Effectiveness of school-based debriefing sessions for Palestinian children affected by war and trauma

Background: There are no psychosocia l interventions to address children psychosocial needs among Palestinian children area of war and conflict. Aim : To evaluate the schoolbased debriefing sessions for children living in a zone of ongoing war conflict. Method : A randomly selected sample of 240 children aged 10 16 years who were affected by the current conflict in the Gaza S trip were interviewed about their war experiences and reactions to the vi olence before and after participating in the 2-week intervention in school s for 8 session. Results : Children themselves reported decrease in all mental health problems after the intervention. However parents di sagreed with their children and reported no change in behavioural and emotional problems of their children after the intervention Conclusion: Our findings that using school based counseling set ting in time of war and trauma could improve children mental hea lth if they report their feelings themselves and not their parents. This hig hlight the need for more long acting and new methods of int ervention for children living in area of war and conflict such as cognitive behaviour therapy an d social skills training to enable children cope with trauma and stress. Introduction There has been increasing number of research on the effectiveness of specific psychological interventions for children living in war zones (Gupta and Zimmer, 2008). However, a number of studies have described or evaluated different models of interventions for PTSD among children who had suffered abuse, experienced natural disasters, or exposed to community violence. These predominantly adopt psychodynamic or cognitive therapeutic frameworks, and a variety of techniques, with the broad aim of enabling the child to make links between trauma, emotions and beliefs, which can subsequently be challenged and modified. Herman (1997) outlined three phases of treatment for traumatized clients: the establishment of safety, remembrance and mourning, and reconnection with ordinary life. Research on young people who had PTSD as a result of exposure to a disaster includes that by Chemtob, Nakashima, and Carlson (2002) examining adolescents with PTSD 2–3 years following exposure to a disaster, and that by Goninan et al. (1997) in which CBT for PTSD began 1.5 years after exposure to a disaster. These studies both indicate that children who have significant PTSD symptoms benefit from CBT intervention for both the PTSD and related difficulties such as depression, social competence and behavioural problems. Three randomized, controlled psychosocial treatment studies of sexually abused children with acute PTSD symptoms also demonstrate the superiority of CBT compared with non-directive supportive therapy or usual treatment in the community (Cohen, 2003). A comprehensive review by Ramchandi and Jones (2003) on treatment available for children who have suffered sexual abuse concluded that, ‘cognitive behavior therapy for children who are symptomatic’ (including suffering from PTSD) ‘has the strongest research evidence for efficacy’. In addition, Feeny et al. (2004) established that CBT and related techniques have been empirically proven to benefit the emotional well-being of young clients suffering from trauma-related psychological concerns such as PTSD. relaxation techniques, problem solving, aggression management, grief resolution, narratives, and stress inoculation are examples of ways to help children and teens cope with natural disasters (Feeny et al., 2004). Feeny et al. also supported the use of psychoeducational groups where children experiencing trauma-related symptoms can meet, share their stories and reactions, gain a sense of cohesion and universality, and learn how to better cope with their feelings, thoughts, and behaviors. When using CBT with individual children or groups, Feeny et al. found that short-term counseling (i.e., 4 sessions) was as effective as treatments involving larger numbers of sessions (i.e., 12 sessions). Also, group interventions were as successful as individual counseling interventions in treating children’s symptoms. Finally, the authors found that starting the counseling process soon after the disaster or traumatic event was more effective in the long term. A randomized controlled Arabpsynet e . Journa l : N°24 – Au tumn 2009 ــــ ـــــ ـــــ ــ ــــ ـــــــ ـــــــ : ــ ــ ـ 24 ـــ ــــــــــــ 2009