The art and skill of delivering culturally responsive trauma-focused cognitive behavioral therapy in Tanzania and Kenya.

Briana A. Woods-Jaeger · Christine Marie Kava · Christopher F. Akiba · Leah Lucid · Shannon Dorsey

44 citations0/0 files storedPsychological Trauma Theory Research Practice and Policy

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Mental Health Treatment and Access Counseling Practices and Supervision Health Policy Implementation Science

Abstract

OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in a culturally responsive manner. METHOD: Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. RESULTS: Lay counselors described the importance of being responsive to TF-CBT participants' customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. CONCLUSION: The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. (PsycINFO Database Record

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References

1992Basics of Qualitative Research: Grounded Theory Procedures and Techniques.2006A General Inductive Approach for Analyzing Qualitative Evaluation Data 1998Cultural Humility Versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education 1993Doing Naturalistic Inquiry: A Guide to Methods 1998Codebook Development for Team-Based Qualitative Analysis 2006Treating Trauma and Traumatic Grief in Children and Adolescents 2010Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective.2008Evidence-Based Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events

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