Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial

Abstract

Arabic-speaking immigrants and refugees constitute one of the largest immigrant groups in Sweden. Previous research on Arabic-speaking immigrants indicates elevated levels of psychological disorders, including depression and anxiety. The aim of the present pilot study was to examine the efficacy of an internet-delivered cognitive behavioural treatment (ICBT) in an Arabic-speaking immigrant population. The intervention was individually tailored based on self-described problems and consisted of nine modules targeting areas such as depression, anxiety and insomnia. In total, 59 individuals were included and randomized to either an 8-week treatment or wait-list control. Selfreported symptoms of depression on the PHQ-9 were used as primary outcome measure. Secondary outcome measures of anxiety, stress, insomnia, quality of life and post-traumatic stress were also used. In the intention-to-treat analysis, depressive symptoms were significantly reduced compared to the wait-list control group with a betweengroup effect at post-treatment of Cohen's d = 0.85 [0.29, 1.41]. We also found significant between-group effects for symptoms of insomnia and stress, but not for anxiety, post-traumatic stress or quality of life measures. The results indicate that ICBT is a promising treatment approach for treating symptoms of depression, insomnia and stress, in an Arabic-speaking immigrant population. Further studies with larger samples are warranted.

Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study

“…As mentioned above, the study was a qualitative followup of a previous randomized controlled trial and was approved by the Regional Board of Ethics of Linköping, Sweden, number 2017/488-31 [28]. The original trial was preregistered at clinicaltrials.gov, ID number NCT03496350.…”

“…These studies indicate that culturally adapted ICBT has moderate to large effects on symptoms of common mental health disorders compared to inactive control conditions. However, in three of these studies there was also a substantial drop-out rate of around 40% [26,28,29], which is higher than what is usually seen in ICBT treatments [30]. The reasons for this high dropout rate are not well understood, although it has been hypothesized that various postmigratory stressors (such as economic adversity, lack of social support and the stress inherent in the asylumseeking process) could contribute, as well as insufficient cultural adaptation which could make the treatment less relevant to participants [28].…”

“…Such adaptions have been found to increase treatment effects [24]. A number of randomized controlled trials (RCTs) of culturally adapted Internetdelivered cognitive behavior therapy (ICBT) targeting various populations have now been published with promising results [25][26][27][28][29]. These studies indicate that culturally adapted ICBT has moderate to large effects on symptoms of common mental health disorders compared to inactive control conditions.…”

“…The aim of the present study was to investigate the experience of undergoing a culturally adapted ICBT trial among Arabic-speaking immigrants and refugees residing in Sweden. The study was conducted alongside a randomized controlled trial (RCT) which investigated the efficacy of culturally adapted ICBT compared to a wait-list control condition [28].…”

Self-help cognitive behavioral therapy application for COVID-19-related mental health problems: A longitudinal trial

“…This research’s major achievement is its successful completion in just two months, from the screening’s beginning to the trial’s end. Compared with the conventional iCBT duration of 4–8 weeks ( Lindegaard et al, 2020 ; O’Dea et al, 2020 ; Yeung et al, 2018 ), we rapidly achieved significant improvement in mental health problems using three short and efficient psychological interventions in a single week. Notably, we did not include a post-intervention follow-up.…”