Since the Syrian civil war began in 2011, nearly 2 million Syrian refugees have flooded into neighboring Lebanon, straining the resources of a country with a population of only about 4 million.

In addition to basic needs like food and shelter, these refugees — victims of war and trauma — need psychosocial aid, Dr. Brigitte Khoury told attendees at a 2015 APA convention session on working with refugees in international settings. So Khoury, a psychologist at the American University of Beirut, has been working with the United Nations Population Fund (UNFPA) to develop a series of problem-solving and support groups for refugee women, run by local nurses, social workers and midwives.

“There are not enough psychologists to provide help,” Khoury said. “So we have to train others.”

Khoury’s program trains these local nurses and social workers to run a previously validated 12-session group intervention in which refugee women learn problem-solving and stress-management skills. The interventions’ loose structure allows the women to bring up specific problems in their lives and talk through solutions with each other and the group’s leader.

Most of the problems are related to the daily hassles of refugee life — such as finding adequate housing and food — as well as issues with children and parenting, family and in-laws, and financial difficulties, Khoury says.

“It was not really about trauma and PTSD,” she said. “It was about their daily lives and how to survive in these difficult circumstances.”

At first, some of the women were reluctant to participate because they weren’t sure what the point was of coming together “just to talk,” with no concrete reward, Khoury said. The groups faced other serious challenges as well. Occasionally, some of the sites — towns on the border with Syria — would be too dangerous for the facilitators to get to, Khoury said.

But the intervention worked: By the end of the 12 weeks, most of the women said that they felt less depressed and anxious. They also established close and supportive friendships with the other women in the group — friendships that could continue to provide support even after the 12-week program ended. 

Khoury’s pilot program reached 25 trainers and 300 women. This month, she is starting a new training session with another group of nurses and social workers. She said she also hopes to expand it to men, as many of the women in the groups said that their husbands could benefit from similar groups.