Dispositif de prise en charge psychologique de groupe : expérience clinique avec les enfants traumatisés de Centrafrique

Abstract

ObjectiveThis article presents a psychological care device for children exposed to war trauma. PatientsChildren exposed to traumatic events in the Central African Republic. The age is between 6 and 16 years old. MethodThe children were recruited during a psychoeducation session organized in the community. Following this, the children responding to the inclusion criteria participated in a psychological care device of five sessions on a weekly basis. This device was created to allow a team of non-professionals of mental health to guarantee a therapeutic project finalized to reduce the traumatic symptomatology of the children in a humanitarian context. Each session was organized in two parts. In the first part, the psychosocial worker, using a card representing a fictional character, encouraged children to speak about a subject. After this discussion, children were invited to draw a picture by following instructions related to the card observed and then to share their drawing with the group. The topics discussed in the sessions led children to rethink life before the war, to discuss difficult times during the war, and to imagine a future after the war. ResultsSix hundred and seventy-four children (410 girls and 264 boys) participated in the group psychological device. At the time of admission to the program 69% of children showed a very high level of trauma (CPTS-RI: M=41.64, SD=10.12). After five weeks of intervention, children were able to significantly reduce their traumatic symptoms (P<0.001). DiscussionThe proposed device in the Central African Republic contributed to reducing symptoms related to traumatic exposure. The subjects evoked by the cards allowed the children to think, nominate and temporally contextualize the traumatic event in order to allow them a re-elaboration of the past and a projection in the future. The children were also able to identify the internal and external resources that can help them overcome difficult times. ConclusionIn humanitarian contexts children may be affected by several traumatic events, and the means in terms of skilled human resources to cope with children's mental suffering may be very limited. The device presented in this article has been shown to be very effective in reducing the traumatic symptoms of children in a humanitarian context with the support of staff without a specific technical background in mental health.