By Charlotte Sutcliffe, PPS & Psychology student '27
On October 17, the Duke Center for Child and Family Policy welcomed Dr. Theresa Betancourt, Salem Professor in Global Practice at the Boston College School of Social Work and director of the Research Program on Children and Adversity, for a special event to discuss her new book, Shadows Into Light.
Drawing on over two decades of longitudinal research in Sierra Leone and related projects in Ethiopia, Uganda, and Rwanda, Betancourt highlights in her book the psychological consequences of war-affected children and families and the social conditions necessary for rehabilitation.
The topic of childhood adversity is of increasing importance with our current world facing the largest humanitarian crisis since World War II. At the end of 2024, 1 in 6 children lived in conflict affected zones, totaling 473 million children worldwide.
In regards to Sierra Leone, the country currently ranks eighth from the bottom of the UN's Human Development Report in 2025, with a low GDP per capita, poor healthcare systems, and a life expectancy of only 59.8 years. Large factors in this were their civil war from 1991-2002, further strained by the 2014-2016 Ebola outbreak, climate change resulting in natural disasters, and only 36.9% of their population vaccinated against COVID-19. Due to all of this, there is a widespread civil conflict for children with over 50% of the population displaced and between 15,000-22,000 children associated with armed groups.
This study focused on 529 former child soldiers in Sierra Leone, looking at how risk and resilience factors — specific to trauma, stigma and social acceptance — influenced their long-term outcomes. Preliminary findings showed that within this sample, the average age of abduction was 10.3 years. The average length of time fighting with armed forces was 4.1 years, and over 25% reported having killed or injured others during war. Fifty percent reported they were forced to use drugs or alcohol. This exposure to violence and displacement overall led to higher rates of depression, anxiety, externalized hostility, and decreased adaptive prosocial behaviors.
However, evidence-based interventions such as Betancourt’s, Youth Readiness Intervention, has shown success even in low-resource areas. This intervention consists of 3 parts:
- Stabilization: Children take part in forms of psychoeducation and emotional regulation.
- Integration: Children go through cognitive restructuring and behavioral activation to better re-integrate with family and community members.
- Connection: Finally, children practice communication and interpersonal skills, problem solving, and plan their life goals.
Additionally, Betancourt highlighted the importance of interactive, group-based activities within the intervention leading to higher success rates in children. At an 8-month follow-up, the study showed participants were six times more likely to maintain enrollment in school and had an overall increased well-being. Betancourt also emphasized the necessity of strong local partnerships. The study team's ability to maintain equitable and ethical partnerships assisted them in connecting with the local community and children as they were able to teach the interventions in their native language, Krio.
Overall, I found Betancourt’s presentation and study to be extremely insightful and eye-opening. One quote that stuck with me was when she was recounted when she was asked if these kids should be considered a lost generation. Betancourt replied saying, “It’s not [lost], there's a tremendous amount of resilience, if only we can tap in and unleash it." There are so many vulnerable youth populations around the world that we turn a closed eye to or are not aware of the issues they are facing. With our expanding level of research and resources available, it is important to spread awareness and continue to work towards just outcomes for all.
