The Effectiveness of Therapeutic and Psychological Intervention Programs in PTC-GAZA
Tóm tắt
The wars on Gaza (2008, 2012 & 2014) have left thousands of children and adults exposed to traumatic events (UNICEF, 2017). This study seeks to study and compare the usefulness of three different intervention programs, namely Therapeutic, Psycho-social support and Focusing. These interventions have been developed based on a holistic and integrated approach aimed at empowering resilience among Palestinian patients with Posttraumatic Stress Disorder (PTSD). PTSD was assessed through a validated scale developed by Altawil (2016). The aforementioned interventions were found to be successful: a) In the Family Therapy Programme (FTP), PTSD diagnosis reduced from 82% before intervention to 20% after intervention; b) In the Community Wellness Focusing Programme (CWF), PTSD diagnosis reduced from 97% before intervention to 19% after intervention; c) In the Psycho-Social Support Programme (SANID), PTSD diagnosis reduced from 50% before intervention to only 14% after intervention. Establishing the impact of interventions can be difficult without good tools for evaluation or assessment. Therefore, PTSD scales must consider culture, specific needs and the context of trauma exposure using both quantitative and qualitative assessment tools. Future tools should examine On-going Traumatic Stress Disorder (OTSD) so that it reflects on-going conflict and trauma in war-torn environments worldwide.
Tài liệu tham khảo
Abu Hein, F., Qouta, S., Thabet, A., & El Sarraj, E. (1993). Trauma and mental health of children. British Medical Journal, 306, 1130–1131.
Altawil, M. A. (2008). The effect of chronic traumatic experience on Palestinian children in the Gaza strip. Unpublished PhD Thesis: University of Hertfordshire at the United Kingdom.
Altawil, M. A. (2016). The effect of chronic traumatic experience on Palestinian children in the Gaza strip. Germany: LAP: Lambert Academic Publishing.
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry & Clinical Neuroscience, 256, 174–186.
Armstrong, J. G., Putnam, F. W., Carlson, E. B., Libero, D. Z., & Smith, S. R. (1997). Development and validation of a measure of adolescent dissociation: The adolescent dissociative experiences scale. Journal of Nervous and Mental Disease, 185, 491–497.
Barber, B. (2008). Contrasting portraits of war: Youths’ varied experiences with political violence in Bosnia and Palestine. International Journal of Behavioral Development, 32, 298–309.
Barber, B., McNeely, C., Olsen, J., Spellings, C., & Belli, R. (2013). Effect of chronic exposure to humiliation on wellbeing in the occupied Palestinian territory: An event-history analysis. The Lancet, 382, (S7, 5).
Bernstein, D. P., & Fink, L. (1998). Childhood trauma questionnaire: A retrospective self-report. The Psychological Corporation.
Betancourt, T. (2004). Mental health in post war Afghanistan. The Journal of the American Medical Association, 292, 626–628.
Betancourt, T. S., & Tanveer, K. (2008). The mental health of children affected by armed conflict: Protective processes and pathways to resilience. International Review of Psychiatry, 20, 317–328.
Bracken, P. J., Giller, J. E., & Summerfield, D. (1995). Psychosocial responses to war and atrocity: The limitations of current concepts. Elsevier Science Ltd..
Buka, S., Stichick, T., Birdthistle, I., & Earls, F. A. (2001). Youth exposure to violence: Prevalence, risks and consequences. American Journal of Orthopsychiatry, 71, 298–310.
D’Andrea, W., Sharma, R., Zelechoski, A., & Spinazzola, J. (2011). Physical health problems after single trauma exposure: When stress takes toot in the body. Journal of the American Psychiatric Nurses Association, 17, 378–392.
De Zulueta, F. (2009). Post-traumatic stress disorder and attachment: Possible links with borderline personality disorder. Advances in Psychiatric Treatment, 15, 172–180.
Denton, M., Prus, S., & Walters, V. (2004). Gender differences in health: A Canadian study of the psychosocial, structural and behavioural determinants of health. Social Science & Medicine., 58, 2585–2600.
DSM-V, American Psychiatric Association (2013). DSM-V diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.
Ehntholt, K. A., Smith, P. A., & Yule, W. (2005). School-based cognitive behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clinical Child Psychology and Psychiatry, 10, 235–250.
El-Khosondar, I. (2004). The effect of rational behaviour therapy in reducing the effect of post-traumatic stress disorder among Palestinian children. Ain Shams University, Cairo, Egypt: Unpublished Doctoral Dissertation.
Giacaman, R., Matarieh, A., Nguyen-Gillham, V., & Safieh, R. (2004). Quality of life in the occupied Palestinian territory, Birzeit, Palestine. Birzeit University: Institute of Community and Public Health.
Hawajri, A. (2003). Effectiveness of a suggested counseling program to alleviate trauma among the students of basic stage in Gaza Governorate. Unpublished M.A. Dissertation, Islamic University, Gaza, Palestine.
Hjemdal, O., Martinussen, M., & Rosenvinge, J. (2001). Preliminary results from the development and validation of a Norwegian scale for measuring adult resilience. Journal Norwegian Psychosocial Association, 38, 310–317.
ICD-10, World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.
Klagsbrun, J. (1999). Focusing, illness, and health care. The Folio: A journal for Focusing and Experiential Psychotherapy, 18, 162–170.
Klagsbrun, J., Lennox, S., & Summers, L. (2010). Effect of clearing a space on quality of life in women with breast cancer. Journal of Body Psychotherapy, 9, 48–53.
Lith, B. K. (2007). Psychosocial interventions for children in war-affected areas: The state of the art. Intervention, 5, 3–17.
Loughry, M., & Eyber, C. (2003). Psychosocial concepts in humanitarian work with children: A review of the concepts and related literature. Washington: National Academies Press.
Morgan, A. (2000). What is narrative therapy? Adelaide: Dulwich Centre Publication.
OCHA. (2014). United Nations Office for the coordination of humanitarian affairs occupied Palestinian territory. Humanitarian bulletin monthly REPORT June-august 2014 [www.ochaopt.org].
Ozer, E. J., & Weinstein, R. S. (2004). Urban adolescents’ exposure to community violence: The role of support, school safety, and social constraints in a school-based sample of boys and girls. Journal of Clinical Child and Adolescent Psychology, 33, 463–486.
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of post-traumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin Journal, 129, 52–73.
PCBS. (2015). Palestinian central bureau of statistics. Ramallah–Palestine (http://www.pcbs.gov.ps).
Persson, T. J., & Rousseau, C. (2009). School-based interventions for minors in war-exposed countries: A review of targeted and general programmes. Torture, 19, 88–101.
Pynoos, R., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., Nunez, F., & Fairbanks, L. (1987). Life threat and post-traumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063.
Rieder, M., & Choonara, I. (2012). Armed conflict and child health. Archives of Disease in Childhood, 97, 59–62.
Saigh, P. A. (2004). Children’s PTSD inventory [manual]. San Antonio, TX: Psych Corp.
Samara M., & Altawil, M. (2013, April). A longitudinal study on factors moderating and increasing the risk of PTSD amongst children in war zones. Poster session presented at the society for research in child development (SRCD), Seattle, USA.
Sehwail, M. (2005). Responding to continuing traumatic events. The International Journal of Narrative Therapy and Community Work, 3 & 4, 53–71. www.dulwichcentre.com.au.
Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the impact of event scale with children at war. Personality and Individual Differences, 34, 315–322.
Summerfield, D. (2000). War and mental health: A brief overview. British Medical Journal, 321, 232–235.
Thabet, A., Abdulla, T., El-Helou, M., & Vostanis, P. (2006). Effect of trauma on children mental health in the Gaza strip and West Bank, In C. W., Greenbaum, P., Veerman, & N., Bacon-Shnoor (Eds.). Protection of children during armed political conflict: A multidisciplinary perspective (pp. 123–138).
Thabet, A., El-Sarraj, E., & Vostanis, P. (2008). Exposure to war trauma and PTSD among parents and children in the Gaza strip. European Child & Adolescent Psychiatry, 17, 191–199.
UNICEF (2017) Children at risk in the Gaza conflict. (https://www.unicef.org/infobycountry/oPt_74620.html)
Werner, W. (2012). Children and war: Risk, resilience, and recovery. Development and Psychopathology, 24, 553–558.