| dc.description.abstract |
Uganda, a nondeveloped country located in East Africa, has a turbulent history of armed conflict. Uganda's population of more than 34 million people represents over 50 indigenous ethnic groups. Across cultures, religion is an important shared value, with 85% of the population identifying with Christianity (Uganda Bureau of Statistics, 2006). Legally, English is the official first language of Uganda, although more than 50 different languages are spoken. Over the past several decades, Uganda has been plagued by civil war, HIV/AIDS epidemic, and other diseases that have led to a proliferation of internally displaced orphans. Children under 15 years of age constitute 50% of Uganda's population, of which 14% (2.3 million) are orphans (Uganda Bureau of Statistics, 2006; United Nations Children's Fund [UNICEF], 2006). UNICEF (2006) and the United Nations Programme on HIV/AIDS, UNICEF, and U.S. Agency for International Development (2004) cautioned that despite the increasing number of orphans, there has been a negligible response to orphaned children's mental health needs. Urgent concerns about the socioeconomic needs of orphaned children in Africa in the last decade have overshadowed the psychological impact of orphanhood (Atwine, Cantor-Graae, & Bajunirwe, 2005), leaving orphanages financially unable to provide resources to meet the attachment, social integration, and acculturation needs of the children in their care (Wakhweya et al., 2002). The scarcity of counselors in Uganda, specifically counselors who are trained to work with children, is also a significant factor in the lack of mental health services for orphans. The development of professional counseling in Uganda is in its infancy and has its genesis in traditional cultural values and beliefs of its people; more recently, professional counseling's influence can be seen in school guidance and efforts to deal with HIV/AIDS in Uganda (Senyonyi, Ochieng, & Sells, 2012). Historically, counseling was provided by community members and religious affiliates with no formal training, thus the term counselor remains ambiguous in Uganda. In 2002, the Uganda Counselling Association (UCA) was formed to advocate for professional standards for competency and ethical practices. As a result, UCA (2009,2010) published a code of ethics and guidelines for accreditation and certification. According to UCA (H. Nsubuga, personal communication, September 2012), there are currently slightly more than 1,000 members; of those, two hold a doctorate and 71 hold a master's degree in counseling. Of the institutions offering counseling curriculum, few offer even minimal training in child counseling. An exhaustive review of the literature revealed a paucity of studies targeting the mental health needs of Ugandan orphans. The few studies available were focused on identifying problems and symptoms expressed by orphaned children and offered limited attention to interventions (Atwine et al., 2005; Betancourt, Speelman, Onyango, & Bolton, 2009; Derluyn, Broekaert, Schuyten, & Temmerman, 2004; Musisi, Kinyanda, Nakasujja, & Nakigudde, 2007). Researchers have identified a host of emotional and behavioral symptoms exhibited by displaced orphans, including anxiety, developmental delays, learning difficulties, sleep disturbances, behavioral problems, social isolation, depression, sadness, hopelessness, and suicidal ideation (Atwine et al., 2005; Musisi et al., 2007; UNICEF; 2006; Wakhweya et al., 2002). Children living in orphanages face additional stressors as a result of being isolated from their extended families and communities and must cope with further challenges associated with being forced to adjust to life with new caregivers (Wakhweya et al., 2002). Wakhweya et al. (2002) found that only 9% of the institutions they surveyed provided care for orphans that included some form of counseling services. Therefore, identifying effective counseling interventions that are responsive to the needs of displaced orphans is a critical need. … |
|