Category: Cultural Diversity / Vulnerable Populations

Symposium

Adaptation and Implementation of an Evidence-Based Transdiagnostic Treatment for Interpersonal Violence in Zambia

Saturday, November 18
3:30 PM - 5:00 PM
Location: Aqua Salon C & D, Level 3, Aqua Level

Keywords: Trauma | Transdiagnostic | Substance Abuse
Presentation Type: Symposium

Background Violence against women and girls (VAWG) is an urgent global health problem that lead to multiple problems. Zambia was found to have the highest percentage of ever-married women reporting IPV (48%) (Kishor & Johnson, 2004). This randomized controlled trial examines the effectiveness of a common elements treatment approach (CETA) for reducing VAWG and comorbid alcohol abuse. CETA is CBT based and is currently the only transdiagnostic model with two rigorous clinical trials in LMIC that each show strong effect sizes across a range of symptoms.


Methods/Design Study participants are family units: an adult woman, her male husband or partner, and one of her children aged 8-17. Eligibility criteria include experience of moderate to severe intimate partner violence by the woman and hazardous alcohol use by her male partner. Family units are randomized to receive 6-12 weeks of CETA or treatment as usual. CETA was adapted to include elements of safety for intrapersonal violence and CBT-based substance use and support (Danielson et al. 2012).


Results:  Baseline results show high rates of trauma, alcohol and other substance use, depression, and comorbidity in this population (n=248 families).  Depression criteria was met by 70% women and 57% men, substance use 49% women, 100% men, post traumatic stress criteria was met by 48% women and 39% men, and non-alcohol substance use by 47% women and 64% men. Among youth, 42% had met criteria for trauma, 12% reported alcohol use, 30% reported other substance use, and 41% reported being abused. We will highlight multiple case studies for family units, showing violence and substance use at different stages of the CETA intervention with weekly monitoring scores, as well as qualitative information on both the mental health problems and CETA implementation and adaptations.


Conclusions: Adaptations to this CETA were needed and were acceptable to providers and consumers. The comorbid symptom presentation underscores the utility and necessity of transdiagnostic models in LMIC where there are limited providers.  If longitudinal data sustains the immediate positive results, CETA could be a model that addresses significant comorbidity.

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