety, post-traumatic stress and function among victims of systematized violence in low-income and active conflict settings. Nonetheless, the difference of effectiveness between the two cities of intervention may indicate that we cannot assume that a mental health intervention known to be effective in one setting will be effective in another, even in similar circumstances and population. This may have special importance when implementing and reproducing these types of intervention in non-controlled circumstances. Further research should address these concerns. Results can be of use by governmental decision-makers when defining mental health programs for survivors.Trial registrationClinicalTrials.gov NCT01856673 (https://clinicaltrials.gov/ct2/...

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“…Therefore, it is necessary to fulfill these needs, by means of human rights restoration processes 22,29,30 . Also, it is need to understand the importance of this local context to create valid instruments and locally appropriate interventions 31 , taking into account healing, living and coping traditions of Afro-Colombian communities 32 . The study has some limitations: Findings cannot be generalized different cultural settings, but it helps to implement community-based interventions for violence survivors in similar contexts.…”

Section: Discussionmentioning

confidence: 99%

Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence

Osorio-Cuellar

Pacichana-Quinayáz

Bonilla-Escobar

et al. 2017

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Do not forget culture when implementing mental health interventions for violence survivors

Abstract: Do not forget culture when implementing mental health interventions for violence survivorsNão se esqueça da cultura quando for implementar intervenções mentais em saúde para sobreviventes da violência

Cited by 15 publications

References 16 publications

Social Impact of a Transformative Service-Learning Experience in a Post-conflict Setting

Social Impact of a Transformative Service-Learning Experience in a Post-conflict Setting

A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants’ survivors of systemic violence in Colombia

Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence

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