Wietse A Tol
Datos Biográficos
| ID | 181732 |
|---|---|
| NOMBRE | Wietse A Tol |
| NOMBRES | Wietse A |
| APELLIDO | Tol |
| FIRMA | TOL W A |
| AFILIACIONES | Johns Hopkins University |
| ORCID | 0000-0003-2216-0526 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 63 |
| TOTAL DE CITAS | 66 |
| TOTAL COMO AUTOR | 63 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2005 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 5 |
A family-systemic intervention for mental health with refugees in Jordan
Forced displacement heightens mental health risks for children, including psychological, environmental and economic stressors, yet few interventions address whole-family needs within humanitarian contexts. Family-systemic approaches show promise, but evidence on interventions addressing social determinants of mental health remains limited. We will conduct a single-masked, two-arm randomised controlled trial with 550 families in East Amman, Jordan…
Mental health and structural injustice
The theory as used in this study sheds new light on the interconnected nature of the environment urban refugees live in. This holistic approach to wellbeing provides clarity on vulnerabilities related to specific social groups
Acceptability and feasibility of CHANGE, a non-specialist worker delivered intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda
If proven to be effective, the acceptability and feasibility of CHANGE makes it a potentially scalable intervention in low resource settings with shortage of specialist healthcare professionals. The intervention may have the potential to be integrated with other programmes of care that can address additional adversities that the population may face in the setting
Developing an explanatory model of alcohol misuse among South Sudanese refugees in northern Uganda
Alcohol misuse is a significant health problem among forcibly displaced populations including male South Sudanese refugees in northern Uganda, yet interventions are sorely lacking. Developing an explanatory model of alcohol misuse in this population is the first step to designing appropriate and effective interventions. The aim of the current study was to examine alcohol misuse in this setting and to conceptualize an explanatory model of alcohol …
Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America
As evidence supporting the effectiveness of mental health and psychosocial interventions grows, more research is needed to understand optimal strategies for improving their implementation in diverse contexts. We conducted a qualitative process evaluation of a multicomponent psychosocial intervention intended to promote well-being among refugee, migrant and host community women in three diverse contexts in Ecuador and Panamá. The objective of this…
Combining a guided self-help and brief alcohol intervention to improve mental health and reduce substance use among refugee men in Uganda
Evidence on the effectiveness and implementation of mental health and psychosocial support (MHPSS) interventions for men in humanitarian settings is limited. Moreover, engagement and retention of men in such interventions has been challenging. Adaptations may therefore be required to improve the appropriateness and acceptability of these interventions for men. This study conducted formative research and examined the feasibility of combining an MH…
Nurturing families
Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of …
Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda
In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day works…
Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador
There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host commu…
Improving Retention in Mental Health and Psychosocial Support Interventions
Research on mental health and psychosocial support (MHPSS) interventions within refugee and migrant communities has increasingly focused on evaluating implementation, including identifying strategies to promote retention in services. This study examines the relationship between participant characteristics, study setting, and reasons for intervention noncompletion using data from the Entre Nosotras feasibility trial, a community-based MHPSS interv…
Common strategies in empirically supported psychological interventions for alcohol use disorders
Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries
Mixed-methods evaluation of a group psychosocial intervention for refugee, migrant and host community women in Ecuador and Panamá
Community-based psychosocial interventions are key elements of mental health and psychosocial support; yet evidence regarding their effectiveness and implementation in humanitarian settings is limited. This study aimed to assess the appropriateness, acceptability, feasibility and safety of conducting a cluster randomized trial evaluating two versions of a group psychosocial intervention. Nine community clusters in Ecuador and Panamá were randomiz…
Why local concepts matter
There is considerable variation in the presentation of mental health problems across cultural contexts. Most screening and assessment tools do not capture local idioms and culturally specific presentations of distress, thus introducing measurement error and overlooking meaningful variation in mental health. Before applying screening and assessment tools in a particular context, a qualitative exploration of locally salient idioms and expression of…
Understanding Nepali widows' experiences for the adaptation of an instrument to assess Prolonged Grief Disorder
The experience of grief varies across different cultures and contexts. Women in Nepal who lose their husbands confront discrimination, social isolation, and abuse that influence their experience of grief. Through eight focus group discussions with Nepali widows, we elicited socially sanctioned grief reactions and local idioms used to describe common cognitive, behavioral, and emotional symptoms of grief. Accordingly, modifications to an existing …
Community-based participatory design of a psychosocial intervention for migrant women in Ecuador and Panama
There is increasing evidence supporting the effectiveness of scalable mental health and psychosocial support (MHPSS) interventions delivered by non-specialists for improving wellbeing among migrant populations in humanitarian settings. Balancing fidelity in the implementation of evidence-based MHPSS interventions with their fit to the needs and preferences of new populations and contexts remains a challenge when introducing MHPSS interventions in…
Social determinants of impaired functioning among Nepali widows
Despite considerable stigmatisation of widows in Nepal, little is known about factors affecting their ability to function in society. Using mixed methods, we studied psychosocial factors associated with impaired functioning among Nepali widows. For the qualitative analysis, we analysed 3 focus groups, 25 in-depth interviews, and 12 key-informant interviews. The quantitative analysis was based on data from 204 widows. Odds ratios were calculated l…
Examining implementation of an intervention to reduce psychological distress and intimate partner violence in a refugee camp setting
An integrated approach to reduce intimate partner violence and improve mental health in humanitarian settings requires coordination across health and protection services. We developed and tested the Nguvu intervention, which combined evidence-based interventions for psychological distress and intimate partner violence among Congolese refugee women in Nyarugusu refugee camp (Tanzania). We conducted 29 semi-structured interviews with Nguvu particip…
Process evaluations of mental health and psychosocial support interventions for populations affected by humanitarian crises
The current state of process evaluations in MHPSS RCTs is heterogeneous. The quality of process evaluations should be improved to strengthen implementation science of the growing number of evidence-informed MHPSS interventions
A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD
INTRODUCTION: Refugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers. METHODS: Randomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically ide…
Priorities for addressing substance use disorder in humanitarian settings
Results from this consultation process highlight existing gaps in knowledge related to the epidemiology and treatment of substance use disorders in humanitarian emergencies. Epidemiological, intervention, and implementation research as well as operational guidance are needed to fill these gaps and improve access to substance use treatment services in humanitarian settings
Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania
The approach to adaptation of a psychological intervention suggested both minor and major required changes. Adaptations based on the findings of this study are anticipated to enhance relevance and acceptability of the EASE intervention and its delivery for camp-residing Burundian refugees in Tanzania
Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings
Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intim…
Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation
Masculinity was described in similar terms by both groups of participants. The interpretation of masculine qualities within the context of help-seeking (e.g. self-reliance as refusing help from others versus listening to others and applying that guidance) was a driving factor behind men's decision to enter psychotherapy
A Complex Intervention for Alcohol Misuse Among Conflict-Affected Populations in Uganda and Ukraine
Qualitative research is increasingly being integrated within the development and evaluation phases of trials of complex health interventions. Qualitative research can complement effectiveness data and provide insights around how context and implementation impact the results of the trial and to what extent interventions fit implementation contexts after evaluation. Several qualitative studies have been conducted at different stages of trials of me…
Cultural Challenges to Psychosocial Counselling in Nepal
This article describes the way in which the practice of psychosocial counselling was adapted culturally to the context of Nepal within the Centre for Victims of Torture, Nepal (CVICT). After a brief description of the Nepali setting and CVICT's counselling and training approach and the relationship of its psychosocial counselling intervention with existing methods of dealing with psychosocial problems, the cultural challenges of implementing psyc…
Social Ecology of Child Soldiers
This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At …
Understanding resilience in armed conflict
Testing a cycle of family violence model in conflict-affected, low-income countries
Communal Violence and Child Psychosocial Well-being
This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children ( N = 9), parents ( N = 11), and teachers ( N = 8), as well as semi-structured interviews with families affected by communal violence ( N = 42), and key informants ( N = 33). An inter…
Recruitment of child soldiers in Nepal
Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews w…
Practice-Driven Evaluation of a Multi-layered Psychosocial Care Package for Children in Areas of Armed Conflict
Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), ben…
Resilience Among Nepali Widows After the Death of a Spouse
Responses to the death of a spouse vary; although some are at increased risk of poorer physical and mental health outcomes, others have more resilient responses. In light of the limited scope of research on widows' experiences in Nepal, a setting where widows are often marginalized, we explore themes of resilience in Nepali widows' lives. Drawing from a larger qualitative study of grief and widowhood, a thematic narrative analysis was performed o…
Treatment Processes of Counseling for Children in South Sudan
Understanding Nepali widows' experiences for the adaptation of an instrument to assess Prolonged Grief Disorder
The experience of grief varies across different cultures and contexts. Women in Nepal who lose their husbands confront discrimination, social isolation, and abuse that influence their experience of grief. Through eight focus group discussions with Nepali widows, we elicited socially sanctioned grief reactions and local idioms used to describe common cognitive, behavioral, and emotional symptoms of grief. Accordingly, modifications to an existing …
Process evaluations of mental health and psychosocial support interventions for populations affected by humanitarian crises
The current state of process evaluations in MHPSS RCTs is heterogeneous. The quality of process evaluations should be improved to strengthen implementation science of the growing number of evidence-informed MHPSS interventions
Emic perspectives on the impact of armed conflict on children’s mental health and psychosocial well-being
Mental health interventions for children in adversity
Cultural Challenges to Psychosocial Counselling in Nepal
This article describes the way in which the practice of psychosocial counselling was adapted culturally to the context of Nepal within the Centre for Victims of Torture, Nepal (CVICT). After a brief description of the Nepali setting and CVICT's counselling and training approach and the relationship of its psychosocial counselling intervention with existing methods of dealing with psychosocial problems, the cultural challenges of implementing psyc…
Psychosocial Counselling in Nepal
The aims of this qualitative study were (1) to add to the understanding of the growing field of psychosocial counselling in Nepal, and (2) gather concrete points for improvement of services. Semi-structured interviews were conducted with clients (n = 34), para-professional counsellors (n = 26) and managers (n = 23) of organizations in which psychosocial counselling was taking place. The main findings were that stakeholders generally presented a p…
Development and validation of the child psychosocial distress screener in Burundi
In non-Western countries, efficient and contextually valid methods of community screening are scarce. The present study describes the validation of a new, brief, 7-item multi-informant screener for conflict-affected children (Child Psychosocial Distress Screener; CPDS). To determine concurrent validity, the CPSD was administered to 65 children and their teachers. CPDS scores were compared with indication for psychosocial treatment based on an in-…
Brief Multi-Disciplinary Treatment for Torture Survivors in Nepal
Background: Little is known about the effectiveness of treatment for torture survivors in low-income settings. Multi-disciplinary treatment is an often used approach for this target group. Aims: This study was aimed at examining the effectiveness of brief multi-disciplinary treatment for torture survivors in Nepal. Methods: A naturalistic comparative design with help-seeking torture survivors and internally displaced persons assigned to a treatme…
Political violence and mental health
Practice-Driven Evaluation of a Multi-layered Psychosocial Care Package for Children in Areas of Armed Conflict
Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), ben…
Social Ecology of Child Soldiers
This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At …
Communal Violence and Child Psychosocial Well-being
This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children ( N = 9), parents ( N = 11), and teachers ( N = 8), as well as semi-structured interviews with families affected by communal violence ( N = 42), and key informants ( N = 33). An inter…
Mental health and psychosocial support in humanitarian settings
Validation of cross-cultural child mental health and psychosocial research instruments
BACKGROUND: The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. METHODS: Six criteria are proposed to evaluate cross-cultural validity of child mental…
Resilience of refugees displaced in the developing world
Understanding how urban refugees cope by negotiating access to various forms of recognition in the absence of legal-recognition will enable organisations working with them to leverage such strengths and develop relevant programmes. In particular, building on these existing resources will lead to culturally compelling and sustainable care for these populations
Mental health interventions for children in adversity
Reintegration of child soldiers in Burundi
The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program
Potential treatment mechanisms of counseling for children in Burundi
Little is known about the impact and treatment processes of psychosocial counseling in low-income countries. This study aimed to generate hypotheses on key working mechanisms of counseling in Burundi. The authors carried out 11 empirically grounded n=1 studies with children (11-14years) screened for depression and anxiety who received counseling. The authors used quantitative (symptom scales) and qualitative instruments (treatment content and per…
Annual Research Review
Interventions for Children Affected by War
BACKGROUND: Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups. AIMS: To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in…
Treatment Processes of Counseling for Children in South Sudan
Mental health interventions in schools in low-income and middle-income countries
Understanding resilience in armed conflict
Testing a cycle of family violence model in conflict-affected, low-income countries
Mental health and psychosocial support for South Sudanese refugees in northern Uganda
The types of MHPSS problems among South Sudanese refugees in northern Uganda are diverse and the burden appears to be considerable, yet there are currently few available services. The assessment indicates the need for a range of services addressing social concerns as well as varied types of mental conditions. The idiom of "overthinking" may form a useful starting point for intervention development and mental health communication
Recruitment of child soldiers in Nepal
Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews w…
Emic perspectives on the impact of armed conflict on children’s mental health and psychosocial well-being
Ethical standards for mental health and psychosocial support research in emergencies
BACKGROUND: Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethic…
Associations between bride price stress and intimate partner violence amongst pregnant women in Timor-Leste
BACKGROUND: Reducing violence against women is a global public health priority, particularly in low-income and conflict-affected societies. However, more needs to be known about the causes of intimate partner violence (IPV) in these settings, including the stress of bride price obligations. METHODS: The representative study of women attending ante-natal clinics in Dili, Timor-Leste was conducted between June, 2013 and September, 2014 with 1672 pr…
Medicine (51 obras) · Psychology (49 obras) · Psychiatry (47 obras) · Migration, Health and Trauma (46 obras) · Mental health (38 obras) · Psychosocial (34 obras) · Psychological intervention (29 obras) · Political science (28 obras) · Clinical Psychology (26 obras) · Nursing (25 obras)