Behavior Problem Clinical Trial
Official title:
Study of Effectiveness of a Treatment to Improve the Mental Health of Children and Adolescents Affected by Armed Conflict in Kachin State, Myanmar
This randomized controlled trial evaluates the effectiveness of a psychotherapeutic intervention, the Common Elements Treatment Approach (CETA), to address the mental health needs of children and adolescents age 8-17 who have been affected by armed conflict in Kachin State, Myanmar. The 10-12 week talk-based counseling treatment, delivered by community mental health workers, will be evaluated against a wait-list control group. This project follows on a recently completed trial of CETA for adult trauma survivors from Myanmar along the Thai-Myanmar border which found that CETA was acceptable, accessible, and effective in improving mental health and functioning of adults. The investigators hypothesize that the intervention will be similarly effective for improving the mental health and functioning of children and adolescents.
The Common Elements Treatment Approach (CETA) is a trans-diagnostic psychotherapeutic
intervention.
Results from qualitative interviews following the randomized controlled trial (RCT) of CETA
for adults (IRB # 00003601) and during the scale-up of CETA services have indicated that
there is a major need for mental health services for children and adolescents in Myanmar, as
currently there are no evidence-based psychotherapy services for children and adolescents in
the country. Specifically, since the initial trial the research team has received requests
from community-based organizations to implement CETA for children and adolescents in Kachin
language-speaking communities in northern Myanmar. Local partners and the Applied Mental
Health Research group (AMHR) at Johns Hopkins University (JHU) believe that CETA is amenable
for use with children and adolescents and that this population would benefit in similar ways
to adults. A qualitative study has since been conducted (IRB# 00006933), and the data used to
develop and validate an assessment instrument with children and adolescents in Kachin state
(IRB# 00006929).
The JHU research team will work with the local partner organization, Kachin Baptist
Convention (KBC), to implement this project. KBC is a well-established community-based
organization that currently provides emergency relief services to approximately 20,000
displaced Kachin people living in 42 camps. Their community outreach activities are
non-denominational.
Participants will mostly be accessed through schools and in partnership with the local
implementing partner. Their teachers, secondary caregivers and persons from the local partner
organization who work with them regularly - all of whom are involved in the study as key
community informants - will identify and refer the potential child/adolescent participants
for screening into the study. Screening will otherwise be open to all children/adolescents,
and those who are eligible will be asked to participate in the trial. Informed consent will
be obtained from the parent/guardian and informed assent from the child. Participants will be
randomly assigned to either receive CETA immediately or be put on a waitlist to receive
treatment later.
Counselors will be current employees of the local partner organization who have participated
in a 2-week initial training followed by 8-10 weeks of supervised practice. Counselors will
receive weekly clinical supervision for the duration of the trial.
During the RCT, 10-12 weekly CETA sessions will be delivered individually in private spaces
either at schools, homes, or in the community. In most cases, the children are living in the
camps with their parents/guardians. Counselors will also follow-up with control children on a
weekly basis to assess their symptoms using a client monitoring form. Both treatment and
control participants will be reassessed using the same assessment instrument following the
treatment period.
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