Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT): study protocol for a randomised controlled trial

Abstract

Background In 2015, 162 877 persons sought asylum in Sweden, 35 369 of whom were unaccompanied refugee minors (URM). Refugee children, especially URM, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called ‘Teaching Recovery Techniques’ (TRT), for refugee youth experiencing PTSD symptoms. Methods/Design A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; c.8 weeks after randomisation) and follow-up (T3; c.20 weeks after randomisation). Discussion This study will provide knowledge about the effect and efficiency of a group intervention for URM reporting symptoms of PTSD in Sweden.

Evaluation of the teaching recovery techniques community-based intervention for accompanied refugee children experiencing post-traumatic stress symptoms (Accompanied refugeeS In Sweden Trial; ASsIST): study protocol for a cluster randomised controlled trial

“…The design was informed by an ongoing RCT with unaccompanied refugee youth in Sweden, to aid comparability across the evaluations. 17 The intervention arm will be offered the TRT programme immediately after randomisation and the waitlist-control arm around 20 weeks later; both trial arms will have access to services as usual. Assessments will take place at three points: pre-intervention (T1), post-intervention (T2; c.8 weeks after randomisation) and follow-up (T3; c.20 weeks after randomisation).…”

“…The CRIES-13 17 is a 13-item measure of PTSD symptoms. Individual items are rated according to the frequency of their occurrence during the past week (None=0, Rarely=1, Sometimes=3 and A lot=5) and in relation to a specific traumatic event.…”

“…The total score has shown to have good internal consistency, and to successfully categorise over 75% of children with and without a PTSD diagnosis. 17 24 CRIES-8 includes the intrusion and avoidance items. The factor structure and internal consistency of the CRIES-8 (Cronbach’s α=0.75) was confirmed in a study of asylum-seekers in Uppsala, Sweden.…”

The Cantril Ladder as a Measure of Well-Being and Life Satisfaction Among Refugee Youth Experiencing Symptoms of Post-Traumatic Stress

“…However, the necessary safety processes associated with this approach require attention. This article details a small-scale study conducted as part of the randomised controlled trial evaluation of a community-based intervention called Teaching Recovery Techniques (TRT) with refugee youth in Sweden [8,9]. Predominantly based on trauma-focused cognitive behavioural therapy, TRT is a brief group-based intervention delivered over five to seven weekly sessions by professionals working with children whom have attended a three-day training [10].…”

Mapping trauma support onto the shifting landscape of seeking refuge in Sweden: insights from an ongoing programme of research on refugee minors’ mental health

“…The results were promising and the next step was to conduct a larger scale, robust evaluation. Funding was secured for a national randomized trial [7] but, by the time recruitment efforts commenced, the landscape had shifted. The emergency infrastructure built so rapidly in response to the 'refugee crisis' was starting to be dismantled.…”