An evaluation of trauma focused cognitive behavioral therapy for children in Zambia |
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| Authors: | Laura K Murray Itziar Familiar Stephanie Skavenski Elizabeth Jere Judy Cohen Mwiya Imasiku John Mayeya Judith K Bass Paul Bolton |
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| Institution: | 1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 8th Floor, 624 North Broadway, Baltimore, MD 21205, USA;2. Catholic Relief Services, Zambia, Longolongo Road, Lusaka 10101, Zambia;3. Drexel University College of Medicine, Allegheny General Hospital, Department of Psychiatry, Four Allegheny Center, 8th Floor, Pittsburgh, PA 15212, USA;4. University Teaching Hospital, Lusaka, Zambia;5. Ministry of Health, City Airport Road, Lusaka, Zambia;6. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, 8th Floor, Baltimore, MD 21205, USA |
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| Abstract: | 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. |
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| Keywords: | Child trauma Evidence-based treatment Implementation International Low-resource setting |
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