Yıl 2019, Cilt 3 , Sayı 1, Sayfalar 71 - 102 2019-12-01

Savaş veya Doğal Afet Sonrasında Çocuk veya Ergenlere Uygulanan Okul Bazlı Müdahalelerin Ruh Sağlığı Semptomlarına Etkililiği Üzerine Bir Sistematik Derleme
A Systematic Review of the Effectiveness of School-based Interventions for Mental Health Symptoms of Children or Adolescents After War or Natural Disaster

Rüveyda ÇAL [1]


Dünya üzerinde azımsanamayacak sayıda çocuk ve ergen, savaşlar ve doğal afetlerden etkilenmekte ve bu sayı gün geçtikçe artmaktadır. Öte yandan, olağan düzeni sarsan bu durumlar, çocuk ve ergenlerin travmatik olaylara maruz kalma olasılıklarını ve dolayısıyla ciddi ruh sağlığı problemleri yaşama risklerini artırmaktadır. Okullar, özellikle bu kriz durumlarından sonra ruh sağlığı hizmetlerinin aktarılmasını sağlayan kurumların başında geldikleri halde, literatürde bu hizmetlerin etkililiği konusunda yeterince çalışma bulunmamaktadır. Bu derlemede, okul bazlı müdahalelerin, savaş veya doğal afet kaynaklı travmaya maruz kalmış çocuk veya ergenlerdeki travma sonrası stres bozukluğu TSSB , depresyon ve anksiyete semptomları üzerinde etkililiği araştırılmıştır. Sistematik araştırma PsychInfo, PubMEd, Scopus ve PTSDPubs veri tabanları üzerinden “okul-bazlı müdahaleler”, “savaş”, “doğal afet” ve “travma” anahtar kelimelerini kullanarak gerçekleştirilmiştir. Erişilen çalışmaların kalite değerlendirmesi “Etkili Halk Sağlığı Projesi” nitel çalışmalar için kalite değerlendirme aracı ile yapılmıştır. Yeterli kalitede bulunan çalışmalar içerisinden dahil etme ve hariç tutma kriterlerine uyan 12 çalışma seçilmiştir. Çalışmaların çoğu TSSB, depresyon ve anksiyete semptomlarında düşüşler olduğunu gösterirken, en başarılı sonuçların doğal afet kaynaklı travma için yapılan müdahaleler sonucunda TSSB semptomlarında alındığı gözlemlenmiştir. Uygulayıcıların öğretmenler olduğu ve diğerlerine göre daha uzun süren müdahalelerin üç semptom türünde de en başarılı müdahaleler olduğu görülmüştür. Bu çalışma sonucunda, savaş ve doğal afetlerden sonra uzun süren ve öğretmenler tarafından aktarılan okul bazlı müdahalelere öncelik verilmesinin TSSB, depresyon ve anksiyete semptomlarını iyileştirmede daha etkili olacağı sonucuna varılmıştır.
Worldwide, wars and natural disasters affect a considerable number of children and adolescents and this number is constantly increasing. On the other hand, such extraordinary situations cause children and adolescents to be exposed to traumatic events and pave the way for serious mental health disorders. Although schools are one of the main institutions in transferring mental health services, especially after these crisis situations, studies on the effectiveness of school-based interventions remain insufficient in the literature. This review examined the efficacy of schoolbased interventions for post-traumatic stress disorder PTSD , depression and anxiety symptoms of war or natural disaster exposed children or adolescents. The systematic research was conducted in four databases, PsychInfo, PubMED, Scopus and PTSDPubs, using key subject terms “schoolbased interventions”, “war”, “natural disaster” and “trauma”. Identified papers were assessed using Effective Public Health Practice Project EPHPP quality assessment tool for quantitative studies. A total of 12 studies were selected that met the inclusion and exclusion criteria. While most studies have shown declines in PTSD, depression and anxiety symptoms, the most successful results have been observed in PTSD symptoms following interventions for natural disaster-induced trauma. Interventions in which practitioners were teachers and lasted longer than others yielded the most successful results in all three types of symptoms. The study concluded that prioritizing schoolbased interventions that persist long and delivered by teachers after wars or natural disasters may be more effective in improving PTSD, depression and anxiety symptoms of children or adolescents
  • American Academy of Pediatrics. (2004). School-based Mental Health Services. Pediatrics, 113(6).
  • American Psychiatric Association & American Psychiatric Association. Task Force on DSM-IV (2000), Diagnostic and statistical manual of mental disorders: DSM-IV-TR, 4th, text revision. edn, American Psychiatric Association, Washington, DC.
  • Attanayake, V., McKay, R., Joffres, M., Singh, S., Burkle, F., & Mills, E. (2009). Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, Conflict, and Survival, 25(1), 4–19. https://doi.org/10.1080/13623690802568913.
  • Barron, I. G., Abdallah, G., & Smith, P. (2013). Randomized Control Trial of a CBT Trauma Recovery Program in Palestinian Schools. Journal of Loss and Trauma, 18(4), 306–321. https:// doi.org/10.1080/15325024.2012.688712.
  • Baum, N. L., Cardozo, B. L., Pat-Horenczyk, R., Ziv, Y., Blanton, C., Reza, A., … Brom, D. (2013). Training Teachers to Build Resilience in Children in the Aftermath of War: A Cluster Randomized Trial. Child and Youth Care Forum, 42(4), 339–350. https://doi.org/10.1007/ s10566-013-9202-5.
  • Berger, R., Abu-Raiya, H., & Benatov, J. (2016). Reducing primary and secondary traumatic stress symptoms among Educators by Training Them to Deliver a Resiliency Program (ERASE-Stress) following the christchurch earthquake in New Zealand. American Journal of Orthopsychiatry, 86(2), 236–251. https://doi.org/10.1037/ort0000153.
  • Berger, R., Gelkopf, M., & Heineberg, Y. (2012). A teacher-delivered intervention for adolescents exposed to ongoing and intense traumatic war-related stress: A quasi-randomized controlled study. Journal of Adolescent Health, 51(5), 453–461. https://doi.org/10.1016/j.jadohealth.2012.02.011.
  • Birleson P. (1981) The validity of depressive disorder in childhood and the development of a self- rating scale: a research report, J. Child Psychol. Psychiat., 22, 73-88.
  • Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997) The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics, Journal of the American Academy of Child & Adolescent Psychiatry, 36, 545–553. http://dx.doi.org/10.1097/00004583-199704000-00018.
  • Bonanno, G. A., & Mancini, A. D. (2008). The Human Capacity to Thrive in the Face of Potential Trauma. Pediatrics, 121(2), 369–375. https://doi.org/10.1542/peds.2007-1648.
  • Centre for Reviews & Dissemination, C. (2009). Systematic Reviews: CRD’s guidance for Undertaking Reviews in Health Care: Centre for Reviews and Dissemination.
  • Colman, A. M. (2015). A Dictionary of Psychology (4 ed.). Oxford University Press.
  • Daviss, W. B., Birmaher, B., Melhem, N. A., Axelson, D. A.,Michaels, S. M., & Brent, D. A. (2006). Criterion validity of the mood and feelings questionnaire for depressive episodes in clinic and non-clinic subjects, Journal of Child Psychology and Psychiatry, 47, 927–934.
  • doi.org/10.1016/S1054-139X(01)00406-2.
  • Hanson, R. F., & Jobe-shields, L. (2017). Trauma-Focused Cognitive – Behavioral Therapy for Children and Adolescents, 2.
  • Jaycox, Lisa H. Morse, Lindsey K. Tanielian, Terri. Stein, B. D. (2006). How Schools Can Help Students Recover from Traumatic Experiences: A Tool Kit for Supporting Long-Term Recovery. https://doi.org/10.1016/j.evopsy.2014.10.003.
  • Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., … Schonlau, M. (2010). Children’s Mental Health Care Following Hurricane Katrina: A field Trial of Trauma Focused Psychotherapies. Journal of Traumatic Stress, 23(2), 223–231.
  • Jordans, M. J. D., Komproe, I. H., Tol, W. A., Kohrt, B. A., Luitel, N. P., MacY, R. D., & De Jong, J. T. V. M. (2010). Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: A cluster randomized controlled trial. Journal of Child Psychology and Psychiatry and Allied Disciplines, 51(7), 818–826. https://doi.org/10.1111/j.1469-7610.2010.02209.x.
  • Kar, N. (2009). Psychological impact of disasters on children: review of assessment and interventions, 5(1), 5–11. https://doi.org/10.1007/s12519-009-0001-x.
  • Karam, E. G., J., F., A.N., K., C.C., T., N., M., Z., M., … Dimassi, H. (2008). Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry,7(2),103109.http://www.ncbi.nlm.nih.gov/pubmed/18560511%0Ahttp:// www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC2430518%0Ahttp://ovidsp. ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed11&NEWS=N&AN=352760044 adresinden edinilmiştir.
  • Kilmer, R. P., Gil-Rivas, V., & MacDonald, J. (2010). Implications of major disaster for educators, administrators, and school-based mental health professionals: Needs, actions, and the example of Mayfair Elementary. In R. P. Kilmer, V. Gil-Rivas, R. G. Tedeschi, & L. G. Calhoun (Eds.), Helping families and communities recover from disaster: Lessons learned from hurricane Katrina and its aftermath (pp. 167-191). Washington, DC, US: American Psychological Association.
  • Laor, N., Wolmer, L, Spirman S. & Wiener Z. (2003) Facing war, terrorism, and disaster: toward a child-oriented comprehensive emergency care system, Child and Adolescent Psychiatric Clinics of North America, 12(2), pp 343-361.
  • Layne, C. M., Saltzman, W. R., Poppleton, L., Burlingame, G. M., Pašalić, A., Duraković, E., … Pynoos, R. S. (2008). Effectiveness of a school-based group psychotherapy program for war- exposed adolescents: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 47(9), 1048–1062. https://doi.org/10.1097/CHI.0b013e31817eecae.
  • Liu, M., Wang, L., Shi, Z., Zhang, Z., Zhang, K., & Shen, J. (2011). Mental health problems among children one-year after Sichuan earthquake in China: A follow-up study. PLoS ONE, 6(2), 8–13. https://doi.org/10.1371/journal.pone.0014706.
  • Macksoud, M. S., & Aber, J. L. (2016). The War Experiences and Psychosocial Development of Children in Lebanon. Wiley on behalf of the Society for Research in Child Development Stabil URL : http://www.jstor.org/stable/1131687 , 67(1), 70–88.
  • Norris, F. H., Byrne, C. M., Diaz, E., Friedman, M. J., Watson, P. J., & Kaniasty, K. (2002). 60 , 000 Disaster Victims Speak : Part I . An Empirical Review of the Empirical Literature , 65(3), 1981–2001.
  • Definitions, reactions, and predictors of outcomes. Helping Children Cope with
  • Disasters and Terrorism., 11–33. https://doi.org/10.1037/10454-001.
  • Smith,P. Dyregrov, A. And Yule, W. (2000) Children and war: teaching recovery techniques. Children and War Foundation.
  • Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the Impact of Event Scale with children in war, Personality and Individual Differences, 34, 315–322.
  • Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884, (July), 1–22.
  • Sullivan, A. L., & Simonson, G. R. (2016). A Systematic Review of School-Based Social-Emotional Interventions for Refugee and War-Traumatized Youth. Review of Educational Research, 86(2), 503–530. https://doi.org/10.3102/0034654315609419.
  • Thabet, A. A., Tawahina, A. A., El Sarraj, E., & Vostanis, P. (2008). Exposure to war trauma and PTSD among parents and children in the Gaza strip. European Child and Adolescent Psychiatry, 17(4), 191–199. https://doi.org/10.1007/s00787-007-0653-9.
  • Tol, W. A., Komproe, I. H., Jordans, M. J., Vallipuram, A., Sipsma, H., Sivayokan, S., ... & De Jong, J. T. (2012). Outcomes and moderators of a preventive school based mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial. World Psychiatry, 11(2), 114-122.
  • UNESCO (2016) Nearly a quarter of the world’s children live in conflict or disaster- stricken countries https://www.unicef.org/press-releases/nearly-quarter-worlds- children-live-conflict-or-disaster-stricken-countries adresinden edinilmiştir (18 Haziran 2019 tarihinde ulaşıldı).
  • Weine S, Becker D, McGlashan T, Vojvoda D, Hartman S, Robbins J (1995) Adolescent survivors of `ethnic cleansing’: observations on the first year in America, Journal of the American Academy of Child and Adolescent Psychiatry, 34 , 1153-1159.
  • Papageorgiou, V., Frangou-Garunovic, A., Iordanidou, R., Yule, W., Smith, P., & Vostanis, P. (2000). War trauma and psychopathology in Bosnian refugee children. European child & adolescent psychiatry, 9(2), 84-90.
Birincil Dil tr
Bölüm Research Article
Yazarlar

Yazar: Rüveyda ÇAL
Kurum: h.r.cal@hss17.qmul.ac.uk

Tarihler

Yayımlanma Tarihi : 1 Aralık 2019

APA Çal, R . (2019). Savaş veya Doğal Afet Sonrasında Çocuk veya Ergenlere Uygulanan Okul Bazlı Müdahalelerin Ruh Sağlığı Semptomlarına Etkililiği Üzerine Bir Sistematik Derleme. Talim , 3 (1) , 71-102 . Retrieved from https://dergipark.org.tr/tr/pub/talim/issue/52878/698666