A group mental health randomized controlled trial for female refugees in Malaysia.

Stacey A. Shaw · Kaitlin Paxton Ward · Veena Pillai · Devon E. Hinton

57 citations0/0 files storedAmerican Journal of Orthopsychiatry

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Migration, Health and Trauma Mental Health Treatment and Access Maternal Mental Health During Pregnancy and Postpartum

Abstract

Forcibly displaced persons confront multiple stressors while awaiting permanent asylum or resettlement and often experience high levels of emotional distress. This study assessed an 8-week somatic-focused culturally adapted cognitive-behavioral therapy (CBT) group intervention with 39 female refugees from Afghanistan living in Kuala Lumpur, Malaysia. Twenty-nine participants were randomly assigned to treatment conditions, resulting in 20 participants in two separate treatment groups and 9 in a waitlist control group. An additional 10 participants were not randomly assigned and therefore were treated as an additional treatment group and analyzed separately. A three-group piecewise linear growth model was specified in Mplus using Bayesian estimation. Dependent variables included emotional distress, anxiety, depression, posttraumatic stress, and social support. From baseline to posttreatment assessments, initial intervention participants experienced significant declines in emotional distress (b = -16.90, p < .001), anxiety (b = -.80, p < .001), depression (b = -.59, p < .001), and posttraumatic stress (b = -.24, p < .05). Gains were maintained three months posttreatment, with similar trends observed among nonrandomized participants. Subsequent to receiving treatment, the waitlist control participants also showed significant declines in emotional distress (b = -20.88, p < .001), anxiety (b = -1.10, p < .001), depression (b = -.79, p < .001), and posttraumatic stress scores (b = -.82, p < .001). Comparing the treatment groups to the waitlist control group revealed large effect sizes: Cohen's d was 2.14 for emotional distress, 2.31 for anxiety, 2.42 for depression, and 2.07 for posttraumatic stress. Relevant public health findings include low drop out, group format, and facilitation by a trained community member. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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References

1991The MOS social support survey 2004A Comparison of Narrative Exposure Therapy, Supportive Counseling, and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement.2011Mental health and psychosocial support in humanitarian settings: linking practice and research 2007Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda 2013Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence 2010Review of refugee mental health interventions following resettlement: Best practices and recommendations.2005A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: A cross-over design 2013The Refugee Health Screener-15 (RHS-15): development and validation of an instrument for anxiety, depression, and PTSD in refugees

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