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      Role of Community Resiliency Model Skills Trainings in Trauma Healing Among 1994 Tutsi Genocide Survivors in Rwanda

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          Abstract

          Background

          Mental health among survivors of the 1994 Tutsi genocide in Rwanda remains poor, even after multiple efforts to assist those recovering from this trauma. The Community Resilience Model (CRM) is a biologically based set of skills that can be delivered in community settings by trained lay persons and has shown to significantly improve mental health in a number of settings and populations, though it has not been used with genocide survivors in Rwanda. This study assessed if the CRM training was able to improve mental health among genocide survivors.

          Methods

          A quasi-experimental design was used to evaluate the CRM intervention among Tutsi genocide survivors from the Huye, Nyamagabe and Nyaruguru districts in Southern Rwanda. Consenting participants completed a questionnaire before and six months after the training to assess their level of trauma, secondary traumatic stress, depression and skills to teach CRM skills to others.

          Results

          The findings revealed significant improvements across all trauma symptoms between the intervention and control group (t = 37, p<0.001). The CRM trainings also resulted in significant within-person declines of depressive symptoms (p < 0.001), perceived secondary traumatic stress (p = 0.003) and trauma-related symptoms (p = 0.002). Training participants also reported significant increases in perceived CRM benefits and satisfaction (p < 0.001).

          Conclusion

          The CRM intervention was found to be effective for improving mental health in 1994 Tutsi genocide survivors. Since CRM can be delivered by trained persons to groups of persons in community settings, it has a high potential for successful broader implementation and sustainability, which is critically important in an environment with few mental health resources.

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          Most cited references34

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            Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?

            Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience. ((c) 2004 APA, all rights reserved)
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              Trauma exposure and psychological reactions to genocide among Rwandan children.

              A total of 3030 children age 8-19 years from Rwanda was interviewed about their war experiences and reactions approximately 13 months after the genocide that started in April 1994. Rwandan children had been exposed to extreme levels of violence in the form of witnessing the death of close family members and others in massacres, as well as other violent acts. A majority of these children (90%) believed that they would die; most had to hide to survive, and 15% had to hide under dead bodies to survive. A shortened form of the Impact of Event Scale used in a group of 1830 of these children documented high levels of intrusion and avoidance. While children living in shelters were exposed to more trauma, they evidenced less posttraumatic reactions. Analyses showed that reactions were associated with loss, violence exposure, and, most importantly, feeling their life was in danger.
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                Author and article information

                Journal
                Psychol Res Behav Manag
                Psychol Res Behav Manag
                prbm
                prbm
                Psychology Research and Behavior Management
                Dove
                1179-1578
                30 July 2021
                2021
                : 14
                : 1139-1148
                Affiliations
                [1 ]Rwanda Resilience and Grounding Organization (RRGO) , Kigali, Rwanda
                [2 ]Prison Fellowship Rwanda , Kigali, Rwanda
                [3 ]Department of Child Development, Protection and Promotion, National Child Development Agency (NCDA) , Kigali, Rwanda
                [4 ]National Rehabilitation Service (NRS) , Kigali, Rwanda
                [5 ]Department of Clinical Psychology, University of Rwanda , Kigali, Rwanda
                [6 ]Department of Social Work and Social Ecology, School of Behavioral Health, Loma Linda University (LLU) , Loma Linda, CA, USA
                Author notes
                Correspondence: Samuel Habimana Tel +250 788765133 Email samhabimana78@gmail.com
                Author information
                http://orcid.org/0000-0001-7494-2779
                Article
                319057
                10.2147/PRBM.S319057
                8331195
                34354379
                5e53ea49-b59d-4de6-9236-ee5804fe6d36
                © 2021 Habimana et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 08 May 2021
                : 21 July 2021
                Page count
                Figures: 0, Tables: 12, References: 37, Pages: 10
                Funding
                Funded by: no funding;
                The research had no funding.
                Categories
                Original Research

                Clinical Psychology & Psychiatry
                community resilience model,resilience,genocide survivor,trauma healing

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