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

Abstract

Clinical supervision is critical for the uptake of psychotherapy but difficult to facilitate in countries with limited providers, resources, and internet infrastructure. Innovative supervision approaches are needed to increase access to mental health treatments in low-to-middle income countries (LMICs). This study examined the content and feasibility of remote WhatsApp text supervision conducted as part of an open clinical trial in Somaliland. Islamic Trauma Healing ITH) is a brief, group, lay-lead, trauma-focused, mosque-based intervention that has demonstrated initial efficacy in pilot studies in the United States and Somaliland.After a 2-day, in-person training, lay leaders led four groups of five to seven members focused on trauma-related psychopathology and community reconciliation. Somali lay leaders trained in ITH (n = 9) and the research team (n = 6) attended weekly WhatsApp supervision during the intervention. Content was logged and subjected to qualitative analysis by two coders. Comments related to intervention implementation indicated that lay leaders understood the treatment rationale, adhered to treatment procedures, and believed the intervention components to be helpful and culturally relevant. Themes related to engagement suggested perfect attendance across groups and high levels of participation.Lay leader psychoeducation and skill development; supervisor praise, support, and encouragement; and supervisee gratitude emerged as additional themes. Remote text supervision conducted via WhatsApp was technologically feasible and may have facilitated skill development and the effective implementation of This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Idioms of distress: Feasibility trial findings on reducing somatic symptoms through a community-based, culturally integrated intervention in Somaliland

“…Supervision of Islamic Trauma Healing group sessions was provided weekly by a team of clinical psychologists and graduate students via a free cross-platform centralized messaging system (e.g., WhatsApp). 40 Key considerations for each group session were identified in advance of WhatsApp supervision meetings (e.g., “In this session, participants turned to Allah in du'a about the trauma for the first time. How did it go?”).…”

What role can (and should) clinical science play in promoting mental health care equity?

“…B. Klein et al, 2023). Further, the use of such a wide array of technological approaches has facilitated community-based research and treatment adaptations for various underserved diagnostic and demographic groups in previously unexplored ways.…”

“…In terms of technology used to directly reach communities, our field has seen burgeoning efforts to directly or indirectly promote equal and open access to mental health treatments and strategies: from the use of numerous smart technology applications to reach both consumers and providers (e.g., Asnaani, Zandberg, & Petersen, 2016), to artificial intelligence (including use of chatbots; e.g., Lim et al, 2022), to objective and real-time monitoring devices/platforms (e.g., ecological momentary assessments/interventions; Brown et al, 2020), creation of virtual safe space support groups using virtual conference platforms (e.g., Asnaani, Charlery White, & Phillip, 2020), to use of social media/communication applications (e.g., use of WhatsApp in low-resource global settings to provide clinical supervision; A. B. Klein et al, 2023).…”