COLOMBIA

The effectiveness of a community-based psychosocial group intervention for those affected by violence

PROJECT
OVERVIEW

Heartland Alliance International (HAI) and La Universidad de Los Andes investigated the effectiveness of HAI’s community-based psychosocial support (PSS) group intervention. This intervention was developed through the Alianza Con Organizaciones Por lo Emocional (ACOPLE) program conducted in the Pacific Coast region of Colombia. ACOPLE leverages identified community leaders, called community psychosocial agents (CPAs), who are trained and supervised by psychologists to provide non-specialized community PSS, thereby strengthening social cohesion, coping, and resilience in their own communities. From 2010-2020, ACOPLE has provided PSS services to survivors of torture and trauma, primarily Afro-Colombian populations affected by violence and conflict. In recent years, in response to feedback from CPAs, HAI recognized the need to adapt the ACOPLE group intervention to better fit the evolving needs of participants by including a greater focus on peer support, community problem-solving, and culturally-based expressive activities.

The current research assessed the effectiveness of this adapted intervention among conflict-affected community members in Quibdó (Chocó), Colombia. The first phase of this work tested feasibility and fidelity of the adapted intervention through a pilot study. During the Covid-19 pandemic, community members participated in the pilot intervention using remote, hybrid, or socially-distanced in-person modalities. After a period of adaptation based on the findings from the pilot, the effectiveness of the finalized adapted model was measured using a randomized controlled trial (RCT) methodology. This model could have global relevance in other countries struggling to build the capacities of communities to cope with the mental health needs stemming from ongoing and past conflict as well as systemic crime and violence.

Study Design

Randomized controlled trial

Participants

Afro-Colombian adults exposed to armed conflict

Setting

Community spaces (schools, religious centers, social spaces) in Quibdo, Colombia
ABOUT THE INTERVENTION

This community-based group intervention (CGT) is located on the second level of the IASC’s MHPSS Pyramid, strengthening community and family supports. This intervention aims to promote wellbeing through a participatory, psychosocial support approach which recognizes Afro-Colombian culture as a key component of community support. It also aims to improve participants’ wellbeing and level of functionality as they relate to the chronic stressors experienced by participants. 

The model emphasizes community problem-solving using skills inspired by WHO’s Problem-Management Plus model. This problem-solving structure guides community members to identify, define, and manage problems commonly experienced in the community through a peer support model. In addition, expressive sessions including art and dance aim to strengthen culturally-based coping mechanisms. Ultimately, the group intervention works to improve participants’ abilities to manage shared and individual stressors by identifying and strengthening individual, family, community, and cultural resources and strategies. In doing so, the model aims to reduce distress (including symptoms of depression, anxiety, and posttraumatic stress disorder) and functional impairment, and improve wellbeing, adaptive coping, emotional regulation, and community resilience.

The CGT is designed for 7-10 participants in each group. It consists of 8 weekly sessions, each lasting approximately two hours with potential extension to three hours for art or dance workshops. Participants can choose to participate remotely through phone/online platforms or in-person in groups meeting in community spaces, such as schools, religious centers, or social centers (with Covid-19 precautionary measures)

"In the sessions, little by little I was facing my fears, my problems, my feelings. The help from the community support agents helped me to face the situation because there are times when I don't know what to do. But I take a breath, relax and think with a cool head what I am going to do."
Project Participant
STUDY PARTNERS
STUDY FUNDER
STUDY COLLABORATORS

Carlos Gantiva, PhD
Associate Professor
Universidad de los Andes

Hernando Chiari
Research Assistant
Universidad de los Andes

Juan Fernando Botero-Garcia, PhD
Research Manager
Heartland Alliance International

Juan Pablo Aranguren-Romero, PhD
Associate Professor
Universidad de los Andes

Leah James, PhD
Global MHPSS Technical Advisor
Heartland Alliance International

Michel Rattner, MSc
Research Manager
Universidad de los Andes

PUBLICATIONS and Products

Protocol for Community Support Groups (English)

Protocol for Community Support Groups (Spanish)

Community Support Groups Facilitation Guide