Effectiveness of Community-based Psychosocial Support Services

Heartland Alliance International (HAI) and La Universidad de Los Andes investigated the effectiveness of HAI’s community-based psychosocial support services program Alianza Con Organizaciones Por lo Emocional (ACOPLE) in the Pacific Coast region of Colombia. In a pilot study, participants in community support groups conducted in remote, in-person, and hybrid modalities showed significant improvement in wellbeing and reduction in distress from pre to post intervention, although coping results varied by modality.   

Lead Implementation Partner: Heartland Alliance International (HAI)
Lead Research Partner: La Universidad de Los Andes
Study Setting: Quibdo, Colombia

Dissemination event in Quibdo, April 21, 2022. Attendees included local, national and international NGOs working in MHPSS and other services for people affected by violence and displacement; officials from the Mayor’s office of Quibdó and the governorship of Chocó; leaders of the rural community of Tutunendo; Venezuelan migrants living in Quibdó; members of the JAC where the CSG took place. 
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Problem: Latin America has recently experienced increasing levels of forced migration, political conflict, economic crises, and community violence. Quibdó, Colombia houses a large number of victims of armed conflict, particularly Afro-Colombian and Venezuelan migrants. From 2020-2021, the region has also been affected by COVID-19, as well as mass protests and police violence, affecting social cohesion in communities.

Question: Since 2010, HAI’s community-based psychosocial support (PSS) services program Alianza Con Organizaciones Por lo Emocional (ACOPLE) has leveraged community psychosocial agents to provide non-specialized community psychosocial support services to survivors of torture and trauma. HAI recognized the need to adapt the ACOPLE intervention to better fit the evolving needs of participants and include a greater focus on peer support and community problem-solving.

Design & Methods: The intervention consisted of 8 weekly group sessions facilitated by non-professional community members from the region with training/supervision from professional mental health and psychosocial support (MHPSS) providers. Sessions focused on collective problem-solving skills, drawing from WHO’s Problem Management Plus, combined with expressive activities based on cultural practices. During the pandemic, sessions were available in remote and in-person modalities. The second phase measured the effectiveness of the finalized adapted model using a randomized controlled trial methodology.

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  • In a pilot study, participants in community support groups (CSGs) conducted in remote, in-person, and hybrid modalities showed significant improvement in wellbeing and reduction in distress from pre to post intervention, although coping results varied by modality.  
  • In a RCT, CSGs were effective in reducing symptoms of anxiety and depression among participants who attended 4+ sessions. Analyses revealed significant reduction in anxiety, depression, and PTSD for in-person participants, but not for remote participants.  
  • Qualitative data across both studies highlights unique challenges and opportunities in each modality, including potential explanations contributing to lack of effectiveness for remote groups:  
  • In-person: Inclusion of traditional practices and cultural codes (e.g., “comadreo,” or  traditional and informal community talks, common among Afro-Colombians in the Pacific region); confidentiality and safety ensured; strong social cohesion and exchange of peer support; attendance challenges due to conflicting activities.
  • Remote: Flexible scheduling benefits but challenges to privacy, connectivity, social cohesion, and managing distractions.

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  • HAI provided the CSG intervention to the Ministry of Health, Victims Unit, and victims’ organizations, contributing to achieving the objectives of the country’s Victims Law and the Peace Accords. 
  • HAI and the National Association of Displaced Afro-Colombians (AFRODES) are working to ensure that the ACOPLE program continues as an independent community-based MHPSS service provider. The adaptations made to the CSG intervention have allowed ACOPLE to widen its technical expertise and its staff’s professional development.
  • The CSG intervention tested was used to provide MHPSS services in the city of Buenaventura, with funding by the United Nations High Commissioner for Refugees. The objective was to serve victims affected by the upsurge in violence since January 2021, providing HAI a space to test the adaptations made to its community-based group intervention. 

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Training with HAI-UNHCR Buenaventura staff. The CSG intervention tested through the HEARD project was used to provide MHPSS services in the city of Buenaventura, with funding by the United Nations High Commissioner for Refugees (UNHCR).