Intervention : Table of Contents

What works in psychosocial programming in humanitarian contexts in low- and middle-income countries: a systematic review of the evidence
Emily E Haroz, Amanda J Nguyen, Catherine I Lee, Wietse A Tol, Shoshanna L Fine, Paul Bolton
January-June 2020, 18(1):3-17
DOI:10.4103/INTV.INTV_6_19

While there is growing evidence for the effectiveness of mental health interventions in low- and middle-income countries and humanitarian contexts, this is lacking for psychosocial programming. We aimed to summarise the evidence for psychosocial programming in these contexts through a systematic review (PROSPERO: CRD42017069066) of peer-reviewed and grey literature of programme evaluations. A total of n = 42,435 unique records were initially identified, with n = 211 records meeting full inclusion criteria. We identified 51 randomised controlled trials of 47 different interventions. The remaining studies used different evaluation methodology. Only three interventions had more than one experimental/quasi-experimental evaluation: Brief Intervention and Contact, Problem Management Plus and Child Friendly Spaces. While there are many studies of interventions, it was challenging to identify the same intervention across studies, leaving almost no interventions with more than one rigorous study supporting their use and many interventions that are poorly described. This makes it difficult to choose between them or even to implement them. Future research should focus on replication of well-described interventions in multiple different sites, to place future intervention selection on a more scientific basis. There is also a need to better understand the impact of psychosocial programmes in sectors other than health and protection, such as nutrition. These sectors may provide critical delivery mechanisms for psychosocial programming to broaden the reach of such interventions. Key implications for practice

Efforts to build the evidence base for psychosocial programming in humanitarian settings are challenged by the breadth of programming delivered, populations served and outcomes targeted in this field, resulting in predominantly one-off studies of a wide range of interventions.
To inform future intervention selection, research initiatives should focus on replication of well-described interventions in multiple contexts or stages of humanitarian response.
Rigorous evaluation of community-focused psychosocial programmes is also needed.

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Psychological first aid through the ‘SIX Cs model’ − an intervention with migrants on the move
Einav Levy, Moshe Farchi, Yori Gidron, Eitan Shahar
January-June 2020, 18(1):71-77
DOI:10.4103/INTV.INTV_51_18

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Peacework and mental health: from individual pathology to community responsibility
Maureen P Flaherty, Ellen Sikorski, Liliya Klos, Viktor Vus, Nina Hayduk
January-June 2020, 18(1):28-36
DOI:10.4103/INTV.INTV_59_18

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Culturally adapted CBT (CA-CBT) for traumatised indigenous South Africans (Sepedi): a randomised pilot trial comparing CA-CBT to applied muscle relaxation
Baland Jalal, Qunessa Kruger, Devon E Hinton
January-June 2020, 18(1):61-65
DOI:10.4103/INTV.INTV_68_18

In South Africa, there is a high rate of events such as criminal violence, stress and sexual assault, particularly in lower socio-economic status (SES) communities. Problems are particularly acute amongst indigenous groups. In spite of the great need for interventions for those having experienced these events, little information is available to guide treatment choices. The goal of this randomised controlled trial was to test the efficacy and feasibility of culturally adapted CBT (CA-CBT) compared to applied muscle relaxation (AMR) for traumatised South Africans belonging to the Sepedi cultural group. Twenty patients with post-traumatic stress disorder (PTSD) completed the study. In the completer analysis, we found that CA-CBT offered substantial benefits over AMR, as seen in large effect sizes for PTSD (d = 2.11) as well as anxiety symptoms (d = 2.41), depressive symptoms (d = 2.25), and culturally salient somatic symptoms and syndromes (d = 1.41). The intent-to-treat analysis showed smaller but still large effect sizes for all measures: PTSD (d = 1.27), associated anxiety symptoms (d = 1.38), depressive symptoms (d = 1.30), and culturally salient somatic symptoms and syndromes (d = .99). Our study suggests that CBT can be successfully adapted for South African indigenous groups. Key implications for practice

This study shows the efficacy and acceptability of CBT in a randomised controlled pilot trial of an understudied group in great need of treatment compared to an active treatment condition (applied muscle relaxation (AMR)).
This is the first study to show efficacy of CBT for PTSD in any South African indigenous group and suggests that CBT may be successfully adapted for that group, with large effect sizes compared to AMR.
CA-CBT, which emphasises the treatment of somatic sensations, yoga-like stretching and meditation techniques to promote emotional and psychological flexibility, may be effective in treating indigenous South Africans.

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Three models of scaling up mental healthcare post-disaster: common challenges
Boris Budosan, John Mahoney, Winnie Campos Dorego, Sabah Aziz, Kesavan Ratnasabapathipillai
January-June 2020, 18(1):18-27
DOI:10.4103/INTV.INTV_11_19

There are number of challenges in strengthening mental healthcare services in underserved areas post-disaster. The objective of this paper is to identify common challenges by comparing and contrasting three models of scaling up mental healthcare services post-disaster. Primary and secondary data were collected before, during and after mental health programming in Sri Lanka, Haiti and the Philippines. A qualitative case study methodology including a set of narrative topics and programme indicators developed by the London School of Hygiene and Tropical Medicine was employed to document the services of the programmes. The authors added a set of outcome indicators to address the outcomes of programmes at community and individual level. We discuss challenges and conclude that sustainability of programme achievements, change of practices of trained non-specialised healthcare providers and their supervision and evidence of impact of clinical interventions are common challenges for scaling up mental health (MH) services post-disaster. We believe that more comparative evidence is needed on how MH services initiated by different actors’ post-disaster function in actual practice, especially in the longer term. Key implications for practice

Mental health services can be significantly scaled up at community, primary and secondary healthcare level within a relatively short period of time post-disaster.
Essential principles/components to be considered as key standards in MHPSS strategies post-disaster include regular consultations with local and national government and health authorities, a clear perspective on how to continue with longer term supervision after theoretical trainings, enough programme time allocated to clinical MH consultations (including follow-up) and focus on monitoring of improvement of clinical symptoms and functionality of clients.
It would be useful for developers of MHPSS programming post-disaster to respect the key standards in designing an innovative service model with an optimal mix of community-based psychosocial, outpatient clinic and inpatient clinic-based interventions to improve wellbeing and resilience of clients at community level and access to PHC and SHC level including affordability of psychiatric medications.

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Engaging men to promote resilient communities among Syrian refugees in Lebanon
Angela Veale, Fiona Shanahan, Alaa Hijazi, Zeina Osman
January-June 2020, 18(1):52-60
DOI:10.4103/INTV.INTV_55_18

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Baby friendly spaces: an intervention for pregnant and lactating women and their infants in Cameroon
Elisabetta Dozio, Karine Le Roch, Cécile Bizouerne
January-June 2020, 18(1):78-84
DOI:10.4103/INTV.INTV_61_18

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Evidence for suicide prevention strategies with populations in displacement: a systematic review
Emily E Haroz, Ellie Decker, Catherine Lee, Paul Bolton, Paul Spiegel, Peter Ventevogel
January-June 2020, 18(1):37-44
DOI:10.4103/INTV.INTV_10_19

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Psychoeducation for children in a psychiatric ward in the immediate aftermath of the 2011 earthquake and tsunami in Japan
Naru Fukuchi
January-June 2020, 18(1):85-91
DOI:10.4103/INTV.INTV_39_19

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Contextualising therapeutic care for child survivors of sexual violence in situations of war: a reflection on theory, context and practice
Buuma M Maisha
January-June 2020, 18(1):45-51
DOI:10.4103/INTV.INTV_50_18

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Use of store-and-forward tele-mental health for displaced Syrians
Nadim Almoshmosh, Hussam Jefee-Bahloul, Waseem Abdallah, Andres Barkil-Oteo
January-June 2020, 18(1):66-70
DOI:10.4103/INTV.INTV_53_19

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Solidarity in the face of global fragility
Wendy Ager
January-June 2020, 18(1):1-2
DOI:10.4103/INTV.INTV_8_20

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Diversity Competence: Cultures don’t meet, people do by Edwin Hoffman and Arjan Verdooren. Bussum: Uitgeverij Coutinho. 2018 (352 pages) ISBN: 978-90-4690598-2
Ton Haans
January-June 2020, 18(1):94-95
DOI:10.4103/INTV.INTV_1_20

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How can the COVID-19 response advance global mental health?
Steven Weine, Mary Bunn
January-June 2020, 18(1):92-93
DOI:10.4103/INTV.INTV_9_20

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