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Culturally Adapted Cognitive Behavioral Therapy Plus Problem Management (CA-CBT+) With Afghan Refugees: A Randomized
Schahryar Kananian1, Yasaman Soltani1, Devon Hinton2
1Department of Psychology, University of Frankfurt, Frankfurt, Germany.
Journal of Traumatic Stress
|November 6, 2020
Summary
Culturally adapted cognitive behavioral therapy plus problem-solving training significantly improved general health and quality of life in Farsi-speaking refugees. These positive outcomes for refugee mental health were maintained long-term with a low dropout rate.
Area of Science:
- Psychiatry
- Psychology
- Global Health
Background:
- Culturally adapted cognitive behavioral therapy (CA-CBT) is an established intervention for refugees.
- Refugee populations often experience significant psychological distress, including PTSD, depression, and anxiety disorders.
- Existing CA-CBT protocols may benefit from enhanced components to address specific needs.
Purpose of the Study:
- To evaluate the efficacy of culturally adapted cognitive behavioral therapy plus problem-solving training (CA-CBT+) in Farsi-speaking refugees.
- To assess the impact of CA-CBT+ on general psychopathological distress, PTSD, depression, anxiety, somatic symptoms, quality of life, and emotion regulation.
- To determine the long-term maintenance of treatment effects and the dropout rate of the intervention.
Main Methods:
- A randomized controlled pilot trial was conducted with male Farsi-speaking refugees diagnosed with DSM-5 PTSD, major depressive disorder, and anxiety disorders.
- Participants were randomly assigned to either the CA-CBT+ intervention group or a waitlist control (WLC) group.
- Assessments were performed pre-treatment, 12-weeks post-treatment, and at a 1-year follow-up, utilizing measures such as the GHQ-28 and PTSD Checklist.
Main Results:
- Large between-group effect sizes were observed at posttreatment for the primary outcome (GHQ-28, d = 3.0) and most secondary outcomes.
- Improvements in the CA-CBT+ group were maintained at 1-year follow-up, showing continued large effect sizes compared to baseline.
- The CA-CBT+ intervention demonstrated a very low dropout rate, with 11 of 12 participants completing the treatment.
Conclusions:
- CA-CBT+ is a highly effective intervention for improving general psychopathological distress and quality of life in Farsi-speaking refugees.
- The addition of problem-solving training to CA-CBT appears to be a promising enhancement, yielding significant and long-lasting mental health benefits.
- The group format and low dropout rate suggest CA-CBT+ is a feasible and beneficial treatment for this population.
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