Evaluation of a Trauma‐Focused Group Intervention for Unaccompanied Young Refugees: A Pilot Study

Abstract

Recent research has shown that unaccompanied young refugees (UYR) encounter a wide range of traumatic events during preflight, flight, and resettlement. Although many UYR are resourceful, many develop posttraumatic stress symptoms (PTSS). However, only a small number of vulnerable UYR have access to trauma-focused interventions. Trauma-focused group interventions, adapted to the needs of UYR, may be one way of improving their mental health. A total of 29 male UYR between 14 and 18 years of age, mainly from Afghanistan, participated in the evaluation study of a trauma-focused group intervention entitled Mein Weg (My Way). The intervention included six sessions of psychoeducation, relaxation, trauma narrative, and cognitive restructuring. Pre-post comparisons of PTSS assessed by the Child and Adolescent Trauma Screen (CATS) were used. At study entry, participants endorsed, on average, eight traumatic events. After the group intervention, the participants reported significantly fewer overall PTSS preintervention mean = 27.6, SD = 7.9; postintervention mean = 20.7, SD = 6.3; t(28) = 4.2, p = .001, Cohen's d = 0.97. Improvement was especially pronounced in the domains of reexperiencing and avoidance, as well as negative alterations in cognitions and mood. There were 14 participants preintervention and 7 postintervention who fulfilled the PTSD criteria. This pilot study presented initial evidence of the efficacy of the trauma-focused group intervention with regard to PTSS reduction.

The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

“…It is worth noting that in our review several significant effects resulted from treatments that were provided by trained lay persons (Betancourt et al, 2012a; Catani et al, 2009; Dybdahl, 2001; Gupta & Zimmer, 2008; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Tol et al, 2012), demonstrating that substantial symptom reduction can be achieved by this means. On the other hand, some treatments delivered by clinicians were ineffective (Schottelkorb et al, 2012; Thabet et al, 2005) or even harmful (Lange-Nielsen et al, 2012).…”

“…Thirteen out of 23 studies examined the effect of evidence-based treatments, such as interpersonal therapy (IPT) (Betancourt et al, 2012a), strict cognitive behavioural therapy (CBT) (Catani et al, 2009; Onyut et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012), eclectic CBT with other elements (Ehntholt, Smith, & Yule, 2005; Möhlen, Parzer, Resch, & Brunner, 2005; Ooi, 2012; Ooi et al, 2016; Šehović, 2002; Tol et al, 2012), or eye movement desensitization and reprocessing (EMDR; within a psychodynamic therapy) (Oras, De Ezpeleta, & Ahmad, 2004). …”

“…In 12 studies, trained lay persons (e.g. teachers, social workers) provided the main intervention (Betancourt et al, 2012a; Catani et al, 2009; Dybdahl, 2001; Ellis et al, 2013; Gupta & Zimmer, 2008; Išpanović-Radojković et al, 2002; Möhlen et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Thabet et al, 2005; in the psychoeducation group; Tol et al, 2012). …”

“…PTSD outcomes were reported for 10 active CBT treatment groups (Catani et al, 2009; Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; both treatment and later treated waitlist group; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Tol et al, 2012; separately for boys/girls), and depression outcomes for seven active CBT treatment groups (Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; treatment and later treated waitlist group; Schauer, 2008; Tol et al, 2012; separately for boys/girls). The combined pre-post effect sizes were SMC = 0.79, 95% CI [0.47, 1.11] for PTSD (total N  = 394), and SMC = 0.30, 95% CI [0.18, 0.43] for depression (total N  = 337) (Figures 2 and 3, respectively).…”

“…On the other hand, some treatments delivered by clinicians were ineffective (Schottelkorb et al, 2012; Thabet et al, 2005) or even harmful (Lange-Nielsen et al, 2012). Some treatments were effectively administered in group settings (Betancourt et al, 2012a; Pfeiffer & Goldbeck, 2017) or at school (Gupta & Zimmer, 2008; Ooi et al, 2016; Schauer, 2008; Tol et al, 2012). Other reviews (Newman et al, 2014; Rolfsnes & Idsoe, 2011) have reported moderate (Rolfsnes & Idsoe, 2011) to large (Newman et al, 2014) effect sizes for trauma-related psychotherapies in the group/school setting, even if they were provided by trained lay persons like teachers or social workers.…”