A Lay-Led Intervention for War and Refugee Related Trauma

项目摘要/摘要 创伤后应激障碍是一种慢性和令人衰弱的精神疾病，在饱受战争蹂躏的地区，如 索马里，以性暴力和其他侵犯人权行为著称(例如，50.1%；Johnson等人，2010年)。在……里面 在与战争和难民有关的重大创伤的后果下，显然需要进行有效性研究 解决索马里人和广大穆斯林重要的、未得到充分解决的心理健康需求 社区。虽然对创伤后应激障碍和相关困难有有效的治疗方法，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，还有很大的障碍 由于伊斯兰信仰盛行，这种治疗方法的传播，特别是向索马里社区传播 与心理健康干预相矛盾，语言差异和获得护理的机会有限(例如，Bentley et Al.，2011；Aloud&Rathur，2009)。对于一个几乎完全是穆斯林的人口来说，一种 融入伊斯兰原则是至关重要的。现有的创伤治疗都不以伊斯兰为重点， 尽管世界上近四分之一的人口信奉这一宗教。我们已经开发出一种 简短的，基于团体的，外行主导的干预，伊斯兰创伤治疗，专门针对精神创伤的治疗 清真寺内的创伤。为期六个交易日的干预结合了经验支持的暴露- 以伊斯兰原则为基础的认知重组技术，以精神、社会、家庭和工作为中心 生活。核心干预部分包括通过先知故事进行认知重建，以及接触 通过与真主的对话回忆创伤。茶、香和祈求是每一组的一部分。 会议，以促进社区意识和灵性。我们将在一项小型随机对照试验中检查干预措施 检查干预机制，特别是关于自我、世界和 其他人以及与他人和真主的联系的变化。我们还将演示初步可行性 在美国以外的一个伊斯兰国家实施该计划，方法是进行一项小型的事前到事后研究 设计。综上所述，这项工作将为美国伊斯兰内部更大规模的RCT奠定基础 难民社区和/或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，可以 解决创伤带来的心理创伤。

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.