Impact of Post Displacement Anxiety Therapy on Emotional Adjustment of Children in Displaced Communities in Plateau State.

Impact of Post Displacement Anxiety Therapy on Emotional Adjustment of Children in Displaced Communities in Plateau State.

Dr Katniyon Henry David, Rike Juliana Musa, Ajere Oyeniyi Kayode
Federal College of Education Pankshin Plateau State, Nigeria

DOI: https://dx.doi.org/10.47772/IJRISS.2023.7739

Received: 17 May 2023; Accepted: 22 June 2023; Published: 20 July 2023

ABSTRACT

This research was conducted to assess the impact of cognitive processing therapy on emotional adjustment of children in displaced communities in Plateau State. The research design adopted for this study was the quasi experimental design. The population for this study comprised of 2,345 internally displaced pupils in three education zones of Plateau state. One hundred pupil aged 6 – 12 were selected for the study using simple random sampling technique. The Child emotional adjustment scale was used to assess the impact of the therapy. With reliability of 0.82. Therapy lasted for six weeks and data was collected was analysed  Findings reveal that Cognitive Processing Therapy (CPT) sessions had significant mean impact on emotional adjustment of primary school pupils in displaced communities as children adjusted in areas of temper control, social assertiveness and mood repair. Conversely, CPT treatment showed marginal mean adjustment in anxiety control for primary school pupils in displaced communities. It was concluded that Child emotional adjustment scale (CEAS) and Cognitive Processing Therapy were useful in treating emotional adjustment of children suffering trauma as a result of displacement. It was recommended that: Children from displaced communities in Plateau state face provided with Cognitive Processing Therapy by local state and Federal Governments in Nigeria to solve the emotional adjustments needs of children in displaced communities.

INTRODUCTION

There is a growing trend of insecurity, attacks and displacement of persons in certain parts of the world. This situation in Nigeria and especially, Plateau state has been acute in the last decade. Several factors accounts for internal displacement of persons, a phenomenon in which individuals are forced to leave their homes but remain within the borders of their own countries. Internal displacement differs from refugee because refugees are involuntarily displaced but across internationally recognized state borders. However, internally displaced persons stay at the border of their countries (World Bank, 2014). Displacement occurs in situations like armed conflict, persecution, situations of widespread violence, natural and human-made disasters and, more recently, large-scale development projects (Olajide, 2015). Internally Displaced Persons (IDPs) are people that have been forced from their homes for various reasons but have not crossed an international border (Danielsen, 2005).

Research such as Katniyon and Johnson (2021) report a worrisome trend of internal displacement in Nigeria as a result of violent conflicts due to ethnic, religious and political tensions. Recent findings have shown that the plight of Internally Displaced Persons in Nigeria is rooted in complex causes, phases and types of displacement; the need for return to a safe and secured environment and reintegration assistance, but unfortunately in a fragmented humanitarian response ( Katniyon and Liyas, 2021). Recent statistical data, on the volume and spread of IDPs in Nigeria reveals the existence of about 1.4 million displaced persons that are being hosted by Akwa Ibom (200,000), Cross River (115,000), Ebonyi (80,000), Bauchi (45,000), Kebbi (50,000), Jigawa (200,000), Plateau (350,000), Taraba (25,000), Benue (48,000), Gombe (100,000), Edo (250,000), and Borno States (16,000) (Katniyon & Johnson 2021).

In Plateau state, no fewer than 325,000 Internally Displaced Persons (IDPs) are taking refuge in various camps, according to the National Emergency Management Agency (NEMA, 2018). NEMA further confirmed that most of the IDPs were victims of the June 23 and 24 violence involving suspected herdsmen and villagers in Barkin Ladi, Riyom, Mangu, Bokkos and Jos South Local Government Areas. They further reported that Most of the violence that led to internal displacements of the affected persons was due to herdsmen attack. It is worrisome that Nigeria continues to be affected by recurring violent conflict between farmers and herders in some States. This situation poses grave threat to national security and destruction of the sources of social and economic livelihood of people. For instance,in the recent attacks, Bokkos LGA has a total of 2, 086 internally displaced persons in six camps of COCIN Headquarters, Bokkos, Central Primary School, Bokkos, LGEA primary school, New layout, G.S.S Bokkos and local government secretariat (State Emergency Management Agency, (SEMA, 2018). The consequences of these displacements are that children of primary schools miss their education.

            The consequences of displacement on social emotional and physical educational development of the child is enormous. The impact of displacement on the education of some affected children in IDP camps revealed anxiety as the major challenge (Katniyon & Liyas, 2021). Most of the pupils affected by conflict are terrified by the horror they witnessed in the crisis as well as fear for the future. Others find it difficult to cope with the new environment especially due to poor living conditions and poor feeding conditions among other factors. All these challenges lead to serious cases of anxiety and depression. Daily post Newspaper of November 24^th 2018 reported that leaders of Internally Displaced Persons at a camp situated at the Church of Christ in Nations (COCIN) in Central Bokkos LGA of Plateau State lamented the neglect by government at all levels. They reported that they were out of food for the past 3 weeks; when Da Rwang Pam International Humanitarian Foundation in collaboration with the Military-Civilian Relief Initiative and the Operation Safe Haven (OPSH) delivered relief materials at the camp.

            Anxiety is a psychological and physiological state characterized by physical, emotional, cognitive, and behavioural components. Anxiety means trouble in either presence or absence of psychological stress, anxiety can create a feeling of fear, worry, uneasiness, and dread. It is considered to be a normal response to stress. Robin (2009) reported that anxiety is a global problem affecting mainly children and adolescents.  Anxiety symptoms are extremely common in childhood and adolescence and can negatively interfere with general well –being, social life, academic performance and development of social skills. Mazzone, Ducci, Scoto, Passaniti, D’Arrigo and Vitiello (2007) stated that anxiety symptoms are associated with impairment of memory and cognitive functions and can contribute to poor school performance and academic failure. Anxiety can also disrupt our lives if it becomes maladaptive.   Internally Displaced Children are regarded as one of the highest risk groups for emotional disturbances.  More than 50% of them manifest mental health problems ranging from chronic disorders to severe trauma (Olajide, 2015). The commonly reported psychological reactions are post-traumatic stress disorders in reaction to violence and depression as a reaction to loss. Other types of mental health problems which have been reported are panic attacks and anxiety disorders (Yehuda, 2002).

Studies by Olajide, (2015) on prevalence of anxiety disorders among Internally Displaced Persons have recorded high burden of mental disorders and disability persisted among people affected by conflict.  In Northern Nigeria, 42.2% post-election violence internally displaced persons were diagnosed with Psychometric Anxiety Disorders. Also, high prevalence  can  be  attributed  to  the  fact  that  those  internally  displaced  persons experience  and  witnessed  extreme  violence  in  terms  of  burning  and  looting  of  properties,  mass destruction,   and   killing   of   family   members   and   relatives (Katniyon & Liyas, 2021). Accommodation post displacement is positively   associated with mental health.   Internally displaced persons who are resettled in permanent, private accommodations having significantly better mental health than those resettled in institutional and temporary private accommodations. Economic   opportunities (right   to   work, access   to   employment, and   maintenance   of socioeconomic status) also have a linear relationship with better mental health (Yehuda, 2002). One empirical treatment for post traumatic experiences among children is the Cognitive processing therapy (Walter & Chard, 2015). Cognitive Processing Therapy (CPT) are treatments offered to traumatic such as: cases of rape, combat childhood abuses physical abuses depression, panic disorder and the likes. CPT treatments can be done individually, in groups or in combination. Studies, Katniyon and Johnson (2021) have found the degree of exposure to a disasters such as displacement has more impact on four domains of emotional functioning which include:1. Temper control: Temper control refers to items testing  a child’s capacity to tolerate and manage feelings of anger and frustration as well as showing patience and perseverance in stressful situations. Example: Has good control of his or her temper. 2. Anxiety control: Anxiety control assess a child’s ability to manage and cope with worries, fears and guilt. Example: Easily able to distract himself or herself when worried. 3. Social assertiveness: This assesssituations pertaining to a child’s sense of confidence or security in social situations. Example: Expresses himself or herself with ease around strangers. 4. Mood repair: This assess situations concerning a child’s competency in dealing with sadness. Example: If sad, realizes that things could have gone worse. The four domains were specifically chosen as they cover important areas of emotionality believed to underlie the development and maintenance of childhood anxiety for children in conditions of displacement (Muris 2006) and depression (Cole et al. 2008). For instance, fear and anger are central components in most emotional disorders. Similarly, shyness and sadness are common characteristics of children experiencing emotional problems (e.g. Walter & Chard, 2015). Although there are many factors that may contribute to the development of emotional disorders, fourdomains were selected in order to ensure strong theoretical relations between the CEAS and Cognitive processing therapy.

Purpose of the Study

The purpose of this study is to investigate the impact of Post Displacement Anxiety Therapy on Emotional Adjustment of Children in Displaced Communities in Plateau State. The objectives of the study are to:

1. Find out the impact of post displacement therapy on temper control  of  primary school pupils in internally displaced communities in Plateau State
2. Determine the impact of post displacement therapy on social assertiveness of primary school pupils in internally displaced communities in Plateau State.
3. Find out the impact of post displacement therapy on Mood repair of  primary school pupils in internally displaced communities in Plateau State
4. Find out the impact of post displacement therapy on Anxiety control of  primary school pupils in internally displaced communities in Plateau State
5. Evaluate the impact of pre and post CPT treatments on emotional adjustments of primary school pupils in internally displaced communities in Plateau State.

Research Questions

The following research questions were raised to guide the researcher:

1. To what extent does post displacement therapy impact temper control of primary school pupils in internally displaced communities in Plateau State?
2. What is the impact of post displacement therapy on social assertiveness of primary school pupils in internally displaced communities in Plateau State?
3. How effective is post displacement therapy on mood repair of primary school pupils in internally displaced communities in Plateau State?
4. To what extent does post displacement therapy control Anxiety of primary school pupils in internally displaced communities in Plateau State?
5. To what extent does the pre and post CPT treatments mean score of primary school pupils in internally displaced communities in Plateau Statediffer?

Hypothesis

There is no significant mean difference in the pre and post CPT treatments scores of primary school pupils in internally displaced communities in Plateau State.

METHODS AND MATERIALS

The research design was a quasi-experimental design.The instrument used for the study was the Child emotional adjustment Scale (CEAS) was used as a pre and post-test assessment tool of Primary children emotional adjustment after exposure to six weeks of post displacement therapy using cognitive processing therapy (CPT)The CEAS was generated from item pool based on reviews of current literature and theory on childhood emotional disorders as well as of relevant assessment instruments (e.g. Chorpita et al. 2000). Four domains were chosen as they cover important areas of emotionality believed to underlie the development of childhood anxiety especially with displaced persons (e.g. Muris 2006) and depression (e.g. Cole et al. 2008). The CEAS contains two sections A and B. Section A contains. The bio-data of respondents such as age and gender while section B contains the research question items. The population for the study involved Pupils in displaced communities in Bokkos LGA of Plateau state. One hundred primary school pupils were sampled aged 6 – 12 years. Where children cannot provide the required information the mother of each pupil provided the information. Instruments were validated and reliability ascertained.  The CEAS contain items on a 5-point Likert-type scale (0 = never, 1 = seldom, 2 = sometimes, 3 = often, 4 = always).Therapy sessions lasted 30 minutes every day withthe pupils. The instruments for the data collection was distributed to the respondents in various IDPs communities and camps in the education zones in the state.

The results is as presented below

RESULTS

Table 1: Percentage Distribution of Respondents by Gender

Table 1 shows that 18 respondents representing 45% of the total respondents are male while 22 respondents representing 55 of total respondents are female.

RESULTS AND DISCUSSION

Research Question one:

1. To what extent does post displacement therapy impact temper control of primary school pupils in internally displaced communities in Plateau State?

Table 1: Pre and Post t-test mean score of adjustment on Temper control

NB: Decision: < 2.5 = Rejected, ≥ 2.5 = Accepted using 4-point Likert scale

Data on Table 1 shows that Pre and Post- test mean score of adjustment on Temper control using the CEAS after treatment. The means of 2.71, 3.12, 3.00, 2.96   ≥ 2.5.  This implies that Cognitive Processing Therapy sessions had significant mean appreciation on emotional adjustment of primary school pupils in displaced communities.

Research Question 2: What is the impact of post displacement therapy on social assertiveness of primary school pupils in internally displaced communities in Plateau State?

Table 2:  Pre and Post t-test mean score of adjustment on Social assertiveness

NB: Decision: < 2.5 = Rejected, ≥ 2.5 = Accepted using 4-point Likert scale

Data on Table 2 shows that Pre and Post t-test mean score of adjustment on social assertiveness shows a means ≥ 2.5 after Cognitive Processing Therapy sessions, this indicates that all means had a significantly appreciated on social assertiveness of primary school pupils in displaced communities. The implication is the improvement in social assertiveness aspects of emotional adjustment after exposure to CPT,

Research Question 3. How effective is post displacement therapy on mood repair of primary school pupils in internally displaced communities in Plateau State?

Table 3: Pre and Post t-test mean score of adjustment on Mood repair

NB: Decision: < 2.5 = Rejected, ≥ 2.5 = Accepted using 4-point Likert scale

Results on Table 3 show that the  Pre and Post t-test mean score of adjustment on mood repair of 2.71, 3.12, 3.00, 2.96 ≥ 2.5.  This implies that Cognitive Processing Therapy sessions had significant mean appreciation on mood repair of primary school pupils with trauma in displaced communities.

Research Question 4: To what extent does post displacement therapy on Anxiety control  of  primary school pupils in internally displaced communities in Plateau State

Table 4: Pre and Post t-test mean score of adjustment on Anxiety control

NB: Decision: < 2.5 = Rejected, ≥ 2.5 = Accepted using 4-point Likert scale

Data on Table 4 shows that Pre and Post t-test mean score of adjustment on anxiety control indicate mean improvement in Cognitive Processing Therapy sessions in items 2 and 4 ≥ 2.5 , However items 1, 3, and 5 have means < 2.5  this indicates that means had a less adjustment  in  anxiety control by primary school pupils in displaced communities. This implies a marginal improvement for anxiety control aspects of emotional adjustment after exposure to CPT.

Test of Hypothesis

There is no significant mean difference in the pre and post CPT treatments scores of primary school pupils in internally displaced communities in Plateau State.

Table 6 t-test of pre and post scores of primary school pupils exposed to treatment

 Data on Table 6 shows that the t value was significant at 0.05 and degree of freedom 99 in respect of the differences between the pre-test and post-test of the pupils after treatment. The null hypothesis was therefore rejected. This implies that overall significant difference using CPT treatments of primary school pupils in internally displaced communities in Plateau State.

DISCUSSION

This study was conducted to find out the impact of post displacement anxiety therapy on emotional adjustment of children in displaced communities in plateau state. Six weeks CPT therapy was administered to 100 children in displaced communities identified with emotional trauma issues as filled by their mothers in CEAS pre – test. Four domains were chosen as they cover important areas of emotionality believed to underlie the development of childhood anxiety especially with displaced persons (e.g. Muris 2006) and depression (e.g. Cole et al. 2008).

Regarding temper control   Pre and Post t-test mean score of adjustment on Temper control using the CEAS after treatment for six weeks using cognitive processing therapy.  The means shows that Cognitive Processing Therapy treatment sessions had significant mean appreciation on emotional adjustment of primary school pupils in displaced communities. This implies improvement in emotional adjustment after treatment for six weeks. This is agreement with Walter and Chard (2015) who found out that CPT was effective in treating traumatic experiences of veterans and other persons exposed to traumatic experiences. Since CPT seems effective in adjusting temper control by primary school pupils in displaced communities, it is instructive to institutionalize the process as it help in emotional adjustment of children displaced by communal conflicts in Plateau state.

On Social assertiveness, data on Table 2 shows that Pre and Post t-test mean score of adjustment on social assertiveness by pupils after treatment for six weeks using cognitive processing therapy.  Result from CPT treatment sessions indicates that all means had a significantly appreciated on social assertiveness of primary school pupils in displaced communities. The implication is the improvement in social assertiveness aspects of emotional adjustment after exposure to CPT, This implies improvement in emotional adjustment after treatment for six weeks. This is consistent with Thorlacius & Gudmundsson (2019) who found out that CPT was effective in treating traumatic experiences of children to traumatic experiences. Since CPT seems effective in adjusting social assertiveness for traumatic and displaced children, it is important to institutionalize the process as it help in social assertiveness in traumatized children.

Considering CPT capability in Mood repair, findings on Table 3 show that the Pre and Post -test mean score of adjustment on mood repair using the CEAS after treatment for six weeks using cognitive processing therapy.  The result show that Cognitive Processing Therapy sessions had significant mean appreciation on mood repair of primary school pupils with trauma in displaced communities. This implies improvement in CPT has positive implication on mood repair after treatment of traumatic pupils for six weeks This is consistent with Forkus, ,Breines, and Weiss (2019) who found out that CPT was effective in treating traumatic experiences of children to traumatic experiences. Since CPT seems effective in adjusting social assertiveness for traumatic and displaced children, it is important to institutionalize the process as it help in social assertiveness of children displaced by communal conflicts in Plateau state.

Findings on Table 4 regarding anxiety control shows that Pre and Post t-test mean score of adjustment on anxiety control by pupils after treatment for six weeks using cognitive processing therapy.  Data indicate positive impact of Cognitive Processing Therapy sessions as indicated that mean values had a less adjustment in anxiety control by primary school pupils in displaced communities. The provides a marginal improvement for anxiety control aspects of emotional adjustment after exposure to CPT. Interestingly,  Jon (2012) has  found a contrary view in his research with children in the USA.  Table 6 also indicate a significant overall mean difference among traumatized pupils as a result of treatment using Cognitive Processing Therapy. This implies CPT should be adopted for trauma treatment in children facing trauma as a result of displacement.

CONCLUSION

It was concluded that Cognitive Processing Therapy (CPT) sessions had significant mean impact on social assertiveness, mood repair and anxiety control in traumatized primary school pupils in displaced communities in Plateau state after treatment.

Overall Post Displacement Anxiety Therapy had significant emotional adjustment of children in displaced communities in Plateau State.

RECOMMENDATIONS

Based on the results, the following recommendations are made:

1. Children from displaced communities in Plateau state face different types of traumatic experiences even after post displacement and thus Cognitive processing therapy should be provided by local, state and Federal governments in Nigeria to solve the emotional adjustments needs of traumatized children in displaced communities.
2. State Universal Education Boards and TRCN should design Continuous professional training packages and workshops should be made to enable teachers acquire the competencies needed identifying pupils with post displacement trauma for counselling and referral purposes.
3. State Government and NGOs should make training and support for screening and CPT treatment for children displaced by prolonged crisis in plateau state.
4. Parents and communities should take advantage of screening tools available to allow children benefit from referral services to clinics and experts in health.

ACKNOWLEDGEMENT

 The authors of this research paper wish to acknowledge the support of Tertiary Education Trust Fund (Tetfund) Institutional Based Research, Federal College of Education Pankshin who fully funded this research.

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