Abstract
BackgroundUnaccompanied refugee minors (URMs) seeking asylum show high rates of posttraumatic stress disorder (PTSD), depression and anxiety. In addition, they experience post-migration stressors like an uncertain residence status. Therefore, psychotherapeutic interventions for URMs are urgently needed but have scarcely been investigated up to now. This study aimed to examine manualized individual trauma-focused cognitive behavioural therapy (TF-CBT) for URMs with PTSD involving their professional caregivers (i.e. social workers in child and adolescent welfare facilities).MethodsWe conducted an uncontrolled pilot study with three follow-up assessments (post-intervention, 6 weeks, and 6 months). Participants who met the PTSD diagnostic criteria were treated in a university psychotherapeutic outpatient clinic in Germany with a mean of 15 sessions of TF-CBT. All participants (n = 26) were male UM (Mage = 17.1, SD = 1.0), predominately from Afghanistan (n = 19, 73.1%) and did not have a residence permit. The sample was severely traumatized according to the number of traumatic event types reported (M = 11.3, SD = 2.8). The primary outcome was PTSD measured with the Child and Adolescent Trauma Screen (CATS) and the Diagnostic Interview for Mental Disorders in Childhood and Adolescence (Kinder-DIPS). Secondary outcomes were depression, behavioural and somatic symptoms. All but the somatic symptoms were assessed in both self-report and proxy report.ResultsAt post-intervention the completer sample (n = 19) showed significantly decreased PTSD symptoms, F(1, 18) = 11.41, p = .003, with a large effect size (d = 1.08). Improvements remained stable after 6 weeks and 6 months. In addition to PTSD symptoms, their caregivers reported significantly decreased depressive and behavioural symptoms in participants. According to the clinical interview, 84% of PTSD cases recovered after TF-CBT treatment. After 6 months, youths whose asylum request had been rejected showed increased PTSD symptoms according to individual trajectories in the Kinder-DIPS. The effect was, however, non-significant.ConclusionsIntervention studies are feasible with URMs. This pilot study presents preliminary evidence for the efficacy of an evidence-based intervention like TF-CBT in reducing PTSD symptoms in URMs. Stressors related to asylum proceedings after the end of therapy have the potential to negatively influence psychotherapy outcomes.
Highlights
Unaccompanied refugee minors (URMs) seeking asylum show high rates of posttraumatic stress disorder (PTSD), depression and anxiety
Research conducted over the last 10 years throughout Europe suggests that unaccompanied refugee minors1 (URMs) who have relocated to European countries have experienced a high number of pre, peri, and postmigration traumatic events [1,2,3] and face various mental health problems in exile, especially posttraumatic stress disorder (PTSD), depression and anxiety [2, 4,5,6]
The inclusion criteria were: (1) arrived in Germany unaccompanied and under the age of 18, (2) current age no older than 21, (3) PTSD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) [26], (4) living in a facility run by the German child and adolescent welfare (CAW) agency, (5) stability of living situation, and (6) availability of a caregiver to take part in assessment and psychotherapy
Summary
Unaccompanied refugee minors (URMs) seeking asylum show high rates of posttraumatic stress disorder (PTSD), depression and anxiety. Research conducted over the last 10 years throughout Europe suggests that unaccompanied refugee minors (URMs) who have relocated to European countries have experienced a high number of pre-, peri-, and postmigration traumatic events [1,2,3] and face various mental health problems in exile, especially posttraumatic stress disorder (PTSD), depression and anxiety [2, 4,5,6] Given their diverse cultural backgrounds, psychological symptoms in young refugees are often linked to a higher degree of somatic problems [3]. Many therapists avoid working with URMs due to a lack of knowledge about the administrative or intercultural characteristics of working with them
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.