Delivering psychotherapy when there is no “post”: The Healing for Gaza Global Clinic's model for care in conditions of ongoing violence

Humanitarian responses to war-related trauma frequently prioritize scalable psychosocial activities or medication-adjacent services, while clinically governed psychotherapy remains uncommon in settings shaped by ongoing state violence. When psychotherapy is introduced, it is often without the conditions that make care safe and clinically coherent: stable privacy, continuity, supervised decision-making, culturally grounded formulation, and enforceable boundary governance. Further, in crises, cultural adaptation may be reduced to literal, decontextualized translation rather than interpretation as part of clinical work. This manuscript provides a program description of Healing for Gaza, a hybrid remote and field-based care model developed to extend access to clinically governed psychotherapy and psychiatric care for Palestinians from Gaza amid protracted violence and displacement. The model integrates trauma-informed psychotherapy, psychiatric services, periodic field missions for in-person and community interventions, and a structured training curriculum emphasizing both learning about care for trauma in this setting and countering clinical assumptions anchored in stable settings. In addition, this paper offers an operational account of how Healing for Gaza delivers psychotherapy as a governed clinical process: centralizing triage and coordination; providing clinic-managed communication channels to protect confidentiality in a system reliant on telehealth care; ensuring interpreters and clinicians are trained, consistently assigned, and integrated into supervision; applying workforce safeguards, including structured supervision and debriefing, reflective practices, caseload caps, and access to psychotherapy; and using a mixed-methods monitoring, evaluation, accountability, and learning framework oriented toward clinical quality and emerging risks. The manuscript concludes with principles that may guide adaptation of this architecture in other humanitarian contexts.