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Theresa Stichick Betancourt, SC.D.

TitleResearch Fellow in Psychiatry (EXT)
InstitutionChildren's Hospital Boston
DepartmentPsychiatry
AddressHarvard School of Public Health
Bagnoud Bldg, Room 709D
651 Huntington Ave
Boston MA 02115
Phone617/432-5003
Other Positions
TitleAssociate Professor of Child Health and Human Rights
InstitutionHarvard School of Public Health
DepartmentFrancois Xavier Bagnoud


 Overview 
 overview
The Research Program on Children and Global Adversity that I direct at the FXB Center for Health and Human Rights focuses on forms of adversity that are exceptions to recent improvements in child health globally: regions affected by armed conflict and regions affected by HIV/AIDS (http://www.harvardfxbcenter.org/programs-rpcga.php).

My research is intended to help build the evidence base on mental health and preventive interventions for vulnerable children and families. I have been involved in the adaptation and testing of evidence-based interventions for mental health problems among war-affected youth, including serving as PI of an NIMH-funded Family Strengthening Intervention (FSI) in Rwanda, and as PI of a USIP-funded Youth Readiness Intervention (YRI) for war-affected youth in Sierra Leone. Both projects are positioned to contribute to our understanding of how effective evidence-based mental health interventions are in low-resource settings in Africa compared to care as usual.

In our Family-Strengthening Intervention in Rwanda (http://projectreporter.nih.gov/project_info_description.cfm?aid=8071892&icde=0) we are using a randomized controlled design to conduct a feasibility pilot, drawing study families (40 FSI, 40 controls) from social work referrals. Protective factors characterizing the family as well as mental health problems in children and caregivers will be assessed pre- and post-intervention using a culturally-validated assessment battery. We will examine feasibility and acceptability of an adapted family-based psychosocial intervention focused on building communication and resilience in families affected by HIV compared to usual care. Our findings will provide refined tools and evaluation materials for use in a future RCT. Our Specific Aims are to: 1) Adapt a US-developed, family-focused, and strengths-based prevention program to the context of HIV/AIDS in post-genocide Rwanda; 2) pilot test the intervention protocol within a small set of families to assess acceptability, feasibility and further refine an intervention manual; and 3) conduct a pilot feasibility study among 80 families to examine whether the intervention a) improves caregiver-child relationships using measures of family connectedness, good parenting and social support, and b) is associated with reduced mental health symptoms, HIV risk behaviors and increased functioning in children.

The Youth Readiness Intervention (YRI) for war-affected youth in Sierra Leone was developed as a Stage 1 trauma intervention with a focus on addressing the interpersonal skills, emotion regulation, and daily functional impairments that are typical among youth exposed to complex trauma such as war exposure in childhood. The YRI integrates common elements of evidence-based interventions for survivors of complex trauma that have demonstrated effectiveness in treatment of inpatient adolescents and survivors of childhood sexual abuse. In preliminary intervention development work, the YRI was culturally-adapted using focus groups and key informant interviews. Findings from our multi-wave longitudinal study of male and female child soldiers have informed the intervention development. The YRI itself is comprised of six empirically-supported treatment components that have demonstrated effectiveness in interventions for troubled youth in other diverse settings. Evaluations of intervention feasibility and acceptability, as well as preliminary evidence on treatment effectiveness as compared to usual care will contribute to gaps in our knowledge about interventions for youth in post-conflict settings. We are also in the process of refining the design to compare the effects of the YRI alone to the effects of secondary school access compared to combined YRI intervention and secondary school access.

In future research, we intend to move our intervention research towards the examination services delivered by well trained and supervised community health workers (task-shifting) to help address the extreme human resource constraints that characterize many low resource settings in sub-Saharan Africa. Once scientifically evaluated, such interventions are well positioned to go to scale given strong partnerships in the regions in which we work with national and international NGOs, UN Agencies, service agencies, and local government.


 Bibliographic 
 selected publications
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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  1. Betancourt TS, Shaahinfar A, Kellner SE, Dhavan N, Williams TP. A qualitative case study of child protection issues in the Indian construction industry: investigating the security, health, and interrelated rights of migrant families. BMC Public Health. 2013; 13:858.
    View in: PubMed
  2. Betancourt TS, Newnham EA, McBain R, Brennan RT. Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study. Br J Psychiatry. 2013 Sep; 203:196-202.
    View in: PubMed
  3. Nakimuli-Mpungu E, Alderman S, Kinyanda E, Allden K, Betancourt TS, Alderman JS, Pavia A, Okello J, Nakku J, Adaku A, Musisi S. Implementation and scale-up of psycho-trauma centers in a post-conflict area: a case study of a private-public partnership in northern Uganda. PLoS Med. 2013 Apr; 10(4):e1001427.
    View in: PubMed
  4. Callands TA, Sipsma HL, Betancourt TS, Hansen NB. Experiences and acceptance of intimate partner violence: associations with sexually transmitted infection symptoms and ability to negotiate sexual safety among young Liberian women. Cult Health Sex. 2013 Jun; 15(6):680-94.
    View in: PubMed
  5. Scorza P, Stevenson A, Canino G, Mushashi C, Kanyanganzi F, Munyanah M, Betancourt T. Validation of the "World Health Organization Disability Assessment Schedule for Children, WHODAS-Child" in Rwanda. PLoS One. 2013; 8(3):e57725.
    View in: PubMed
  6. Betancourt TS, Meyers-Ohki SE, Charrow AP, Tol WA. Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care. Harv Rev Psychiatry. 2013 Mar-Apr; 21(2):70-91.
    View in: PubMed
  7. Thomas B, Mimiaga MJ, Mayer KH, Closson EF, Johnson CV, Menon S, Mani J, Vijaylakshmi R, Dilip M, Betancourt T, Safren SA. Ensuring It Works: A Community-Based Approach to HIV Prevention Intervention Development for Men Who Have Sex with Men in Chennai, India. AIDS Educ Prev. 2012 Dec; 24(6):483-99.
    View in: PubMed
  8. Betancourt TS, Newnham EA, Layne CM, Kim S, Steinberg AM, Ellis H, Birman D. Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. 2012 Dec; 25(6):682-90.
    View in: PubMed
  9. McBain R, Salhi C, Morris JE, Salomon JA, Betancourt TS. Disease burden and mental health system capacity: WHO Atlas study of 117 low- and middle-income countries. Br J Psychiatry. 2012 Dec; 201:444-50.
    View in: PubMed
  10. Betancourt T, Scorza P, Meyers-Ohki S, Mushashi C, Kayiteshonga Y, Binagwaho A, Stulac S, Beardslee WR. Validating the center for epidemiological studies depression scale for children in rwanda. J Am Acad Child Adolesc Psychiatry. 2012 Dec; 51(12):1284-92.
    View in: PubMed
  11. Betancourt TS, Borisova I, Williams TP, Meyers-Ohki SE, Rubin-Smith JE, Annan J, Kohrt BA. Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research. J Child Psychol Psychiatry. 2013 Jan; 54(1):17-36.
    View in: PubMed
  12. Betancourt TS, McBain R, Newnham EA, Brennan RT. Trajectories of internalizing problems in war-affected sierra leonean youth: examining conflict and postconflict factors. Child Dev. 2013 Mar; 84(2):455-70.
    View in: PubMed
  13. Betancourt TS, Meyers-Ohki SE, Charrow A, Hansen N. Annual Research Review: Mental health and resilience in HIV/AIDS-affected children - a review of the literature and recommendations for future research. J Child Psychol Psychiatry. 2013 Apr; 54(4):423-44.
    View in: PubMed
  14. Ellis BH, Miller AB, Abdi S, Barrett C, Blood EA, Betancourt TS. Multi-tier mental health program for refugee youth. J Consult Clin Psychol. 2013 Feb; 81(1):129-40.
    View in: PubMed
  15. Williams TP, Binagwaho A, Betancourt TS. Transactional sex as a form of child sexual exploitation and abuse in Rwanda: implications for child security and protection. Child Abuse Negl. 2012 Apr; 36(4):354-61.
    View in: PubMed
  16. Betancourt TS, Newnham EA, Brennan RT, Verdeli H, Borisova I, Neugebauer R, Bass J, Bolton P. Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda. J Adolesc Health. 2012 Dec; 51(6):544-50.
    View in: PubMed
  17. Betancourt TS, Salhi C, Buka S, Leaning J, Dunn G, Earls F. Connectedness, social support and internalising emotional and behavioural problems in adolescents displaced by the Chechen conflict. Disasters. 2012 Oct; 36(4):635-55.
    View in: PubMed
  18. Betancourt TS, Yudron M, Wheaton W, Smith-Fawzi MC. Caregiver and adolescent mental health in Ethiopian Kunama refugees participating in an emergency education program. J Adolesc Health. 2012 Oct; 51(4):357-65.
    View in: PubMed
  19. Betancourt TS, Williams TP, Kellner SE, Gebre-Medhin J, Hann K, Kayiteshonga Y. Interrelatedness of child health, protection and well-being: an application of the SAFE model in Rwanda. Soc Sci Med. 2012 May; 74(10):1504-11.
    View in: PubMed
  20. Kimmel AD, Daniels N, Betancourt TS, Wood R, Prosser LA. Decision maker priorities for providing antiretroviral therapy in HIV-infected South Africans: a qualitative assessment. AIDS Care. 2012; 24(6):778-92.
    View in: PubMed
  21. McBain R, Norton DJ, Morris J, Yasamy MT, Betancourt TS. The role of health systems factors in facilitating access to psychotropic medicines: a cross-sectional analysis of the WHO-AIMS in 63 low- and middle-income countries. PLoS Med. 2012 Jan; 9(1):e1001166.
    View in: PubMed
  22. Du YB, Lee CT, Christina D, Belfer ML, Betancourt TS, O'Rourke EJ, Palfrey JS. The living environment and children's fears following the Indonesian tsunami. Disasters. 2012 Jul; 36(3):495-513.
    View in: PubMed
  23. Kelly JT, Betancourt TS, Mukwege D, Lipton R, Vanrooyen MJ. Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study. Confl Health. 2011; 5:25.
    View in: PubMed
  24. Patel PP, Russell J, Allden K, Betancourt TS, Bolton P, Galappatti A, Hijazi Z, Johnson K, Jones L, Kadis L, Leary K, Weissbecker I, Nakku J. Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian action summit 2011. Prehosp Disaster Med. 2011 Nov-Dec; 26(6):470-81.
    View in: PubMed
  25. Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, Golaz A, van Ommeren M. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011 Oct 29; 378(9802):1581-91.
    View in: PubMed
  26. Betancourt TS, Meyers-Ohki S, Stulac SN, Barrera AE, Mushashi C, Beardslee WR. Nothing can defeat combined hands (Abashize hamwe ntakibananira): protective processes and resilience in Rwandan children and families affected by HIV/AIDS. Soc Sci Med. 2011 Sep; 73(5):693-701.
    View in: PubMed
  27. Betancourt TS, Rubin-Smith JE, Beardslee WR, Stulac SN, Fayida I, Safren S. Understanding locally, culturally, and contextually relevant mental health problems among Rwandan children and adolescents affected by HIV/AIDS. AIDS Care. 2011 Apr; 23(4):401-12.
    View in: PubMed
  28. Betancourt TS. Attending to the mental health of war-affected children: the need for longitudinal and developmental research perspectives. J Am Acad Child Adolesc Psychiatry. 2011 Apr; 50(4):323-5.
    View in: PubMed
  29. Zraly M, Rubin-Smith J, Betancourt T. Primary mental health care for survivors of collective sexual violence in Rwanda. Glob Public Health. 2011; 6(3):257-70.
    View in: PubMed
  30. Betancourt TS, Borisova II, de la Soudière M, Williamson J. Sierra Leone's child soldiers: war exposures and mental health problems by gender. J Adolesc Health. 2011 Jul; 49(1):21-8.
    View in: PubMed
  31. Betancourt TS, Borisova II, Williams TP, Brennan RT, Whitfield TH, de la Soudiere M, Williamson J, Gilman SE. Sierra Leone's former child soldiers: a follow-up study of psychosocial adjustment and community reintegration. Child Dev. 2010 Jul-Aug; 81(4):1077-95.
    View in: PubMed
  32. Betancourt TS, Abrams EJ, McBain R, Fawzi MC. Family-centred approaches to the prevention of mother to child transmission of HIV. J Int AIDS Soc. 2010; 13 Suppl 2:S2.
    View in: PubMed
  33. Betancourt TS, Brennan RT, Rubin-Smith J, Fitzmaurice GM, Gilman SE. Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry. 2010 Jun; 49(6):606-15.
    View in: PubMed
  34. Betancourt TS, Fawzi MK, Bruderlein C, Desmond C, Kim JY. Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development. Psychol Health Med. 2010 May; 15(3):243-65.
    View in: PubMed
  35. Fawzi MC, Betancourt TS, Marcelin L, Klopner M, Munir K, Muriel AC, Oswald C, Mukherjee JS. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming. BMC Public Health. 2009; 9:482.
    View in: PubMed
  36. Betancourt TS, Agnew-Blais J, Gilman SE, Williams DR, Ellis BH. Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010 Jan; 70(1):17-26.
    View in: PubMed
  37. Allden K, Jones L, Weissbecker I, Wessells M, Bolton P, Betancourt TS, Hijazi Z, Galappatti A, Yamout R, Patel P, Sumathipala A. Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group. Prehosp Disaster Med. 2009 Jul-Aug; 24 Suppl 2:s217-27.
    View in: PubMed
  38. Betancourt TS, Speelman L, Onyango G, Bolton P. A qualitative study of mental health problems among children displaced by war in northern Uganda. Transcult Psychiatry. 2009 Jun; 46(2):238-56.
    View in: PubMed
  39. Betancourt TS, Bass J, Borisova I, Neugebauer R, Speelman L, Onyango G, Bolton P. Assessing local instrument reliability and validity: a field-based example from northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2009 Aug; 44(8):685-92.
    View in: PubMed
  40. Betancourt TS, Khan KT. The mental health of children affected by armed conflict: protective processes and pathways to resilience. Int Rev Psychiatry. 2008 Jun; 20(3):317-28.
    View in: PubMed
  41. Betancourt TS. Child soldiers: reintegration, pathways to recovery, and reflections from the field. J Dev Behav Pediatr. 2008 Apr; 29(2):138-41.
    View in: PubMed
  42. Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, Neugebauer R, Murray L, Verdeli H. Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA. 2007 Aug 1; 298(5):519-27.
    View in: PubMed
  43. Betancourt TS. Stressors, supports and the social ecology of displacement: psychosocial dimensions of an emergency education program for Chechen adolescents displaced in Ingushetia, Russia. Cult Med Psychiatry. 2005 Sep; 29(3):309-40.
    View in: PubMed
  44. Bolton P, Betancourt TS. Mental health in postwar afghanistan. JAMA. 2004 Aug 4; 292(5):626-8.
    View in: PubMed
  45. Stichick T. The psychosocial impact of armed conflict on children. Rethinking traditional paradigms in research and intervention. Child Adolesc Psychiatr Clin N Am. 2001 Oct; 10(4):797-814.
    View in: PubMed
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