scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  

Abstract 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.

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  

Abstract Background: Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before 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. Methods/design: This trial is the first evaluation of a short-term, transdiagnostic treatment protocol to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Further, we will investigate participants’ subjective experiences with the intervention manual via 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.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schiess-Jokanovic ◽  
Dina Weindl ◽  
...  

Abstract Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before 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 limited mainly to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety. Methods/design This trial is the first evaluation of a short-term, transdiagnostic treatment protocol for treatment-seeking Afghan refugees which addresses mental health problems and PMLDs while using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor-blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Furthermore, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One hundred twenty people will be assessed and randomly allocated to either the intervention arm or a treatment-as-usual arm. Clinical psychologists will conduct the treatment, and the sessions will take place with a Dari interpreter. The protocol consists of six 90-min sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints are the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the World Health Organization 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. Trial registration German Clinical Trials Register (DRKS) registration number: DRKS00016538. Universal Trial Number: U1111-1226-3285. Registered on January 7, 2019. https://www.drks.de/drks_web/setLocale_EN.do


2018 ◽  
Vol 25 (9) ◽  
pp. 1270-1284 ◽  
Author(s):  
Tilmann von Soest ◽  
Leila Torgersen ◽  
Ingela Lundin Kvalem

Cosmetic breast surgery experience and a wide range of mental health, psychosocial, and sociodemographic variables were assessed in the population-based Norwegian Mother and Child Cohort Study ( N = 78,252). Breast augmentation patients reported elevated mental health problems. Factors in the domains of physical appearance, drug use, relationships, and exposure to abuse were all related to breast augmentation. Adjusting for such factors reduced the relationships between breast augmentation surgery and all mental health problems to non-significance. Results indicate that the increased prevalence of mental health problems among breast augmentation patients has to be understood from multiple perspectives involving several psychosocial domains.


2021 ◽  
Author(s):  
Zhonghuan Liang ◽  
Xiuli Ou ◽  
Jieming Li ◽  
Gang He ◽  
Qingdong Xu ◽  
...  

Abstract Purpose The global epidemic of 2019 Novel Coronavirus Diseases (COVID-19) has caused many psychological problems. At present, there are few studies on the mental health status and correlation of COVID-19 patients. Methods During the peak period of COVID-19 outbreak in China, COVID-19 patients from 5 designated hospitals with new coronary pneumonia were selected by convenient sampling method. Symptom Checklist 90 (SCL-90) were investigated by either a convenient online questionnaire at: WJX.cn as a data collecting platform or an equivalent paper questionnaire. Results It showed that the positive detection rate of SCL-90 in the COVID-19 patients was 29.83%. The most common mental health problem was anxiety (28.3%), and the top three prominent mental health problems are depression (9.4%), interpersonal sensitivity (9.4%), paranoia ideation (7.7%). Compared with the Chinese adult norm, there were significant differences in the SCL-90 total score and somatization, depression, anxiety, and phobic anxiety dimension (P < 0.05). The main influencing factors of mental health of COVID-19 patients are the number of confirmed cases nationwide, sex, marital status and psychological intervention. Conclusion The mental state of some groups is relatively low, which leads to depression and anxiety more easily. In particular, the most vulnerable group was found to be unmarried women who have a high occurrence rate of mental health problems. We need to pay particular attention to high risk groups, and support patients with increased susceptibility, which will require timely assessment by mental health care professionals.


2016 ◽  
Vol 12 (14) ◽  
pp. 175
Author(s):  
Eneida Frasheri ◽  
Eris Dhamo

Mental health policy is a major challenge in every government engagement. Human wellbeing is threatened by mental health issue, and this is why it is necessary to position mental health as a health priority (WHO, 2001). The reduction of human and economic cost of mental health problems can be achieved by providing equitable and evidence-based mental healthcare and treatment. In Albania, the organization of mental health policy has experienced changes in the past half century, especially after the 90’s. This was driven by political commitment at national and intergovernmental levels in response to the challenges posed by mental health problems. The purpose of this paper is to analyze, present factors, and circulates what affects and prepossess the adoption of new mental health policy. The methodology used for this paper was based on two main elements. The first was the analyzing of Albanian conceptual framework, which is derived from two grounded elements: policy content and health policy process. The second element involves data collection using semistructured interview (12) with three levels of policy: policymakers, health policy administrator, and mental health care provider. Also, we consulted a wide range of electronic databases before underpinning the research with additional search. This search includes the scanning of a range of websites, reference lists of included studies, the legal mental health framework, and the respective documents. The activities stipulated in the First Component of the South-Eastern European Mental Health Project under the Stability Pact urged the process of a new mental health policy formulation and adoption of mental health legislation stressing human rights of patients. The WHO has influenced the whole mental health policy framework. They have instructed the National Policy Document for the Mental Health and the recpective action plans. In addition, they have supervised the impemention of this Documents and has trained mental health experts at all levels. Albanian policymaker are concerned with having an adequate map of mental health facilities. This is because many of the dedicated program are far way to be reached from persons in need. All policymaker actors are focused on the need for identification. In this trend of increase in the number of persons with mental health problems and their need for a more holistic care, finances has a crucial role to play.


2018 ◽  
Author(s):  
Susanne Schweizer ◽  
Jovita T. Leung ◽  
Rogier Kievit ◽  
Maarten Speekenbrink ◽  
William R. Tender ◽  
...  

Abstract Background: 75% of all mental health problems have their onset before the end of adolescence. Adolescence, thus may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AC-Training) to a placebo training (P- Training) app. 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AC-Training will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, 1 month and 1 year after training. Discussion: If, as predicted, the proposed study finds that AC-Training successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032, http://www.isrctn.com/ISRCTN17213032). Keywords: Mental health; Adolescence; Emotion regulation; Affective control; App-based training


Author(s):  
Amie R. Newins ◽  
Laura C. Wilson

Sexual assault is associated with an increased risk of a wide range of mental health problems; therefore, treatment should be targeted to address the client’s primary presenting concerns. In this chapter, specific recommendations are provided for using psychotherapy to treat survivors of sexual assault. In particular, suggestions are given for using exposure-based treatments and cognitive-based treatments with these clients. These recommendations focus on how to increase disclosure of details of the assault and to address negative reactions that clients may have received from other disclosure recipients. Furthermore, suggestions are offered related to the terminology and language used during these discussions in treatment.


2016 ◽  
Vol 3 ◽  
Author(s):  
S. M. Doherty ◽  
R. Craig ◽  
M. Gardani ◽  
T. M. McMillan

Objective.Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service.Method.Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required.Results.The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate–severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases.Conclusion.The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.


2011 ◽  
Vol 26 (S2) ◽  
pp. 452-452
Author(s):  
A. Datta ◽  
J. Frewen

IntroductionAsylum seekers and refugees (ASR) are commonly portrayed as opportunists who came to Ireland to fraudulently scrounge off the Irish public. Such views and the consequent exclusion and discrimination they experience can aggravate their mental health risks and reduce their willingness to seek professional help.ObjectivesTo identify the mental health risks faced by ASR and outline specific measures to improve their situation.AimsThrough available hardcopy and online literature1/Assess and evaluate impact of asylum seeking and refugee integration process on ASR psychiatric problems in Ireland.2/Assess and evaluate knowledge and understanding of ASR mental health status; effects of segregation from local communities due to living in isolated ‘centres’ and no employment entitlement; communication and cultural integration difficulties; impact of exclusion and/or (racial) discrimination; apprehension of alien mental health system and treatment process; differing outcome expectations held by ASR and mental health specialists; and fear of being stigmatised by peers.MethodsRigorous review of relevant and applicable hardcopy and internet literature in English language since 2000.ResultsASR mental health problems associated are generally multi-dimensional. In addition to ‘normal’ stresses, many ASR are haunted by past hardships, experience exclusion and integration difficulties and endure a highly stressful asylum process.ConclusionASR require additional, specifically targeted mental health assistance and services that respect and understand their particular needs. Mental health services should work with the asylum process and other relevant socio-economic sectors to develop programmes to tackle potential ASR mental health concerns.


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