CBS has been delivered to over 20,000 people in Rwanda since 2005 to promote community connections and individual wellbeing after the genocide of 19945. Compared with usual care, CBS has been associated with significantly increased civic participation and significantly decreased distress in conflict-affected people in Rwanda at 8 months follow-up6.
- It is practised in groups of between ten to fifteen people who meet weekly for approximately three hours over fifteen weeks in a community space that is safe and convenient for group members to access.
- Over the course of the intervention the following six principles are applied: interest, equality, democracy, participation, responsibility, and learning-by-doing, and using actual and current situations
- The CBS groups facilitate community members to identify, acknowledge, share, and manage together their everyday psychosocial problems related to their experiences of upheaval, displacement and/or conflict.
- The focus during the first weeks is on actual daily life problems - including, for instance, poverty issues, family conflicts, health issues, drug abuse, and mistrust between neighbours
- As a sense of safety and trust builds, the CBS sessions also provide opportunities to share about their experience of past distress and trauma
- Two trained facilitators (drawn from the community) guide the groups through the CBS phases of safety, trust, care, respect, new rules, and memories.
- The role of the facilitators is to facilitate shared learning and to help group members manage strong emotions related to past experiences and present-day suffering
To date CBS has not been adapted and evaluated for use with refugee populations. The ‘Community-based Sociotherapy Adapted for Refugees’ (COSTAR) project is conducting research aimed at adapting CBS for use with Congolese refugees in Rwanda and Uganda, and to this effect is undertaking a large cluster randomised controlled trial of CBS in both countries.
The evaluation will also explore the effectiveness and cost-effectiveness of the approach for reducing depressive symptomatology. A range of knowledge exchange materials relating to specific aspects of this research activity will be developed and shared with the scientific community.