The Project on Genocide, Psychiatry and Witnessing
Bosnian CAFES Family Study

One million refugees of ethnic cleansing in Bosnia-Herzegovina are an extreme, recent example of the global problem of torture and political violence. Despite the existence of formal mental health services offering efficacious treatments, there are still vast numbers of torture survivors who are suffering trauma related mental health consequences and who do not access mental health care. The overall aim of the proposed research is to test a Prevention and Access Intervention for Families (PAIF) who are torture survivors and who are not utilizing formal mental health services. It aims to: 1) Help families to be better able to draw upon the families’ strengths and resources to cope together under the stresses of survival and displacement; 2) Improve the families’ ability to obtain appropriate care for possible mental health consequences of torture from sources outside of the family. Specifically, we are investigating a Coffee and Family Education and Support (CAFES) group, which is a time-limited multi-family education and support group for Bosnian families. This condition is being compared with a control group that receives no such intervention. We are randomly assigning a group of 225 survivors with Post Traumatic Stress Disorder and their families to receive either the intervention or the control condition. Longitudinal assessments primarily test whether the intervention: 1) increases social support and expands the social networks; 2) improves knowledge and attitudes concerning trauma mental health; 3) enhances family processes; 4) increases service utilization. Results should contribute to an increased understanding of families role in recovery and service usage, and in the use of multi-family group modality as a preventive intervention in Bosnians and in other groups of survivors. This project is supported by a grant from the National Institute of Mental Health (RO1 MH59573-01).