Capacity Building Methods for Capacity Building Methods for Providers of Mental Health Providers of Mental Health Interventions Interventions with Trauma Survivors with Trauma Survivors in Low Resource Countriesin Low Resource Countries

Center for Victims of Center for Victims of TortureTorture(CVT)(CVT)

Minneapolis, Minnesota

David R. Johnson, MD, MPHDavid R. Johnson, MD, MPHLinda Nielsen, MSW, LICSWLinda Nielsen, MSW, LICSWPamela Santoso, MPH Pamela Santoso, MPH (cand.)(cand.)Carol White, MS, MPH Carol White, MS, MPH (cand.)(cand.)Neal Porter, MA, MPPMNeal Porter, MA, MPPM

“To heal the wounds on individuals, their families, and their communities and to stop torture worldwide.”

Center for Victims of Torture, 2003

CVT: hybrid health care & human rights organization

I. Mission & target population II. Human Rights / Advocacy work

III. Local health care and training

IV. National Capacity Building

V. International Services & Capacity Building

CVT International ProjectsInternational

ServicesInternational

Capacity Building Project

Trauma Healing Initiative - Cambodia

Provide direct services, training / capacity building, & community sensitization.

Build clinical, organizational, & advocacy capacity of foreign torture treatment centers.

Develop capacity of government & non-governmental service providers, & expands resource network

-Sierra Leone-Guinea (completed)

-Liberia

-Democratic Republic of Congo

-Sudan, Ethiopia, Rwanda, Uganda, Kenya, Cameroon, Namibia, S. Africa.-Bangladesh, India, Cambodia, Pakistan-Palestine, Bulgaria, Romania, Kosovo-Peru, Guatemala.

-Cambodia

Guidelines for International Training in MH & Psychosocial Interventionsfor Trauma Exposed Populations in Clinical and Community Settings

ValuesValues Contextual Contextual ChallengesChallenges

Core Curricular Core Curricular Training ElementsTraining Elements

Monitoring & Monitoring & EvaluationEvaluation

-Respectful-Scientific-Legitimacy of multiple perspectives-Open dialog-Integrating differing perspectives

-Culturally sensitive-Entering insecure environments-Consider needs of all subgroups -Integrated with development efforts-Address short & long term challenges-Transparent-Uses public health principles

-Listening & communication skills-Assessment-Interventions to diminish distress-Understand local context-Problem solving strategies-Treat unexplained somatic pain-Ongoing supervision structure-Covers self care

-Training include monitoring / eval.-Identify objective w/ needs assess.-Identify process indicators-Indicators to evaluate impact on trainees skills, on services, and on beneficiaries.-Use appropriate approaches -Report & dissem.

Weine, S., Danieli, Y., Silove, D., van Ommeren, M., Fairbank, J., & Saul, J.

Three Models of Clinical Capacity Building

Project DescriptionKey ActivitiesContext and process for model selectionStrengths and challenges of each approach

•Scope•Sustainability•Effectiveness

Lessons Learned