title: A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in north-eastern Democratic Republic of Congo.
abstract: Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n=79) carried out by supervised local, lay facilitators or a wait-list control group (n=80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d=0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398.
authors.affiliation: School of Psychology, Queen's University, Belfast, Northern Ireland, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: O'Callaghan
authors.affiliation: Programme Director, Central Africa at Discover the Journey, Senior Producer at Discover the Journey, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Branham
authors.affiliation: School of Psychology, Queen's University, Belfast, Northern Ireland, UK.
authors.forename: Ciarán
authors.initials: C
authors.lastname: Shannon
authors.affiliation: Child Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, 651 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.affiliation: School of Psychology, Queen's University, Belfast, Northern Ireland, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Dempster
authors.affiliation: School of Psychology, Queen's University, Belfast, Northern Ireland, UK.
authors.forename: John
authors.initials: J
authors.lastname: McMullen
mesh_terms: D000293:Adolescent; D002648:Child; D003415:Crime / Q000523:psychology*; D015023:Democratic Republic of the Congo; D005190:Family / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012423:Rural Health; D012919:Social Behavior; D016896:Treatment Outcome; D014754:Violence / Q000523:psychology; D014857:Warfare
keywords: Abduction; Internalising symptoms; Post-traumatic stress symptoms; Psychosocial; War; Youth