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

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 manualised mosque-based, lay-led group intervention aimed at healing the individual and communal mental wounds of war and refugee trauma. The six-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.

This paper outlines the study protocol for a hybrid effectiveness-implementation randomized control trial (RCT) in the Somaliland, with implementation in the cities of Hargeisa, Borama, and Burao. In this study the Islamic Trauma Healing (ITH) intervention to promote mental health and reconciliation will be examined in 200 participants. Participants will be assessed at pre, 3 weeks, 6 weeks, and 3-month follow-up. The primary outcome will be assessor-rated posttraumatic stress symptoms (PTSD), with secondary outcomes of depression, somatic symptoms, and well-being. A training of trainers model will be tested, examining the implementation outcomes. Additional measures include potential mechanisms of change and cost effectiveness.

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.