Skip to main content
Top
Published in: Journal of Immigrant and Minority Health 1/2017

01-02-2017 | Original Paper

Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers

Authors: Rebekah Pratt, Nimo Ahmed, Sahra Noor, Hiba Sharif, Nancy Raymond, Chris Williams

Published in: Journal of Immigrant and Minority Health | Issue 1/2017

Login to get access

Abstract

To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.
Literature
1.
go back to reference Sheikh Omar Y. Social integration and the sense of hope among Somali youth in Australia and the United States. Bildhaan Int J Somali Stud. 2013;12(1):34–52. Sheikh Omar Y. Social integration and the sense of hope among Somali youth in Australia and the United States. Bildhaan Int J Somali Stud. 2013;12(1):34–52.
2.
go back to reference Halcón LL, Robertson CL, Savik K, et al. Trauma and coping in Somali and Oromo refugee youth. J Adolesc Health. 2004;35(1):17–25.CrossRefPubMed Halcón LL, Robertson CL, Savik K, et al. Trauma and coping in Somali and Oromo refugee youth. J Adolesc Health. 2004;35(1):17–25.CrossRefPubMed
3.
go back to reference Elmi AS. A study on the mental health needs of the Somali community in Toronto. Toronto: York Community Services and Rexdale Community Health Centre Toronto; 1999. Elmi AS. A study on the mental health needs of the Somali community in Toronto. Toronto: York Community Services and Rexdale Community Health Centre Toronto; 1999.
4.
go back to reference Johnsdotter S, Ingvarsdotter K, Östman M, Carlbom A. Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis. Mental Health Relig Cult. 2011;14(8):741–55.CrossRef Johnsdotter S, Ingvarsdotter K, Östman M, Carlbom A. Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis. Mental Health Relig Cult. 2011;14(8):741–55.CrossRef
6.
go back to reference Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64(12):1465–75.CrossRefPubMed Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64(12):1465–75.CrossRefPubMed
7.
go back to reference Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237–47.CrossRefPubMed Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237–47.CrossRefPubMed
8.
go back to reference Shah A. The burden of psychiatric disorder in primary care. Int Rev Psychiatry. 1992;4(3–4):243–50.CrossRef Shah A. The burden of psychiatric disorder in primary care. Int Rev Psychiatry. 1992;4(3–4):243–50.CrossRef
9.
go back to reference Ostler K, Thompson C, Kinmonth AL, Peveler RC, Stevens L, Stevens A. Influence of socio-economic deprivation on the prevalence and outcome of depression in primary care: the Hampshire depression project. Br J Psychiatry. 2001;178(1):12–7.CrossRefPubMed Ostler K, Thompson C, Kinmonth AL, Peveler RC, Stevens L, Stevens A. Influence of socio-economic deprivation on the prevalence and outcome of depression in primary care: the Hampshire depression project. Br J Psychiatry. 2001;178(1):12–7.CrossRefPubMed
10.
go back to reference Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.CrossRefPubMedPubMedCentral Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.CrossRefPubMedPubMedCentral
11.
go back to reference Ellis BH, Lincoln AK, Charney ME, Ford-Paz R, Benson M, Strunin L. Mental health service utilization of Somali adolescents: religion, community, and school as gateways to healing. Transcult Psychiatry. 2010;47(5):789–811.CrossRefPubMed Ellis BH, Lincoln AK, Charney ME, Ford-Paz R, Benson M, Strunin L. Mental health service utilization of Somali adolescents: religion, community, and school as gateways to healing. Transcult Psychiatry. 2010;47(5):789–811.CrossRefPubMed
12.
go back to reference Hill N, Hunt E, Hyrkas K. Somali immigrant women’s health care experiences and beliefs regarding pregnancy and birth in the United States. J Transcult Nurs. 2012;23(1):72–81.CrossRefPubMed Hill N, Hunt E, Hyrkas K. Somali immigrant women’s health care experiences and beliefs regarding pregnancy and birth in the United States. J Transcult Nurs. 2012;23(1):72–81.CrossRefPubMed
13.
go back to reference Pavlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med. 2010;71(2):353–61.CrossRefPubMedPubMedCentral Pavlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med. 2010;71(2):353–61.CrossRefPubMedPubMedCentral
14.
go back to reference Robertson CL, Halcon L, Savik K, et al. Somali and Oromo refugee women: trauma and associated factors. J Adv Nurs. 2006;56(6):577–87.CrossRefPubMed Robertson CL, Halcon L, Savik K, et al. Somali and Oromo refugee women: trauma and associated factors. J Adv Nurs. 2006;56(6):577–87.CrossRefPubMed
15.
go back to reference Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360(9339):1083–8.CrossRefPubMed Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360(9339):1083–8.CrossRefPubMed
16.
go back to reference Dahlberg LL, Krug EG. Violence—a global public health problem. In: Krug EG, et al., editors. World report on violence and health. Geneva: World Health Organization; 2002. p. 3–21. Dahlberg LL, Krug EG. Violence—a global public health problem. In: Krug EG, et al., editors. World report on violence and health. Geneva: World Health Organization; 2002. p. 3–21.
17.
go back to reference Levano W, Miller JW, Leonard B, et al. Public education and targeted outreach to underserved women through the national breast and cervical cancer early detection program. Cancer. 2014;120(S16):2591–6.CrossRefPubMedPubMedCentral Levano W, Miller JW, Leonard B, et al. Public education and targeted outreach to underserved women through the national breast and cervical cancer early detection program. Cancer. 2014;120(S16):2591–6.CrossRefPubMedPubMedCentral
18.
go back to reference Padela AI, Killawi A, Forman J, DeMonner S, Heisler M. American Muslim perceptions of healing: key agents in healing, and their roles. Qual Health Res. 2012;22(6):846–58.CrossRefPubMedPubMedCentral Padela AI, Killawi A, Forman J, DeMonner S, Heisler M. American Muslim perceptions of healing: key agents in healing, and their roles. Qual Health Res. 2012;22(6):846–58.CrossRefPubMedPubMedCentral
19.
go back to reference Deyo NS. Cultural traditions and the reproductive health of Somali refugees and immigrants. Master’s Thesis, University of San Francisco; 2012. Deyo NS. Cultural traditions and the reproductive health of Somali refugees and immigrants. Master’s Thesis, University of San Francisco; 2012.
20.
go back to reference Guerin P, Hussein Elmi F, Guerin B. Weddings and parties: cultural healing in one community of Somali women. Austr e-J Adv Mental Health. 2006;5(2):105–12.CrossRef Guerin P, Hussein Elmi F, Guerin B. Weddings and parties: cultural healing in one community of Somali women. Austr e-J Adv Mental Health. 2006;5(2):105–12.CrossRef
21.
go back to reference Bortolotti B, Menchetti M, Bellini F, Montaguti MB, Berardi D. Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials. Gen Hosp Psychiatry. 2008;30(4):293–302.CrossRefPubMed Bortolotti B, Menchetti M, Bellini F, Montaguti MB, Berardi D. Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials. Gen Hosp Psychiatry. 2008;30(4):293–302.CrossRefPubMed
22.
go back to reference Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37(09):1217–28.CrossRefPubMed Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37(09):1217–28.CrossRefPubMed
23.
go back to reference Rahman A. Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan—a multi-method study. Arch Women’s Mental Health. 2007;10(5):211–9.CrossRef Rahman A. Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan—a multi-method study. Arch Women’s Mental Health. 2007;10(5):211–9.CrossRef
24.
go back to reference Rahman A, Malik A, Sikander S, Roberts C, Creed F. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet. 2008;372(9642):902–9.CrossRefPubMedPubMedCentral Rahman A, Malik A, Sikander S, Roberts C, Creed F. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet. 2008;372(9642):902–9.CrossRefPubMedPubMedCentral
25.
go back to reference Williams C, Chellingsworth M. CBT: A clinician’s guide to using the five areas approach. Boca Raton: CRC Press; 2010. Williams C, Chellingsworth M. CBT: A clinician’s guide to using the five areas approach. Boca Raton: CRC Press; 2010.
26.
go back to reference Williams C. Overcoming anxiety, stress and panic: a five areas approach. London: Hodder Arnold; 2012. Williams C. Overcoming anxiety, stress and panic: a five areas approach. London: Hodder Arnold; 2012.
27.
go back to reference Williams C, Wilson P, Morrison J, et al. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial. PLoS One. 2013;8(1):e52735.CrossRefPubMedPubMedCentral Williams C, Wilson P, Morrison J, et al. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial. PLoS One. 2013;8(1):e52735.CrossRefPubMedPubMedCentral
28.
go back to reference Williams C, Martinez R. Increasing access to CBT: stepped care and CBT self-help models in practice. Behav Cogn Psychother. 2008;36(06):675–83.CrossRef Williams C, Martinez R. Increasing access to CBT: stepped care and CBT self-help models in practice. Behav Cogn Psychother. 2008;36(06):675–83.CrossRef
29.
go back to reference Petersen I, Lund C, Bhana A, Flisher AJ. Mental Health and Poverty Research Programme Consortium. A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings. Health Policy Plan. 2012;27(1):42–51.CrossRefPubMed Petersen I, Lund C, Bhana A, Flisher AJ. Mental Health and Poverty Research Programme Consortium. A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings. Health Policy Plan. 2012;27(1):42–51.CrossRefPubMed
30.
go back to reference Patel V. The future of psychiatry in low-and middle-income countries. Psychol Med. 2009;39(11):1759–62.CrossRefPubMed Patel V. The future of psychiatry in low-and middle-income countries. Psychol Med. 2009;39(11):1759–62.CrossRefPubMed
31.
go back to reference Gambino C, Trevelyan E, Fitzwater J. The foreign-born population from Africa: 2008–2012. Washington: US Census Bureau; 2014. Gambino C, Trevelyan E, Fitzwater J. The foreign-born population from Africa: 2008–2012. Washington: US Census Bureau; 2014.
32.
go back to reference Charmaz K. Constructing grounded theory. Thousand Oaks: Sage; 2014. Charmaz K. Constructing grounded theory. Thousand Oaks: Sage; 2014.
33.
go back to reference Morse JM, Stern PN, Corbin J, Bowers B, Clarke AE, Charmaz K. Developing grounded theory: the second generation (developing qualitative inquiry). Walnut Creek: Left Coast Press; 2009. Morse JM, Stern PN, Corbin J, Bowers B, Clarke AE, Charmaz K. Developing grounded theory: the second generation (developing qualitative inquiry). Walnut Creek: Left Coast Press; 2009.
34.
go back to reference Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.CrossRefPubMed Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.CrossRefPubMed
Metadata
Title
Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers
Authors
Rebekah Pratt
Nimo Ahmed
Sahra Noor
Hiba Sharif
Nancy Raymond
Chris Williams
Publication date
01-02-2017
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 1/2017
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-015-0338-2

Other articles of this Issue 1/2017

Journal of Immigrant and Minority Health 1/2017 Go to the issue