Developing a Professional Counselling Protocol for Managing Post-Traumatic Stress in Conflict-Affected Communities in North East Nigeria

Conflict-affected communities in North East Nigeria bear a substantial burden of post-traumatic stress that existing mental health service infrastructure is inadequately equipped to address in culturally appropriate and scalable ways. This study developed a professional counselling protocol for PTSD management specifically designed for application in community settings in Borno, Adamawa, and Yobe States. A protocol development methodology was employed, integrating systematic review of evidence-based PTSD interventions adapted for low-resource settings with qualitative consultations involving 15 community counsellors, eight mental health specialists, and six community leaders. The systematic review identified trauma-focused cognitive behavioural therapy, narrative exposure therapy, and problem management plus as the most evidence-based approaches applicable to community settings. Stakeholder consultations revealed that cultural and spiritual dimensions of trauma processing, including prayer, communal mourning rituals, and Islamic forgiveness frameworks, were insufficiently addressed by existing Western-derived protocols. The developed protocol integrates trauma-focused CBT core components with culturally specific adaptation guidelines, incorporating community and religious authority roles, Hausa and Kanuri language materials, and group delivery formats suited to IDP camp and resettlement settings. Expert review by ten mental health and humanitarian specialists confirmed the protocol's clinical coherence and cultural sensitivity. The study recommends piloting the protocol in six community counselling posts across the three states, with fidelity monitoring and outcome evaluation at 3 and 6 months post-intervention commencement.

Keywords: PTSD protocol, conflict trauma, North East Nigeria, community counselling, culturally adapted intervention