A Lay-Led Intervention for War and Refugee Related Trauma

Rates of PTSD, a chronic and debilitating mental disorder, are considerably higher in war-torn regions like Somalia, known for sexual violence and other human rights violations e.g., 50.1 percent Johnson et al., 2010. In the aftermath of substantial war- and refugee-related trauma, there is a clear need for effectiveness research addressing the significant, under-addressed mental health needs of Somalis and the broader Muslim community. While efficacious treatments exist for PTSD and related difficulties, such treatments typically require extensive training of providers prior to treatment delivery. Furthermore, there are significant barriers to dissemination of such treatments, particularly to the Somali community, due to Islamic beliefs that run contradictory to mental health interventions, language differences, and limited access to care e.g., Bentley etal., 2011 Aloud and Rathur, 2009. For a population that is almost exclusively Muslim, a treatment that incorporates Islamic principles is essential. No existing trauma-focused treatments have an Islamic focus, despite the fact that almost a quarter of the worlds population practices this religion. We have developed a brief, group-based, lay-led intervention, Islamic Trauma Healing, which specifically targets healing the mental wounds of trauma within mosques. The six-session intervention combines empirically-supported exposure-based and cognitive restructuring techniques with Islamic principles central to spiritual, social, family, and worklife. Core intervention components include cognitive restructuring through Prophet stories, and exposure to trauma memories through talking to Allah. Tea, incense, and supplications are included as part of each group session to promote a sense of community and spirituality. We will examine the intervention in a small RCT and examine intervention mechanisms, specifically the effects of shifts in negative cognitions about self, world, and others and changes in connectedness with others and Allah. We also will demonstrate the initial feasibility of implementing the program outside of the U.S. to an Islamic country by conducting a small pre- to post-study design. Taken together, this work will serve as the foundation for a larger scale RCT within the U.S. Islamic refugee community and or in the larger Islamic community outside of the U.S. The Islamic Trauma Healing program has the potential to provide a low-cost, self-sustaining model of faith-based intervention that can address the psychological wounds of trauma.