Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average educational and mental health literacy level. Traumatic experiences and hardship pre- and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety as well.
Methods/design This trial is the first evaluation of the efficacy of a short-term, transdiagnostic treatment protocol adapted to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. We investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial. Furthermore we investigate participants’ subjective experiences with the intervention manual with in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12).
Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.
psychotraumatology, refugees, psychological intervention, post-migration living difficulties, Problem Management Plus, Trans-diagnostic, Low resource settings, Cognitive behavioural therapy, psychotherapy, complex PTSD, mhGAP