Effectiveness of a Trauma/Grief–Focused Group Intervention: A Qualitative Study with War–Exposed Bosnian Adolescents

Abstract

The effectiveness and impacts of a school-based, trauma/grief-focused group treatment program for war-exposed youth in Bosnia and Herzegovina were investigated using semistructured focus groups, conducted separately for students and their school counselor group leaders. Overall, students' and leaders' evaluations of the groups were generally positive. General themes of outcomes and impacts perceived by students and group leaders include: acquisition of coping skills and attitudes, willingness to advocate for peers, improved interpersonal relationships, negative impacts, general positive impacts, impacts in the schools, impacts on the group and logistics of the program, and broader impacts on the perception of mental health in the community. The broad positive impacts of this program suggest that trauma/grief-focused group treatment intervention programs targeting trauma-exposed youth may be effective on multiple levels with war-exposed youth and their communities.

Identifying Priorities for Mental Health Interventions in War-Affected Youth: A Longitudinal Study

“…Although the treatment of complex trauma and related conditions, such as posttraumatic stress disorder, often requires highly trained mental health professionals (eg, psychiatrists and/or doctorallevel psychologists) and, often, an individual therapy setting, there is a growing evidence base suggesting that internalizing disorders can be treated by bachelor's-level mental health workers with rigorous training and supervision using evidenced-based techniques such as cognitive behavioral therapy and/or interpersonal therapy with minimal risk of adverse iatrogenic effects. 3,[18][19][20][21][22][23][24][25] Furthermore, a stepped care approach can be adopted in which the most acute individuals or those suffering from resistant trauma symptoms can be directed toward more sophisticated treatment resources tailored to their conditions if initial stabilization-focused interventions do not yield sufficient symptom relief. 26,27 A focus on war trauma has dominated many of the interventions for war-affected youth.…”

Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence

“…Interventions included (a) enhancing knowledge of specific types of social support (e.g., emotional closeness, social connection, feeling 296 Essential Elements of Mass Trauma Intervention needed, reassurance of self-worth, reliable alliance, advice, physical assistance, and material support); (b) identifying potential sources of such support; and (c) learning how to appropriately recruit support (Layne et al, 2001). Notably, consumers identified this support-seeking skill as one of the most valuable program elements (Cox, Davies, Burlingame, Campbell, & Layne, 2005).…”

Interventions for Children Affected by War

“…58–60 In an RCT, this school-based psycho-therapeutic group intervention was implemented by local school counselors. One hundred twenty-seven war-exposed secondary school students participated in the study.…”

“…Several of the studies reviewed here highlight how paraprofessionals and lay facilitators may be successfully mobilized to deliver mental health and psychosocial interventions. 29,50–53,58,59,63 Additional research to examine how families and communities can be trained to address the mental health consequences of war would be useful for extending the continuum of care beyond clinical or school settings to ensure more community-based resources. More research is also needed to assess how locally developed models of healing and spiritual guidance may provide a natural base for building robust, culturally resonant, locally delivered interventions.…”