Research Projects

• Child-Focused Research
• Adult-Focused Research
  

Child-Focused Research

Zambia - In February of 2005 AMHR conducted a qualitative study looking at the problems of HIV infected mothers and their children in Lusaka, Zambia. This study revealed that child sexual abuse is a major problem among this HIV-affected population, along with a number of other traumatic experiences such as domestic violence, physical abuse and traumatic grief. AMHR then developed a collaboration with the University Teaching Hospital (UTH) and the Univeristy of Zambia (UNZA) to examine the psychosocial issues of child sexual abuse and how to treat them. Four mental health assessment measures were chosen, adapted, tested and validated in a UTH One-Stop Centre for sexually abused children.  Simultaneously, the qualitative data was used to guide us in the selection of an appropriate intervention, Trauma-Focused Cognitive Behavior Therapy (TF-CBT), to treat the symptoms Training was completed for 16 Zambians on Trauma-Focused Cognitive Behavioral Therapy (TF-CBT; www.musc.edu/tfcbt), during which the local counselors helped adapt the treatment.  A feasibility study was conducted examining the acceptability of a Western model for client and counselors, the ability of lay counselors to implement TF-CBT with adherence, and the effectiveness of the treatment.

Funding source:USAID, CDC, and NIH
Status: Ongoing

Zambia - In February of 2009, AMHR partnered with Catholic Relief Services (CRS) to test the feasibility of implementing the validated mental health assessment tools and TF-CBT into existing HIV-focused infrastructures – namely two hospices.  Over 45 home-based caregiver volunteers were trained in and implemented the assessment tools. A new cohort of 18 Zambian counselors were trained in TF-CBT and supervised through training cases.

Funding source: USAID, CRS
Status: Completed

Cambodia – Working with World Vision and their partners, AMHR completed a qualitative needs assessment in 2007 to examine the mental health needs of formally-trafficked and/or exploited girls who had been rescued and are currently living in transition shelters in and around Phnom Penh.  Using the result of this study AMHR adapted standard measures of trauma, depression and anxiety symptoms along with measures of shame and hope to develop the Child Exploitation Psychosocial Assessment Tool (CEPAT).  Simultaneous to the development of this instrument, the qualitative data was used to guide us in the selection and adaptation of an appropriate intervention, Trauma-Focused Cognitive Behavior Therapy (TF-CBT), to treat the symptoms.  Currently AMHR is collaborating with two shelters in Phnom Penh to test the feasibility of this intervention provided by local Cambodian caregivers.

Funding source:World Vision
Status: Ongoing

Global - Providing expertise in design, implementation, monitoring and evaluation (DIM&E) of mental health interventions for multiple World Vision country programs assisting children in crisis. This includes qualitative assessments, training workshops, and instrument development and validation. Many of the World Vision programs are for street children or children affected by war or conflict, whose experiences predispose them to mental health problems.

Funding source: World Vision
Status: Ongoing

Jordan – Together with the International Medical Corps (IMC), AMHR conducted a qualitative needs assessment to identify the needs of adolescent Iraqi refugees and their families.  This data was used to develop psychosocial well-being assessment tools geared towards the adolescents and their parents and to inform the development of a family-based social interaction/community-building activity among Iraqi refugee families currently living in and around Amman.  As part of this collaboration, AMHR also completed an impact assessment, with control families, to understand the impact of the intervention activities on family and social cohesion and general psychosocial well-being.

Funding source:International Medical Corps and USAID
Status: Completed

Georgia - Working with Save the Children-Georgia and the USAID mission, AMHR completed a qualitative study in July of 2005 during which AMHR examined the causes of children going to the street. An additional qualitative study looking at the problems of children on the street and those that are institutionalized was conducted in May/June of 2006. The data from these 2 studies was used to adapt the Child Behavior Check List (an existing measure of child mental health and behavior) for use among this population. This instrument underwent reliability and validity testing among the same population (street children and those in institutions) in 2007.  The CBCL is currently being used by NGOs working in Georgia to assess need and impact of their programming among similar populations.

Funding source: USAID - Displaced Children and Orphans Fund (DCOF)
Status: Completed

Northern Uganda - In 2005 AMHR in collaboration with World Vision Uganda and War Child Holland conducted a three-armed randomized controlled trial assessing the impact of two mental health interventions on depression, anxiety, and behavioral issues among local adolescents affected by war. The results of this trial were published in JAMA (see Publications) and have since informed programming by both our collaborating partners.

Funding source: World Vision USA and War Child Holland.
Status: Completed

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Adult-Focused Research

Kurdistan, Northern Iraq – Together with Heartland Alliance, AMHR is working to improve the community-level mental health services for survivors of torture in Kurdistan.  Having completed initial needs assessment and instrument development and validation studies, AMHR are currently implementing a multi-armed randomized controlled trial of different psychological treatments for the depression, anxiety and trauma symptoms of torture survivors.  Kurdish Community Mental Health Workers (CMHWs) have been trained on one of three treatment options and are currently recruiting and treating survivors in three regions of Kurdistan:  Dohuk in the north, Erbil in the center and Sulaimaniya in the South.  Data from this study will allow us to understand the feasibility and effectiveness of the different intervention strategies for survivors of torture in this region.

Funding source:USAID - Victims of Torture Fund (USAID-VTF)
Status: Ongoing

Eastern Democratic Republic of Congo - In 2006 AMHR began a collaboration with the International Rescue Committee (IRC) to assess the needs and improve services for survivors of Gender-Based Violence.  This collaboration began with a qualitative study of problems associated with populations who have experienced gender-based violence (GBV) in Sange district in South Kivu Province. Based on this assessment, a mental health monitoring and assessment tool was developed and tested and has since been used as part of IRC’s ongoing clinic-based services.  Clients are interviewed with the tool when they first join the GBV program to provide a baseline measurement. They are interviewed again after several months and at the end of the program, to assess the program’s impact.  In June 2009 AMHR analyzed all data collected to date.  Analysis suggested that the rates of mental distress and dysfunction among those entering the program were high, and that participation was associated with substantial improvement in both parameters. Based on this initial evidence IRC and AMHR are planning a formal controlled trial of specific mental health and economic interventions for GBV survivors in the same region. 

Funding source: USAID - Victims of Torture Fund (USAID-VTF)
Status: Completed

Brazil – As part of a larger initiative on maternal HIV issues, AMHR are working with faculty from the University of Caxias do Sul to investigate the risk factors associated with prenatal and postpartum depression among HIV-infected women in Porto Alegre.

Funding source: NIH – Fogarty Center
Status: Ongoing

Indonesia - Working with the International Catholic Migration Commission (ICMC) in July 2006, AMHR conducted a qualitative study of psychosocial problems facing survivors of intentional violence in Jakarta. This information is being used to inform the development of program indicators for an ongoing counseling program. A similar qualitative study has been conducted in Aceh among non-Tsunami affected populations, and the data are currently being analyzed. This information will inform the development of a program monitoring and evaluation system.

Funding source: USAID - VTF
Status: Completed

Haiti - A qualitative assessment of the problems affecting local people resulting from exposure to torture and organized violence. The project was based in Cap Haitien (northern Haiti) in February, 2006. A final report has been completed and can be accessed through the USAID Development Experience Clearinghouse. Download also available from the AMHR Group Publications page.

Funding source: USAID - VTF
Status: Completed

Mexico - In March 2006 AMHR conducted a qualitative study of the mental health problems facing violence affected populations in Tamaulipas, Mexico. The study was done in collaboration with a local human rights organization, to identify the mental health needs of affected individuals and inform the selection of promising mental health intervention models.

Funding source:USAID - VTF
Status: Completed

Democratic Republic of Congo - In February 2005, AMHR conducted an investigation of depression-like illness among post-partum women in Kinshasa, DRC. Using qualitative research methods, AMHR identified a depression-like syndrome among new mothers in the capital of the Democratic Republic of Congo. Using the information from the qualitative study, AMHR adapted and validated a quantitative instrument to be used to measure depression among this population.

Funding source: National Institutes for Health (NIH)
Status: Completed

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