HEALING TRAUMA IN GROUPS

Training Paraprofessionals in Sri Lanka

Northern Sri Lanka, a mostly Tamil region, was wracked by a brutal civil war for 26 years. Eight years after the conflict ended in 2009, it remains one of the trauma ‘hot spots’ of the world. Rates of suicide, substance abuse and sexual violence have soared. Fourteen percent of Tamils suffer from PTSD. An estimated 315,000 need mental health services, particularly specialized trauma treatment. But access is hampered by the rural setting in which most Tamils live, and by a lack of mental health professionals trained in trauma treatment techniques who can serve them.

EMDR Therapy, one of the two WHO-approved trauma therapies, has a trusted history in Sri Lanka. Since 2005, 30 Sri Lankan mental health professionals have been fully trained in EMDR Therapy and have used it successfully to treat many soldiers and victims of the 2004 tsunami. Moreover, given the enormous need, there are still not enough trauma-informed mental health professionals in the country, let alone in rural communities. And it takes years of specialized training and the proper credentials to become fully trained.

Properly trained paraprofessionals can effectively fill the treatment shortfall. The largest psychiatry trial conducted in the developing world, the MANAS intervention, convincingly demonstrated that trained lay health counsellors could play a crucial role in helping to deliver effective care for depression and anxiety in resource-poor communities in India.

GIST-T seeks support for a pilot project to train, supervise and evaluate 100 Northern Sri Lankan paraprofessionals in the use of a simplified EMDR group therapy protocol. The Confronting Stress and Trauma Resource Kit, with its online and face-to-face components, would form the basis for comprehensive training.

Once trained, paraprofessionals would work in pairs to provide 10 group sessions annually, with 30 Tamil participants per session (50 facilitator pairs x 10 sessions per pair per year x 30 participants per group). Over a three-year period, 45,000 trauma-affected Tamils would receive the care they need to help alleviate their trauma symptoms.