COLOMBIA

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

PROJECT
OVERVIEW

This intervention examined the effectiveness of the community-based psychosocial support services program Alianza Con Organizaciones Por lo Emocional (ACOPLE) in the Pacific Coast region of Colombia. In a pilot study, participants in community support groups 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.  

Lead Implementation Partner: Heartland Alliance International
Lead Research Partner: La Universidad de Los Andes
Population: Survivors of armed conflict in the municipality of Quibdó, Colombia

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

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. 
  • HAI and the National Association of Displaced Afro-Colombians (AFRODES) are working to ensure that the ACOPLE program continues as an independent community-based MHPSS service provider. The adaptations made to the CSG intervention have allowed ACOPLE to widen its technical expertise and its staff’s professional development.
  • The CSG intervention tested was used to provide MHPSS services in the city of Buenaventura, with funding by the United Nations High Commissioner for Refugees. The objective was to serve victims affected by the upsurge in violence since January 2021, providing HAI a space to test the adaptations made to its community-based group intervention. 
PUBLICATIONS and Products

Protocol for Community Support Groups (English)

Research Brief: A Mixed-Method Study of a Community-Based Psychosocial Support Intervention for survivors of the armed conflict in the Colombian Pacific

Protocol for Community Support Groups (Spanish)

Community Support Groups Facilitation Guide

Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic

Feasibility, acceptability and preliminary effectiveness of a community-based group psychosocial support model for conflict survivors in Colombia: An assessment of in-person and remote intervention modalities during the COVID-19 pandemic

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