Impact of WACIT Practice-Focused Interprofessional Training

                                   Panos Vostanis, John Maltby, Michelle O'Reilly, Charlie Duncan & Elizabeth Anderson​​


Following the completion of the first phase of the project, we established key stakeholders' views and experiences, as well as their recommendations on how to refine and improve it the practice-focused training, thus aim for more sustainable impact.  To this effect, the aim of this study was to establish evidence on stakeholders' experiences of the international training workshops and related activities in six countries (Kenya, Rwanda, Turkey, Pakistan, Indonesia and Brazil).  Through semi-structured interviews, we explored experiences of the training workshops and related events, the role of the organizations, the children they serve and challenges they may be facing in meeting their psychosocial needs. 

Vostanis, P, Maltby, J, Duncan, C & O'Reilly, M. (2018) Stakeholder perspectives on children’s psychosocial needs and supports in six low- and middle-income countries. Children and Society, 32, 457-469

Vostanis, P., O'Reilly, M., Duncan, C., Maltby, J. & Anderson, E. (2018) Interprofessional training on resilience-building for children who experience trauma: Stakeholders’ views from six low- and middle-income countries. Journal of Interprofessional Care

Development, Implementation and Preliminary Evaluation of WACIT Framework: 3-Continent Project
Panos Vostanis, Esther Smit, Seyda Eruyar, John Maltby & Michelle O'Reilly 

A service method is being developed to assist NGOs and statutory organizations in identifying needs, setting goals and action plans, definining measures of impact and success, and implementing them with target groups of vulnerable children.

The framework is based on the WACIT six-dimension model, and will be accompanied by detailed criteria and supporting resources.

The first phase will be delivered and evaluated through participatory action methods in three countries, and hosted by the followign WACIT partner NGOs:

Nakuru, Kenya (FANET) - slums area
Istanbul, Turkey (Hayat Foundation) street/refugee children
Rio de Janeiro, Brazil (ASEC) - favelas area

Children's Conceptualization of Resilience across Cultures
                   (Kenya, Turkey, Brazil and Saudi Arabia)

John Maltby, Munevver Ozdemir, Nouf Al Shehri, Michelle O'Reilly & Panos Vostanis

Although resilience is increasingly influential in research and development of interventions, there is limited knowledge on children's concepts, particularly across different developmental and cultural groups.

The aim of this study is to develop such a child-led model based on participatory school class observations in primary and secondary schools in areas of disadvantage in India, Kenya, Saudi Arabia and Turkey. Children's definitions in their own language will inform the development of a resilience questionnaire to be tested with larger samples in the same populations.

WACIT Texts and Reference Documents

In addition to research papers and training materials, key evidence can be found in review papers, chapters and books:

Vostanis, P (2018) Hope for Children in Trauma: An International Perspective. London: Taylor & Francis.

Hodes, M. & Vostanis, P. (2018). Mental health problems of refugee children and their management. Child Psychology and Psychiatry, in press.

Eruyar, S, Huemer, J & Vostanis, P (2017). How should refugee services respond to the refugee crisis? Child and Adolescent Mental Health, doi:10.1111/camh.12252

Majumder, P, Vostanis, P, Karim, K & O'Reilly (2018). Potential barriers in the therapeutic relationship in unaccompanied minors in mental health. Journal of Mental Health doi:10.1080/09638237.2018.1466045

Vostanis, P (2017) Global child mental health: Emerging challenges and opportunities. Child and Adolescent Mental Health, 22, 177-178.

Vostanis, P (2016) A Practical Guide to Helping Children and Young People who Experience Trauma. London: Speechmark.

Vostanis, P. (2016) New approaches to interventions for refugee children. World Psychiatry, 15, 75-77.

Vostanis, P. (2015) (Editorial) Healthcare professionals in war zones are vulnerable too. Journal of Psychiatric and Mental Health Nursing, 22, 747–748.

Vostanis, P (2014) Helping Children and Young People who Experience Trauma: Children of Despair, Children of Hope. London: Radcliffe.

Vostanis, P. (2014) (Editorial) Meeting the mental health needs of refugee and asylum seekers. British Journal of Psychiatry, 204, 176-177.

                        International Child Mental Health Study Group Surveys 
D Stevanovic, Serbia; O Atilola, Nigeria; YPS Balhara, India; M Avicenna, Indonesia; H Kandemir, Turkey;     KR Knez & F Toslav,  Croatia; P Petrov, Bulgaria; P Moreira, Portugal; P Vostanis, UK 

This group of researchers from low- and middle-income income countries completed, without any resources, an international school child mental health survey that has provided
evidence to respective governments to plan services. A current project is looking at the impact of traumatic events on child mental health. The ICMHG co-ordinates a Network, and provides free advice and support to young clinicians and researchers from low income countries.

This project examined the relationship between being exposed to war trauma and developing mental health problems among Syrian refugee living in Turkey. In particular, it investigated the role of parenting and attachment styles in this relationship. Results revealed that attachment relationships contributed significantly in explaining children's PTSD and general mental health problems; whilst parenting practices predicted PTSD, and parental psychopathology predicted general mental health problems. The first study was followed by a feasibility evaluation of Theraplay with refugee children and their parents in order to improve emotional regulation and attachment relationships. According to feasibility reports, Theraplay was acceptable and relevant to the study population, althuogh there were difficulties in engaging parents. Preliminary results indicate that attachment difficulties and PTSD symptoms improved in half of the participating children. 

Eruyar, S., Maltby, J. & Vostanis, P. (2018) Mental health problems of Syrian refugee children: The role of parental factors. European Child and Adolescent Psychiatry, 27, 401-409.

The Role of Parenting Factors in the Association between War Trauma and Mental Health Problems among Syrian Refugee Children in Turkey
Seyda Eruyar 

Psychosocial Intervention for Children Victims
of Ethnic Conflict in Kenya

Getanda, E, O’Reilly, M. & Vostanis, P. (2017) Exploring the challenges of meeting. child mental health needs through community engagement in Kenya. Child and Adolescent Mental Health, 22, 201-208.

Tamburino, I., Getanda, E., O'Reilly, M. & Vostanis, P. (2018) "Everybody's responsibility": Conceptualization of youth mental health in Kenya. Journal of Child Health Care, in press.


Elijah Getanda

Focus groups with stakeholders (children, parents, teachers and other professionals) established perspectives on the cultural adaptation of psychosocial interventions in a disadvantaged area of Nakuru, Kenya. This was followed by a feasibility evaluation of a psychoeducation intervention for children exposed to ethnic violence and presenting with emotional problems.

Predictors of Post-Traumatic Growth among Children in Pakistan Care Homes
Saima Ali & Sajida Hassan

There is plenty of evidence on the impact of risk factors, and increasing interest in the role of resilience, but not how the two interact to predict post-traumatic growth. This is the focus of this study in Karachi and Skardu orphanages. 
Mental Health Needs of Young  People in Care in Turkey
Fatih Sobaci

This study explored the conceptualization of mental health problems and associated causes, as well as experiences of mental health supports within the care system and by mental health services for young people in care in Turkey. Stakeholder perspectives were established in 37 interviews with young people, caregivers, social workers and mental health professionals in Istanbul. Four themes emerged on perceptions of mental wellbeing and mental health problems, and associated vulnerabilities for and impact of mental health problems in relation to children's experiences and living in the care sytem; supports within care; experiences of mental health interventions and services; and recommendations for future improvement. Key findings were children's difficulties in defining mental health in positive terms; mixed views by caregivers and social workers in understanding challenging behaviours as both 'troubling' and as an expression of emotional problems; and the fragmentation of service responses.
The Protective Role of Individual, Family and Community Factors among Children Exposed to Civil War in Libya
Ahmad Faraq
This study adopted the socioecological framework in investigating the role of resilience factors in 100 internally discplaced children in Libya. Their coping strategies, family and community supports were rated by children and their parents, as well as general mental health and PTSD symptoms.


The Role of Religious Coping Strategies in Building Child Mental Health Resilience
in Saudi Arabia 

Nouf Alshehri

Also by adopting the socioecological resilience framework, this study will investigate the specific role that religious coping strategies play in relation to family and community supports and other factors in mederating the impact of disadvanatage among children in Saudi Arabia.

A Creative Resilience-Building Intervention
for Refugee Children in the UK
Virginia Kocik
A school-based creative group intervention to strengthen refugee children's resilience in being evaluated for its feasibility in London. This was adapted following needs-led recommendations by refugee children, their parents and teachers.

Identifying the Mental Health Service Needs of Refugee Children in the UK:
Developing a Needs-led Model using the WACIT Framework
Sarah Hunt

This research project will be conducted in collaboration with a number of UK Councils and services to improve the service provision for refugee children in the UK. The project comprises two Phases.

The aim of Phase 1 is to explore stakeholder perspectives on the mental health service needs of refugee children in the UK. Specifically, Phase 1 aim's to identify barriers to access and engagement with services from the perspective of both service users (children and parents) and service providers.

The aim of Phase 2 is to respond to stakeholder views and experiences with the development of a needs-led service model. This will involve a series of stakeholder participatory workshops, where together stakeholders will map perspectives onto the WACIT psychosocial framework. This will provide a methodological approach to identifying both challenges and opportunities across multiple levels. Interdisciplinary training will be provided to support the development of actions plans, with a view to capacity build across services.