The Egyptian Revolution of 2011 resulted in high‐level exposure to sociopolitical violence, placing a large burden on the mental health care system that cannot be effectively met given the small number of available providers in Egypt. We conducted a nonblinded, randomized controlled pilot trial of an online, self‐directed tool for managing posttraumatic stress symptoms (PTSS). The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of the PTSD Coach Online–Arabic. Trauma‐exposed Egyptian adults with clinically significant PTSS (N = 87; intervention group: n = 41) completed assessments at baseline, weekly over the treatment period, posttest, and 3‐month follow‐up. Of participants who completed weekly surveys, 88.9% used the program; 22.0% of participants reported regular, weekly use. Most tools received good likeability and perceived benefit scores, but lower perceived benefit scores on three tools suggest that some content may require additional adaptation. Intent‐to‐treat analyses using multilevel modeling with multiple imputation to account for missing data were conducted. Effect sizes for PTSS were below the cutoff for small effects at posttest, d = −0.14, but demonstrated a small positive effect at 3‐months, d = −0.25. There was a small positive effect of treatment on anxiety at posttest, d = −0.37, and a medium effect at 3‐month follow‐up, d = −0.49. Treatment effects for depressed mood were below the cutoff for small effects at posttest and 3‐months, ds = −0.14 and −0.18. These findings suggest that the PTSD Coach Online–Arabic may be a promising supplemental resource for support in this setting.
The following study describes the usability and the acceptability of an online intervention for the treatment of posttraumatic stress disorder (PTSD), PTSD Coach Online that was culturally adapted and translated into local Egyptian dialect. The adapted intervention was piloted in a randomized control trial with 87 Egyptians meeting clinical criteria for a diagnosis of PTSD. Of the 41 participants who participated in the treatment condition, 15 participants (10 females, 5 males) were randomly selected to take part in a semistructured interview to explore their user experience. Favorable feedback centered on the program's ease of access, user-friendly tools, and cultural appropriateness. Participants also described benefits including increased awareness of PTSD, symptom reduction, and increased willingness to seek psychological support online or in person. In contrast, participants highlighted some drawbacks of the online program, particularly the need for further support or some kind of "human" interaction as well as feelings that the information was not sufficiently personalized and that activities could have been more interesting. The findings suggest that while the PTSD Coach Online-Arabic is unlikely to be an effective stand-alone support, approximately half of the sample indicated that the availability of online tools is important for accessibility of mental health care, particularly for those concerned with stigma. As such, it may be an important supplemental offering for other forms of ongoing care and support. Future research may consider integrated approaches to care that were highlighted as being of particular interest to participants. Clinical Impact StatementQuestion: Are online psychotherapy interventions an acceptable and effective way to help manage the symptoms of posttraumatic stress disorder (PTSD) amongst Egyptians exposed to trauma? Findings:The PTSD Coach Online-Arabic is an online tool that service users can adopt in managing their symptoms. It is culturally acceptable, helps to overcome barriers such as stigma in the Middle East and opens the door to further engagement in psychotherapy amongst Egyptians. Meaning: Online psychotherapy is an acceptable and valuable clinical tool in treating mental health conditions such as PTSD and clinicians can direct service users to the PTSD Coach Online-Arabic intervention as an additional resource to manage the symptoms of PTSD in Egypt. Next Steps: It is indicated that further research to refine the PTSD Coach Online-Arabic is needed to increase effectiveness and engagement, particularly the addition of a human element of support in accessing the intervention.
A Western worldview pervades the social and psychological study of children. The current study employed a story-stem method to qualitatively explore the daily and family life experiences of young Ghanaian primary school children in urban Ghana through their story narratives. The recorded narratives of 69 5- to 8-year-old children were elicited through presenting stems of common child-caregiver scenarios and thematically analysed. Five overarching themes were identified: daily routines and concerns, child-caregiver interactions, spirituality, death-related fears and depictions, and responses to injury. The narrative themes reveal the likely mental and physical occupations of these children, as characterized by household chores, financial concerns and school concerns, as well as underlying cultural values through their portrayals of parenting values, parental discipline and spiritual beliefs. Story stems depicting common childhood problems (e.g. knee injury) sometimes evoked death and hospitalization subthemes following an escalation of health problems. Possible interpretations for these findings are discussed, taking into account cultural, developmental and emotional factors. Story stems are a promising and developmentally appropriate tool for qualitative analysts to investigate the experiences and worldview of young children in non-Western cultures.
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