BMJ Open. 2026 Aug 21;16(8):e116194. doi: 10.1136/bmjopen-2026-116194.
ABSTRACT
OBJECTIVES: The 2014 genocide perpetrated by Islamic State in Iraq and Syria (ISIS) against the Yazidi community resulted in widespread psychological trauma, mass displacement and targeted destruction of cultural heritage. This exploratory study examined a therapeutic arts and photography intervention with formerly captured Yazidi women, alongside the participatory development of a cultural archive, as an integrated approach to supporting mental health, cultural resilience and survivor authorship in a postconflict setting.
DESIGN: Mixed-methods exploratory study using a pre-post quantitative design integrated with qualitative semistructured interviews and participatory focus groups.
SETTING: Humanitarian, camp-based and community settings in northern Iraq within a Yazidi-led psychosocial support programme in a postconflict context.
PARTICIPANTS: Twelve formerly captured Yazidi women initially enrolled, with 10 completing the intervention and quantitative assessments; all were adult women who had survived captivity by ISIS and were engaged with local psychosocial services.
PRIMARY OUTCOME MEASURES: Primary quantitative outcomes were psychological distress, flourishing and coping, assessed using a modified Refugee Health Screener (RHS-15); qualitative outcomes focused on participants’ experiences of wellbeing, coping and meaning-making through arts engagement and cultural archiving.
RESULTS: Quantitative analyses indicated statistically significant reductions in psychological distress (p=0.015) and increases in flourishing (p=0.046); corresponding effect sizes suggested large but imprecise changes consistent with the small sample and exploratory nature of the study. Qualitative analyses identified outcomes related to enhanced social-emotional well-being, occupational justice and renewed future orientation, alongside therapeutic mechanisms including emotional expression, social connection, skill development, positive distraction and artistic medium-specific processes. The participatory archive development process yielded four primary functions: cultural and religious preservation, community well-being and resilience, education and understanding and participant-defined purpose and preferred forms of artistic expression. Mixed-methods integration demonstrated convergence between improvements in well-being and qualitative accounts of agency, identity reconstruction and cultural continuity.
CONCLUSIONS: This study provides preliminary evidence that therapeutic arts and photography, integrated with participant-led cultural archiving, may support reductions in distress and increases in flourishing among formerly captured Yazidi women. Positioning cultural archiving as a psychosocial and community-based practice highlights its potential to support collective resilience, survivor authorship and occupational justice alongside individual healing. Further research is needed to examine long-term outcomes, scalability and comparative effectiveness across contexts and to develop accessible, culturally grounded models for integrating such interventions into clinical and community services.
PMID:42629149 | DOI:10.1136/bmjopen-2026-116194
