Teaching recovery techniques to adolescents exposed to multiple trauma following war and ongoing violence in Baghdad

Abstract EN

background: Adolescents in Baghdad have had repeated experiences of war and community violence during their lifetime.

The majority will have maintained good mental health although some will struggle with social, emotional and behavioral difficulties often associated with posttraumatic stress reactions (PTS).

Psychosocial interventions that enhance coping and resilience can improve mental health.

Few have been evaluated in communities affected by such conflict.

The current study was conducted in 2015 when an upsurge in violence across Iraq triggered a rise in car bombs, aerial bombardment, armed conflict and internal displacement.

Method: Four classrooms from three randomly chosen, single-sex secondary schools in Baghdad were selected.

Of the 116 students recruited, 102 (48 boys, 54 girls) agreed to participate; ages ranged from 13-18 years.

Trauma history, anxiety and PTSD-related symptoms were assessed using age appropriate, reliable and valid self-report measures.

Teaching Recovery Techniques (TRT) involved a five session, group-based intervention for PTSD-related symptoms with one psychoeducational session for parents and post-assessment at two weeks.

Results: Exposure to seven or more traumatic events were reported in 44% of students.

Those with more severe PTSD-related symptoms (44%) demonstrated statistically significant improvement.

Overall results showed no statistically significant difference for anxiety or PTSD-related symptoms.

Parent engagement was low although feedback from teachers and participants was positive.

Conclusion: Multiple trauma exposure and moderate-to-severe PTSD-related symptoms reported by most participants suggests the need for targeted interventions, such as TRT.

Further evaluation using an active control possibly in a community-based setting may improve outcomes and increase parent engagement.

Delivery and implementation should be localized with costs kept to a minimum to ensure sustainability.