Contextual adaptation and piloting of Group Integrative Adapt Therapy (IAT-G) amongst Rohingya refugees living in Bangladesh
Mahmuda Mahmuda1, Mohammad Abdul Awal Miah2, Mohamed Elshazly3, Sanjida Khan4, Alvin Kuowei Tay5, Peter Ventevogel6
1 MS, Public Health and Nutrition Unit, UNHCR Cox’s Bazar, Bangladesh
2 MPhil, Perdana University, Centre for Research Excellence (PUCRE), Selangor, Malaysia
3 MD, MSc, ABPsyc, IMMHPS, Public Health and Nutrition Unit, UNHCR Cox’s Bazar, Bangladesh
4 MS, Department of Psychology, Jagannath University, Dhaka, Bangladesh
5 PhD, School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
6 MD, PhD, Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
Mohammad Abdul Awal Miah
Adjunct senior Lecturer, Perdana University, Centre for Research Excellence (PUCRE), Selangor
Source of Support: None, Conflict of Interest: None
A main gap in the delivery of mental health and psychosocial (MHPSS) services to Rohingya refugees in Cox’s Bazar district in Bangladesh is the limited coverage of psychotherapeutic interventions. There is a shortage of mental health professionals who can provide culturally adapted and linguistically appropriate psychotherapeutic interventions that are congruent with the refugee experience. This article describes preliminary work on training Bangladeshi psychologists and para-professionals in applying a novel group-based psychological intervention for refugees, Group Integrative Adapt Therapy (IAT-G). This is a pragmatic, eclectic and transdiagnostic approach, based on the Adaptation and Development After Persecution and Trauma (ADAPT) model. It aims to help refugees to develop resilience and capacities for managing maladaptive reactions to trauma and post-migration living difficulties. This paper describes the key strategies and challenges during the first phase of the project. Activities included an extensive desk review, a one-week training workshop with competency assessments, cultural adaptation of the treatment manual and assessment measures, training on digital literacy and electronic data collection and a blended supervisory model (involving onsite and online sessions). It proved to be generally feasible but not easy to introduce IAT-G in this population.
Key implications for practice
- The introduction of a brief scalable psychological intervention within an acute and ongoing emergency was feasible, but faced considerable challenges including high staff turnover.
- Implementation involves multiple components including stakeholder engagement, contextual adaptation of tools and materials, training and supervision and setting up a monitoring system.
- Setting up a supervision is of critical importance but can be complicated in the context of an unfolding emergency.