Empowerment group therapy for refugees with affective disorders: results of a multicenter randomized controlled trial

Author:

Wiechers MarenORCID,Strupf Michael,Bajbouj MalekORCID,Böge KeremORCID,Karnouk Carine,Goerigk StephanORCID,Kamp-Becker Inge,Banaschewski Tobias,Rapp MichaelORCID,Hasan Alkomiet,Falkai Peter,Jobst-Heel Andrea,Habel Ute,Stamm Thomas,Heinz AndreasORCID,Hoell AndreasORCID,Burger Max,Bunse Tilmann,Hoehne EdgarORCID,Mehran NassimORCID,Kaiser Franziska,Hahn EricORCID,Plener Paul,Übleis Aline,Padberg Frank

Abstract

Abstract Background Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU). Method At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery–Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life. Results Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F(1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F(1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21–1.15 for PHQ-9 and d = 0.51, 95% CI 0.04–0.99 for MÅDRS). Conclusion In the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.

Publisher

Royal College of Psychiatrists

Subject

Psychiatry and Mental health

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1. Videogestützte Psychotherapie für Geflüchtete: Eine Pilotstudie;PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie;2024-03

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