Academic journal article Journal of Cognitive Psychotherapy

Delivering Interventions to Young People Exposed to War-Related Violence and Sexual Exploitation: Longstanding Struggles but Lasting Successes

Academic journal article Journal of Cognitive Psychotherapy

Delivering Interventions to Young People Exposed to War-Related Violence and Sexual Exploitation: Longstanding Struggles but Lasting Successes

Article excerpt

This article outlines the impact of conflict and war-related sexual exploitation on young people's mental health and explores some of the predisposing factors which contribute to this psychological distress. It then outlines how a lack of valid measures of psychological distress, limited research, diverse services, treatments and cultural practices, previous trauma, and a multitude of competing agencies can hamper mental health delivery in war-affected countries before explaining how using non-Western measures of distress, extensive preresearch preparation, cultural respect tinged with scepticism, a duty of care, and involving stakeholders in decision-making can mitigate these problems. Lastly, this article outlines one study that overcame the logistical, security, and educational challenges of service delivery and calls for further research on psychosocial interventions, dismantling studies of cognitive behavioral therapy (CBT) interventions, and hybrid inventions which target both mental health and psychosocial need and fruitful partnerships between academic institutions and civil society organizations.

Keywords: war-affected youth; sexual violence; mental health and psychosocial interventions; trauma-focused cognitive behavioral therapy; possibilities

Everything was going according to plan, at the border crossing from Rwanda to the Democratic Republic of Congo (DR Congo), until a customs official called Mama Fatuma spotted a bulging money waist bag beneath my shirt. "What's that?" she asked. My heart sank. "It's a money belt," I stammered, my Swahili deserting me for the first time since entering the room. Ominously she closed the door.

"How much money have you got in it?" She looked at me quizzically. "Write it down for me on this paper," she demanded. My mind raced. I had more than $1,300 around my waist. (Carrying large sums of money is not uncommon in war-affected regions with no ATMs, no access to online banking, and where shops and hotels do not accept credit cards). I panicked. I scribbled down the equivalent in British pounds and prayed she would not know the exchange rate between the pound and dollar. "Don't you know that you can't bring in large amounts of money into the country?" she continued. "Take all your money out and put it on the table." The friendly tone had long since left the room. I stalled. "Don't be afraid," she soothed. "You can trust me." I inwardly choked and stalled again. "Take out your money and leave it on the table." I recognized that tone. She was not for backing down.

Slowly, I lifted up my shirt and fumbled at my money bag. I opened my wallet and looked inside. I could not believe my eyes. There was only euro70 in the pocket I had opened. Prior to leaving, I must have separated my money into two pockets in my money bag and put all my dollars in another pocket. I gingerly placed my euro on the table. "Is that all you've got?" she asked. "Yes," I answered (after all, it was all the euro I had on me). "Make sure you change your money in a bank," she cautioned before telling me to return my money again. "No problem at all," I responded, my voice returning to its usual tone and pitch again. "And don't forget to come in and say hello to us when you pass by again," she reminded me before handing over my passport with the all-important stamp. I left the building weak-kneed and relieved to still have all my U.S. dollars and said a quiet prayer of thanks for the goodness of friends whose last-minute donation had saved us from having to leave a small fortune in U.S. dollars at the border crossing that day.

Nature of the MeNtal health ProbleM

The Impact of Armed Conflict on Mental Health

Armed conflicts cause significant psychological and social suffering to affected populations. Psychological suffering includes posttraumatic stress disorder (PTSD), depression, anxiety, substance abuse, suicidal ideation, social withdrawal, low self-esteem, loss of trust, and feelings of guilt and shame (Schaal, Elbert, & Neuner, 2009). …

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