Online Program

Telehealth Approach to Enhance Treatment Capacity and Monitoring Practice in Mental Health Service in the Post-Conflict Setting

Tuesday, November 3, 2015

Shr-Jie Wang, MPH, PhD, Danish Institute Against Torture (DIGNITY), Copenhagen, Denmark
Feride Rushiti, FR, Kosova Rehabilitation Centre for Torture Victims, Pristina, Kosovo
Moshe Landman, ML, Psycology, University of Pristina, Pristina, Kosovo
Uwe Harlacher, UH, Danish Institute Against Torture (DIGNITY), Copenhagen, Denmark
Jens Modvig, JMO, Danish Institute Against Torture (DIGNITY), Copenhagen, Denmark
Lack of local expertise to address the consequence of trauma has been major impediment for the reconciliation in the post-conflict setting. The present work is part of a randomized controlled trial of effectiveness of interdisciplinary intervention in war victims in Kosovo, using telehealth concept for therapy adjustment, clinical education and supervision.

Three Kosovar clinical psychologists were trained by an accredited CBT supervisor from Denmark in a 35-hour workshop in Pristina to provide cognitive behavior therapy (CBT) to war victims. After the workshop they were involved in a 6-month randomized controlled trial under long-distance coaching and supervision from Denmark. Each psychologist provided 60-100 treatment sessions (from 90 to 150 hours) during the trial and received 1-2 hours weekly supervision via videoconferencing (60 hours in total), and 40-hour in-person performance monitoring by reviewing the audio tapes of selected treatment sessions with CBT supervisors. The psychologists also assisted at baseline and follow-up assessments (30 hours) and received feedback from an independent local assessor. We fulfilled the European Association For Cognitive and Behavior Therapies (EACBT) Standards for Training and Accreditation for CBT therapists.

The model substantially reduces the cost and length of expat specialist staying in the field. Use of telehealth technique enhances the ability of specialists to provide coaching and feedback to local health workers, which improves the treatment integrity and data reliability. The local workers were highly motivated by on-the-job development and certification program. This approach addresses the gap between workshop-learned theories and skills and actual practice in the developing countries.

Learning Areas:

Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Describe a training and monitoring model using telehealth approach to advance cognitive bahavior therapy (CBT) skills and integrate CBT into routine clinical pratice in a post-conflict setting Demonstrate how the expat specialists provide coaching to local health staff in daily practices and use feedback to improve treatment integrity at a randomised controlled trial, applying telehealth concept and technique

Keyword(s): Telehealth, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received MPH from Yale University School of Public Health and PhD in Clinical and Intervention Epidemiology from Swiss Tropical and Public Health Institute, Basel University. I have been working with war-affected population and marginalised population in Africa, Middle-east and south-east Asia with NGOs and UN agencies since 1998.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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