12 It was interesting to see the outcome of the clients treated by the trainees. It was hoped that the trainees would routinely use the SRQ-8 or the SRQ-20 on a regular basis to assess outcome on followup, but for a variety of reasons this was not done. There were considerable differences between the trainees in the frequency with which they used objective measures to assess outcome, with at least two trainees doing this on a routine basis. Most relied on self-report to assess outcome. Figure 8. Outcome of trainees’ treatments: Pre and post scores on SRQ-20. 6.315789474 3.578947368 1.335524515 1.426565007 10 SRQ1 mean s.dev SRQ2 6.32 1.34 3.58 1.43 7 6 5 4 As can be seen from Figure 8, there was a general trend towards improvement as measured by the SRQ-20, although the cases seen do not appear to have 3 been very severe, as evidenced by the low mean SRQ-20 score taken before therapy began [SRQ-20(1)]. 2 The results of those cases for whom self-report scores were kept show a strong effect for improvement: 85% (33 cases) were rated as improved1 as opposed to 15% (6 cases) that remained the same or got worse. 0 In addition to managing cases, the trainees also made referrals when they felt the need. The major SRQ1 SRQ2 point of referral was to doctors, which is unsurprising, but it was also gratifying to see that the trainees made use of most local resources, and did not show dependency upon AMANI as the major source of support. This can be interpreted as weak evidence for local sustainability. This brief review indicates that nurses and other health workers can be trained in methods of psychological management, and, furthermore, that simple, cost-effective methods of psychological treatment can be successfully applied in the community setting. We will comment later upon the relative strengths and weaknesses of the approaches developed by the Amani Trust, but next we move to a brief review of the training programme developed. AMANI TRUST: Psycho-Social assistance to Survivors of the Liberation War. A report on Mashonaland Central Province, Zimbabwe.