Community Mental Health Journal

, Volume 49, Issue 3, pp 354–367 | Cite as

Treatment Processes of Counseling for Children in South Sudan: A Multiple n = 1 Design

  • M. J. D. JordansEmail author
  • I. H. Komproe
  • W. A. Tol
  • J. Nsereko
  • J. T. V. M. de Jong
Original Paper


Studies into treatment processes in low-income settings are grossly lacking, which contributes to the scarcity of evidence-based psychosocial treatment. We conducted multiple n = 1 studies, with quantitative outcome indicators (depression-, PTSD- and anxiety- symptoms, hope) and qualitative process indicators (treatment- perceptions, content and progress) measured before, during and after counseling. We aimed to explore commonalities in treatment processes associated with change profiles within and between cases. The study was conducted in South Sudan with children aged between 10 and 15 years. Change profiles were associated with the quality of the counselor-client relationship (instilling trust and hope through self-disclosure, supportive listening and advice giving), level of client activation, and the ability of the counselor to match treatment strategies to the client’s problem presentation (trauma- and emotional processing, problem solving, cognitive strategies). With limited time, due to restricted resources in low-income settings, training courses can now be better focused on key treatment processes.


Treatment process Counseling South Sudan Single case Children 



We would like to thank Eva Smallegange for her contributions to this study. This study was financed by a grant from PLAN Netherlands.

Conflict of interest

None of the authors have any competing interests to disclose.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • M. J. D. Jordans
    • 1
    • 4
    Email author
  • I. H. Komproe
    • 1
    • 5
  • W. A. Tol
    • 1
    • 6
  • J. Nsereko
    • 2
  • J. T. V. M. de Jong
    • 3
    • 7
  1. 1.Research and Development DepartmentHealthNet TPOAmsterdamThe Netherlands
  2. 2.Country OfficeHealthNet TPOYeiSouth Sudan
  3. 3.VU University Medical CenterVrije UniversiteitAmsterdamThe Netherlands
  4. 4.Center for Global Mental HealthLondon School of Hygiene and Tropical MedicineLondonUK
  5. 5.Faculty of Social and Behavioural SciencesUtrecht UniversityUtrechtThe Netherlands
  6. 6.Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  7. 7.School of MedicineBoston UniversityBostonUSA

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