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Randomized Controlled Trial of Trauma Focused CBT in Tanzania and Kenya

Shannon Dorsey, PhD
Kathryn Whetten, PhD
Augustine Wasonga, MBA, MA
Dafrosa Itemba


The primary goal of this randomized controlled trial is to study the effectiveness of lay counselor delivered Trauma-focused Cognitive Behavioral Therapy (TF-CBT) in treating maladaptive grief and posttraumatic stress for orphaned children and young adolescents in two East African sites with high prevalence HIV: Moshi, Tanzania (TZ) and Bungoma, Kenya (KE).
In our feasibility study of TF-CBT with orphans in Tanzania, we found a group-based TF-CBT intervention to be feasible and acceptable, with promising clinical outcomes. In the feasibility study, lay counselors with no prior mental health experience delivered the intervention with training and supervision by our team of mental health and TF-CBT experts. The current RCT builds on this work, testing the effectiveness of TF-CBT compared to usual care in TZ and KE for maladaptive grief and traumatic stress. The study extends our prior work in three ways: 1) includes a comparison condition; 2) involves two countries to examine broader applicability and effectiveness; and 3) increases local leadership and sustainment potential, in that experienced lay counselors from the feasibility led training and supervision of the lay counselors.