HAI Colombia Project

Problem: Latin America has recently experienced increasing levels of forced migration, political conflict, economic crises, and community violence. Quibdó, Colombia houses a large number of victims of armed conflict, particularly Afro-Colombian and Venezuelan migrants. From 2020-2021, the region has also been affected by COVID-19, as well as mass protests and police violence, affecting social cohesion in communities.

Question: Since 2010, HAI’s community-based psychosocial support (PSS) services program Alianza Con Organizaciones Por lo Emocional (ACOPLE) has leveraged community psychosocial agents to provide non-specialized community psychosocial support services to survivors of torture and trauma. HAI recognized the need to adapt the ACOPLE intervention to better fit the evolving needs of participants and include a greater focus on peer support and community problem-solving.

Design & Methods: The intervention consisted of 8 weekly group sessions facilitated by non-professional community members from the region with training/supervision from professional mental health and psychosocial support (MHPSS) providers. Sessions focused on collective problem-solving skills, drawing from WHO’s Problem Management Plus, combined with expressive activities based on cultural practices. During the pandemic, sessions were available in remote and in-person modalities. The second phase measured the effectiveness of the finalized adapted model using a randomized controlled trial methodology.

Research Findings:

• In a pilot study, participants in community support groups (CSGs) conducted in remote, in-person, and hybrid modalities showed significant improvement in wellbeing and reduction in distress from pre to post intervention, although coping results varied by modality.  
• In a RCT, CSGs were effective in reducing symptoms of anxiety and depression among participants who attended 4+ sessions. Analyses revealed significant reduction in anxiety, depression, and PTSD for in-person participants, but not for remote participants.  
• Qualitative data across both studies highlights unique challenges and opportunities in each modality, including potential explanations contributing to lack of effectiveness for remote groups:  
• In-person: Inclusion of traditional practices and cultural codes (e.g., “comadreo,” or  traditional and informal community talks, common among Afro-Colombians in the Pacific region); confidentiality and safety ensured; strong social cohesion and exchange of peer support; attendance challenges due to conflicting activities.
• Remote: Flexible scheduling benefits but challenges to privacy, connectivity, social cohesion, and managing distractions.

Policy & Practice Achievements: 

• HAI provided the CSG intervention to the Ministry of Health, Victims Unit, and victims’ organizations, contributing to achieving the objectives of the country’s Victims Law and the Peace Accords.