A culturally responsive education program for trauma counsellors in developing countries

The vast majority of training for para-counsellors and community workers who facilitate trauma recovery programs in Uganda and Sri Lanka is based on Western developed conceptual frameworks and techniques that tend to strengthen the resilience of the individual. Yet little known research is available to determine how the gained knowledge and skills through individualistic-oriented training programs are adapted in practice within collective-based contexts where the clients have experienced enduring political violence and civil warfare. Specifically, this research aims to identify how trauma counselling trainees understand, cope and adapt counselling skills and strategies that are designed within a different cultural framework to their own. The researcher adapted an ethnographic case study design. Two case studies were selected. One case study was conducted in Uganda. The second case study was conducted in Sri Lanka. The participants in each of these studies were purposefully selected from among three cohorts of para-counsellors who participated in training programs that were conducted by the researcher in collaboration with local organisations and counsellors in these two countries. Data were collected through a variety of data gathering strategies: interviews with three samples of trainees, examination of cultural artefacts nominated or described by the trainees to represent their trauma experience, observations of the trainees during training sessions, the analysis of the training documents, the diaries produced by the trainees and the researcher’s diary. Data were entered, analysed and coded using the NVivo computer program. Initial readings of the data enabled the researcher to create wide-ranging codes. Then, an iterative process was employed to develop narrower concept categories and sub-categories that were allocated descriptive titles derived from the researcher’s conceptual memos. This facilitated engagement with the process of continuous meaning making to provide an understanding of the research participant’s experiences. The findings show that the trainees adapted some aspects of the therapeutic approaches and tools of counselling gained during their training that were more consistent with collective social harmony, particularly in Uganda; for example, the para-counsellors de-emphasise probing but encourage storytelling as a form of selfdisclosure. A similar adaptation was not observed in Sri Lanka. The para-counsellors here tend to implement the learned trauma-counselling strategies in similar ways to their Western colleagues. The Ugandan clergy de-emphasise their previous understandings of trauma, illness and adversity as being related to the religious viewpoints that underpin African Tribal Religion. However, they encourage the use of Psychoeducation as a therapeutic tool of counselling that explains trauma in terms of neurobiology. The trauma recovery education program would benefit from continuing to facilitate the trainees’ self-disclosure, using the selected therapeutic tools of counselling, as they were generally found to result in their personal growth, assist them in symptom reduction and decrease their distress. Equal numbers of male and female participants may constitute a shift in male dominance and may lead to greater self-disclosure and female participation. Also, the trauma recovery education program may be more beneficial to the trainees if it includes less Western theoretical knowledge and more content that aligns to the trainees’ life experiences and needs, especially in adapting the selected counselling tools to fit the collective value of social harmony in trauma recovery. This may be achieved through role-plays of family situations where several family members exhibit trauma symptoms and behaviours that interfere with their capacity to function in their socially assigned roles.