Islamic trauma healing (ITH): A scalable, community-based program for trauma: Cluster randomized control trial design and method

Lori A Zoellner; Norah C Feeny; Dega A Angula; Mohamed H Aideed; Essa N Liban; Muumin H Egeh; Abdisalan I Awke; Ahmed S Ismail; Mohamed A Kunle; Eesha Ali; Carol E Levin; Christopher J Burant; Jacob A Bentley

doi:10.1016/j.conctc.2023.101237

Islamic trauma healing (ITH): A scalable, community-based program for trauma: Cluster randomized control trial design and method

Contemp Clin Trials Commun. 2023 Dec 10:37:101237. doi: 10.1016/j.conctc.2023.101237. eCollection 2024 Feb.

Authors

Affiliations

¹ University of Washington, Department of Psychology, Seattle, WA, USA.
² Case Western Reserve University, Department of Psychological Sciences, Cleveland OH, USA.
³ University of Washington, Department of Global Health, Seattle, WA, USA.
⁴ Somaliland Youth Development and Voluntary Organization (SOYDAVO), Burao, Somalia.
⁵ University of Burao, Burao, Somalia.
⁶ University of Burao, Department of Management, Burao, Somalia.
⁷ University of Burao, Department of Research Studies, Burao, Somalia.
⁸ Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland OH, USA.
⁹ University of Washington, Department of Rehabilitation Medicine, Seattle, WA, USA.

Abstract

Background: Somalia has long been in a state of humanitarian crisis; trauma-related mental health needs are extremely high. Access to state-of-the-art mental health care is limited. Islamic Trauma Healing (ITH) is a manualized mosque-based, lay-led group intervention aimed at healing the individual and communal mental wounds of war and refugee trauma. The 6-session intervention combines Islamic principles with empirically-supported exposure and cognitive restructuring principles for posttraumatic stress disorder (PTSD). ITH reduces training time, uses a train the trainers (TTT) model, and relies on local partnerships embedded within the strong communal mosque infrastructure.

Methods: We will conduct a hybrid effectiveness-implementation randomized control trial (RCT) in the Somaliland, with implementation in the cities of Hargeisa, Borama, and Burao. In this study, a lay-led, mosque-based intervention, Islamic Trauma Healing (ITH), to promote mental health and reconciliation will be examined in 200 participants, randomizing mosques to either immediate ITH or a delayed (waitlist; WL) ITH conditions. Participants will be assessed by assessors masked to condition at pre, 3 weeks, 6 weeks, and 3-month follow-up. Primary outcome will be assessor-rated posttraumatic stress symptoms (PTSD), with secondary outcomes of depression, somatic symptoms, and well-being. A TTT model will be tested, examining the implementation outcomes. Additional measures include potential mechanisms of change and cost effectiveness.

Conclusion: This trial has the potential to provide effectiveness and implementation data for an empirically-based principle trauma healing program for the larger Islamic community who may not seek mental health care or does not have access to such care.

Clinical trial registration number: ClinicalTrials.gov NCT05890482.

World health organization trial registration data set information: See Supplemental Appendix 1.

Keywords: Cognitive behavioral therapy; Islam; Lay leaders; Posttraumatic stress disorder; Psychotherapy; Trauma.

Associated data

ClinicalTrials.gov/NCT05890482