Barriers to Accessing Community Based Trauma-focused Cognitive Behavioral Therapy (TF-CBT) for Posttraumatic Stress Disorder (PTSD) Management in Post Conflict Acholi Sub-region
DOI:
https://doi.org/10.47672/ajp.1276Keywords:
Barriers, disorder, therapy.Abstract
Purpose: The study aimed at assessing barriers in accessing Community-Based Trauma- Focused Cognitive Behavioral Therapy (TF-CBT) for Posttraumatic Stress Disorder (PTSD) management in post-conflict Acholi sub-region with interest in providing solutions to those barriers.
Methodology: The study adopted a survey approach which was qualitative. This was done through interviews. This was supplemented by the pragmatic paradigm that concerned assessing effectiveness of community-based TF-CBT. The research design used to assess barriers and facilitators of TF-CBT was cross sectional. The use of cross-sectional survey design involved the elements of comparative, exploratory and descriptive approaches. Sample selection of participants involved organizational staff comprising of, social workers, clinical psychologists, Village Health Team (VHTs). Beneficiaries who included 120 men and 299 women. The 419 beneficiaries were interrogated using a questionnaire, 36 participants for Focused Group Discussions (FGDs), four social workers and, one clinical psychologist and 25 in-depth interviews with beneficiaries.
Findings: Results indicated; limited mobilization, stigmatization, lack of enough human resource, alcoholism, lack of commitment and economic crisis amongst others as barriers to accessing TF-CBT for PTSD management. The study suggests that these can be handled through sensitization, radio talk shows, visiting clients in their homes and increasing number of staff. The study suggests community sensitization, recruiting more staff to handle TF-CBT, visitations by staff to clients, family support from spouses & caregivers and increased infrastructure as the recommended measure to handle this problem.
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References
Baguma, P. (2001). Stress and Coping among Ugandan Nurses. Journal of Psychology in Africa, Vol. 11(1). 16-37.
Baloyi, M.E. (2014). Distance no impediment for funerals: death as a uniting ritual for African people - A pastoral study. Journal of Verbum Eccles. Vol.35 (1):1-6.
Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, Vol.43 (4), 393-402.
Cohen J.A. & Mannarino, A.P. (2015).Trauma-Focused Cognitive Behavioral Therapy for Traumatized Children and Families. Journal of Child Adolescent Psychiatry, Vol. 24(3):557-570.
Cohen, J.A., Mannarino, A.P., Kleithermes, M. & Murray, L.A. (2012). Trauma-focused Cognitive Behavioral Therapy for Youth with complex trauma. Child Abuse Neglect. 2012; 36:528-541. [PMC free article] [PubMed] [Google Scholar].
Corvalan, J.C. & PTSD: Klein,D. (2011). Diagnosis, Evolution, and Treatment of Combat-Related Psychological/Psychiatric Injury. Journal of Missouri State Medical Association, Vol. (108(4): 296-303.
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011).Trauma- focused cognitive behavioral therapy for children: Impact of the trauma narrative and treatment length. Depression and Anxiety, 28(1), 67-75.
Dobson, K. S., & Dozois, D. J. (2001). Historical and Philosophical bases of theCognitive-behavioral Therapies. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (2nd ed., pp. 3-39). New York. Guilford Press.
Jensen, T. K., Holt, T., Ormhaug, S. M., Egeland, K., Granly, L., Hoaas, L. C., & Wentzel-Larsen, T. (2014). A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth. Journal of Clinical Child & Adolescent Psychology, 43(3), 356-369.
Kane, J. C., Adaku, A., Nakku, J., Odokonyero, R., Okello, J., Musisi, S., & Tol, W. A. (2015). Challenges for the implementation of World Health Organization guidelines for acute stress, PTSD, and bereavement: a qualitative study in Uganda. Implementation Science, 11(1), 36.
Keegan, E., & Holas, P. (2009). Cognitive-behavior therapy. Theory and practice. In R. Carlstedt (Ed.), Integrative clinical psychology, psychiatry and behavioral medicine (pp. 605-643). New York: Springer.
Mugisha, J., Muyinda, H., Wandiembe, P & Kinyanda, E. (2015).Prevalence and Factors Associated with Posttraumatic Stress Disorder seven years after the Conflict in Three districts in Northern Uganda (The Wayo-Nero Study). Journal of BMC Psychiatry, Vol. 15(1):1-12.
Ovuga, E. & Larroque, C. (2014). Post Traumatic Stress Disorder. A Northern Uganda Clinical Perspective. Accessed on 29th September 2021. https://www.researchgate.net/publication/221922864. Pages 184-207.
Peter D. Steele, P.D. (2019). Looking to the Future with the Burdens of the Past: Exploring the Systems of Mental Health Treatment for War-Affected Youth in Northern Uganda. Unpublished M.A Thesis of the Dalhousie University Halifax, Nova Scotia.
Pfeiffer A., & Elbert T. (2011), PTSD, depression and anxiety among former abductees in Northern Uganda. Journal of Conflict and Health 2011.
Schultz, J-H., & Weisaeth, L. (2015). "The power of Rituals in Dealing with Traumatic Stress Symptoms: Cleansing Rituals for Former Child Soldiers in Northern Uganda." Mental Health, Religion & Culture Vol.18 (10), 822-837.
Sonderegger, R., Rombouts, S., Ocen, B., & McKeever, R. S. (2011). Trauma Rehabilitation for war"affected persons in Northern Uganda: A pilot evaluation of the EMPOWER programme. British Journal of Clinical Psychology, Vol. 50(3), 234-249.WHO.
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