Evaluation of a community-based family therapy intervention in Kenya
Principal Investigator: Eve S. Puffer
Co-Principal Investigator: David Ayuku
Co-Investigator: Eric P. Green, Elsa A. Friis, Ali Giusto
Tuko Pamoja, meaning “We are together” in Kiswahili, is a family therapy intervention for families experiencing high levels of conflict and who have a child or adolescent with emotional or behavioral concerns. It is designed to be delivered by lay providers and in collaboration with existing social structures, such as religious congregations. We have completed a feasibility trial and are currently conducting a single case series study in Eldoret, Kenya.
Tuko Pamoja was informed by a qualitative study of family functioning and mental health in Kenya. Best practices in family therapy and adolescent mental health treatment were evaluated alongside qualitative data, and evidence-based strategies were chosen and adapted based on the best match with common negative family processes and cultural and contextual norms. Core strategies include those from solution-focused family therapy, behavioral skills training in communication and parenting skills, and cognitive behavioral therapy. The intervention was streamlined for lay providers who are local trusted community members recruited based on their current roles as informal counselors in their communities. Tuko Pamoja includes 6 modules addressing domains of family functioning that are matched with needs of families. A mobile phone tool also guides counselors during sessions and presents skills demonstrations.
Funders: Grand Challenges Canada (grant awarded to co-PI at Moi University), Duke University Center for AIDS Research, Johnson and Johnson, Duke Arts and Sciences Council Committee on Faculty Research, the Trent Foundation Endowment Fund, and the Duke Global Health Institute.