Reaching the Unreached: Bridging Islam and Science to Treat the Mental Wounds of War

Abstract

Radical new paradigms are needed to equip non-professionals and leverage community faith-based infrastructure to address the individual and communal wounds of war- and conflict-related trauma. Muslims in war-torn regions like Somalia experience high rates of trauma and posttraumatic stress; yet, lack of providers, potential stigma, and lack of integration with one's faith are substantial barriers to care. In this pre-post feasibility clinical trial (NCT03761732), mosque leaders implemented a brief, group- and mosque-based intervention, Islamic Trauma Healing, targeting trauma-related psychopathology and community reconciliation for trauma survivors (N = 26) in Somaliland, Somalia. Leaders were trained in a brief 2-day training, with supervision provided remotely via WhatsApp. This six-session intervention combines empirically-supported trauma-focused psychotherapy and Islamic principles, focusing on wisdom from the lives of the Prophets and turning to Allah in dua about trauma. There were large, clinically meaningful effects for PTSD (g = 1.91), depression (g = 2.00), somatic symptoms (g = 2.73), and well-being (g = 1.77). Qualitative data from group members highlighted how well the program was aligned with their Islamic faith, built community, and need to expand the program. These results highlight the feasibility of this non-expert, easily up-scalable mental health approach in war-torn Muslim regions and refugee communities. This program has the potential to provide a low-cost, self-sustaining, Islam-based intervention addressing the psychological wounds of war consistent with the IOM's call to develop novel approaches to address unmet clinical needs.ClinicalTrials.govIdentifier: NCT03761732.

WITHDRAWN: Cognitive Behavior Therapy (CBT), Islam-Based Interventions (IBIs) and Pharmacotherapy (PTh) for Patients with Major Depressive Disorder-Mild (MDD-m): A Randomized Control Trial

“…Islam-based therapy has also gained popularity as an evidence-based intervention to deal with depressive symptoms with various positive outcomes [13]. When patients do not respond to pharmacotherapy and do not improve daily functions are usually referred to long-term therapies with intensive treatment services.…”

WhatsApp supervision for a lay‐led Islamic trauma‐focused intervention in Somaliland: Qualitative content analysis

“…Finally, we did not assess whether supervision itself was linked to improved clinical outcomes. Notably, in this trial, ITH led to large and clinically meaningful effects on PTSD, depression, somatic symptoms, and well‐being (Zoellner et al., 2021). Future work should include quantitative measures of WhatsApp supervision effectiveness to evaluate the association between supervision and clinical outcomes.…”

“…Lay leaders attended a 2‐day training that lasted a total of approximately 8 hr in Djibouti, Djibouti, led by the supervision team (Zoellner et al., 2021). The training for ITH is purposefully brief to reduce leaders’ time burden and promote easy scaling of the intervention.…”

Living the Good Life: An Islamic Perspective on Positive Psychology

“…However, the study did not include a secular form of psychotherapy as an active comparison group. Similarly, in qualitative data from a pilot study with Somali Muslims (N = 26), participants in an Islamic-accommodated, trauma-focused intervention reported they benefited from the incorporation of Islamic beliefs and practices (e.g., Prophetic traditions, verses from the Qur'an, prayer to God) into the treatment (Zoellner et al, 2021); however, it is worth noting that this pilot study lacked a control condition.…”