The Center for Victims of Torture has provided group counselling interventions beginning in 1999 in Guinea, and subsequently in Sierra Leone, Liberia, the Democratic Republic of Congo, Kenya, Ethiopia, and Jordan. These interventions specifically target the previously unmet clinical needs of survivors of war and torture, and those displaced by violence and living in refugee camps. A new iteration of the CVT group counseling manual was created based on the need for documentation and contribution of counseling resources to the field, which experiences a lack of mental health torture treatment resources for low-resource and post-conflict settings.
The development the group counseling model is a result of The Center for Victims of Torture's 15 years of group counseling experience in diverse post-conflict settings where there displaced survivors of violence have extremely limited rehabilitation resources. The recently redeveloped manual is based on previous versions of CVT-developed group counseling manuals for use in low-resource settings, and the group counseling model is formulated from a rigorous review, CVT best-practice and collaborative process. The review and writing process for the group counseling model took place over 18 months. The internal review integrated data and lessons learned from CVT's extensive group counseling work around the world. A participatory review included focus groups with former clients and completed surveys by local mental health counsellors and expert trainers. A literature review was conducted to include current evidence based practices, and current best-practice in the field. A team of CVT Clinical Advisors wrote the new group counseling manual through a combination of week- long intensive collaborative writing process, ongoing virtual collaboration meetings, feedback from pilot trials of the updated manual in Kenya and Jordan, and a peer review which collected feedback on the updated manual from experts and practitioners from around the world.
The review and writing process produced an integrative group counseling intervention that follows a tri-phasic model of: 1) safety and stabilization, 2) remembrance and mourning, and 3) reconnection to self and others, based on Judith Herman's stages of trauma recovery. The model has theoretical underpinnings from Cognitive Behavioural Theory, Narrative Exposure Therapy, Somatic Psychology, Interpersonal Therapy, Neuroscience, Dance and Movement Therapy, resilience and strength-based approaches, and CVT's own extensive experience. The intervention incorporates effective, evidence-based components from these theoretical underpinnings, such as psycho-education, behavioural activation, relaxation, cognitive coping, somatic processing, and exposure.
We will present preliminary outcome data from two program sites. The group counseling intervention is a 10-session model, intended for delivery by trained counselors in the local context receiving ongoing clinical supervision and training. The group counselling manual provides a clear and understandable guide for providing the intervention in varying circumstances, cultures, and contexts.
Funding & No Conflicts Declaration
Funded by USAID, PRM and The Center for Victims of Torture. The authors are not aware of any conflicts of interest.