Global Initiative for Stress and Trauma Treatment - Traumatic Stress Relief training for allied and para-professionals to treat traumatic stress in underserved populations: a case study

Abstract Low and Middle Income Countries (LMICs) face a shortage of mental health professionals to cope with the burden of traumatic stress (TS). In an attempt to build capacity amongst allied and paraprofessionals, the Global Initiative for Stress and Trauma Treatment developed a four-day AIP-informed training package (TSR). In this paper, we study the feasibility and acceptability of this training package in East Africa. Information about the knowledge and self-efficacy were collected before and after training from 47 participants from Rwanda, DRC, and Uganda. In addition, oral and written feedback from the training sessions, as well as supervision notes of subsequent meetings with participants were analysed. Results showed that all participants found the TSR training acceptable and useful to support them in treating and referring clients with TS symptoms. Some 77% (7/9) of TSR stabilisation techniques were applicable, including the Safe/Calm Place, the Container, the Butterfly Hug Technique, Deep Breathing, the Three-minute Meditation and Grounding. Those that were not adopted included Pendulation and Balanced Breathing. The tools provided to measure TS and psychological resources were not culturally adapted and often difficult to complete. The group protocols need adaptations to be better implemented. Most of the participants themselves were found to have high levels of TS, hence we recommend that training programmes include TSR intervention for participants prior to their own training. In conclusion, the TSR training is feasible and acceptable for allied and paraprofessionals in East Africa. With further cultural adaptations, it can form a suitable trauma-intervention for LMICs.