RESUMO
Central American youth are at a high risk for experiencing trauma and related psychosocial problems. Despite this, few studies of evidence-based trauma-focused interventions with this population exist. The objective of this project was twofold: 1) to train providers in El Salvador in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as part of a clinical implementation project within a non-governmental organization, and 2) to conduct program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. Fifteen Salvadoran psychologists were trained in TF-CBT who then provided TF-CBT to 121 children and adolescents ages 3-18 in community-based locations. The mean number of traumas reported by youth was 4.39. Results demonstrated large effect sizes for reduction in youth-reported trauma symptoms (Cohen's d = 2.04), depressive symptoms (Cohen's d = 1.68), and anxiety symptoms (Cohen's d = 1.67). Our program evaluation results suggest that it was feasible to train providers in TF-CBT, that providers were in turn able to deliver TF-CBT in community-based settings, and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in El Salvador. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for youth in Latin American countries.
RESUMO
Salvadoran youth have an elevated risk of trauma exposure and related mental health problems. However, investigations of childhood trauma exposure and mental health sequelae in El Salvador are limited. The present study aimed to (a) explore the prevalence of exposure to potentially traumatic events and symptoms of posttraumatic stress, anxiety, and depression and (b) evaluate the associations between specific trauma types and emotional functioning among Salvadoran youth. A total of 1,296 youth aged 8-21 years from seven public schools completed self-report measures of trauma exposure, posttraumatic stress symptoms (PTSS), anxiety, and depression. Participants reported high levels of trauma exposure, endorsing an average of 3.62 (SD = 2.32) trauma types. In total, 34.5% of participants reported clinically elevated PTSS; fewer youths reported elevated depressive (8.7%) and anxiety symptoms (8.6%). Although boys reported exposure to more trauma types than girls, d = 0.22, girls were more likely to endorse elevated PTSS, V = .11; anxiety, V = .06; and depression, V = .10. Adolescents reported exposure to more trauma types than younger children, d = 0.23, and were more likely to endorse elevated PTSS, V = .07; anxiety, V = .13; and depression, V = .16. Undergoing a frightening medical procedure, OR = 2.30; female sex, OR = 1.92; witnessing domestic violence, OR = 1.70; and experiencing war between gangs, OR = 1.61, were strong predictors of elevated PTSS. This broad, school-based screening was a critical step toward better understanding the rate of trauma exposure and trauma-related symptoms among Salvadoran youth.
Assuntos
Saúde Mental , Transtornos de Estresse Pós-Traumáticos , Adolescente , Criança , El Salvador/epidemiologia , Feminino , Humanos , Masculino , Projetos Piloto , Instituições Acadêmicas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: The increased risk of mental health disorders in the months and years following a natural disaster highlights the need for more immediate preventive intervention. The objective of the current study was to learn from a real-time implementation of a natural disaster response following the Hurricane Maria in Puerto Rico to identify strategies for providing mental health services immediately after a natural disaster. METHODS: Two focus groups were held with faculty (n = 6) and graduate students (n = 4) from a graduate psychology program at the Universidad Carlos Albizu, Centro Universitario Mayagüez. An additional key informant interview was conducted with two faculty member participants. Data were analyzed qualitatively using thematic analysis. RESULTS: The delivery of mental health services was organized into three major themes: (1) finding a way to communicate, (2) targeting key access points for outreach and centralization of resources, and (3) providing triaged mental health care based on level of need. CONCLUSIONS: Findings are used to guide recommendations for mental health response preparation in future natural disaster contexts.