An evaluation of trauma focused cognitive behavioral therapy for children in Zambia.

Journal: Child abuse & neglect

Volume: 37

Issue: 12

Year of Publication: 2015

Affiliated Institutions:  Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, th Floor, North Broadway, Baltimore, MD , USA. Catholic Relief Services, Zambia, Longolongo Road, Lusaka , Zambia. Drexel University College of Medicine, Allegheny General Hospital, Department of Psychiatry, Four Allegheny Center, th Floor, Pittsburgh, PA , USA. University Teaching Hospital, Lusaka, Zambia. Ministry of Health, City Airport Road, Lusaka, Zambia. Department of International Health, Johns Hopkins Bloomberg School of Public Health, North Wolfe Street, th Floor, Baltimore, MD , USA.

Abstract summary 

To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5-18 completed the TF-CBT treatment, with pre- and post-assessments. The mean number of traumas reported by the treatment completers (N=58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (p<0.0001), and severity of shame symptoms (p<0.0001). Our results suggest that TF-CBT is a feasible treatment option in Zambia for OVC. A decrease in symptoms suggests that a controlled trial is warranted. Implementation factors monitored suggest that it is feasible to integrate and evaluate evidence-based mental health assessments and intervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the Apprenticeship Model of training and supervision.

Authors & Co-authors:  Murray Laura K LK Familiar Itziar I Skavenski Stephanie S Jere Elizabeth E Cohen Judy J Imasiku Mwiya M Mayeya John J Bass Judith K JK Bolton Paul P

Study Outcome 

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Statistics
Citations :  Agardh A, Tumwine G, Asamoah BO, Cantor-Graae E. The invisible suffering: sexual coercion, interpersonal violence, and mental health--a cross-sectional study among university students in south-western Uganda. PLoS One. 2012;7(12):e51424.
Authors :  9
Identifiers
Doi : 10.1016/j.chiabu.2013.04.017
SSN : 1873-7757
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Child trauma;Evidence-based treatment;Implementation;International;Low-resource setting
Study Design
Study Approach
Country of Study
Zambia
Publication Country
England