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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.
One or more keywords matched the following items that are connected to Betancourt, Theresa
Item TypeName
Academic Article Mental health in postwar afghanistan.
Academic Article 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.
Academic Article A qualitative study of mental health problems among children displaced by war in northern Uganda.
Academic Article Sierra Leone's child soldiers: war exposures and mental health problems by gender.
Academic Article Attending to the mental health of war-affected children: the need for longitudinal and developmental research perspectives.
Academic Article Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.
Academic Article Stressors, supports and the social ecology of displacement: psychosocial dimensions of an emergency education program for Chechen adolescents displaced in Ingushetia, Russia.
Academic Article The mental health of children affected by armed conflict: protective processes and pathways to resilience.
Academic Article Primary mental health care for survivors of collective sexual violence in Rwanda.
Academic Article Caregiver and adolescent mental health in Ethiopian Kunama refugees participating in an emergency education program.
Academic Article Annual Research Review: Mental health and resilience in HIV/AIDS-affected children-- a review of the literature and recommendations for future research.
Academic Article Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming.
Academic Article Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.
Academic Article Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States.
Academic Article Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health.
Academic Article Understanding locally, culturally, and contextually relevant mental health problems among Rwandan children and adolescents affected by HIV/AIDS.
Academic Article Multi-tier mental health program for refugee youth.
Academic Article Disease burden and mental health system capacity: WHO Atlas study of 117 low- and middle-income countries.
Academic Article Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.
Academic Article Mental health and psychosocial support in humanitarian settings: linking practice and research.
Concept Mental Health
Concept National Institute of Mental Health (U.S.)
Concept Community Mental Health Services
Concept Mental Health Services
Academic Article Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care.
Academic Article Implementation and scale-up of psycho-trauma centers in a post-conflict area: a case study of a private-public partnership in northern Uganda.
Academic Article Context matters: community characteristics and mental health among war-affected youth in Sierra Leone.
Academic Article After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda.
Academic Article Developing and validating the Youth Conduct Problems Scale-Rwanda: a mixed methods approach.
Academic Article Family-based prevention of mental health problems in children affected by HIV and AIDS: an open trial.
Academic Article HIV and child mental health: a case-control study in Rwanda.
Academic Article Evidence of impact: health, psychological and social effects of adult HIV on children.
Academic Article The psychological toll of slum living in Mumbai, India: a mixed methods study.
Academic Article Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study.
Academic Article Youth mental health after civil war: the importance of daily stressors.
Academic Article Addressing health disparities in the mental health of refugee children and adolescents through community-based participatory research: a study in 2 communities.
Academic Article Identifying Priorities for Mental Health Interventions in War-Affected Youth: A Longitudinal Study.
Academic Article Risk and protective factors for suicidal ideation and behaviour in Rwandan children.
Academic Article The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone.
Academic Article Optimizing an Era of Global Mental Health Implementation Science.
Academic Article Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.
Academic Article Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda.
Academic Article Exploring the potential of a family-based prevention intervention to reduce alcohol use and violence within HIV-affected families in Rwanda.
Academic Article HIV Status Disclosure through Family-Based Intervention Supports Parenting and Child Mental Health in Rwanda.
Academic Article Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone.
Grant Family-Based Prevention of Mental Health Problems in HIV/AIDS Affected Children
Grant Youth FORWARD: Capacity Building in Alternate Delivery Platforms and Implementation Models for Bringing Evidence-Based Behavioral Interventions to Scale for Youth Facing Adversity in West Africa
Grant Intergenerational impact of war: A prospective longitudinal study
Grant Addressing Mental Health Disparities in Refugee Children Through Family and Community-based Prevention: A CBPR Collaboration and Hybrid Implementation Effectiveness Trial
Grant Addressing Mental Health Disparities in Refugee ChildrenL A CBPR Collaboration
Grant Reducing Violence and HIV Risk Among War-Exposed Liberian Youth
Grant Modifiable Protective Processes in the Mental Health of Refugee Children
Academic Article Building an evidence base on mental health interventions for children affected by armed conflict.
Academic Article Mental Health and Antiretroviral Adherence Among Youth Living With HIV in Rwanda.
Academic Article Improving Mental Health Outcomes of Burmese Migrant and Displaced Children in Thailand: a Community-Based Randomized Controlled Trial of a Parenting and Family Skills Intervention.
Academic Article Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study.
Academic Article Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey.
Academic Article Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.
Academic Article Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS.
Academic Article Family-based promotion of mental health in children affected by HIV: a pilot randomized controlled trial.
Academic Article Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children.
Academic Article Civilians in World War II and DSM-IV mental disorders: results from the World Mental Health Survey Initiative.
Academic Article War-Related Traumas and Mental Health Across Generations.
Academic Article Correction to: Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey.
Grant Addressing Mental Health Disparities in Refugee Children Through Family and Community-based Prevention: A CBPR Collaboration and Hybrid Implementation Effectiveness Trial
Academic Article Commentary: Advancing an implementation science agenda on mental health and psychosocial responses in war-affected settings: comment on trials of a psychosocial intervention for youth affected by the Syrian crisis - by Panter-Brick et al. (2018).
Academic Article Preventive mental health interventions for refugee children and adolescents in high-income settings.
Grant Expanding the Reach of Evidence-Based Mental Health Treatment: Diffusion and Spillover of Mental Health Benefits Among Peer Networks and Caregivers of Youth Facing Compounded Adversity in Sierra Leone
Academic Article Editorial: Home-Visiting Interventions and Caregiver Mental Health.
Academic Article Stigma and Acceptance of Sierra Leone's Child Soldiers: A Prospective Longitudinal Study of Adult Mental Health and Social Functioning.
Academic Article Family-Based Mental Health Promotion for Somali Bantu and Bhutanese Refugees: Feasibility and Acceptability Trial.
Academic Article Mental Health of Refugee Children and Youth: Epidemiology, Interventions, and Future Directions.
Academic Article Diffusion and spillover effects of an evidence-based mental health intervention among peers and caregivers of high risk youth in Sierra Leone: study protocol.
Academic Article Mental health problems among children in Sierra Leone: Assessing cultural concepts of distress.
Academic Article The NIMH global mental health research community and COVID-19.
Academic Article The intergenerational impact of war on mental health and psychosocial wellbeing: lessons from the longitudinal study of war-affected youth in Sierra Leone.
Academic Article Intergenerational impacts of trauma and hardship through parenting.
Academic Article Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol.
Academic Article Past trauma, resettlement stress, and mental health of older Bhutanese with a refugee life experience.
Search Criteria
  • Mental Health
Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.