Developing a Therapeutic Model for Addressing Post-Conflict Complex Trauma in North East Nigeria: An Iterative Intervention Design Study

Complex trauma arising from prolonged armed conflict in North East Nigeria produces a symptom profile encompassing PTSD, dissociation, attachment disruption, affect dysregulation, and identity fragmentation that existing evidence-based trauma treatments designed for single-incident trauma inadequately address. This study develops an original Contextualised Complex Trauma Therapy Model for North East Nigeria through an iterative intervention design methodology. Phase 1 systematically reviews existing complex trauma treatments (Structural Dissociation Model, EMDR, Narrative Exposure Therapy) for their cultural and contextual applicability to North East Nigerian communities through an expert panel process involving 20 trauma clinicians, traditional healers, and community representatives from Borno and Yobe States. Phase 2 conducts 50 in-depth qualitative interviews with complex trauma survivors to identify culturally salient treatment targets and healing mechanisms. Phase 3 develops the therapy protocol through an iterative design-test-revise cycle applied to 15 pilot cases in a single-case experimental design. Phase 4 conducts a small-scale feasibility randomised controlled trial with 60 participants. The Complex PTSD Framework by Herman and Cloitre, Narrative Exposure Therapy Theory, and Indigenous Healing Integration Framework provide the theoretical scaffolding. The original contribution is an evidence-based, culturally grounded Complex Trauma Therapy for North East Nigeria, filling a critical treatment development gap. Findings will directly inform WHO and UNICEF psychosocial programme design in the North East. Keywords: complex trauma, trauma therapy model, North East Nigeria, PTSD treatment, intervention design.