The art and skill of delivering culturally responsive trauma-focused cognitive behavioral therapy in Tanzania and Kenya.
Open accessAbstract
OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in a culturally responsive manner. METHOD: Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. RESULTS: Lay counselors described the importance of being responsive to TF-CBT participants' customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. CONCLUSION: The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. (PsycINFO Database Record
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Community support was sometimes reported as a facilitator, especially in small, tight-knit communities where collaboration with community members allowed implementers to safely identify and engage potential clients and ensure community acceptability.
“Community factors such as community support were sometimes reported as facilitators, especially when interventions were held in small, tight-knit communities where collaboration with community members (e.g., community leaders, traditional healers) allowed for implementers to safely identify and engage potential clients, and ensure the community acceptability of the intervention [60, 67].”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [60]
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References 39 · Cited by 44
Research works printed but not linked: 3
- Betancourt TS Beardslee W Kirk C Hann K Zombo M Mushashi C Bizimana JI Thornicroft G Patel V Working with vulnerable populations Global Mental Health Trials 2014 New York, NY Oxford University Press
- Dorsey S McLaughlin K Kerns S Harrison J Lambert H Briggs-King E Amaya-Jackson LA Evidence-base on trauma treatment: Updates and recommendations Journal of Clinical Child and Adolescent Psychology in press PMC5395332 27759442
- WHO Scaling up care for mental, neurological, and substance use disorders 2008 Retrieved from http://www.who.int/mental_health/mhgap_final_english.pdf 26290926
- Authors
- Woods-Jaeger, B. A., Kava, C. M., Akiba, C. F., Lucid, L., & Dorsey, S.
- Affiliations
- Children's Mercy Hospital (US)
- University of Iowa (US)
- Johns Hopkins University (US)
- University of Washington (US)
- Corresponding author
- Woods-Jaeger, Briana A.
- Venue
- Psychological Trauma: Theory, Research, Practice, and Policy
- Published
- 2017-03
- Volume
- 9
- Issue
- 2
- Pages
- 230-238
- ISSN
- 1942-9681 (ISSN-L)
- 1942-969X
- PMC
- PMC5237406
- OpenAlex
- W2472104153
- Cited by
- 44
- References
- 39
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 15 · 2021: 2 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Trauma Theory Research Practice and Policy (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH096633)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- trauma-focused cognitive behavioral therapy, culturally responsive treatment, task sharing, lay counselors, child mental health, evidence-based treatment, mental health treatment gap, low- and middle-income countries, treatment acceptability, socio-economic needs, Tanzania, Kenya
- MeSH terms
- Trauma and Stressor Related Disorders, Bereavement, Child, Community Health Workers, Culture, Delivery of Health Care, Female, Humans, Interviews as Topic, Kenya, Male, Mental Health Services, Parents, Pediatrics, Socioeconomic Factors, Tanzania, Cognitive Behavioral Therapy, Evidence-Based Medicine, Qualitative Research, Culturally Competent Care
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