Example 3: Youth Readiness Intervention in Sierra Leone
Project Type: Advocacy/Capacity Building
François-Xavier Bagnoud Center for Health and Human Rights
Longitudinal Study of War-Affected Youth (LSWAY) Principal Investigator: Theresa S. Betancourt, Sc.D., M.A.
The François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University is an interdisciplinary academic center that works to advance the rights and wellbeing of children, adolescents, youth and their families living in the most extreme circumstances worldwide. Founded in 1993, the Center works with local partners and communities to conduct and support research, teaching, advocacy, and targeted action in the areas of child protection and adolescent empowerment.
The FXB Center’s Research Program on Children and Global Adversity (RPCGA) engages in applied research to contribute to stronger and evidence-based interventions to serve children and families in adversity worldwide. The RPCGA is involved in a variety of projects, including the Longitudinal Study of War-Affected Youth in Sierra Leone. Building on collaborations and research dating from 2002, the RCPGA has continued to advance its work with former child soldiers and other war-affected youth in Sierra Leone.
The longitudinal research has followed a cohort of over 500 girls and boys—many of them former child soldiers—from ages 10-17 into adulthood and now into an intergenerational phase. The longitudinal findings to date have been used to develop and evaluate the Youth Readiness Intervention in Sierra Leone and interest is growing to extend it to several other settings including northern Uganda, the DRC and Somalia.
Former child soldiers frequently experience high rates of emotional and behavioral problems (anger, hopelessness, high risk behavior) related to exposure to violence and loss. These issues may be exacerbated by post-conflict stressors, such as stigma, community distrust, poverty, poor educational opportunity, and limited community and social support. These challenges are particularly salient in Sierra Leone, which experienced a bloody 11-year conflict from 1991 to 2002. As many as 28,000 children and youth were engaged in war-related activities, including involvement with the Sierra Leone army, civilian defense forces and the Revolutionary United Front, the rebel group central to the conflict. Many young people witnessed, perpetrated and were subjected to acts of intense violence.
After the war, short-term disarmament, demobilization, and reintegration programs sought to prepare former child soldiers to return to their homes. During this process, many programs and sensitization campaigns emphasized that children had been forcibly involved in armed groups against their will. Nevertheless, returning youth were frequently treated with fear, distrust and stigma when they attempted to reintegrate. While tremendous resilience has been evidenced in this setting, for some youth, psychological trauma, problems with community stigma, interpersonal deficits and distrust placed many at risk for poor health and developmental outcomes, low rates of school completion, and limited economic self-sufficiency.
Longitudinal data collected in 2002, 2004 and 2008 indicate that more risky developmental trajectories and poor life outcomes are associated with a constellation of war-related toxic stress exposures (i.e. being forced to injure or kill others, sexual violence) and post-conflict stressors (stigma, poor access to school, loss of caregivers, poor social support). According to Dr. Theresa S. Betancourt, the principal investigator of LSWAY:
“…[T]here are multiple influences on psychosocial adjustment and social reintegration for child soldiers. Certainly, individual-level war experiences, coping skills, and competencies matter, but outcomes are also strongly shaped by family community, and even larger macro-level factors such as the availability of education programs for youth who have missed many years of schooling due to war. Such enabling environments have a critical role to play in supporting the health adjustment of war affected youth.”
Results & Lessons Learned
The RPCGA team has used its findings to design an integrated intervention for war-affected youth in Sierra Leone with strong links to job skills training and educational initiatives. The Youth Readiness Intervention is the first initiative to use epidemiological findings in the region to target the multiple problems areas and interrelated risk factors common in war-affected youth. It consists of six empirically-supported treatment components that have been shown to be effective for troubled youth in other settings (i.e. building skills in emotion regulation, coping and addressing interpersonal deficits).
The model has been evaluated in a recent randomized controlled trial conducted in August-October of 2012 which demonstrated significant improvements among youth receiving the YRI on outcomes of emotion regulation, daily functioning, social support and prosocial skills compared to a wait list control group. The research team has been working with local development funders and the Sierra Leone government to examine mechanisms for taking this evidence based intervention to scale.
Through targeted methods of participatory research, community engagement, and policy advocacy, such evidence-based readiness interventions have the potential to be systematically integrated into education and employment programs for young people affected by war and communal violence.