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 (URMs). Refugee children, especially URMs, 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 waitlistcontrol 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; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation). Discussion: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden.

Implementation and Maintenance of a Community-Based Intervention for Refugee Youth Reporting Symptoms of Post-Traumatic Stress: Lessons from Successful Sites

“…Additionally, involving representatives from the refugee community in programme development and delivery as well as research, is just as important. In the ongoing trials of TRT [17,18], in which the authors are involved, users are represented by refugee parents and youth, who are involved in all major decision in the trials [23]. Through user involvement, the potential recipients' voices are represented throughout the process and can potentially lead to more culturally appropriate programmes as well as more relevant and reliable research.…”

“…In comparison, TRT is a more light-touch intervention aiming to reach large numbers of children. There are two ongoing randomized controlled trials of TRT in Sweden [17,18]. The present study builds on this evidence base regarding the need to explore factors affecting implementation and maintenance of TRT delivery across 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 Open access 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.…”

“When you talk about it, something in your heart becomes lighter”

“…It is a five-session programme based on trauma-focused CBT and includes psychoeducation, affect modulation, relaxation, imaginary techniques, desensitization, and reprocessing techniques ('knee-tapping') and guided exposure. Our group has trialed Teaching Recovery Techniques in Sweden on unaccompanied refugee minors [12] and we are currently conducting larger scale trials on both accompanied and unaccompanied minors [13]. The response from the children has been overwhelmingly positive, with a direct quote serving as the title for this piece.…”