Worlds of Pain: A process evaluation of the Caregiver Support Intervention with Syrian refugees in Lebanon

This paper reports on a process evaluation conducted as part of a randomized controlled trial of the Caregiver Support Intervention (CSI), a nine-session preventive group psychosocial intervention, with Syrian refugees in Lebanon. It analyzes the focus group data to explore the mechanism of impact of the CSI on caregiver wellbeing and parenting, as well as examining the impact of multiple adversities on the results of the trial, which was conducted in a context of widespread social unrest, a severe economic crisis, and the COVID-19 pandemic. Overall, the study underscores the limits of a stand-alone psychosocial intervention in a setting of extreme adversity, where unmet basic needs in nearly every domain of life continue to generate high levels of stress.