The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon
Armed conflict leads to increased risk of emotional distress among children and adolescents, and increased exposure to significant daily stressors such as poverty and community and family violence. Unfortunately, these increased risks usually occur in the context of largely unavailable mental health...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00212/full |
| _version_ | 1811335862358638592 |
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| author | Felicity L. Brown Felicity L. Brown May Aoun Karine Taha Frederik Steen Pernille Hansen Martha Bird Katie S. Dawson Sarah Watts Rabih el Chammay Rabih el Chammay Marit Sijbrandij Aiysha Malik Mark J. D. Jordans Mark J. D. Jordans |
| author_facet | Felicity L. Brown Felicity L. Brown May Aoun Karine Taha Frederik Steen Pernille Hansen Martha Bird Katie S. Dawson Sarah Watts Rabih el Chammay Rabih el Chammay Marit Sijbrandij Aiysha Malik Mark J. D. Jordans Mark J. D. Jordans |
| author_sort | Felicity L. Brown |
| collection | DOAJ |
| description | Armed conflict leads to increased risk of emotional distress among children and adolescents, and increased exposure to significant daily stressors such as poverty and community and family violence. Unfortunately, these increased risks usually occur in the context of largely unavailable mental health services. There is growing empirical support that evidence-based treatment techniques can be adapted and delivered by non-specialists with high fidelity and effectiveness. However, in order to improve feasibility, applicability, and outcomes, appropriate cultural and contextual adaptation is essential when delivering in different settings and cultures. This paper reports the adaptation process conducted on a new World Health Organization psychological intervention—Early Adolescent Skills for Emotions (EASE)—for use in the north of Lebanon. Lebanon is a middle-income country that hosts the largest number of refugees per capita globally. We conducted: i) a scoping review of literature on mental health in Lebanon, with a focus on Syrian refugees; ii) a rapid qualitative assessment with adolescents, caregivers, community members, and health professionals; iii) cognitive interviews regarding the applicability of EASE materials; iv) a psychologist review to reach optimal and consistent Arabic translation of key terms; v) “mock sessions” of the intervention with field staff and clinical psychology experts; vi) gathering feedback from the Training of Trainers workshop, and subsequent implementation of practice sessions; and vii) gathering feedback from the Training of Facilitators workshop, and subsequent implementation of practice sessions. Several changes were implemented to the materials—some were Lebanon-specific cultural adaptations, while others were incorporated into original materials as they were considered relevant for all contexts of adversity. Overall, our experience with adaptation of the EASE program in Lebanon is promising and indicates the acceptability and feasibility of a brief, non-specialist delivered intervention for adolescents and caregivers. The study informs the wider field of global mental health in terms of opportunities and challenges of adapting and implementing low-intensity psychological interventions in settings of low resources and high adversity. |
| first_indexed | 2024-04-13T17:31:07Z |
| format | Article |
| id | doaj.art-03ae28af6abd49c9966d197035fbdfc9 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-13T17:31:07Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-03ae28af6abd49c9966d197035fbdfc92022-12-22T02:37:34ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-03-011110.3389/fpsyt.2020.00212496907The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in LebanonFelicity L. Brown0Felicity L. Brown1May Aoun2Karine Taha3Frederik Steen4Pernille Hansen5Martha Bird6Katie S. Dawson7Sarah Watts8Rabih el Chammay9Rabih el Chammay10Marit Sijbrandij11Aiysha Malik12Mark J. D. Jordans13Mark J. D. Jordans14Research and Development Department, War Child Holland, Amsterdam, NetherlandsAmsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, NetherlandsResearch and Development Department, War Child Holland, Beirut, LebanonResearch and Development Department, War Child Holland, Beirut, LebanonResearch and Development Department, War Child Holland, Amsterdam, NetherlandsThe Reference Centre for Psychosocial Support, The International Federation of Red Cross and Red Crescent Societies, Copenhagen, DenmarkThe Reference Centre for Psychosocial Support, The International Federation of Red Cross and Red Crescent Societies, Copenhagen, DenmarkSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaIndependent Researcher, Geneva, SwitzerlandDepartment of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, LebanonNational Mental Health Programme, Ministry of Public Health, Beirut, LebanonDepartment of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborative Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, Netherlands0Oxford Institute of Clinical Psychology Training, Warneford Hospital, University of Oxford, Oxford, United KingdomResearch and Development Department, War Child Holland, Amsterdam, NetherlandsAmsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, NetherlandsArmed conflict leads to increased risk of emotional distress among children and adolescents, and increased exposure to significant daily stressors such as poverty and community and family violence. Unfortunately, these increased risks usually occur in the context of largely unavailable mental health services. There is growing empirical support that evidence-based treatment techniques can be adapted and delivered by non-specialists with high fidelity and effectiveness. However, in order to improve feasibility, applicability, and outcomes, appropriate cultural and contextual adaptation is essential when delivering in different settings and cultures. This paper reports the adaptation process conducted on a new World Health Organization psychological intervention—Early Adolescent Skills for Emotions (EASE)—for use in the north of Lebanon. Lebanon is a middle-income country that hosts the largest number of refugees per capita globally. We conducted: i) a scoping review of literature on mental health in Lebanon, with a focus on Syrian refugees; ii) a rapid qualitative assessment with adolescents, caregivers, community members, and health professionals; iii) cognitive interviews regarding the applicability of EASE materials; iv) a psychologist review to reach optimal and consistent Arabic translation of key terms; v) “mock sessions” of the intervention with field staff and clinical psychology experts; vi) gathering feedback from the Training of Trainers workshop, and subsequent implementation of practice sessions; and vii) gathering feedback from the Training of Facilitators workshop, and subsequent implementation of practice sessions. Several changes were implemented to the materials—some were Lebanon-specific cultural adaptations, while others were incorporated into original materials as they were considered relevant for all contexts of adversity. Overall, our experience with adaptation of the EASE program in Lebanon is promising and indicates the acceptability and feasibility of a brief, non-specialist delivered intervention for adolescents and caregivers. The study informs the wider field of global mental health in terms of opportunities and challenges of adapting and implementing low-intensity psychological interventions in settings of low resources and high adversity.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00212/fullpsychological interventioncultural adaptationlow- and middle-income countrieshumanitarian emergenciesarmed conflictadolescents |
| spellingShingle | Felicity L. Brown Felicity L. Brown May Aoun Karine Taha Frederik Steen Pernille Hansen Martha Bird Katie S. Dawson Sarah Watts Rabih el Chammay Rabih el Chammay Marit Sijbrandij Aiysha Malik Mark J. D. Jordans Mark J. D. Jordans The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon Frontiers in Psychiatry psychological intervention cultural adaptation low- and middle-income countries humanitarian emergencies armed conflict adolescents |
| title | The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon |
| title_full | The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon |
| title_fullStr | The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon |
| title_full_unstemmed | The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon |
| title_short | The Cultural and Contextual Adaptation Process of an Intervention to Reduce Psychological Distress in Young Adolescents Living in Lebanon |
| title_sort | cultural and contextual adaptation process of an intervention to reduce psychological distress in young adolescents living in lebanon |
| topic | psychological intervention cultural adaptation low- and middle-income countries humanitarian emergencies armed conflict adolescents |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00212/full |
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