title: The Youth Readiness Intervention for war-affected youth.
abstract: OBJECTIVE
  Mental disorders are among the largest contributors to the global burden of disease. Since the cessation of the Sierra Leonean civil war in 2002, there have been few mental health resources available for war-affected youth. Co-occurring psychological problems are commonly reported by youth in the post-conflict setting, suggesting a need for evidence-based interventions that cater to comorbid psychological difficulties. This feasibility study outlines the implementation and evaluation of a mixed-methods approach for developing and piloting a culturally grounded group mental health treatment-the Youth Readiness Intervention (YRI)-for war-affected Sierra Leonean youth.
  
  
  METHODS
  Participating youth (N = 32; 50% female; ages, 15-24 years) were allocated to one of four gender- and age-stratified groups, facilitated by gender-matched Sierra Leonean interventionists. The intervention comprised adapted cognitive behavioral therapy techniques to address issues pertinent to war-affected youth. Analyses comprised assessments of reliable symptom change, mental health, functional adaptation, and interventionist fidelity outcomes.
  
  
  RESULTS
  The YRI was found to be acceptable, feasible and associated with reliable changes in internalizing and externalizing symptoms and improvements in functional impairments and emotion regulation (mean effect size, d = .64).
  
  
  CONCLUSIONS
  Youth struggling with the mental health consequences of past trauma due to war merit special attention. The YRI presents a feasible and acceptable intervention for use in this low resource setting. A randomized controlled trial is planned to further test intervention effectiveness and scalability.
authors.affiliation: François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Newnham
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: McBain
authors.affiliation: François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Katrina
authors.initials: K
authors.lastname: Hann
authors.affiliation: Department of Psychology, City College of New York, New York, New York.
authors.forename: Adeyinka M
authors.initials: AM
authors.lastname: Akinsulure-Smith
authors.affiliation: Department of Psychiatry, Harvard University, Boston, Massachusetts.
authors.forename: John
authors.initials: J
authors.lastname: Weisz
authors.affiliation: François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Lilienthal
authors.affiliation: Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Hansen
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: Theresa_Betancourt@harvard.edu.
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012807:Sierra Leone; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D000067453:War Exposure / Q000009:adverse effects*; D055815:Young Adult
keywords: Mental health; Post-conflict; Psychotherapy intervention; War-affected; Youth