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      Training non-specialists in teaching recovery techniques (TRT) to help traumatised children in humanitarian settings: a qualitative analysis of experiences gained from 20 years of practice

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          Abstract

          Background

          Although several manuals and guidelines have been developed to enhance the quality of task-sharing interventions, it remains challenging to train non-professional personnel in mental health and psychosocial support. Practitioners must translate general recommendations into practical applications to make them relevant in demanding contexts. However, limited research exists on practical experiences with standardised programmes in the field.

          Aim

          To explore how experiences gained from the training of first-line health providers in a low-threshold intervention for children with trauma symptoms may guide implementation of such interventions in local communities in low-income countries. Method: We summarise 20 years of experience in the training of first-line health providers, teachers, and school counsellors in providing a low-threshold intervention. The intervention is called teaching recovery techniques (TRT), developed by the Children and War Foundation (CAW). Field notes containing notes from trainings and oral, informal feedback from participants are analysed using thematic analysis, a method well-suited for identifying, analysing, and reporting patterns, or themes, within data in qualitative research.

          Findings

          The analysis showed three main themes/ challenges: (1) Who can conduct the TRT intervention? (2) What form and content should the training take? (3) How can the intervention be used in a responsible way to follow the ‘do no harm’ principle? We discuss the implications of the findings for trainings in scalable interventions and further research.

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          Most cited references50

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          Using thematic analysis in psychology

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              Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries.

              Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.
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                Author and article information

                Contributors
                unni.heltne@uib.no
                anna.sarkadi@pubcare.uu.se
                lars.lien@sykehuset-innlandet.no
                ragnhild.dybdahl@fhi.no
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                11 September 2023
                11 September 2023
                2023
                : 22
                : 187
                Affiliations
                [1 ]GRID grid.7914.b, ISNI 0000 0004 1936 7443, Centre for Crisis Psychology, , University of Bergen, ; Bergen, Norway
                [2 ]GRID grid.8993.b, ISNI 0000 0004 1936 9457, Uppsala University, ; Uppsala, Sweden
                [3 ]National Competence Services for Concurrent Addiction and Mental Disorders, Brummundal, Norway
                [4 ]GRID grid.418193.6, ISNI 0000 0001 1541 4204, Norwegian Institute of Public Health, ; Oslo, Norway
                Article
                1999
                10.1186/s12939-023-01999-z
                10494337
                37697272
                78b6f3fb-a57b-4912-b866-e4f1838b498b
                © BioMed Central Ltd., part of Springer Nature 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 May 2023
                : 25 August 2023
                Funding
                Funded by: University of Bergen (incl Haukeland University Hospital)
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Health & Social care
                psychosocial support in emergencies,task-sharing,trauma reactions,group interventions,children and adolescents,global mental health

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