Interprofessional training on resilience-building for children who experience trauma: Stakeholders’ views from six low- and middle-income countries

Abstract

Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low-and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations for future training. The findings indicate the importance of coordinated policy, service and training development in an interprofessional context to maximize resources; the need for cultural adaptation of skilled-based training and interventions; and the usefulness of new technologies to enhance accessibility and reduce costs in LMIC.

Pilot implementation of child psychosocial framework in Kenya, Turkey and Brazil

“…The range of community and professional roles of the participants (Table 1) indicates a positive stance towards interdisciplinary training and working, with the latter also being supported by the data. This is consistent with the findings of an earlier study on practicefocused training in child mental health across six LMIC (Vostanis et al, 2019).…”

“…In phase 1, target groups of vulnerable children were identified in three LMIC through ongoing partnerships with NGOs under the (World Awareness for Children in Trauma) programme, who had previously co-ordinated practice-focused training (Vostanis et al, 2019). In phase 2, the authors and each host NGO identified agencies operating in the target areas and in contact with the identified vulnerable groups (see below for details) from primary health, mental health, child protection and other social care, schools, special needs, community and religious organizations, care homes, NGOs, and policy makers.…”

“…Children, young people and parents (with one exception in Kenya) were not involved in this stage of delivery. In Phase 3, the one-day workshops adapted an interdisciplinary stance designed so that participants interacted to learn "with, from and about one another" to share their expertise in meeting children's psychosocial needs (WHO, 2010, p. 6;Vostanis et al, 2019). Training guidelines and a draft manual were developed by the workshop facilitators (co-authors 1 and 3) according to the framework.…”

Application of digital child mental health training to improve capacity in majority world countries: Professional perspectives from Turkey and Pakistan

“…The second module aims at systemic improvements in service provision that go beyond individual practice. Its objectives are to establish interprofessional networks, map current strengths and gaps in resources, co-produce action plans with local stakeholders and implement these action plans in a target area ( Vostanis et al, 2019a ) Figure 2 ). Participating agencies work together along six domains of a service transformation framework informed by child mental health literature in MWC, socioecological systems theory ( Bronfenbrenner, 1979 ) and the scaled service model ( World Health Organisation, 2016 ).…”

Children’s prolonged exposure to the toxic stress of war trauma in the Middle East

“…Thirdly, mental health professionals should be trained and supervized to implement level two interventions. Capacity building should be tailored to community and specialist levels, and an interdisciplinary context is needed to promote joint working, networks, and efficient use of resources 81. The particular social, cultural, and religious contexts in the Middle East should be taken into account.…”