The Youth Readiness Intervention for War-Affected Youth

• Published in: Journal of adolescent health 2015-06, Vol.56 (6), p.606-611
• Main Authors: Newnham, Elizabeth A., Ph.D, McBain, Ryan K., Sc.D, Hann, Katrina, M.A, Akinsulure-Smith, Adeyinka M., Ph.D, Weisz, John, Ph.D, Lilienthal, Grace M, Hansen, Nathan, Ph.D, Betancourt, Theresa S., Sc.D., M.A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anxiety - etiology; Anxiety - therapy; Cognitive Therapy - methods; Depression - etiology; Depression - therapy; Emotions; Feasibility Studies; Female; Humans; Implementation; Intervention; Male; Mental Health; Mental Health Services; Mental Illness; Pediatrics; Pilot Projects; Post-conflict; Psychotherapy intervention; Sierra Leone; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; Symptoms; War; War Exposure - adverse effects; War-affected; Young Adult; Youth
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2015.01.020

Abstract Purpose 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.