Author(s)

Ibrahim A. Kira¹, Linda Lewandowski², Jeffery S. Ashby³, Andrea Z. Omidy⁴

¹Center for Cumulative Trauma Studies, Stone Mountain, USA.
²University of Massachusetts, Amherst, USA.
³Georgia State University, Atlanta, USA.
⁴Boston Medical Center, Boston, USA.

Children of refugee torture survivors present a compelling case of cumulative and continuous chronic past and current traumas and complex post-cumulative trauma symptoms. Traditional models of interventions with victims of single past traumas may not be effective with such victims. The goal is to develop and initially test a new open multi-systemic, multi-component and multi-modal intervention model (MMMM) as applied in the context of Summer Day Treatment and After School (SDTAS) program, and to determine its potential effectiveness as well as the feasibility of a larger study with more rigorous experimental design. A total of 27 secondary torture survivor Iraqi refugee children (13 males and 14 females, age between 11-16), living in the US, who suffered from serious symptoms and were non-responsive to treatment as usual for at least the previous six months, completed the planned interventions and three times follow-up assessments of five domains: PTSD, complex PTSD, anxiety, depression, and global level of functioning (GAF). Repeated measure analysis of variance was used to analyze changes over the three time points. Results indicated significant decrease in symptoms, and increased GAF with high effect sized (Partial Eta Squared ranged between 0.85 - 0.93). The amount of change displayed by the treated individuals was large enough to be clinically meaningful. Current study provides evidence of potential effectiveness of this novel intervention and of the feasibility of more rigorous and larger future controlled clinical trials to help develop evidence-based treatments for the multiply traumatized children who suffer past and present ongoing adversities. We suggest that the model is cost effective, and can be conducted with children of torture survivors and refugees in different settings world-wide by professionals or by trained supervised para-professionals.

Torture Survivors’ Children, Cumulative Trauma, Ecological Model of Recovery, Treatment Outcome, Current, Continuous, and Cumulative Trauma-Focused Cognitive Behavior Therapy CCC-TF-CBT

Kira, I. , Lewandowski, L. , Ashby, J. and Omidy, A. (2015) Development and Piloting the MMMM Ecological Interactive Open Systems Model: A Prospective One-Year Treatment Outcome of Children of Tortured Refugees. Psychology, 6, 1277-1296. doi: 10.4236/psych.2015.610125.