Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series

C.M. Van Es; M.E. Velu; M.J.T. Sleijpen; N. van der Aa; P.A. Boelen; G.T.M. Mooren

doi:10.3389/fpsyg.2023.1125740

Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series

C.M. Van Es^*
, M.E. Velu
, M.J.T. Sleijpen
, N. van der Aa
, P.A. Boelen
, G.T.M. Mooren

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs.

Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children’s Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview.

Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed.

Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs. Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.

Original language	English
Article number	1125740
Pages (from-to)	1-13
Number of pages	13
Journal	Frontiers in Psychology
Volume	14
DOIs	https://doi.org/10.3389/fpsyg.2023.1125740
Publication status	Published - 1 Jun 2023

Bibliographical note

Publisher Copyright:
Copyright © 2023 Van Es, Velu, Sleijpen, van der Aa, Boelen and Mooren.

Funding

This work was supported by the Asylum, Migration and Immigration Fund (AMIF) under project number 2017EFA2017. AMIF had no role in the implementation of study. The authors would like to thank all participants, their guardians, and mentors, the involved therapists (Renate van Loon, Annemariek Sepers, and Marjan Veldman) and intercultural mediators (Mustafa Khaled, Michael Kidane, Nebil Kusmallah, Akberet Okbu, Bet-El Teklemariam, and Amanuel Yohannes), the project team (Hans te Brake, Winta Ghebreab, Juul Gouweloos, Carla Lebesque, Marjan Schippers, and Marhainska Welvaart-Sakoetoe), and their colleagues at ARQ Centrum’45 for consultation during this project.

Funders	Funder number
Marhainska Welvaart-Sakoetoe
Asylum, Migration and Integration Fund	2017EFA2017

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 16 Peace, Justice and Strong Institutions

Keywords

depression
mixed-methods
multiple baseline
posttraumatic stress disorder
trauma-focused treatment approach
unaccompanied refugee minors

Access to Document

10.3389/fpsyg.2023.1125740Licence: CC BY

fpsyg-14-1125740Final published version, 1.38 MBLicence: CC BY

Cite this

@article{eb562a81b7144c1490f6ab631873b76d,

title = "Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series",

abstract = "Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs. Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children{\textquoteright}s Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview. Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed. Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs. Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.",

keywords = "depression, mixed-methods, multiple baseline, posttraumatic stress disorder, trauma-focused treatment approach, unaccompanied refugee minors",

author = "\{Van Es\}, C.M. and M.E. Velu and M.J.T. Sleijpen and \{van der Aa\}, N. and P.A. Boelen and G.T.M. Mooren",

note = "Publisher Copyright: Copyright {\textcopyright} 2023 Van Es, Velu, Sleijpen, van der Aa, Boelen and Mooren.",

year = "2023",

month = jun,

day = "1",

doi = "10.3389/fpsyg.2023.1125740",

language = "English",

volume = "14",

pages = "1--13",

journal = "Frontiers in Psychology",

issn = "1664-1078",

publisher = "Frontiers Media SA",

}

TY - JOUR

T1 - Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors

T2 - a multiple baseline case series

AU - Van Es, C.M.

AU - Velu, M.E.

AU - Sleijpen, M.J.T.

AU - van der Aa, N.

AU - Boelen, P.A.

AU - Mooren, G.T.M.

PY - 2023/6/1

Y1 - 2023/6/1

N2 - Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs. Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children’s Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview. Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed. Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs. Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.

AB - Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs. Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children’s Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview. Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed. Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs. Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.

KW - depression

KW - mixed-methods

KW - multiple baseline

KW - posttraumatic stress disorder

KW - trauma-focused treatment approach

KW - unaccompanied refugee minors

UR - https://www.scopus.com/pages/publications/85162053166

U2 - 10.3389/fpsyg.2023.1125740

DO - 10.3389/fpsyg.2023.1125740

M3 - Article

AN - SCOPUS:85162053166

SN - 1664-1078

VL - 14

SP - 1

EP - 13

JO - Frontiers in Psychology

JF - Frontiers in Psychology

M1 - 1125740

ER -

Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this