A group-based approach to stabilisation and symptom management in a phased treatment model for refugees and asylum seekers

Robertson, Mary E. A.; Blumberg, Jocelyn; Gratton, Jacqui L.; Walsh, Elizabeth; Kayal, Hamodi

doi:10.3402/ejpt.v4i0.21407

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…Evidence is growing that stabilization techniques positively affect refugees’ mental health [ 7 - 9 ]. In this context, stabilizing and guided imagery techniques in line with Reddemann [ 10 ] are promising treatment approaches for adult and minor refugees with PTSD in individual and group therapy approaches [ 11 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study

Zehetmair¹,

Nagy²,

Leetz³

et al. 2020

J Med Internet Res

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Background Refugees have an increased risk of developing mental health problems. There are insufficient psychosocial care structures to meet the resulting need for support. Stabilizing and guided imagery techniques have shown promising results in increasing traumatized refugees’ emotional stabilization. If delivered via audio files, the techniques can be practiced autonomously and independent of time, space, and human resources or stable treatment settings. Objective This study aimed to evaluate the self-practice of stabilizing and guided imagery techniques via digital audio files for traumatized refugees living in a reception and registration center in Germany. Methods From May 2018 to February 2019, 42 traumatized refugees participated in our study. At T1, patients received digital audio files in English, French, Arabic, Farsi, Turkish, or Serbian for self-practice. Nine days later, at T2, a face-to-face interview was conducted. Two months after T2, a follow-up interview took place via telephone. Results At T2, about half of the patients reported the daily practice of stabilizing and guided imagery techniques. At follow-up, the average frequency of practice was once weekly or more for those experiencing worse symptoms. No technical difficulties were reported. According to T2 and follow-up statements, the techniques helped the patients dealing with arousal, concentration, sleep, mood, thoughts, empowerment, and tension. The guided imagery technique “The Inner Safe Place” was the most popular. Self-practice was impeded by postmigratory distress factors, like overcrowded accommodations. Conclusions The results show that self-practice of stabilizing and guided imagery techniques via digital audio files was helpful to and well accepted by the assessed refugees. Even though postmigratory distress factors hampered self-practice, “The Inner Safe Place” technique was particularly well received. Overall, the self-practiced audio-based stabilizing and guided imagery techniques showed promising results among the highly vulnerable group of newly arrived traumatized refugees.

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Section: Introductionmentioning

confidence: 99%

Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study

Zehetmair¹,

Nagy²,

Leetz³

et al. 2020

J Med Internet Res

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“…Multicomponent approaches have been recommended for CPTSD, 21 with phased interventions evidenced to be especially effective for refugee and asylum-seeker populations. 22 Our results suggest that our sample experienced high levels of CPTSD symptoms, elevated clinical distress and significant difficulties in post-migration adjustment especially in the relationships domain. With these multicomponent challenges in mind, individuals who present with CPTSD can be offered a tailor-made, formulation-driven, treatment package that includes trauma-focused therapy interventions to target the core symptoms of PTSD, as well as additional modules to address the DSO symptom clusters.…”

Section: Discussionmentioning

confidence: 62%

Complex post-traumatic stress disorder in asylum seekers and victims of trafficking: treatment considerations

et al. 2021

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Asylum-seekers experience high levels of traumatic events pre-, post- and during migration. Poly-traumatisation is associated with complex post-traumatic stress disorder (CPTSD), which has not yet been extensively explored in this population. CPTSD is a prevalent and highly disabling disorder in the present population requiring culturally sensitive diagnostic and treatment approaches. In this service evaluation, we evidence the high prevalence of CPTSD in an asylum-seeking sample and its association with greater distress compared with PTSD. We outline the treatment needs of asylum seekers with CPTSD.

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“…In mental-health services stabilizing treatment is often offered in a group-format, either alone or conjoint with individual treatment (Dorrepaal et al, 2012 ; Herman & Kallivayalil, 2019 ; Robertson, Blumberg, Gratton, Walsh, & Kayal, 2013 ; Stige, 2011 ; Zehetmair et al, 2018 ; Zlotnick et al, 1997 ). The group setting makes it possible to counteract a sense of isolation and offer an opportunity for new interpersonal experiences, while the individual therapy ensures support to handle reactions and experiences from the group (Schwartze, Barkowski, Strauss, Knaevelsrud, & Rosendahl, 2019 ).…”

Section: Treatmentmentioning

confidence: 99%

Stabilizing group treatment for childhood-abuse related PTSD: a randomized controlled trial

Bækkelund

Karlsrud

Hoffart

et al. 2021

European Journal of Psychotraumatology

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Background : Patients with PTSD related to childhood-abuse often experience additional problems such as emotional dysregulation and interpersonal difficulties. Psychotherapy focused on stabilization of symptoms, emotion-regulation, and skills training has been suggested as a treatment for this patient population, either as preparation for further treatment or as a stand-alone intervention. Objective : The present study tests the efficacy of treatment using a group-protocol for stabilizing treatment delivered adjunct with conventional individual therapy. Methods : In a delayed-treatment design with switching replication, a clinically representative sample of 89 patients with PTSD and histories of childhood abuse were randomly assigned to either 20-week stabilizing group treatment or a corresponding waiting-period, both adjunct with conventional individual therapy. After the waiting-period, patients in the control condition were offered group treatment. The primary outcome was psychosocial functioning, measured with interview – assessed Global Assessment of Functioning (GAF), while secondary outcome was self-reported PTSD symptoms. These were measured before treatment, after treatment and at 6 months follow up. The trial was preregistered at Clinical Trials (NCT02450617). Results : We found large within-group effect sizes in both conditions on GAF and moderate effects on PTSD symptoms. Linear mixed-models did not indicate significant differences in treatment trajectories between conditions. Conclusion : Stabilizing group treatment focused on emotional-regulation and skills-training does not improve outcomes beyond individual-treatment alone, and should not be recommended as first-line treatment for this patient-group

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A group-based approach to stabilisation and symptom management in a phased treatment model for refugees and asylum seekers

Cited by 14 publications

References 18 publications

Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study

Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study

Complex post-traumatic stress disorder in asylum seekers and victims of trafficking: treatment considerations

Stabilizing group treatment for childhood-abuse related PTSD: a randomized controlled trial

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