Biography

Theresa S. Betancourt, Sc.D., M.A., is Director of the Research Program on Children and Global Adversity (RPCGA) and Associate Professor of Child Health and Human Rights at the Harvard School of Public Health (HSPH). Her central research interests include:

• Developmental and psychosocial consequences of concentrated adversity on children and families;
• Resilience and protective processes in child development;
• Child health and human rights; and
• Applied cross-cultural mental health research.

Dr. Betancourt has extensive experience in conducting research among children and families in low-resource settings, particularly in the context of humanitarian emergencies. She has been involved in the adaptation and testing of several mental health interventions for children and families facing adversity due to violence and chronic illness, including as PI of an NIMH-funded project to develop and evaluate a parenting/Family Strengthening Intervention (FSI) for HIV-affected families in Rwanda. She has recently worked with partners to adapt this intervention to focus on families with young children (<3 years) living in extreme poverty and options for delivering such family home visiting interventions via Rwanda's Social Protection system.

Dr. Betancourt is currently PI of an ongoing project to integrate an evidence-based behavioral intervention for war-affected youth (the Youth Readiness Intervention) into education and employment programs in Sierra Leone. She is also PI of an NIMHD-funded project using community-based participatory research methods to study conceptualizations of mental health problems as well as attitudes about healing and help-seeking to design family-based preventive interventions for Somali Bantu and Bhutanese refugees in the Boston metropolitan area.
One of Dr. Betancourt’s longest standing projects (begun in 2002), is a prospective longitudinal/intergenerational study of war-affected youth in Sierra Leone. A current NICHD R01 research grant is supporting a fourth wave of data collection in the cohort to investigate the intergenerational effects of war in Sierra Leone by examining health and development of the young children of the original cohort as well as intimate partner relationships. This research comprises one of the few intergenerational studies of war ever conducted in sub-Saharan Africa. Dr. Betancourt has written extensively on mental health, child development, family functioning and resilience in children facing adversity including recent articles in Child Development, Lancet Global Health, The Journal of the American Medical Association, The Journal of the American Academy of Child and Adolescent Psychiatry, JAMA Psychiatry, Social Science and Medicine, and PLoS One.

1-056 - Using Longitudinal Data to Develop Group Mental Health Interventions for War-Affected Youth

Session Type: Invited Address

Integrative Statement

The global burden of mental disorders due to violence and conflict is substantial, particularly in sub-Saharan Africa where the impact of war has been disproportionately high. Children exposed to war suffer from high rates of traumatic stress reactions, comorbid internalizing, externalizing problems and high risk behaviors, as well as interpersonal deficits and problems in emotion regulation.

In 2002, we began a prospective longitudinal study of war-affected children in Sierra Leone (N=529). Follow-up data were collected in 2003/2004 and 2008. The study examined risk and protective factors shaping social reintegration and psychosocial adjustment in these youth over time. Findings to date indicate that exposure to toxic stress (i.e. extreme violence) as well as post-conflict hardships (e.g., poor community relationships) are risk factors for poor developmental outcomes, while protective factors, such as community acceptance and family support, positively impact psychosocial adjustment.

Based on the findings of the longitudinal study, we developed a culturally-informed group mental health intervention for war-affected youth. The Youth Readiness Intervention (YRI) is a Stage 1 trauma intervention aimed at improving interpersonal skills, emotion regulation, and daily functioning. The YRI integrates common elements of evidence-based interventions for survivors of complex trauma, and was culturally-adapted using focus groups and key informant interviews. We conducted a randomized controlled trial in Sierra Leone for 15-24 year-old youth exhibiting psychological distress and functional impairments. Participants were randomized to the YRI (n=222) or a control condition (n=214). YRI participants received 10 weekly group sessions, after which youth were randomized to subsidized education (n=220) or wait-list control (n=216). Youth were assessed at post-intervention and six-month follow-up. Post-intervention, YRI youth reported greater improvements in emotion regulation, prosocial attitudes/behaviors, social support, and reduced functional impairment, and significant follow-up effects on school enrollment, school attendance, and classroom behavior compared to controls. However, at eight-month follow-up, teachers reported that YRI participants were 8.9 times more likely to be in school and showed better attendance and academic performance.

Sub Unit

• SRCD Biennial Meeting

Chair

• Ann S Masten, University of Minnesota

Speaker

• Theresa Betancourt, Harvard University