11 Stress Disorder (PTSD), developed in the United States16, and used previously in a study of Zimbabwean war veterans 17. * * * * * * Self-Reporting Questionnaire (SRQ-20) Structured Assessment Form Medical History History of violence Clinician Administered PTSD Scales (CAPS) Self-ratings of improvement Follow-up interviews were conducted at the hospitals at three, six and twelve months. Progress during the previous months was reviewed, new problems (if any) were noted and new solutions generated if necessary, and the measures were repeated. The outcome measures were of three kinds: the SRQ-20, the CAPS and Self-ratings of improvement. The Self-ratings used a simple 5-point scale (much better, better, same, worse, much worse), all answered on a “yes-no” basis. The scale was scored from 0 (much worse) to 4 (much better). A very simple scale was used due to the nature of the client population, most of who have very little education and are not very psychologically sophisticated. Prior to beginning therapy all clients had received a lengthy assessment (described above), which lasted from two to three hours over two to three sessions. This study was a clinical study of the effectiveness of a single counselling session on patients with psychological disorders due to torture. A comparison with an untreated control group would have allowed much stronger confidence in the results, but the ethical problem of using either an untreated control group or a waiting list group and thus denying the survivors of gross human rights violations treatment decided us against this design. The therapy approach itself seemed to be acceptable to the clients, and was not difficult to implement. It followed logically on the detailed assessment procedure, and the combination of feedback, psycho-education and problem solving seems a useful approach to the management of trauma. 2. Problem Solving Problem solving is probably one of the most common approaches to patient management used by nurses, and thus the AMANI Trust decided to examine the efficacy of problem solving for psychological disorders. In addition, problem solving is the most basic skill used in Basic Skills training programme. The study was conducted at two health care facilities in Muzarabani District, Mashonaland Central Province. St Albert’s Mission Hospital serves as the district referral hospital, whilst Muzarabani Clinic, a rural health centre in the Zambezi Valley, serves as a referral centre for four small clinics further out on the Valley floor. 16 See Blake, D.D. (1993), Rationale and development of the Clinician-Administered PTSD Scales, PTSD RESEARCH QUARTERLY, 5, 1- 2. 17 See Reeler,A.P., & Mupinda,M. (1996), An Investigation into the Sequelae of Torture and Organised Violence in Zimbabwean war veterans, LEGAL FORUM, 8, 12-27. Training nurses in the assessment and management of psychological disorders: Report of AMANI Trust’s programme in Mashonaland Central Province, Zimbabwe.