(PS9-80) Islamic Trauma Healing: A Qualitative Study Examining Trainers’ and Supervisors’ Experiences Training Lay Leaders in a Community Trauma Reconciliation Program

Abstract Text: There are over 3.9 million displaced individuals within Somaliland, a region of Somalia historically rife with political violence. About 30% of displaced Somalis meet the criteria for posttraumatic stress disorder (PTSD), with common traumas including war-related violence and physical injury. Islamic Trauma Healing (ITH), a lay-led intervention for trauma-exposed Somalis that integrates components of the Muslim faith with evidence-based treatment principles, is emerging as an effective treatment. ITH reduces PTSD and depression symptoms and increases well-being among Somali refugees. Built on a train-the-trainer model, lay leaders who initially delivered ITH then train and supervise new lay leaders. In this study, we qualitatively explore the experiences of ITH trainers so that mental health professionals are better able to support lay-led training efforts moving forward. Two gender-separated focus groups were conducted during a research uptake meeting in Nairobi, Kenya, with one group of male trainers (N = 6) and one group of female trainers (N = 6). Semi-structured interviews were led by male and female interviewers, with live translators. All interviews were audio recorded, transcribed and translated to English by a team member with Somali fluency, and subjected to qualitative analysis. Two independent coders used an inductive phenomenological approach and thematic content analysis to develop a codebook of themes and codes to be analyzed using NVivo version 14.24.2. Four themes were identified: 1) cultural and religious trauma healing (27.0%); 2) barriers to ITH (10.3%); 3) personal and professional growth as trainers/supervisors (40.7%); and 4) the need for further training (22.0%). Fifteen codes were developed within the broad themes listed, including the importance of religious values and prophet narratives, community involvement, language and monetary challenges, fulfillment relating to healing trauma and supporting lay leaders, as well as the need for further training from mental health professionals on severe trauma, and other domains. Percent agreement across coders and codes was high across men’s (92.6% - 100%) and women’s groups (94.6%-100%). Most frequent codes included supporting lay leaders in program engagement (19.3%), prophet narratives (17.4%), healing those with trauma (9.0%), and need for additional trainer trainings (7.0%). Findings suggested that trainers found personal meaning in helping heal their community members with trauma related symptoms by supporting lay leaders. They emphasized the need for additional trainings and greater support from mental health professionals on clinical challenges. Findings suggested that involving former lay leaders in supervisory roles can aid supervisors in greater personal meaning and community involvement, as well as enhance the overall sustainability of implementing lay-led interventions in the community. Additional studies scaling up interventions through inclusion of trainers and supervisors found that the trainer-peer relationship, cultural similarity, and increased use of training were deemed helpful. Strengthening and scaling interventions with professional guidance could enhance the long-term impact of lay-led interventions.