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  Most popular articles (Since February 01, 2018)

 
 
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ARTICLES
Underrepresentation of men in gender based humanitarian and refugee trauma research: a scoping review
William Affleck, Ann Selvadurai, Lindsey Sikora
March 2018, 16(1):22-30
DOI:10.1097/WTF.0000000000000157  
Sex and gender are important considerations within refugee studies. Risks to health and wellbeing may manifest differently for refugee women and men, as may the use of health and social services and responses to interventions. Since the 1980s, increased attention has been paid to the experience of girls and women in refugee and humanitarian research, however, much less attention has been paid to boys and men. The purpose of this systematic scoping review was to investigate whether there is a gender bias in refugee and humanitarian research on refugee trauma. Findings demonstrate that since 1988, fully 95% of gender focused refugee research addressed women’s issues, while only 5% addressed the experience of refugee men. This article offers possible explanations for this gap and discusses its ramifications for both research and clinical practice.
  1,294 201 2
Highlighting the gender disparities in mental health among Syrian refugees in Jordan
Anita L Kisilu, Lina Darras
July 2018, 16(2):140-146
DOI:10.4103/INTV.INTV_18_18  
Jordan has been a host country to many refugees from neighbouring countries for many years and has recently become a place of refuge for thousands of Syrians. The Syrian crisis has resulted in millions of Syrians fleeing their homes, uncertain of When they will return. Most of those seeking refuge have witnessed and/or experienced traumatic events that have affected their mental well-being in addition to starting over as refugees. Despite the large number of non-profit organizations providing free mental health services to refugees, not everyone has equal access to these services. This report, based on a literature review and a focus group discussion, highlights the different gender dimensions of mental health among Syrian refugees in Jordan. These risk factors include access to and use of mental health services, manifestation of mental health and psychosocial problems, treatment by mental-health workers and the socio-economic outcomes of living with someone suffering from mental health. Key implications for practice
  • To highlight the gender disparities in mental health among Syrian refugees residing in Jordan
  • To highlight the gender differences in mental health needs and services among Syrian refugees in Jordan
  • To provide insight about the level of mental health services provided for Syrian refugees in Jordan.
  1,178 67 -
Closing the gap between disaster mental health research and practice: evidence for socio-ecological mental health interventions through multilevel research
Tim R Wind, Ivan H Komproe
March 2018, 16(1):5-13
DOI:10.1097/WTF.0000000000000153  
Socio-ecological interventions assume that there are ‘links’ between the individual process that determines disaster mental health and the social context one lives in. However, there is insufficient empirical basis for this claim. This paper summarises the main findings from a research programme, in which two advanced statistical techniques on data from two floods were applied, respectively Uttar Pradesh, India 2008 and Morpeth, England, 2008. By means of multilevel structural equation modelling it was found that individual psychosocial resources (coping behaviour and social support) are employed more parsimoniously and effectively when disaster affected individuals can rely on a trustworthy and effective social community. Additionally, using multilevel confirmatory factor analyses to address screening outcomes yielded two methodological problems: nested variance due to the disaster context and poor construct validity. These can be illustrated, but not dismissed without applying advanced statistical analyses. The findings strongly suggest that community interventions promoting social context and individual interventions not only share the same objective, but also impact mental health via the same individual mechanisms.
  1,002 236 1
Marital conflict in the aftermath of genocide in Rwanda: an explorative study within the context of community based sociotherapy
Emmanuel Sarabwe, Annemiek Richters, Marianne Vysma
March 2018, 16(1):14-21
DOI:10.1097/WTF.0000000000000147  
This article explores the ongoing impact of the genocide in Rwanda on marital relationships. Its specific focus are genocide related factors that generate relational trauma and the consequences of this trauma for the everyday lives of spouses affected by it. The qualitative study that informs this article was conducted within the context of a community based sociotherapy programme. The factors found to be contributing to traumatic marital conflict are categorised as those related to genocide perpetration and its consequences, refugeehood, victimisation by genocidal violence and its consequences, intermarriages, and being a descendant of a genocide survivor or a genocide perpetrator. Study participants give a relative high prevalence to factors regarding genocide perpetration, while they assume that the prevalence of traumatic marital conflict among the second generation may continue unless sufficient preventive measures are taken.
  961 200 1
EDITORIAL
From the editor: welcome to open access!
Marian Tankink
March 2018, 16(1):1-2
DOI:10.4103/INTV.INTV_11_18  
  821 190 -
ARTICLES
Integrating psychosocial support at Ebola treatment units in Sierra Leone and Liberia
Inka Weissbecker, Reshma Roshania, Vanessa Cavallera, Michaela Mallow, Ashley Leichner, Jules Antigua, James Gao, Adam Carl Levine
July 2018, 16(2):69-78
DOI:10.4103/INTV.INTV_8_18  
The Ebola virus disease (EVD) epidemic killed almost 12,000 people across Sierra Leone, Liberia and Guinea, causing significant psychological distress and suffering. This paper describes International Medical Corps’ innovative and comprehensive model for integrating mental health and psychosocial support (MHPSS) considerations and activities into Ebola treatment units (ETUs) across Sierra Leone and Liberia. This includes staff capacity building as well as psychosocial considerations and activities to address needs and challenges at the ETUs. This model was aimed at reducing patient and family distress and promoting healthy behaviours and recovery. We also include data describing mental health-related symptoms reported by our ETU patients, as well as psychosocial support interventions utilised. We discuss recommendations and lessons learnt and conclude that in line with global guidelines, MHPSS considerations and activities should be integral to all aspects of EVD care. Key implications for practice
  • Patients admitted to ETUs face several stressors and challenges related to the ETU environment and procedures, separation from families and effects of EVD
  • Mental health and psychosocial support considerations should be an integral part of all aspects of care provided at the ETU
  • Paraprofessional psychosocial support workers can play a key role in meeting patient needs at the ETU in line with global mental health and psychosocial support guidelines.
  859 142 -
Developing a culturally sensitive mental health intervention for asylum seekers in the Netherlands: A pilot study
Ortal Slobodin, Samrad Ghane, Joop T.V.M De Jong
July 2018, 16(2):86-94
DOI:10.4103/INTV.INTV_2_18  
Introduction: This pilot study investigated asylum seekers’ needs and expectations in the mental health field to develop a culturally sensitive psychosocial intervention. Method: Participants were residents of a certain asylum-seekers centre in the Netherlands, with most of them from the Middle East crisis. Needs and expectations were identified using therapy expectations questionnaire (11 participants) and two focus groups (17 participants). Results: Participants associated mental health problems with post-migration stressors more often than with past traumatic experiences. Often, health problems were silenced due to shame, guilt, anxiety and the fear of negative stigma. Individuals and communities were limited in their ability to provide support for those suffering from psychosocial distress due to heavy stigma and the burden of multiple stressors. Conclusion: We underscore the importance of considering the local knowledge of mental health in developing emergency interventions and emphasise the need to reach beyond the trauma-focused approach to strengthen capacities within the community. Key implications for practice
  • Developing a culturally sensitive mental health intervention for asylum seekers requires local knowledge of mental health issues
  • Mental health interventions in emergencies should reach beyond the individualistic trauma-focused approach to address the whole context of forced displacement
  • Because armed conflict often leads to a disruption of the social ecology of a community, mental health interventions should build on existing local support and services and strengthen capacities within the community.
  788 187 -
LETTER TO EDITOR
Psychosocial activities and peace building
Anica Mikuš Kos
March 2018, 16(1):3-4
DOI:10.4103/INTV.INTV_12_18  
  729 214 -
ARTICLES
The role and experience of local faith leaders in promoting child protection: a case study from Malawi
Carola Eyber, Blessings Kachale, Tracy Shields, Alastair Ager
March 2018, 16(1):31-37
DOI:10.1097/WTF.0000000000000156  
Frequently, community based strategies include engagement with local faith leaders. However, there have been few systematic attempts to document how faith leaders themselves define their roles in these initiatives. This study examined local faith leaders and their spouses, in flood affected areas of Malawi, who had been oriented to child protection issues through World Vision workshops aimed explicitly at relating protection concerns to religious teachings. Many participants reported that attending a workshop had been transformational in terms of their perspectives regarding the protection of children. The key child protection issues identified by participants included child marriage, lack of attendance at school, child labour (including forced labour), harsh physical punishment and sexual abuse. Many faith leaders − and their wives − became active in addressing child protection issues as a result of the programme, although the form of this action varied widely and was significantly influenced by their varied status and capacities.
  729 117 -
SPECIAL SECTION: PSYCHOSOCIAL SUPPORT AND CONFL ICT TRANSFORMATION: A NECESSARY DIALOGUE
Using art tools with older Syrian refugee women to explore activated development
Bayan Hakki
July 2018, 16(2):187-194
DOI:10.4103/INTV.INTV_46_18  
The case study this field report is based on used creative art activities and a systematic approach through the framework of the complex circle. Its aim was to aid Syrian refugee women between the ages of 55–65 to explore changes in their roles and their adversity-activated development after fleeing Syria due to the current conflict. Five psychosocial sessions were conducted, twice a week, with a group of three Syrian refugee women living in Kilis, Turkey. A simplified version of the qualitative ‘adversity-activated development’ grid was used as a pre- and post-intervention assessment and results were analysed qualitatively. Findings showed that at the end of sessions women were expressing more positive feelings and realising positive role changes as well as continued sadness in terms of the separation of their families.
  688 59 -
ARTICLES
Trauma-related mental health problems and effectiveness of a stress management group in national humanitarian workers in the Central African Republic
Capucine de Fouchier, Marianne S Kedia
July 2018, 16(2):103-109
DOI:10.4103/INTV.INTV_9_18  
The aim of this study is to assess the levels of anxiety, depression and post-traumatic stress disorder (PTSD) in national aid workers in Central African Republic as well as to evaluate the effectiveness of a stress management group in reducing those symptoms. Twenty-seven stress management groups were evaluated in two international non-governmental organisations in which 197 national humanitarian aid workers took part. There was a significant decrease in the intensity of every psychopathological variable tested despite a decrease in the sample between the pre- and post-tests. At post-test, 8.1, 5.1 and 11.1% of the participants had scores indicating anxiety, depression and PTSD compared to 25, 18.9 and 26% at pre-test. The group intervention has demonstrated to be a realistic, effective and cost-effective way to respond to mental health problems in national aid workers living in a context of ongoing violence and where access to specialised services is extremely limited. Key implications for practice
  • Documenting the mental health of national humanitarian staff working in unsecure environment in Central African Republic
  • A one session stress management group protocol can reduce the levels of anxiety, depression and PTSD in this population and hence demonstrating that it is feasible and cost-effective for organizations to honour their duty of care towards national humanitarian workers
  • Further research is needed to confirm these preliminary results, especially in other cultural and humanitarian contexts.
  634 94 -
FIELD REPORTS
Resilience building through alternative intervention: ‘STARTTS “Project Bantu Capoeira Angola”’; On the road to recovery
Shakeh Momartin, Edielson da Silva Miranda, Jorge Aroche, Mariano Coello
July 2018, 16(2):154-160
DOI:10.4103/INTV.INTV_6_18  
As a consequence of prolonged exposure to the high levels of cumulative trauma such as war, gross human rights violations and traumatic loss, refugee adolescents are at significant risk of developing psychological and behavioural complications. During resettlement in Australia, they are often faced with social challenges. It is vital to provide support at this vulnerable stage to reduce future setbacks. In response to the high rates of truancy, challenging behaviour in school and negative relationship with teachers and peers, Capoeira Angola programme was implemented to help them better settle in school life, build resilience, using individual strengths and kinesthetic movement for personal growth and recovery. The main aim of this qualitative evaluation was to establish efficacy and ascertain the impact attributable to the programme on psychological and social issues. Positive changes were observed by participant and teacher’s accounts, demonstrating improvements in resilience, self-esteem, interpersonal relationships and school attendance. The significance and benefits of the programme was established and was endorsed its continuation.
  539 81 -
EDITORIAL
From the editor: on deviation(s)
Marian Tankink
July 2018, 16(2):63-65
DOI:10.4103/INTV.INTV_49_18  
  439 150 -
CURRENT AFFAIRS
Children ‘disappeared’ at the United States/Mexico border: a symptom with consequences for the United States
Gerald Gray
July 2018, 16(2):66-68
DOI:10.4103/INTV.INTV_48_18  
‘Disappearing’ people as an act of torture has an ordinary language meaning, such that the United Nations could describe it and various torture treatment centres that address it as torture. The present United States policy of separating families into different prisons at its border with Mexico results in many such disappearances, and therefore is torture of both children and the families they are separated from. This article follows the United Nations description.
  448 129 -
FIELD REPORTS
Operational and ethical challenges of applied psychosocial research in humanitarian emergency settings: a case study
Elisabetta Dozio, Cécile Bizouerne, Marion Feldman, Marie Rose Moro
March 2018, 16(1):46-53
DOI:10.1097/WTF.0000000000000158  
Interventions on mental health and psychosocial wellbeing have been largely implemented in low and middle income countries. In order to adapt the support offered, an increasing number of applied research projects in mental health and psychosocial support have been conducted. However, while challenges arising can be related to the specificity of the mental health and psychosocial sector, within a broader perspective they are also strongly linked to difficulties of access to beneficiaries, security and protections issues, and competence of staff. Research priorities and guidelines have the objective of providing recommendations to ensure a framework of best practice for research during emergencies. Therefore, this article presents and discusses operational and ethical challenges of research conducted during an emergency, as implemented by the international nongovernmental organisation Action Contre la Faim.
  460 112 -
ARTICLES
New targets for behaviour change in Ebola outbreaks: Ideas for future interventions
Tara Rava Zolnikov
July 2018, 16(2):79-85
DOI:10.4103/INTV.INTV_4_18  
Ebola virus disease (EVD) is an infectious disease with serious individual health and population consequences. While Ebola is extremely contagious, the 2014 outbreak in West Africa was the worst to date. Many strategies were implemented for the containment and treatment of the disease, although some were limited by a lack of focus on social and behavioural factors. These factors must be taken into consideration during intervention development at the levels of individuals, communities and international networks to address issues that could block intervention success. Projects in which social and behavioural understandings are embedded can have long-lasting results not only within affected communities, but also within institutions, with key players, and at a broader level. Ultimately, removing the barriers to outbreak response strengthens health and social systems and could help to prevent EVD infection and reduce transmission worldwide. Key implications for practice
  • Behaviour-based strategies should include communication through specific groups and subsets of people.
  • This type of communication embedded with social and behavioural understanding can have long-lasting results not only within the community, but also in institutions, key players, and other communities and levels of society.
  • Ultimately, removing the barriers to outbreak response strengthens health and social systems.
  • Being aware of cultural norms and traditions at various levels (individual, community and international) could ultimately help prevent EVD infection and reduce transmission.
  441 96 -
Our NGO family has suffered a tragedy, and we will survive.’ Evaluating a crisis response intervention with expatriate aid workers in Afghanistan
Sarilee Kahn
March 2018, 16(1):38-45
DOI:10.1097/WTF.0000000000000154  
In 2008, Taliban forces killed four aid workers in Afghanistan. Immediately afterwards, expatriate and national field staff undertook crisis management activities on the ground. While this was a devastating event, field and headquarters staff agreed that the organisational response to the crisis was positive. Nine months later, 19 expatriate staff members involved in the crisis response participated in an evaluation to reflect on personal and organisational factors that contributed to their post crisis resilience. Results suggest that clear security protocols, crisis simulation preparedness training, team cohesiveness, strong leadership, staff mobilisation, well timed psychological support and support from managers may all contribute to staff resilience in high stress environments. Recommendations are offered to the international nongovernmental organisation community seeking to support staff following critical incidents.
  426 89 -
SPECIAL SECTION: PSYCHOSOCIAL SUPPORT AND CONFL ICT TRANSFORMATION: A NECESSARY DIALOGUE
Dealing with stress using social theatre techniques with young Syrian students adapting to a new educational system in Turkey: A case study
Cafer Yuksek
July 2018, 16(2):175-180
DOI:10.4103/INTV.INTV_38_18  
After a migration process, people begin to yearn for the settledness of their previous lives; this includes those in the education process. After the crisis in Syria, millions of refugees came to Turkey, in that, many of whom were students. The students started to enrol and although the schools’ curricula are in Arabic, students of these schools must pass a university entrance exam in the Turkish language to apply. There is also a quota limitation imposed on foreign students in universities. As these obstacles evoke extra-migratory stress among young refugees, the psychosocial support (PSS) needs become even more pronounced. The PSS workshop series outlined in this field report was conducted for Syrian students as they prepare for university admission. The series aimed to support participants to deal with this stressful process through six sessions using art and creativity methods and social theatre tools, including drama therapy games and forum theatre techniques. Through such techniques, the participants were encouraged to express their fears and future anxieties as well as find solutions for self-defined obstacles.
  416 86 -
FIELD REPORTS
The impact of war and economic sanctions on the mental health system in Iraq from 1990 to 2003: a preliminary report
Maha Sulaiman Younis, Azhar Madlom Aswad
March 2018, 16(1):54-58
DOI:10.1097/WTF.0000000000000144  
This paper explores the effects of war in Iraq in the period between 1991 and 2003, with a focus on the effect of economic sanctions on mental health services. The authors, Iraqi psychiatrists with direct contact with patients and events during this period, review literature and reports published contemporaneously. They describe how the mental health system in Iraq was deteriorated, not only by war, but also by United Nations imposed sanctions during the period between the first and second Iraq war.
  390 67 -
BOOK REVIEW
Psychological Torture. Definition, evaluation and measurement by Pau Pérez-Sales. New York: Routledge: 2017 (414 pages) ISBN 978-1-138-67155-3
Andrew M Jefferson
March 2018, 16(1):61-62
DOI:10.1097/WTF.0000000000000152  
  302 124 -
Borderlands of Mental Health: Explorations in medical anthropology, psychiatric epidemiology, and health systems research in Afghanistan and Burundi by Peter Ventevogel, PhD thesis. Geneva: Peter Ventevogel: 2016 (374 pages) ISBN: 978-90-9029910-5
Devon E Hinton
March 2018, 16(1):59-60
DOI:10.1097/WTF.0000000000000159  
  303 75 -
SPECIAL SECTION: PSYCHOSOCIAL SUPPORT AND CONFL ICT TRANSFORMATION: A NECESSARY DIALOGUE
Enhancing the awareness of emotions through art and drama among crisis-affected Syrian refugee children in southeast Turkey
Necile S Gurle
July 2018, 16(2):164-169
DOI:10.4103/INTV.INTV_41_18  
By learning to identify feelings and express emotions, children can better cope with the difficulties they face, as well as increase their personal resilience. As the Syrian crisis has entered its seventh year, it has had a negative effect on vulnerable populations, especially children. It should be noted that while not all children have been traumatised, many have experienced conflict and crisis, and in turn face challenges expressing and regulating their emotions and behaviour. The aim of the small study, described in this field report, is to explore the power of using drama and art as tools for Syrian children to help them learn to identify their emotions. The qualitative study was conducted at an informal education centre in southeast Turkey, with 10 children, over the course of five workshops. Basic drama and creative art skills were used to raise awareness about emotions as the first phase of emotion regulation.
  313 65 -
FIELD REPORTS
Psychosocial support to foster social cohesion between refugee and host communities in Jordan
Paulina Acosta, Nuria Chica
July 2018, 16(2):147-153
DOI:10.4103/INTV.INTV_40_18  
The internal conflict in Syria has displaced large numbers of the population into neighbouring countries since the uprising in 2011. The large influx of displaced people into Jordan poses great challenges to the international community as well as local authorities, with increasing competition for already scarce resources and services creating rising tensions between refugee and host communities. In this context, the non-governmental organisation, Action Contre la Faim, implemented a programme aimed at improving psychosocial well-being, fostering resilience and promoting positive interactions between the members of both communities. Through the participation of support groups within community-based organisations, dialogue was facilitated, and interactions took place in a safe and therapeutic environment. Participants reported improved perception of well-being and self confidence, as well as improved mutual understanding and communication, reduced isolation and the extension of social support, enhanced empathy and reduce prejudice.
  235 77 -
ARTICLES
‘This is not paranoia, this is real life’: Psychosocial interventions for refugee victims of torture in Athens
Gail Womersley, Laure Kloetzer
July 2018, 16(2):95-102
DOI:10.4103/INTV.INTV_5_18  
The need for culturally relevant treatment interventions for refugees focusing on post-migration factors is clearly of no small concern. To (i) explore culturally informed perspectives on trauma from an individual, qualitative perspective and (ii) track the trajectory of post-traumatic responses in relation to processes of social integration, we present the results of 12 months of research among asylum seekers and refugees in an NGO-run centre for victims of torture in Athens, Greece. This included an in-depth follow-up of 10 victims of torture, as well as interviews with 36 health professionals, seven cultural mediators and 21 refugee community leaders. A case study from the research project is presented to illustrate the substantial psychological impact of current material realities of refugee victims of torture as they adapt to their new environment. An interpersonal-social model is presented which examines various post-migration ‘feedback loops’ influencing post-traumatic symptomatology. Key implications for practice
  • Professionals working with refugee populations need to take into account the various cultural manifestations and understandings of trauma
  • Post-migration factors encountered in Europe, including delayed asylum trials and poor living conditions, have a substantial impact on post-traumatic symptoms
  • Psychosocial interventions need to include a focus on the current social, political and economic context.
  242 68 -
SPECIAL SECTION: PSYCHOSOCIAL SUPPORT AND CONFL ICT TRANSFORMATION: A NECESSARY DIALOGUE
Non-violent communication and theatre of the oppressed: A case study with Syrian refugee women from the Kareemat Centre in Turkey
Usama Alshughry
July 2018, 16(2):170-174
DOI:10.4103/INTV.INTV_45_18  
This field report describes a case study on the applicability of non-violent communication (NVC) within the Syrian refugee context, and the usefulness of theatre of the oppressed techniques in practicing NVC. The intervention was applied to refugee women working or attending activities in a livelihood centre in Turkey. Through the work, NVC was explained and discussed with participants, who brought real-life themes and scenarios to practice learnt skills using theatre of the oppressed techniques. Participants reported improved self-compassion, compassion, communication and collaboration with others. They also reported that such activities changed their view of conflict. Theatre of the oppressed helped participants achieves more empathy and understanding and to try different solutions to scenarios in which they faced conflict.
  203 76 -
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