Intervention to Support the Reintegration of Former Combatants and Soldiers

Study Overview
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Brief Summary
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The project aims to investigate if trauma-related disorders and appetitive aggression can be reduced in former ex-combatants in DR Congo when a specific intervention (Narrative Exposure Therapy for Forensic Offender Rehabilitation, FORNET) is delivered by trained local personnel (phase 1). In a second step, the project aims to investigates the treatment success if this specific therapy is carried out by local personnel who have been trained by other local personnel (train the trainer, phase 2) under the supervision of experts of the University of Konstanz.

Detailed Description
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The reintegration of former child soldiers and ex-combatants is a big challenge in war-torn countries. Former child soldiers and ex-combatants often suffer from mental health problems and show enhanced levels of aggression. The present study focuses on the reduction of appetitive aggression and the improvement of mental health in former child soldiers and ex-combatants in DR Congo. The project consists of four steps: Training of selected DDRRR personnel(first generation)in FORNET (a variant of Narrative Exposure Therapy to treat trauma-related disorders and to reduce appetitive aggression)by experts from the University of Konstanz. Treatment phase 1: Intervention will be carried out by therapists of the first generation. The trained therapists of the first generation will be supervised from the experts of the University of Konstanz. Training of a second generation of DDRRR personnel in FORNET by the therapists of the first generation. Treatment phase 2: Intervention will be carried out by therapists of the second generation. The trained therapists of the second generation will be supervised from the therapists of the first generation. The study is conceived as a randomized controlled study. In phase 1 and in phase 2, study participants will be randomized allocated to the intervention group (FORNET) and the control group (no intervention). The treatment effect will be measured by pre-post and 6-months follow-up evaluations.

Conditions
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Appetitive Aggression, Post-traumatic Stress Disorder

Intervention / Treatment
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* Behavioral: NET for Forensic Offender Rehabilitation (FORNET): a variant of Narrative Exposure Therapy
* Other: Control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ex-combatants who live in a transit camp in Goma, Congo. Exclusion Criteria:

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: NET for Forensic Offender Rehabilitation<br>Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) | Behavioral: NET for Forensic Offender Rehabilitation (FORNET): a variant of Narrative Exposure Therapy<br>* During the proposed therapy, the client constructs a chronological narrative of his or her whole life which includes all traumatic experiences and perpetrated violent acts. All emotions, cognitions, sensory information, and physiological reactions are activated and linked to the autobiographical context.In five sessions the trained therapist and the client try to go through all important traumatic experiences and perpetrated violent acts. The sixth session is a group session with four to five clients. The group session is oriented on Interpersonal Psychotherapy and focuses on the role change from soldier to civilian.<br>Other: Control group<br>* The control group receives no intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Appetitive Aggression (Appetitive Aggression Scale) |  | 6 months | 
| Symptoms of post-traumatic stress disorder (Post-traumatic Diagnostic Scale, PDS) |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Symptoms of depression (Patient Health Questionnaire (PHQ-9) |  | 6 months | 
| Functionality (Work and Social Adjustment Scale) |  | 6 months | 
| Substance abuse |  | 6 months | 
| Re-integration questionnaire |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Treatment of ex-combatants, FORNET for ex-combatants, Appetitive Aggression, Post-traumatic Stress Disorder