Resilience, social support and psychological wellbeing among adolescents in institutional care in Lusaka, Zambia

Bishamarho Murhembo Fabrice

doi:10.51867/ajernet.7.4.129

Authors

Bishamarho Murhembo Fabrice The University of Zambia https://orcid.org/0009-0007-3821-568X

DOI:

https://doi.org/10.51867/ajernet.7.4.129

Keywords:

Adolescents, Cognitive Behavioural Therapy (CBT), Institutional care, Psychological wellbeing, Resilience, Social support, Zambia

Abstract

Adolescents in institutional care are exposed to parental loss, neglect, abandonment and poverty, which heighten their risk of stress, anxiety, depression and impaired psychological wellbeing. Evidence from Zambia on how resilience and social support relate to wellbeing in institutional settings, and on interventions that can strengthen them, is limited. This study sought to (i) identify the stressors experienced by adolescents in institutional care; (ii) assess their perceived levels of resilience and social support; (iii) determine the relationship between resilience, social support and psychological wellbeing; and (iv) evaluate the effectiveness of Cognitive Behavioural Therapy (CBT) in enhancing psychological wellbeing. This study is anchored in Lazarus and Folkman's Stress and Coping Theory. A quasi-experimental, one-group pre-test–post-test design (O₁ → X → O₂) was used. The target population was orphaned adolescents aged 10–18 years in registered institutional care facilities in Lusaka and surrounding districts. Facilities were selected purposively, and a sample size of 300 was determined using Yamane's formula (N = 1,200; e = 0.05). Data were collected with the Perceived Stress Scale (PSS-10), the Depression Anxiety Stress Scale (DASS-21), the Child and Youth Resilience Measure (CYRM-28), the Multidimensional Scale of Perceived Social Support (MSPSS), the WHO-5 Well-Being Index and Ryff's 18-item Psychological Well-being Scale, before and after a six-week group CBT intervention. Data were analysed using descriptive statistics, Pearson correlations, linear regression and paired-samples t-tests with Cohen's d (α = .05). At baseline, 89% of adolescents reported moderate or high perceived stress; emotional/psychological (92%), social/relational (78%) and environmental/institutional (71%) stressors were most prevalent. Resilience (M = 72.4) and social support (M = 47.8) were low to moderate, with family support the weakest domain (78% low). Resilience and social support were positively correlated (r = .58) and negatively correlated with stress, anxiety and depression (r = −.44 to −.53); both correlated positively with World Health Organization [WHO]-5 wellbeing (r = .61 and .59). After CBT, resilience, social support and wellbeing increased and stress, anxiety and depression fell by about 30% (all p < .001; d = 0.97–1.19). Resilience and social support are jointly associated with better psychological wellbeing among adolescents in Zambian institutional care, and a structured group CBT programme was followed by large, consistent improvements. Because the design had no control group, these improvements indicate promise rather than proven causal effect. Recommendation, institutions and policymakers should integrate CBT-based psychosocial programmes, caregiver training, routine mental health screening and family-linked support into institutional care, and controlled trials should test these effects further.

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