BEYOND BIOMEDICAL INTERVENTION: COMMUNITY-PREFERRED INTERVENTION MODELS FOR TRAUMATIC DISTRESS AMONG THE KANURI OF NORTH-EASTERN NIGERIA

Abstract

Mental health interventions for trauma-affected populations in non-Western settings are typically developed in Western contexts and exported globally without systematic adaptation. This practice assumes that what works in one cultural context will work in another, an assumption increasingly challenged by cross-cultural research. This study investigated the desirable intervention models for traumatic distress as articulated by the Kanuri people of North-Eastern Nigeria. A qualitative design guided by social constructivist, behaviour settings, and social-ecological frameworks was employed. Thirty-two Kanuri participants (aged 30-60 years; 50% female) in Damaturu, Yobe State, Nigeria, participated in in-depth interviews (n=20) and focus group discussions (n=12). Data were analysed using inductive thematic analysis. Two themes emerged. First, participants expressed a strong preference for spiritually and culturally grounded interventions, including spiritual intervention, religious healing, religious-based counselling, and community-based counselling. Hospital medication and individual psychotherapy were viewed as last resorts, addressing symptoms rather than causes. Second, participants identified specific legitimate intervention channels; sheikhs (imams), family members, community elders, and traditional herbalists. Western-trained mental health professionals were not recognised as a preferred channel. The Kanuri possess a coherent framework for desirable PTSD intervention that centres spirituality, religiosity, and cultural practices. A culturally adapted stepped-care model is proposed: Level 1 (mild distress) → family support + personal prayer; Level 2 (moderate distress) → sheikh counselling + congregational prayer; Level 3 (severe distress) → traditional healer + hospital referral if needed; Level 4 (life-threatening) → immediate hospital care with family and religious involvement. This model respects community preferences while ensuring biomedical care for severe cases.