A Behavioral Intervention for War-Affected Youth in Sierra Leone

Betancourt and colleagues are justly well-known for their impressive prospective longitudinal study of former child soldiers in Sierra Leone. That body of research documented the deleterious effect of wartime experiences upon the mental health of former child soldiers, identifying specific risk and resilience factors that impact upon emotional well-being – for instance, social stigma, sexual violence, and family support (see e.g.1 and 2).

In this recent well conducted study, Betancourt and colleagues address a question they have posed formerly: what kind of post-conflict intervention could potentially address the links between poor mental health and school drop-out, underemployment and violence among affected youth? The intervention they undertook, again in Sierra Leone, was focussed on improving psychological and behavioural readiness to return to school amongst 15-24 year olds whose daily functioning was impaired by emotional distress and behavioural difficulties. 436 youth were randomly allocated to a 10 session Youth Readiness Intervention (YRI) or to a control condition. Following the intervention, youth from both groups received an educational subsidy enabling them to return to school.  Outcome measures reveal that youth in the YRI group improved in their functioning following the intervention, and subsequently evidenced better attendance and behaviour at school than those who had received an education subsidy only.

Of particular interest is that though the components of the YRI are based on sound mental health intervention principles and practice, the intervention was not focussed on resolving mental health or trauma symptoms. Indeed, post-traumatic stress symptoms or psychological distress were not resolved by the intervention. Rather the focus on preparing these troubled youth to return to school by improving their self-regulation, functioning and interpersonal skills, meant that the intervention was able to be delivered by trained community workers, under supervision, rather than by highly trained health professionals. The paper therefore describes an intervention that has great practical potential in resource- poor post- conflict contexts, both in terms of its delivery and also for providing youth with ways to function more effectively in school and so improve their educational outlook.  Whether this in turn will impact on their future economic and livelihood opportunities is, as the authors note, a question for future research.

Dr Linda Dowdney
Editor, Psychosocial content for Child Soldiers International

March 2015

1. See: Betancourt, T.S. et al (2010) Sierra Leone’s Former Child Soldiers: A Follow-Up Study of Psychosocial Adjustment and Community reintegration: http://www.child-soldiers.org/psychosocial_report_reader.php?id=627

2. Betancourt et al, (2010) Past Horrors, Present Struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone http://www.child-soldiers.org/psychosocial_report_reader.php?id=274 

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