Capacity Building Methods for Providers of Mental Health Interventions with Trauma Survivors in Low Resource Countries Center for Victims of Torture (CVT) Minneapolis, Minnesota

David R. Johnson, MD, MPH Linda Nielsen, MSW, LICSW Pamela Santoso, MPH (cand.) Carol White, MS, MPH (cand.) Neal Porter, MA, MPPM “To heal the wounds on individuals, their families, and their communities and to stop torture worldwide.”

 Center for Victims of Torture, 2003

CVT: hybrid health care & human rights organization

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I. Mission & target population

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II. Human Rights / Advocacy work

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III. Local health care and training

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IV. National Capacity Building

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V. International Services & Capacity Building

CVT International Projects

International Services International Capacity Building Project Provide direct services, training / capacity building, & community sensitization.

Build clinical, organizational, & advocacy capacity of foreign torture treatment centers.

-Sierra Leone -Guinea (completed) -Liberia -Democratic Republic of Congo -Sudan, Ethiopia, Rwanda, Uganda, Kenya, Cameroon, Namibia, S. Africa.

-Bangladesh, India, Cambodia, Pakistan -Palestine, Bulgaria, Romania, Kosovo -Peru, Guatemala.

Trauma Healing Initiative Cambodia Develop capacity of government & non governmental service providers, & expands resource network -Cambodia

Guidelines for International Training in MH & Psychosocial Interventions

for Trauma Exposed Populations in Clinical and Community Settings Weine, S., Danieli, Y., Silove, D., van Ommeren, M., Fairbank, J., & Saul, J.

Values Contextual Challenges Core Curricular Training Elements

-Respectful -Scientific -Legitimacy of multiple perspectives -Open dialog -Integrating differing perspectives -Culturally sensitive -Entering insecure environments -Consider needs of all subgroups -Integrated with development efforts -Address short & long term challenges -Transparent -Uses public health principles -Listening & communication skills -Assessment -Interventions to diminish distress -Understand local context -Problem solving strategies -Treat unexplained somatic pain -Ongoing supervision structure -Covers self care

Monitoring & Evaluation

-Training include monitoring / eval.

-Identify objective w/ needs assess.

-Identify process indicators -Indicators to evaluate impact on trainees skills, on services, and on beneficiaries.

-Use appropriate approaches -Report & dissem.

Three Models of Clinical Capacity Building

Project Description Key Activities Context and process for model selection Strengths and challenges of each approach

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Scope

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Sustainability

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Effectiveness Lessons Learned