Trauma-informed Cognitive Behavioural Therapy (TiCBT) to aid reintegration of former terrorists and their families in Nigeria: A pilot study

Tarela Ike received a BISA Early Career Small Research Grant to help fund a project testing the feasibility and cultural appropriateness of Trauma-informed Cognitive Behavioural therapy to improve attitudes toward reintegration. Tarela's research involved 24 participants from Nigeria and she is now able to share the results, alongside a summary of the methodology, and a video that showcases the research themes and findings.

Reintegration of former terrorists and their families poses significant challenges partly due to the trauma suffered by the community from psychological, economic and well-being perspectives. According to the United Nations High Commissioners for Refugees (UNHCR, 2020), Boko Haram has led to over 2 million internally displaced persons in Nigeria. Over a ten-year assessment period, Nigeria suffered the highest economic impacts of Boko Haram terrorism, accounting for 89% of the total US$109 billion costs estimated. Previous studies highlighted the lack of emphasis on the community in reintegration (Felbab-Brown, 2018; Ike et al., 2022). The present study bridged the gap and made an original contribution by testing the feasibility and acceptability of a Trauma-informed Cognitive Behavioural Therapy (TiCBT) intervention on community members who are victims of Boko Haram by addressing the trauma that could trigger community stigma against ex-Boko Haram members and, by extension, encourage reintegration. The intervention was informed by the author’s previous work (Ike et al., 2021, 2022) and coupled with participatory action research, which involved affected victims from Borno (Maiduguri) in Nigeria in further culturally adapting and refining the intervention using a Participatory Action Research Approach.

In terms of methodology, the study is a mixed-method single-arm control trial designed to test the feasibility, cultural appropriateness, and acceptability of Trauma-informed Cognitive Behavioural Therapy intervention in encouraging reintegration in Nigeria. The study’s population and inclusion criteria are: community members who are victims of Boko Haram terrorism and had previous experiences of trauma/depression, score five and above for the culturally-adapted Trauma Screening Questionnaire (Brewinn et al., 2002), are aged 18+ years, able to give informed consent, speak English and are residents or from areas within Nigeria including Maiduguri, Adamawa, and Plateau environs. Twenty-four participants were recruited, and the rationale is that it is a pilot study.

Regarding the intervention, the TiCBT consists of 8 group training sessions (lasting approximately 60 minutes), and a session was delivered at an interval of 3 days each for four weeks. The session covered relevant aspects of tackling trauma, and the CBT component involved addressing negative thoughts and building more positive ones. Measurement was collected at baseline pre– and post-intervention and three months after the intervention.

The primary outcome measures of the project are to test the feasibility of the TiCBT intervention in terms of recruitment, retention, adherence to the intervention and community members’ satisfaction with the overall programme. The members’ satisfaction with the intervention was assessed using the Service Satisfaction Scale. The project’s secondary outcome measures also aim to address the policy problem by determining whether the TiCBT intervention could help manage and reduce trauma whilst improving attitudes towards the reintegration of former Boko Haram members and their families. Measurements and assessments were carried out using the culturally adapted Trauma Screening Questionnaire (Brewinn et al., 2002) and the Attitude Towards Former Boko Haram members and their Reintegration Scale (Ike et al., 2023).

Data were analysed using Wilcoxon sign ranked test for the quantitative data, and thematic analysis from a social identity theoretical lens (Braun & Clarke, 2013) was adopted to analyse the qualitative data. Based on the analysis, it was found that 91.7% of the participants indicated the acceptability of the intervention, with only 8.3% indicating it was slightly acceptable. There was also a high level of satisfaction with the intervention, with 79.2% indicating their satisfaction and willingness to recommend the intervention to others, while 20.8% indicated being satisfied. Concerning the attitude towards former Boko Haram members’ reintegration, measured using the ATRTS scale, we also found a difference from baseline (Md = 3.00) when compared to the end of intervention (Md = 4.00) with z = -3.494. The study also found some difference in the score for the TSQ from baseline (Md = 3.00) when compared to the end of intervention (Md = 5.00) with z = -3.242. Overall, the result indicates that the intervention is feasible. Collectively, the result underscores the significance of involving the community in the design of interventions and also addressing community trauma in fostering positive reintegration and reducing recidivism.

References

• Braun, V and Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. London: SAGE.

• Brewin, C.R., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S. and Foa, E.B. (2002). Brief screening instrument for post-traumatic stress disorder. The British Journal of Psychiatry, 181(2), pp.158-162.

• Felbab-Brown V (2018) Nigeria’s troubling counterinsurgency strategy against Boko Haram. Foreign Affairs. Available at: https://www.foreignaffairs.com/articles/nigeria/2018-03-30/nigerias-tro… (accessed 31 January 2024).

• Ike, T.J., Jidong, D.E., Ayobi, E.E. and Francis, C., (2023). Demystifying Reintegration: A Legal Education Plus Trauma-Informed Therapy Multicentred Randomised-Control Trial to Improve Communities’ Reintegration of Former Boko Haram Members in Nigeria. International Criminology, 3(3), pp.270-292.

• Ike, T.J., Singh, D., Jidong, D.E., Murphy, S. and Ayobi, E.E., (2021). Rethinking reintegration in Nigeria: community perceptions of former Boko Haram combatants. Third World Quarterly, 42(4), pp.661-678. 

• Ike, T.J., Singh, D., Murphy, S., Jidong, D.E., Porritt, F. and Ayobi, E.E. (2021). Community perspectives of former terrorist combatants, militants and reintegration programmes in Nigeria: a systematic review. Behavioral Sciences of Terrorism and Political Aggression, pp.1-27.

• UNHCR. 2020. “Nigeria Emergency.” Accessed March 3, 2022 (accessed 30 November 2023).