INVESTIGATING THE EFFECTIVENESS OF COMMUNITY-BASED TRAUMA COUNSELLING PROGRAMMES IN PROMOTING MENTAL HEALTH AND WELL-BEING IN COMMUNITIES IN ANAMBRA STATE, NIGERIA

Abstract

This study presented a culturally resonant, mixed-methods framework for assessing the effectiveness of community-based trauma Counselling programs in Anambra State, Nigeria. Trauma exposure in the region was widespread, driven by historical conflicts (Nigerian Civil War legacy, gendered violence) and contemporary stressors (violent crime, political agitation), contributing to a high burden of mental distress and critical gaps in validated, locally tailored interventions. The research problem stemmed from the deficiency of rigorous effectiveness data for psychotherapeutic models adapted for West African contexts, especially concerning systemic and cultural barriers such as the Igbo community's spiritual interpretation of mental illness and the acute shortage of formal mental health professionals. The evaluation methodology employed a Mixed-Methods Community-Based Participatory Research (MMCBPR) design, guided by a Theory of Change (ToC) and the RE-AIM framework to assess outcomes. The investigation found high clinical Effectiveness (rejecting H01), with statistically significant reductions in PTSD (∆ 32.51 points, p <.001) and depression (estimated 60.3% clinical recovery rate). Culturally sensitive strategies led to successful Adoption (69.1% practice adoption) and high Implementation fidelity (79.6%), thereby rejecting H02. However, the structural analysis led to the acceptance of H03, concluding that long-term Maintenance was critically threatened by pervasive system-level barriers, evidenced by the high frequency of medication stock-outs (60% of observed PHC sites constrained). Ultimately, this framework provided an academically rigorous blueprint for investigating therapeutic success and highlighted the necessity of policy reform to ensure long-term systemic change in complex, resource-limited environments like Anambra State.