Pilot Randomized Control Trial: Efficacy of a Group-Based Psychosocial Program for Youth with PTSD in the Brazilian Fave
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ORIGINAL ARTICLE
Pilot Randomized Control Trial: Efficacy of a Group-Based Psychosocial Program for Youth with PTSD in the Brazilian Favelas Ian Barron 1
&
Fernando Freitas 2 & Christina Anderson Bosch 1
Accepted: 25 October 2020 # Springer Nature Switzerland AG 2020
Abstract The study aimed to evaluate Teaching Recovery Techniques (TRT) delivered to Brazilian youth who experienced drug violence in one Favela. Thirty children, 8 to 14 years, were randomly assigned to TRT (n = 14) or to a treatment as usual group (n = 16) involving boxing/martial arts. Youth received five 90-min sessions over successive weeks. Standardized measures assessed Posttraumatic Stress and Depression at 2 weeks pre and post-test. An exploratory assessment of posttraumatic growth was also utilized. An interview with group leaders explored perceptions of delivering TRT within the favela. Medium effect sizes were found for PTSD and Depression, and a small effect size for posttraumatic growth. Group leaders emphasized understanding the favela context for program adaptation. In conclusion, TRT was found to be effective for children with PTSD and Depression who experienced drug violence in a Brazilian favela. TRT is recommended for future delivery. Larger scale RCTs are needed in Brazilian favelas. Keywords PTSD . Drug gangs . Favelas . Youth . Depression
Research in Brazil has increasingly explored both the prevalence and association of violence and mental health (Andreoli et al. 2009; Teche et al. 2017). The prevalence of psychiatric disorders in urban centers in Brazil has been linked to high rates of exposure to traumatic events, such as assaultive violence, natural and human-made disasters, witnessing a shootout, seeing or touching a corpse, and witnessing atrocities (Ribeiro et al. 2013). Brazilian youth face high odds of being the primary perpetrators as well as victims of violence in the community (Faus et al. 2019). Sexual abuse and exploitation, psychological and physical violence, and neglect have been registered as the main reasons for attention from Brazilian social welfare centers for children under 14 years of age (Cardia et al. n.d.). Poverty, maternity psychiatric illness, and violence have been found to be strongly associated with higher rates of psychiatric disorders amongst Brazilian youth aged 7 to 14 (Fleitlich and Goodman 2001). The World Health
* Ian Barron [email protected] 1
Center for International Education, College of Education, University of Massachusetts Amherst, Amherst, MA, USA
2
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Organization estimates that mental health problems affect 10– 20% of children worldwide, compared to 12% to 25% of Brazilian children and adolescents and almost 100% involved in the country’s justice system (Ribeiro et al. 2019). Exposure to traumatic events has been found to be higher for urban Brazilians who are under 24 years of age, and those with such exposure have significantly higher rates of substance abuse, depression, and anxiety disorders in adulthood (Ja
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