New directions in the mental health care of migrants, including refugees—A randomized controlled trial investigating the efficacy of value‐based counselling

Orang, Tahereh; Missmahl, Inge; Thoele, Anna-Maria; Valensise, Livia; Brenner, Anna; Gardisi, Maryam; Peter, Helmut; Kluge, Ulrike

doi:10.1002/cpp.2728

Cited by 16 publications

(11 citation statements)

References 55 publications

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“…Looking at the studies with large effect size estimates (SMD ≥ .80) in adult samples, six studies emerged (Ali, 2020;De Graaff et al, 2020;Koch et al, 2020;Orang et al, 2022;Renner et al, 2011;Shaw et al, 2021). In a study with moderate risk of bias, De Graaff et al ( 2020 (2020) found constantly larger effect sizes for the same program in a population of adult Syrian refugees in the Netherlands, Spaaij ( 2022) -yet in a feasibility and acceptability trial -reported nonsignificant but inverse effect sizes for a sample of Syrian refugees and asylum seekers in Switzerland.…”

Section: Discussionmentioning

confidence: 99%

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Transdiagnostic Psychosocial Interventions to Promote Mental Health in Forcibly Displaced Persons: A Systematic Review and Meta-Analysis

Michael¹,

Kunzler²,

Lindner³

et al. 2022

Preprint

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People forced to leave their homes, such as refugees and internally displaced persons, are exposed to various stressors during their forced displacement, putting them at risk for mental disorders. In view of the Russian military offensive in Ukraine, this review aimed at summarizing the evidence on the efficacy of transdiagnostic psychosocial interventions to promote mental health and/or to prevent mental symptoms in forcibly displaced persons of all ages. Four electronic databases and reference lists were searched for randomized controlled trials on interventions in this population from inception to March 11, 2022. Thirty-six studies were eligible, 32 were included in random-effects multilevel meta-analyses. Results on mental symptoms, M(SMD) = 0.26, p = .075, and positive mental health indicators like wellbeing, M(SMD) = 0.41, p = .182, provided no evidence for an effect favoring transdiagnostic interventions over control conditions in children/adolescents and adults. After excluding studies at risk of bias, meta-analyses on adult samples provided evidence for a small effect on mental symptoms and positive mental health, while analyses on children/adolescents yielded unchanged results. Heterogeneity was considerable, and certainty of evidence was very low. Future research should combine the imperative of humanitarian aid in face of major crises with studying forcibly displaced persons’ diverse needs to improve future interventions.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, the remaining four studies with large effect sizes in adult samples was associated with at least 'some concerns' for risk of bias in three out of five domains (Ali, 2020;Orang et al, 2022;Renner et al, 2011;Shaw et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Transdiagnostic Psychosocial Interventions to Promote Mental Health in Forcibly Displaced Persons: A Systematic Review and Meta-Analysis

Michael¹,

Kunzler²,

Lindner³

et al. 2022

Preprint

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“…Nevertheless, according to a number of refugee studies, attention is being paid to the positive resources of refugees ( 63 ). As a result of conducting value-based counseling on refugees, enhancing the client's self-efficacy and ultimately demonstrating their inherent resilience, it was found that most psychological indicators, such as depression and anxiety, improved in comparison to the control group ( 64 ). Therefore, it is crucial to create a strength-based therapeutic environment that helps NKDs receive direct support when necessary.…”

Section: Discussionmentioning

confidence: 99%

Exploring trajectories of depressive symptoms in North Korean defectors: A latent class mixed analysis

Kim

Park

et al. 2022

Front. Psychiatry

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BackgroundNorth Korean defectors (NKDs) are known to be vulnerable to depression due to the influence of various psychosocial factors during their settlement process. Therefore, this study aimed to explore different trajectories of depressive symptoms in NKDs and identify predictors of the worsening of depressive symptoms. In particular, the focus was on whether posttraumatic stress disorder (PTSD) functions as a significant predictor.MethodsParticipants consisted of 300 NKDs who settled in South Korea within 3 years of entering in the country. Five waves of longitudinal data collected from 2016 to 2019 were used. In this study, the North Korean Composite International Diagnostic Interview (NK-CIDI), a diagnostic interview tool, was conducted at baseline and depressive symptoms were measured at each wave. Trajectory identification was based on latent class mixed modeling. Logistic regression was used to extract the significant factors predicting a high/increasing depressive symptom trajectory.ResultsTwo trajectories of depressive symptoms were identified: “low/stable symptom” (76.7% of participants) and “high/increasing symptom” (23.3% of participants). Predictors of the high/increasing symptom group were being female and a low use of mental health services. Generalized anxiety disorder, social phobia, and alcohol dependence acted as significant predictors. Although PTSD was not a significant predictor, self-reported PTSD symptom scores were high in the high/increasing symptom group.ConclusionsIdentifying the trajectories of depressive symptoms in NKDs helps identify the risk factors of clinically vulnerable groups. In the process of establishing government-level interventions, it may be helpful to create a therapeutic environment. In addition, when evaluating initial psychiatric problems, it is important to primarily consider NKDs' anxiety levels and alcohol problems. There should also be an appropriate consideration of PTSD symptoms.

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“…The present paper presents the data collected on variables of resilience and perspective taking. Two recent papers which focused on further data collected for the study focused on the clinically meaningful reduction of depression and PTSD symptoms, perceived stress, anxiety, and somatic complaints experienced by participants in the VBC group after an average of four counselling sessions [43,44].…”

Section: Trial Designmentioning

confidence: 99%

“…When large numbers of refugees began to arrive in Germany in 2015, the approach was used to empower migrants and refugees resettled in Germany, as it corresponds well with the specific needs of mobile, culturally heterogeneous populations like migrants and refugees. Two recent studies investigating the effectiveness of VBC in this context revealed significant symptom reductions with medium to large effect sizes [43,44].…”

Section: Introductionmentioning

confidence: 99%

Rethinking mental health care provided to migrants and refugees; a randomized controlled trial on the effectiveness of Value Based Counseling, a culturally sensitive, strength-based psychological intervention

et al. 2023

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Background Despite traumatic experiences and persistent psychosocial stressors, many refugees and migrants display resilience and strength in the midst and aftermath of hardships. ‘Value Based Counseling’ (VBC), a low-threshold, short-term and culturally sensitive psychological intervention avoids the stigmatization and pathologization of mental health problems, and, in line with latest research calling for a rethink of mental health care for migrants and refugees, focusses on the resilience and resources of clients. Method This pragmatic, assessor-blinded randomized controlled trial employed a pre-post control group design to assess the effectiveness of VBC in the development of psychological assets. Refugees and migrants aged 18 or above were randomly assigned to either VBC sessions delivered by counselors matched with their clients according to gender and native language, or to a waiting list. Results Per protocol and intention-to-treat (ITT) analyses revealed that compared with participants in the waiting-list group (n = 50), the VBC group (n = 53) experienced a greater improvement in resilience (adjusted difference 11.59, 95% CI 8.35 to 14.84, effect size .49, p < .001) and perspective taking (adjusted difference 3.98, 95% CI 2.12 to 5.84, effect size .39, p < .001) after four sessions on average. These positive results remained consistent until a 3-month follow-up assessment within the VBC group. Conclusion VBC with a focus on personal resources in the Here and Now, and with a culturally sensitive approach, helps clients exposed to persistent psychosocial stressors to develop strength and to increase agency over their lives.

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New directions in the mental health care of migrants, including refugees—A randomized controlled trial investigating the efficacy of value‐based counselling

Cited by 16 publications

References 55 publications

Transdiagnostic Psychosocial Interventions to Promote Mental Health in Forcibly Displaced Persons: A Systematic Review and Meta-Analysis

Transdiagnostic Psychosocial Interventions to Promote Mental Health in Forcibly Displaced Persons: A Systematic Review and Meta-Analysis

Exploring trajectories of depressive symptoms in North Korean defectors: A latent class mixed analysis

Rethinking mental health care provided to migrants and refugees; a randomized controlled trial on the effectiveness of Value Based Counseling, a culturally sensitive, strength-based psychological intervention

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