A Lay-Led Intervention for War and Refugee Related Trauma

项目总结/摘要 创伤后应激障碍是一种慢性的、使人衰弱的精神疾病， 索马里以性暴力和其他侵犯人权行为而闻名（例如，50.1%;约翰逊等人，2010年）。在 在经历了大量与战争和战争有关的创伤之后，显然需要进行有效性研究 解决索马里人和更广泛的穆斯林的重大、未得到充分解决的心理健康需求 社区虽然存在对PTSD和相关困难的有效治疗，但这种治疗通常 在提供治疗之前，需要对提供者进行广泛的培训。此外，还存在重大障碍， 传播这种治疗，特别是向索马里社区，由于伊斯兰信仰， 与心理健康干预措施相矛盾，语言差异，以及获得护理的机会有限（例如，本特利等 例如，2011; Aloud & Rathur，2009）。对于一个几乎完全是穆斯林的人口来说， 伊斯兰教的原则是必不可少的。现有的创伤治疗方法都不以伊斯兰为重点， 尽管世界上几乎四分之一的人口信奉这种宗教。我们已经开发出一种 一个简短的，以小组为基础的，由外行领导的干预，伊斯兰创伤愈合，专门针对愈合的精神 清真寺内的创伤。六个疗程的干预结合了医疗支持的暴露- 以伊斯兰原则为基础的认知重建技术，这些原则是精神，社会，家庭和工作的核心 生活核心干预内容包括通过先知故事进行认知重建， 通过与真主交谈来恢复创伤记忆茶，香，并恳求包括作为每一组的一部分 会议，以促进社区意识和精神。我们将在一个小型随机对照试验中研究干预措施， 检查干预机制，特别是对自我，世界和 与其他人和真主的联系的变化。我们还将展示以下初步可行性： 在美国以外的伊斯兰国家实施该计划，通过进行小型的前期到后期研究， 设计总的来说，这项工作将作为美国伊斯兰教内更大规模RCT的基础。 难民社区和/或在美国以外的更大的伊斯兰社区伊斯兰创伤愈合 该计划有可能提供一种低成本，自我维持的基于信仰的干预模式， 解决创伤造成的心理创伤

PROJECT SUMMARY/ABSTRACT Rates of PTSD, a chronic and debilitating mental disorder, are considerably higher in war-torn regions like Somalia, known for sexual violence and other human rights violations (e.g., 50.1%; Johnson et al., 2010). In the aftermath of substantial war- and refugee-related trauma, there is a clear need for effectiveness research addressing the significant, under-addressed mental health needs of Somalis and the broader Muslim community. While efficacious treatments exist for PTSD and related difficulties, such treatments typically require extensive training of providers prior to treatment delivery. Furthermore, there are significant barriers to dissemination of such treatments, particularly to the Somali community, due to Islamic beliefs that run contradictory to mental health interventions, language differences, and limited access to care (e.g., Bentley et al., 2011; Aloud & Rathur, 2009). For a population that is almost exclusively Muslim, a treatment that incorporates Islamic principles is essential. No existing trauma-focused treatments have an Islamic focus, despite the fact that almost a quarter of the world's population practices this religion. We have developed a brief, group-based, lay-led intervention, Islamic Trauma Healing, which specifically targets healing the mental wounds of trauma within mosques. The six-session intervention combines empirically-supported exposure- based and cognitive restructuring techniques with Islamic principles central to spiritual, social, family, and work life. Core intervention components include cognitive restructuring through Prophet stories, and exposure to trauma memories through talking to Allah. Tea, incense, and supplications are included as part of each group session to promote a sense of community and spirituality. We will examine the intervention in a small RCT and examine intervention mechanisms, specifically the effects of shifts in negative cognitions about self, world, and others and changes in connectedness with others and Allah. We also will demonstrate the initial feasibility of implementing the program outside of the U.S. to an Islamic country by conducting a small pre- to post-study design. Taken together, this work will serve as the foundation for a larger scale RCT within the U.S. Islamic refugee community and/or in the larger Islamic community outside of the U.S. The Islamic Trauma Healing program has the potential to provide a low-cost, self-sustaining model of faith-based intervention that can address the psychological wounds of trauma.