Community based sociotherapy in Byumba, Rwanda

Richters, Annemiek; Dekker, C.; Scholte, Willem F.

doi:10.1097/wtf.0b013e328307ed33

Cited by 74 publications

(58 citation statements)

References 2 publications

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“…While no evidence for direct prediction of PTSD symptom severity using economic factors was found, physical illness seems to function as a mediator between both, as its correlates with social as well as economic factors demonstrate. The direct consequences of genocidal violence such as HIV infection, chronic pain or disability, which were especially present in the group of survivors, have an immediate impact on the economic growth of a family in an already poor environment [50]. The respondents mainly worked as peasants, as is common for the rural Rwandan population.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, while released prisoners rarely mentioned problems of reintegration following their release, their other family members such as their wives and children did. As Richters et al [50] demonstrated, sources for ongoing conflicts might be found within families in which the father is extensively absent due to imprisonment. In such circumstances, the man returning home from prison may find that his wife has brought another man home or has even had children with other men.…”

Section: Discussionmentioning

confidence: 99%

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Rwanda – lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children

Rieder

Elbert

2013

Confl Health

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BackgroundThe 1994 genocide of the Tutsi in Rwanda left about one million people dead in a period of only three months. The present study aimed to examine the level of trauma exposure, psychopathology, and risk factors for posttraumatic stress disorder (PTSD) in survivors and former prisoners accused of participation in the genocide as well as in their respective descendants.MethodsA community-based survey was conducted in four sectors of the Muhanga district in the Southern Province of Rwanda from May to July 2010. Genocide survivors (n = 90), former prisoners (n = 83) and their respective descendants were interviewed by trained local psychologists. The PTSD Symptom Scale Interview (PSS-I) was used to assess PTSD, the Hopkins Symptom Checklist (HSCL-25) to assess symptoms of depression and anxiety and the relevant section of the M.I.N.I. to assess the risk for suicidality.ResultsSurvivors reported that they had experienced on average twelve different traumatic event types in comparison to ten different types of traumatic stressors in the group of former prisoners. According to the PSS-I, the worst events reported by survivors were mainly linked to witnessing violence throughout the period of the genocide, whereas former prisoners emphasized being physically attacked, referring to their time spent in refugee camps or to their imprisonment. In the parent generation, when compared to former prisoners, survivors indicated being more affected by depressive symptoms (M = 20.7 (SD = 7.8) versus M = 19.0 (SD = 6.4), U = 2993, p < .05) and anxiety symptoms (M = 17.2 (SD = 7.6) versus M = 15.4 (SD = 7.8), U = 2951, p < .05) but not with regard to the PTSD diagnosis (25% versus 22%, χ2(1,171) = .182, p = .669).A regression analysis of the data of the parent generation revealed that the exposure to traumatic stressors, the level of physical illness and the level of social integration were predictors for the symptom severity of PTSD, whereas economic status, age and gender were not. Descendants of genocide survivors presented with more symptoms than descendants of former prisoners with regard to all assessed mental disorders.ConclusionsOur study demonstrated particular long-term consequences of massive organized violence, such as war and genocide, on mental health and psychosocial conditions. Differences between families of survivors and families of former prisoners accused for participation in the Rwandan genocide are reflected in the mental health of the next generation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rwanda – lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children

Rieder

Elbert

2013

Confl Health

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“…Indeed, addressing livelihood skills, interpersonal skills and mobilizing community resources are all essential elements of such empowering approaches. While also an extremely under-researched area, examples from India and Rwanda show positive effects of support groups on the symptoms of common mental disorders (Richters et al, 2008;Scholte et al, 2011;Tripathy et al, 2010). Interestingly, these successful interventions did not use any medical language, such as ' depression ' , ' post-traumatic stress disorder ' or other psychiatric jargon (Patel, 2014).…”

Section: Engaging Communities To Be Partners In Psychosocial Intervenmentioning

confidence: 93%

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

Ventevogel

2014

International Review of Psychiatry

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Since 2008 the World Health Organization (WHO), through its mental health Gap Action Programme, has attempted to revitalize efforts to integrate mental health into non-specialized (e.g. primary) healthcare. While this has led to renewed interest in this potential method of mental health service delivery, it has also prompted criticism. Some concerns raised are that it would contribute to the medicalization of social and psychological problems, and narrowly focus on primary care without sufficient attention given to strengthening other levels of the healthcare system, notably community-based care and care on district levels. This paper discusses seven elements that may be critical to preventing inadvertently contributing to increasing a narrow biomedical approach to mental healthcare when integrating mental health into non-specialized healthcare: (1) using task shifting approaches within a system of stepped care, (2) ensuring primary mental healthcare also includes brief psychotherapeutic interventions, (3) promote community-based recovery-oriented interventions for people with disabling chronic mental disorders, (4) conceptualizing training as a continuous process of strengthening clinical competencies through supervision, (5) engaging communities as partners in psychosocial interventions, (6) embedding shifts to primary mental healthcare within wider health policy reforms, and (7) promoting inter-sectoral approaches to address social determinants of mental health.

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“…Mental health interventions used with refugees have been primarily trauma-focused, including narrative exposure therapy (NET) (Neuner, Schauer, Klaschik, Karunakara, & Elbert, 2004), group therapy (Tucker & Price, 2007), support groups (Ley, 2006), and individual therapy (Neuner et al, 2004). Other interventions include sociotherapy (Richters, Dekker, & Scholte, 2008), psychoeducation (Yeomans, Forman, Herbert, & Yuen, 2010), and community-based interventions (Weine et al, 2004). …”

Section: Theoretical Justification and Empirical Support For The Intementioning

confidence: 99%

Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.

Goodkind¹,

Hess²,

Isakson³

et al. 2014

Psychological Services

104

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Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of post-migration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multi-method, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address post-migration stressors. We found the intervention to be feasible, acceptable and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants’ psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally-appropriate, and replicable model for doing so.

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Community based sociotherapy in Byumba, Rwanda

Cited by 74 publications

References 2 publications

Rwanda – lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children

Rwanda – lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.

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