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

Abstract

Over the last few years there have been attempts to scale-up Teaching Recovery Techniques (TRT), a community-based group intervention for refugee youth reporting symptoms of post-traumatic stress, across Sweden using the distribution network pathway model. This implementation model allows for quick spread, but only for a low level of control at local sites. This study explores factors and agents that have facilitated the implementation and maintenance of the community-based intervention in successful sites. Seven semi-structured interviews were conducted with personnel from “successful” community sites, defined as having conducted at least two groups and maintaining full delivery. Data were analyzed using content analysis to identify a theme and categories. The main theme “Active networking and collaboration” was key to successful maintenance of community-based delivery. Categories included “Going to where the potential recipients are”, relating to the importance of networks, and “Resource availability and management for maintenance”, relating to the challenges due to the lack of a lead organization supplying necessary funds and support for maintenance. Additionally, “Careful integration of the interpreter” underlined that interpreters were essential co-facilitators of the intervention. Although the interviewed professionals represented successful sites, they remained dependent on informal networks and collaboration for successful maintenance of community-based delivery.

Health system responsiveness to the mental health needs of Syrian refugees: mixed-methods rapid appraisals in eight host countries in Europe and the Middle East

“…Availability and accessibility of mental health services were concerns in all countries. Demand outstrips supply of mental health resources, with insufficient numbers of mental health workers and/or services reported in Egypt, Jordan 38 – 40 , Türkiye, Switzerland 41 – 44 , Sweden 45 , 46 , Germany 47 – 50 , and in Lebanon:…”

Feasibility of a randomised trial of Teaching Recovery Techniques (TRT) with refugee youth: results from a pilot of the Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT)

“…Given these circumstances, TRT facilitators have a great responsibility in facilitating attendance and progression throughout the intervention. Qualitative evaluation of the factors that have aided the implementation and maintenance of TRT delivery revealed that group facilitators should go to where the youth are, rather than expect them to come to where TRT is offered [ 47 ]. When URM are not residing together, one may need to consider other strategies, such as offering TRT in the school setting or online delivery of TRT.…”

A Preliminary Scoping Review of Trauma Recovery Pathways among Refugees in the United States

“…The complexity of post-migration-related concerns among traumatized refugees highlights the growing necessity for contextual information on recovery techniques and clinical interventions among these individuals that are essential to their survival [7]. This will primarily emphasize both mental and physical health, as well as enhance general health behaviour, daily life functioning, and psycho-social adjustment [8,9]. It is equally relevant to establish that the fundamental requirements of refugees, such as shelter, regular meals, protection from harm as well as the ability to work and earn income are crucial and inevitable in tackling the general wellbeing of refugees in trauma therapy and care [10].…”