Institutional and family-based models of attention for Colombian child soldiers from a psychosocial perspective

This qualitative study aimed at analysing the implementation of the strategy of psychosocial accompaniment, its main pillars, gaps and differences between the institutional and family-based models of attention provided to former child soldiers in Colombia. Horizontal relationships based on confidence, guidance directed at empowering the persons, participatory and community-based approaches should form the core of this paradigm. A combination of qualitative methods (semi-structure interviews, field notes from observations, informal talks) and participants (74 adolescents, 42 professionals, 18 foster mothers) was used in this descriptive-analytical study of cross-sectional type. The data were analysed using the deductive content analysis. From the psychosocial perspective, the family-based models permitted more horizontal relationships between the adolescents and the professionals, although the level of confidence remained limited. Within the family environments, adolescents' autonomy, individual interests and social nets could be enhanced more easily than in the boarding institutions, but in practice it depended on the attitudes of the caregivers. The overprotection of the adolescents within the programme constituted the main obstacle to their real empowerment as subjects of rights. As the results showed, the paternalistic design of the programme, unclear understanding of the psychosocial approach by many professionals and related deficiencies in adequate strategies limit the potential of the psychosocial accompaniment to provide the adolescents with positive outcomes on a psychological and social level. These findings may guide the professionals from different areas when working with vulnerable populations worldwide

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Psychosocial impacts among adolescents disengaged from Colombian illegal armed groups and challenges to their attention.

OBJECTIVES: Our study focused on the impacts on health among adolescents who became members of illegal armed groups in Colombia and their attention within the specialized government programme as seen by the professionals who work directly with them. Previous research indicates that those victims of armed violence are usually highly affected on their emotional and social health, but with appropriate and timely support more serious mental health problems can be prevented. Therefore, the care provided to them should be based on broader and holistic approaches. METHODS: This cross-sectional study used the qualitative method based on semi-structured interviews with 42 professionals, and internal reports on the health condition of 165 adolescents, 57 (34.5%) females and 108 (65.5%) males, as a secondary source of information. All information was anonymous and confidential. RESULTS: The interviews with professionals and their reports demonstrated that about a half of the 165 adolescents, 35 of 57 (61.4%) females and 48 of 108 (44.4%) males, suffered from serious symptoms requiring therapeutic and psychiatric attention. About 20% of the adolescents presented clinically important post-traumatic stress symptoms, 27% admitted sexual abuse and 29% psychoactive substance abuse. The professionals stressed various obstacles to the attention of these multiple impacts related both to the administrative and institutional issues and the particular characteristics of this population. CONCLUSIONS: Our findings show the complexity of the psychosocial impacts among adolescent victims of the Colombian armed conflict and their attention. Highly trained professionals and alternative strategies including active listening, observation and art therapy activities seem to be vital for an effective care. The lessons learned from the Colombian reintegration programme serve as important inputs to be considered when attending children and adolescents from conflict-stricken areas also in other contexts.