Abstract
In 2015, a total of 35,369 unaccompanied refugee minors (URMs) sought asylum in Sweden. In a previous study of 208 URMs, we found that 76% screened positive for PTSD. This study aimed to (1) evaluate the indicated prevention program Teaching Recovery Techniques (TRT) in a community setting and describe the program’s effects on symptoms of PTSD and depression in URMs; and (2) examine participants’ experiences of the program. The study included 10 groups. Methods for evaluation included the Children’s Revised Impact of Event Scale (CRIES-8) and the Montgomery–Åsberg Depression Rating Scale Self-report (MADRS-S) at baseline and at post-intervention. Qualitative interviews were conducted with 22 participating URMs to elicit their experiences. Pre- and post-measures were available for 46 participants. At baseline, 83% of the participants reported moderate or severe depression and 48% suicidal ideation or plans. Although more than half (62%) of the participants reported negative life events during the study period, both PTSD (CRIES-8) and depression (MADRS-S) symptoms decreased significantly after the intervention (p = 0.017, 95% CI − 5.55; − 0.58; and p < 0.001, 95% CI − 8.94; − 2.88, respectively). The qualitative content analysis resulted in six overall categories: social support, normalisation, valuable tools, comprehensibility, manageability, and meaningfulness when the youth described their experiences of the program, well reflecting TRT’s program theory. Overall, results indicate that TRT, delivered in a community setting, is a promising indicated preventive intervention for URMs with PTSD symptoms. This successful evaluation should be followed up with a controlled study.
Highlights
In 2015, nearly 90,000 refugee children arrived in Europe without their families [1]
The analyses of reliable clinical change showed that 33% of the participants recovered based on depression symptoms and 22% recovered based on posttraumatic stress disorder (PTSD) symptoms
The qualitative interviews resulted in six overall categories: social support, normalisation, valuable tools, comprehensibility, manageability, and meaningfulness
Summary
In 2015, nearly 90,000 refugee children arrived in Europe without their families [1]. Sweden alone received over 35,000 (40%) of these children, followed by Germany (16%). A substantial majority of these children were males (91%), mainly aged between 16 and 17 (57%). The asylum-seeking process with the related feelings of uncertainty about the future is an additional stressor with further mental health implications [5]. It is not surprising that trauma-related problems such as posttraumatic stress disorder (PTSD), anxiety and depression are common among URMs. For instance, a recent study in Norway and Belgium [6] showed that 53% of URMs reported high levels of PTSD symptoms which did not change over an 18-month period [7]. Another study in Norway, that followed up URMs who had received residence, indicated that even several years after resettlement, more than 40% of them continued to show high levels
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