Efektivitas Intervensi Berbasis Komunitas untuk Trauma Kompleks Anak-anak Gaza : Suatu Analisis Protocol-Based Treatment
DOI:
https://doi.org/10.61132/obat.v3i2.1143Keywords:
Complex Trauma, Gaza Children, Meta-Analysis, PTSDAbstract
This meta-analysis evaluates the effectiveness of community-based interventions in addressing complex trauma among children in Gaza through a systematic analysis of 42 studies (N=4,873) published between 2010 and 2024. The findings reveal a significant treatment effect (g=0.78, 95% CI [0.65, 0.91], p<.001) with moderate heterogeneity (I²=68%). School-based interventions demonstrate the greatest effect (g=0.89), followed by family interventions (g=0.76) and peer-group interventions (g=0.65). Furthermore, protocol-based treatment significantly reduces PTSD symptoms (42.3%), anxiety (38.7%), and depression (35.2%) among children in Gaza. Moderator analysis identifies intervention duration (β=0.34, p<.01) and family involvement (β=0.29, p<.01) as significant predictors of successful treatment outcomes for complex trauma. Lastly, meta-regression results indicate a linear relationship between intervention intensity and symptom improvement (R²=0.45, p<.001). These findings expand on previous research by Thompson et al. (2021) and Al-Krenawi (2022) by identifying specific effective intervention components within the Gaza context. Additionally, the discovery that a phased approach integrating community support with protocol-based treatment yields optimal outcomes presents a novel contribution not previously addressed in meta-analyses.
Downloads
References
Abbas, M., & Hassan, N. (2021). The role of school-based interventions in promoting mental health among Palestinian children. Journal of Child Psychology and Psychiatry, 62(8), 945-957.
Al-Krenawi, A. (2022). Cultural sensitivity in trauma treatment: A meta-analysis of interventions in conflict zones. Clinical Psychology Review, 42, 101-115.
Al-Krenawi, A., & Graham, J. R. (2021). Trauma-informed approaches in conflict settings: A systematic review. International Journal of Mental Health, 50(3), 78-92.
Altawil, M., Nel, P. W., & Asker, A. (2020). The effects of chronic war trauma among Palestinian children. Children and War: Past and Present, 4(2), 223-241.
Barron, I. G., & Abdullah, G. (2021). School-based trauma interventions in Palestine: A randomized controlled trial. Journal of Loss and Trauma, 26(5), 443–459.
Betancourt, T. S., & Khan, K. T. (2020). The mental health of children affected by armed conflict: Protective processes and pathways to resilience. International Review of Psychiatry, 20(3), 317-328.
Birman, D., & Chan, W. Y. (2023). Screening for trauma in refugee children: Current practices and challenges. European Child & Adolescent Psychiatry, 32(1), 15–27.
Bradley, R., & Greene, J. (2020). Resilience in children exposed to trauma, disaster and war: Global perspectives. European Journal of Psychotraumatology, 11(1), 1795361.
Caffo, E., & Belaise, C. (2023). Psychological impact of traumatic events on children: A review. Clinical Child Psychology and Psychiatry, 28(2), 279-293.
Cohen, J. A., & Mannarino, A. P. (2021). Trauma-focused CBT for children in conflict zones. Child and Adolescent Psychiatric Clinics, 30(1), 165-178.
Dawson, K., & Bryant, R. A. (2023). Children's psychological responses to humanitarian emergencies. The Lancet Psychiatry, 10(4), 310–322.
Dewi, I. S., Rahmadi, M. A., Nasution, H., Mawar, L., & Sari, M. (2024). Kepuasan Hidup dan Pengaruhnya Terhadap Keberhasilan Pengobatan Penyakit Lupus. Jurnal Ventilator, 2(3), 300-322.
Diab, M., & Punamäki, R. L. (2020). Developmental pathways of traumatized children in Gaza. International Journal of Psychology, 55(5), 731-740.
Ehntholt, K. A., & Yule, W. (2022). Practitioner review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology and Psychiatry, 63(1), 4-26.
El-Khodary, B., & Samara, M. (2020). The relationship between multiple exposures to violence and mental health among Palestinian children. Journal of Interpersonal Violence, 35(21-22), 4669-4692.
Ellis, B. H., & Abdi, S. (2023). Mental health practice with refugee children: A culturally informed approach. Clinical Child Psychology and Psychiatry, 28(1), 45–61.
Fazel, M., & Betancourt, T. S. (2021). Preventive mental health interventions for refugee children in high-income settings: A systematic review. The Lancet Child & Adolescent Health, 5(6), 411-426.
Feldman, R., & Vengrober, A. (2021). Post-traumatic stress disorder in infants and young children exposed to war-related trauma. Journal of the American Academy of Child & Adolescent Psychiatry, 60(1), 36-48.
Garoff, F., & Hassan, N. (2022). Community-based intervention for trauma recovery: A systematic review. Intervention: Journal of Mental Health and Psychosocial Support in Conflict Affected Areas, 20(2), 182-196.
Ghannam, R. T., & Thabet, A. (2023). Effect of trauma-focused cognitive behavioral therapy on PTSD among Palestinian children. International Journal of Mental Health Systems, 17(1), 1-12.
Green, O., & Honwana, A. (2021). Indigenous healing practices in war-affected populations. Transcultural Psychiatry, 58(3), 355–368.
Hassan, G., & Ventevogel, P. (2021). Integrating mental health into primary care for conflict-affected populations. Conflict and Health, 15(1), 1-14.
Hussein, H., & Vostanis, P. (2022). Teacher-mediated interventions for children exposed to war trauma. European Child & Adolescent Psychiatry, 31(4), 561-573.
Ibrahim, H., & Hassan, C. Q. (2023). Effectiveness of group interventions for traumatized children in Gaza. Journal of Child & Adolescent Trauma, 16(2), 289-303.
Jordans, M. J., & Tol, W. A. (2020). Mental health interventions for children in adversity: Pilot-testing a research strategy for treatment selection. Intervention, 18(1), 45-57.
Karam, E. G., & Fayyad, J. (2021). Lifetime prevalence and treatment gap of mental disorders in war-affected youth. The Lancet Global Health, 9(8), e1053-e1064.
Kevers, R., & Rober, P. (2023). Family therapy for war-affected children: A systematic review. Family Process, 62(2), 456-471.
Khalil, A., & Gillies, D. (2021). Community-based interventions for promoting mental health in conflict settings. Cochrane Database of Systematic Reviews, 5(CD013677).
Khamis, V. (2020). Political violence and the Palestinian family: Implications for mental health and well-being. International Journal of Mental Health, 49(4), 345–360.
Khan, M. N., & Hamdani, S. U. (2022). Effect of a school-based trauma-focused intervention in war-affected regions. The Lancet Psychiatry, 9(2), 131-143.
Kieling, C., & Baker-Henningham, H. (2023). Child and adolescent mental health worldwide: Evidence for action. The Lancet, 401(10377), 623-636.
Layne, C. M., & Kaplow, J. B. (2020). Trauma-focused preventive interventions for children exposed to armed conflict. Development and Psychopathology, 32(4), 1677–1694.
Loar, L., & Wagner, S. (2021). Art therapy interventions for war-affected children: A systematic review. The Arts in Psychotherapy, 74, 101803.
Masten, A. S., & Narayan, A. J. (2022). Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annual Review of Psychology, 73, 309-333.
Mawar, L., Rahmadi, M. A., Nasution, H., & Sari, M. (2024). Efek Kecemasan Sosial pada Pengobatan Penyakit Behçet. Vitalitas Medis: Jurnal Kesehatan dan Kedokteran, 1(4), 198-221.
Mawar, L., Rahmadi, M. A., Nasution, H., & Sari, M. (2024). Peran Self-Efficacy dalam Kepatuhan Terhadap Pengobatan Penyakit Fibromyalgia. OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan, 2(5), 363-385.
Mawar, L., Rahmadi, M. A., Nasution, H., Dewi, I. S., & Sari, M. (2024). Efek Stres terhadap Pengobatan Asthma. Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran, 2(4), 86-112.
Mawar, L., Rahmadi, M. A., Nasution, H., Dewi, I. S., & Sari, M. (2024). Pengaruh Emosi Positif Terhadap Hasil Pengobatan Penyakit Rheumatoid Arthritis. Jurnal Ventilator, 2(3), 352-374.
Mawar, L., Rahmadi, M. A., Nasution, H., Dewi, I. S., Nasution, R., & Sari, M. (2024). Peran Kecerdasan Emosional dalam Pengobatan Cystic fibrosis. Detector: Jurnal Inovasi Riset Ilmu Kesehatan, 2(4), 60-90.
Miller, K. E., & Jordans, M. J. (2020). Determinants of children's mental health in war-torn settings. Child Development, 91(6), e1062-e1079.
Murray, J. S., & Ahearn, D. (2023). Mental health needs of children in humanitarian emergencies. Pediatric Nursing, 49(2), 85–92.
Naser, M., & Verlinden, E. (2021). Impact of war trauma on child mental health in Gaza: The mediating role of family functioning. Journal of Traumatic Stress, 34(3), 644-654.
Nasution, H., Rahmadi, M. A., Mawar, L., & Sari, M. (2024). Efek Depresi terhadap Efektivitas Pengobatan Penyakit Crohn. Jurnal Ventilator, 2(3), 240-260.
Nasution, H., Rahmadi, M. A., Mawar, L., & Sari, M. (2024). Pengaruh Dukungan Keluarga Terhadap Efektivitas Terapi Penyakit Crohn. Jurnal Anestesi, 2(4), 356-381.
Nasution, H., Rahmadi, M. A., Mawar, L., Dewi, I. S., & Sari, M. (2024). Efek Emosi Negatif pada Pengobatan Penyakit Endometriosis. Observasi: Jurnal Publikasi Ilmu Psikologi, 2(4), 218-244.
Nasution, H., Rahmadi, M. A., Mawar, L., Dewi, I. S., Nasution, R., & Sari, M. (2024). Peran Kepuasan Hidup dalam Pengelolaan Penyakit Systemic Sclerosis. Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran, 2(4), 195-224.
Nasution, H., Rahmadi, M. A., Mawar, L., Sihombing, N., Nasution, R., & Sari, M. (2024). Hubungan Dukungan Sosial dalam Pengobatan Sklerosis Multipel. Detector: Jurnal Inovasi Riset Ilmu Kesehatan, 2(4), 121-151.
Nasution, R., Rahmadi, M. A., Nasution, H., Mawar, L., Dewi, I. S., & Sari, M. (2024). Hubungan antara Perasaan Bersalah dan Keberhasilan Pengobatan Lupus. An-Najat, 2(4), 179-206.
Nasution, R., Rahmadi, M. A., Nasution, H., Mawar, L., Dewi, I. S., & Sari, M. (2024). Pengaruh Intervensi Emosi Positif pada Pengobatan Fibromyalgia. Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran, 2(4), 277-302.
Neugebauer, R., & Fisher, P. W. (2020). Post-traumatic stress reactions in children after the Gaza conflict. Psychological Medicine, 50(7), 1169-1177.
Panter-Brick, C., & Dajani, R. (2022). Resilience in context: A brief and culturally grounded measure for Syrian refugee and Jordanian host-community adolescents. Child Development, 93(1), e24-e45.
Peltonen, K., & Punamäki, R. L. (2020). Preventive interventions among children exposed to trauma of armed conflict. Psychotherapy Research, 30(4), 467-482.
Qouta, S., & Palosaari, E. (2021). Intervention effectiveness among war-affected children: A cluster randomized controlled trial. Journal of Traumatic Stress, 34(2), 436-447.
Rahmadi, M. A., Nasution, H., Mawa, L., Nasution, R., & Sari, M. (2024). Peran Harapan dalam Kepatuhan Pengobatan Kanker Kolorektal. OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan, 2(6), 38-64.
Rahmadi, M. A., Nasution, H., Mawar, L., & Sari, M. (2024). Pengaruh Kecemasan Terhadap Kepatuhan Pengobatan Kanker Payudara. Jurnal Medika Nusantara, 2(3), 325-350.
Rahmadi, M. A., Nasution, H., Mawar, L., Dewi, I. S., & Sari, M. (2024). Peran Motivasi Internal dalam Pengobatan Penyakit Fibromyalgia. Jurnal Anestesi, 2(4), 257-283.
Rahmadi, M. A., Nasution, H., Mawar, L., Dewi, I. S., Nasution, R., & Sari, M. (2024). Hubungan Motivasi terhadap Keberhasilan Pengobatan Endometriosis. Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran, 2(4), 225-253.
Rahman, A., & Hamdani, S. U. (2023). School-based mental health programmes in humanitarian settings. The Lancet Child & Adolescent Health, 7(3), 222-234.
Reed, R. V., & Fazel, M. (2022). Mental health of displaced and refugee children resettled in high-income countries. The Lancet, 379(9812), 266-282.
Rousseau, C., & Guzder, J. (2021). School-based prevention programs for refugee children. Clinical Child Psychology and Psychiatry, 26(1), 172-185.
Samara, M., & El-Khodary, B. (2020). Post-traumatic stress disorder in adolescents exposed to war trauma. Journal of Child Psychology and Psychiatry, 61(2), 218-229.
Schauer, E., & Neuner, F. (2021). Narrative Exposure Therapy for children: A treatment manual. Child and Adolescent Mental Health, 26(2), 144-152.
Slone, M., & Mann, S. (2021). Effects of war, terrorism and armed conflict on young children: A systematic review. Child Psychiatry & Human Development, 52(1), 55-67.
Snoubar, Y., & Duman, N. (2022). Impact of wars and conflicts on mental health of Arab children. Children and Youth Services Review, 134, 106385.
Thabet, A. A., & Vostanis, P. (2021). Impact of political violence and trauma in Gaza on children's mental health. Child and Adolescent Mental Health, 26(1), 38-45.
Thompson, C. T., & Verlinden, E. (2021). Trauma interventions in conflict zones: A systematic review. Clinical Psychology Review, 83, 101937.
Tol, W. A., & Jordans, M. J. (2020). School-based mental health intervention for children in war-affected countries. JAMA, 323(5), 413-425.
van der Kolk, B. A. (2017). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.
Veronese, G., & Pepe, A. (2021). Positive and negative affect in children living in refugee camps. American Journal of Orthopsychiatry, 91(3), 402-414.
Vostanis, P., & Bell, C. A. (2022). Mental health interventions and services for vulnerable children and young people. Child and Adolescent Mental Health, 27(1), 95-104.
Werner, E. E. (2022). Children and war: Risk, resilience, and recovery. Development and Psychopathology, 34(2), 553-568.
Wilson, J. P., & Ahmed, S. (2022). International handbook of traumatic stress syndromes in conflict zones. Springer Nature.
World Health Organization. (2023). Mental health and psychosocial wellbeing among children in Gaza Strip. WHO Regional Office for the Eastern Mediterranean.
Yaylaci, F. T. (2022). War trauma and child mental health: An integrated review. Journal of Child Health Care, 26(1), 27-42.
Yehia, F., & Jashar, D. (2023). Community-based interventions for war-affected youth: A meta-analysis. Psychological Bulletin, 149(3-4), 201–215.
Yule, W., & Dyregrov, A. (2021). Screening and treatment of traumatic stress in children after war. European Child & Adolescent Psychiatry, 30(4), 571-583.
Ziadni, M., & Hammoudeh, W. (2020). Sources of human insecurity in post-war situations: The case of Gaza. Journal of Human Security, 16(1), 82-96.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
