Abstract
The study aimed to evaluate Teaching Recovery Techniques (TRT) delivered to Brazilian youth who experienced drug violence in one Favela. Thirty children, 8 to 14 years, were randomly assigned to TRT (n = 14) or to a treatment as usual group (n = 16) involving boxing/martial arts. Youth received five 90-min sessions over successive weeks. Standardized measures assessed Posttraumatic Stress and Depression at 2 weeks pre and post-test. An exploratory assessment of posttraumatic growth was also utilized. An interview with group leaders explored perceptions of delivering TRT within the favela. Medium effect sizes were found for PTSD and Depression, and a small effect size for posttraumatic growth. Group leaders emphasized understanding the favela context for program adaptation. In conclusion, TRT was found to be effective for children with PTSD and Depression who experienced drug violence in a Brazilian favela. TRT is recommended for future delivery. Larger scale RCTs are needed in Brazilian favelas.
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Ali, N. S., Al-Joudi, T. W., & Snell, T. (2019). Teaching recovery techniques to adolescents exposed to multiple trauma following war and ongoing violence in Baghdad. The Editorial Assistants–Jordan, 30(1), 25–33. https://doi.org/10.12816/0052933.
Andreoli, S. B., Ribeiro, W. S., Quintana, M. I., Guindalini, C., Breen, G., Blay, S. L., Coutinho, E. S. F., Harpham, T., Jorge, M. R., Lara, D. R., Moriyama, T. S., Quarantini, L. C., Gadelha, A., Vilete, L. M. P., Yeh, M. S. L., Prince, M., Figueira, I., Bressan, R. A., Mello, M. F., Dewey, M. E., Ferri, C. P., & de Jesus Mari, J. (2009). Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: The protocol for an epidemiological and genetic survey. BMC Psychiatry, 9, 34. https://doi.org/10.1186/1471-244X-9-34.
Asbahr, F. R., Castillo, A. R., Ito, L. M., de Oliveira Latorre, M. R. D., Moreira, M. N., & Lotufo-Neto, F. (2005). Group cognitive-behavioral therapy versus sertraline for the treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44(11), 1128–1136. https://doi.org/10.1097/01.chi.0000177324.40005.6f.
Barbosa, L. P., Quevedo, L., da Silva, G. D. G., Jansen, K., Pinheiro, R. T., Branco, J., Lara, D., Oses, J., & da Silva, R. A. (2014). Childhood trauma and suicide risk in a sample of young individuals aged 14–35 years in southern Brazil. Child Abuse & Neglect, 38(7), 1191–1196. https://doi.org/10.1016/j.chiabu.2014.02.008.
Barron, I. G., Abdallah, G., & Smith, P. (2013). Randomized control trial of a CBT trauma recovery program in Palestinian schools. Journal of Loss and Trauma, 18(4), 306–321. https://doi.org/10.1080/15325024.2012.688712.
Barron, I., Abdallah, G., & Heltne, U. (2016). Randomized control trial of teaching recovery techniques in rural occupied Palestine: Effect on adolescent dissociation. Journal of Aggression, Maltreatment & Trauma, 25(9), 955–973. https://doi.org/10.1080/10926771.2016.1231149.
Barron, I., Mitchell, D., & Yule, W. (2017). Pilot study of a group-based psychosocial trauma recovery program in secure accommodation in Scotland. Journal of Family Violence, 32(6), 595–606. https://doi.org/10.1007/s10896-017-9921-8.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa.
Cardia, N., Lagatta, P., & Affonso, C (n.d.) Assessment of child maltreatment prevention readiness country report Brazil. Available at https://www.who.int/violence_injury_prevention/violence/child/brazil_rap_cm.pdf?ua=1.
Cornelius, J. R., Douaihy, A., Bukstein, O. G., Daley, D. C., Wood, S. D., Kelly, T. M., & Salloum, I. M. (2011). Evaluation of cognitive behavioral therapy/motivational enhancement therapy (CBT/MET) in a treatment trial of comorbid MDD/AUD adolescents. Addictive Behaviors, 36(8), 843–848. https://doi.org/10.1016/j.addbeh.2011.03.016.
Costa, A. B., Pasley, A., de Lara Machado, W., Alvarado, E., Dutra-Thome, L., & Koller, S. H. (2017). The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group. Frontiers in Psychology, 8, 192. https://doi.org/10.3389/fpsyg.2017.00192.
Curto, B. M., Paula, C. S., Do Nascimento, R., Murray, J., & Bordin, I. A. (2011). Environmental factors associated with adolescent antisocial behavior in a poor urban community in Brazil. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1221–1231. https://doi.org/10.1007/s00127-010-0291-2.
de Assis, S. G., de Oliveira, R. D. V. C., de Oliveira Pires, T., Avanci, J. Q., & Pesce, R. P. (2013). Family, school and community violence and problem behavior in childhood: Results from a longitudinal study in Brazil. Paediatrics Today, 9(1), 36–48. https://doi.org/10.5457/p2005-114.59.
de Souza, M. A. M., Salum, G. A., Jarros, R. B., Isolan, L., Davis, R., Knijnik, D., Manfro, G. G., & Heldt, E. (2013). Cognitive-behavioral group therapy for youths with anxiety disorders in the community: Effectiveness in low and middle income countries. Behavioural and Cognitive Psychotherapy, 41(3), 255–264. https://doi.org/10.1017/S1352465813000015.
Encyclopedia Britannica (2009). 8th edition. Encyclopedia Britannica. Chicago. 2009.
Farias de Azambuja, C., Cardoso de Azevedo, T., Mondin, T. C., Souza de Mattos, L. D., da Silva, R. A., Kapczinski, F., Magalhães da Silva, P. V., & Jansen, K. (2019). Clinical outcomes and childhood trauma in bipolar disorder: A community sample of young adults. Psychiatry Research, 275, 228–232. https://doi.org/10.1016/j.psychres.2018.12.114.
Farnia, V., Naami, A., Zargar, Y., Davoodi, I., Salemi, S., Tatari, F., & Alikhani, M. (2018). Comparison of trauma-focused cognitive behavioral therapy and theory of mind: Improvement of posttraumatic growth and emotion regulation strategies. Journal of Education Health Promotion, 7, 58. https://doi.org/10.4103/jehp.jehp_140_17.
Fatori, D., Polanczyk, G. V., de Morais, R. M. C. B., & Asbahr, F. R. (2019). Long-term outcome of children and adolescents with obsessive–compulsive disorder: A 7–9-year follow-up of a randomized clinical trial. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-019-01457-8.
Faus, D. P., de Moraes, C. L., Reichenheim, M. E., Borges da Matta Souza, L. M., & Taquette, S. R. (2019). Childhood abuse and community violence: Risk factors for youth violence. Child Abuse & Neglect, 98, 104182. https://doi.org/10.1016/j.chiabu.2019.104182.
Fleitlich, B., & Goodman, R. (2001). Social factors associated with child mental health problems in Brazil: Cross sectional survey. BMJ [British Medical Journal], 323(7313), 599–600. https://doi.org/10.1136/bmj.323.7313.599.
Grassi-Oliveira, R., & Stein, L. M. (2008). Childhood maltreatment associated with PTSD and emotional distress in low-income adults: The burden of neglect. Child Abuse & Neglect, 32(12), 1089–1094. https://doi.org/10.1016/j.chiabu.2008.05.008.
Habigzang, L. F., Damásio, B. F., & Koller, S. H. (2013). Impact evaluation of a cognitive behavioral group therapy model in Brazilian sexually abused girls. Journal of Child Sexual Abuse, 22(2), 173–190. https://doi.org/10.1080/10538712.2013.737445.
Habigzang, L. F., de Freitas, C. P. P., Von Hohendorff, J., & Koller, S. H. (2016). Cognitive-behavioral group therapy for girl victims of sexual violence in Brazil: Are there differences in effectiveness when applied by different groups of psychologists? Anales de Psicología/Annals of Psychology, 32(2), 433–441. https://doi.org/10.6018/analesps.32.2.213041.
Jaen-Varas, D., de Jesus Mari, J., da Silva Coutinho, E., Baxter Andreoli, S., Quintana, M. I., de Mello, M. F., Affonseca Bressan, R., & Silva Ribeiro, W. (2016). A cross-sectional study to compare levels of psychiatric morbidity between young people and adults exposed to violence in a large urban center. BMC Psychiatry, 16, 1–8. https://doi.org/10.1186/s12888-016-0847-0.
Larkins, E. R. (2015). The spectacular favela: Violence in modern Brazil (Vol. 32). Berkeley: University of California Press.
McDermott, M. A. N., & Palchanes, K. (1994). A literature review of the critical elements in translation theory. Image: The Journal of Nursing Scholarship, 26(2), 113–118. https://doi.org/10.1111/j.1547-5069.1994.tb00928.x.
Piccinini, C. A., Alvarenga, P., & Marin, A. H. (2013). Child-rearing practices of Brazilian mothers and fathers: Predictors and impact on child development. In Parenting in South American and African Contexts. IntechOpen. Open access peer reviewed chapter. https://doi.org/10.5772/57242.
Pupo, M. C., Serafim, P. M., & de Mello, M. F. (2015). Health-related quality of life in posttraumatic stress disorder: 4 years follow-up study of individuals exposed to urban violence. Psychiatry Research, 228(3), 741–745. https://doi.org/10.1016/j.psychres.2015.05.030.
Ribeiro, W. S., Mari, J. d. J., Quintana, M. I., Dewey, M. E., Evans-Lacko, S., Vilete, L. M. P., Figueira, I., Bressan, R. A., de Mello, M. F., Prince, M., Ferri, C. P., Coutinho, E. S. F., & Andreoli, S. B. (2013). The impact of epidemic violence on the prevalence of psychiatric disorders in Sao Paulo and Rio de Janeiro, Brazil. PLoS One, 8(5), e63545. https://doi.org/10.1371/journal.pone.0063545.
Ribeiro, D. S., Ribeiro, F. M. L., & Deslandes, S. F. (2019). Discourses about mental health demands of young offenders serving detention measure in juvenile correctional centers in Rio de Janeiro, Brazil/Discursos sobre as demandas de saude mental de jovens cumprindo medida de internacao no Rio de Janeiro, Brasil. Ciência & Saúde Coletiva, 10, 3837–3846. https://doi.org/10.1590/1413-812320182410.23182017.
Sarkadi, A., Ådahl, K., Stenvall, E., Ssegonja, R., Batti, H., Gavra, P., Fängström, K., & Salari, R. (2018). Teaching recovery techniques: Evaluation of a group intervention for unaccompanied refugee minors with symptoms of PTSD in Sweden. European Child & Adolescent Psychiatry, 27(4), 467–479. https://doi.org/10.1007/s00787-017-1093-9.
Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the impact of event scale with children in war. Personality and Individual Differences, 34(2), 315–322. https://doi.org/10.1016/S0191-8869(02)00047-8.
Smith, P., Dyregrov, A., & Yule, W. (2018). The teaching recovery techniques manual. The Children and War Foundation: Bergen.
Teche, S. P., Barros, A. J. S., Rosa, R. G., Guimarães, L. P., Cordini, K. L., Goi, J. D., Hauck, S., & Freitas, L. H. (2017). Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: A cross-sectional case-control study. Trends in Psychiatry and Psychotherapy, 39(2), 116–123. https://doi.org/10.1590/2237-6089-2016-0070.
Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1007/bf02103658.
Thabrew, H., Stasiak, K., Bavin, L. M., Frampton, C., & Merry, S. (2018). Validation of the mood and feelings questionnaire (MFQ) and short mood and feelings questionnaire (SMFQ) in New Zealand help-seeking adolescents. International Journal of Methods in Psychiatric Research, 27(3), e1610. https://doi.org/10.1002/mpr.1610.
Tucci, A. M., Kerr-Corrêa, F., & Souza-Formigoni, M. L. O. (2010). Childhood trauma in substance use disorder and depression: An analysis by gender among a Brazilian clinical sample. Child Abuse & Neglect, 34(2), 95–104. https://doi.org/10.1016/j.chiabu.2009.07.001.
Waldemar, J. O. C., Rigatti, R., Menezes, C. B., Guimarães, G., Falceto, O., & Heldt, E. (2016). Impact of a combined mindfulness and social–emotional learning program on fifth graders in a Brazilian public school setting. Psychology & Neuroscience, 9(1), 79–90. https://doi.org/10.1037/pne0000044.
WHO (2013). World Health Organization, Geneva. https://www.who.int/mediacentre/news/releases/2013/trauma_mental_health_20130806/en/. Accessed 26 July 2020.
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This study was made possible by the commitment of the workers, volunteers and children and families at Luta Lela Paz / Fight for Peace, Complexo da Mare, Rio De Janeiro, Brazil.
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Barron, I., Freitas, F. & Bosch, C.A. Pilot Randomized Control Trial: Efficacy of a Group-Based Psychosocial Program for Youth with PTSD in the Brazilian Favelas. Journ Child Adol Trauma 14, 335–345 (2021). https://doi.org/10.1007/s40653-020-00328-8
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DOI: https://doi.org/10.1007/s40653-020-00328-8