Trauma-Informed Psychoeducation for Somali Refugee Youth in Urban Kenya: Effects on PTSD and Psychosocial Outcomes
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The current study developed and implemented a trauma-informed psychoeducation (TIPE) intervention that is culturally relevant to urban Somali refugees in Nairobi, Kenya. A total of 141 Somali refugee youth completed 12 sessions of peer-led TIPE intervention. A series of pre- and post-tests revealed that TIPE made positive impacts on PTSD symptoms and psychosocial factors, with a differential effect observed according to baseline PTSD symptom report. Participants with high baseline PTSD scores (i.e. above clinical threshold) reported a significant decrease in PTSD symptoms and increase in perceived social support. In the meantime, those with no to mild baseline PTSD symptoms showed an increase in self-awareness of trauma responses and thus PTSD symptom report within the range of normalcy. This research supports the effect of a culturally relevant psychoeducation intervention in addressing the high mental health and psychosocial needs of the marginalized urban Somali refugee community in low resource settings.
KeywordsMental health Refugee trauma Intervention Social support Peer-led psychoeducation
The authors wish to acknowledge Tawakal Medical Centre (TMC), which mobilized the community, recruited community leaders and Somali youth participants, and translated research materials for both training and interventions. We are grateful to the local CBO, Saxansaxo (meaning Breeze of Hope), which consists of youth leaders for helping provide the TIPE intervention to youth peers in collaboration with community counselors. We also thank Africa Mental Health Foundation for coordinating and managing the administrative aspect of the project. This study was funded by the Kenya Transitional Initiative (KTI), USAID.
Compliance with Ethical Standards
Disclosure of Interest
Hyojin Im has no conflict of interest to disclose. Jennifer F. Jettner has no conflict of interest to disclose. Abdilkadir H. Warsame has no conflict of interest to disclose. Maimuna M. Isse has no conflict of interest to disclose. Dalia Khoury has no conflict of interest to disclose. Avina I. Ross has no conflict of interest to disclose.
Ethical Standards and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
- Center for Victims of Torture (2008). Education and Support Group for War Trauma Survivors: A manual for facilitators. The Center for Victims of Torture. Minneapolis. MN.Google Scholar
- De Jong, J. (Ed.). (2006). Trauma, war, and violence: Public mental health in socio-cultural context. Springer Science & Business Media.Google Scholar
- DeVellis, R. F. (2011). Scale Development: Theory and Applications (3rd ed). Sage Publications.Google Scholar
- Eisinga, R., Grotenhuis, M. T., & Pelzer, B. (2013). The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown?. International Journal of Public Health, 1–6. https://doi.org/10.1007/s00038-012-0416-3.
- Ellis, B. H., MacDonald, H. Z., Lincoln, A. K., & Cabral, H. J. (2008). Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. Journal of Consulting and Clinical Psychology, 76(2), 184. https://doi.org/10.1037/0022-006X.76.2.184.CrossRefPubMedGoogle Scholar
- Gerritsen, A. A., Bramsen, I., Deville, W., van Willgen, L. H., Hovens, J. E., & van der Ploeg, H. M. (2006). Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 41, 18–26.CrossRefPubMedGoogle Scholar
- Hinton, D. E., & Lewis-Fernandez, R. (2011). The cross-cultural validity of posttraumatic stress disorder: Implications for DSM-5. Depression and Anxiety, 28. https://doi.org/10.1002/da.20753.
- Im, H., Ferguson, A., & Hunter, M. (2017). Cultural translation of refugee trauma: cultural idioms of distress among Somali refugees in displacement. Transcultural Psychiatry, 54(5–6), 626–652.Google Scholar
- Jordans, M. J., Tol, W. A., & Komproe, I. H. (2011). Mental health interventions for children in adversity: pilot-testing a research strategy for treatment selection in low-income settings. Social Science & Medicine, 73(3), 456–466. https://doi.org/10.1016/j.socscimed.2011.06.004.CrossRefGoogle Scholar
- Miller, K. E., & Rasmussen, A. (2010). War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Social Science and Medicine, 70, 7–16. https://doi.org/10.1016/j.socscimed.2009.09.029.CrossRefPubMedGoogle Scholar
- National Ethical Review Committee (2004). Kenya medical research institute (KEMRI) national ethical review committee guidelines and standard operating procedures (SOPs). Retrieved from https://www.daidscrss.com/partners/Page_Regulatory_Management/Docs_Regulatory_Management/Docs_Flag_Forms/Kenya_KEMRI_GUIDELINES_FINAL_VERSION.pdf.
- Pavanello, S., Elhawary, S., & Pantuliano, S. (2010). Hidden and exposed: Urban refugees in Nairobi, Kenya. Londond: Overseas Development Institute.Google Scholar
- Peltonen, K., Qouta, S., El Sarraj, E., & Punamäki, R.-L. (2012). Effectiveness of school-based intervention in enhancing mental health and social functioning among war-affected children. Traumatology Online, 1–10. https://doi.org/10.1177/1534765612437380.
- Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. The Lancet, 379(9812), 250–265. https://doi.org/10.1016/S0140-6736(11)60050-0.CrossRefGoogle Scholar
- Rivera, R., & Borasky, D. (2009). Research Ethics Training Curriculum, Family Health International (FHI). Retrieved from https://www.fhi360.org/sites/default/files/media/documents/Research%20Ethics%20Training%20Curricula.pdf.
- Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & Van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. Journal of the American Medical Association, 302(5), 537–549.CrossRefPubMedGoogle Scholar
- Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics, 5th. Needham Height, MA: Allyn & Bacon.Google Scholar
- Tol, W. A., Rees, S. J., & Silove, D. M. (2013). Broadening the scope of epidemiology in conflict-affected settings: opportunities for mental health prevention and promotion. Epidemiology and Psychiatric Sciences, 22(03), 197–203. https://doi.org/10.1017/S2045796013000188.CrossRefPubMedGoogle Scholar
- UNESCO (2005). Inter-Agency Peace Education Programme: Skills for Constructive Living. Retrieved from http://www.ineesite.org/en/peace-education.
- UNESCO (2016). “What do we mean by ‘youth’?” Retrieved from http://www.unesco.org/new/en/social-and-human-sciences/themes/youth/youth-definition/.