Piloting the Skills fOr Life Adjustment and Resilience (SOLAR) program in Tuvalu

Brief name: Skills fOr Life Adjustment and Resilience (SOLAR). Description: SOLAR is a brief psychosocial intervention aimed at promoting adjustment and resilience among disaster and other trauma survivors. In this pilot SOLAR was delivered to cyclone affected individuals in a face to face, intensive group format. This entailed 5, 1 to 2 hour sessions delivered across 5 consecutive days by trained community workers (termed SOLAR coaches). Each session comprised a session overview, revision of homework tasks completed by participants, an explanation of the session topics and rationale behind their inclusion in the program, instruction and demonstration of relevant skills, opportunities to practice new skills, and setting of homework. Sessions involved a combination of psycho education by the facilitator, group discussion, group activities, partner work, and individual reflection tasks. Coaches comprised 12 local community members who were nominated by an array of government and non-government and community organisations, with prior experience providing spiritual, practical or emotional support within their communities. Coaches received 6 days of face to face training in the SOLAR protocol by Phoenix Australia - Centre for Posttraumatic Mental Health and were provided with a SOLAR Tuvalu coach manual. They delivered the intervention in pairs to groups of up to 10 participants. Participants were allocated to the Nui intervention group or Funafuti control group according to their place of residence. The decision to include a control period prior to the intervention period in Funafuti, rather than Nui, was made for practical reasons. Travel to Nui outer island is possible only by a 2-4 day ferry ride from Funafuti and the ferry operates according to a loose schedule subject to frequent changes. This meant we could not ensure sufficient time on Nui island to provide both conditions. Participants were provided with a SOLAR Tuvalu participant workbook in English and/or Tuvaluan. The participant workbook included an outline of the topics covered each session, instructions of activities covered each session to enable further practice at home, and space for participants to write down reflections and questions, a plan for activities they wanted to practice, and monitoring forms to keep track of activities completed. The SOLAR protocol was developed through an international expert collaboration led by Phoenix Australia - Centre for Posttraumatic Mental Health. The protocol was adapted for this pilot to improve cultural fit through a process involving expert review, focus group discussion, and iterative adaptation on the basis of coach feedback. Fidelity to the protocol was determined through observation of program delivery and completion of fidelity checklists by the Phoenix Australia project manager and Tuvaluan research assistants. Coaches received daily supervision.