Asylee perspectives on psychotherapies for posttraumatic stress

Area of Science:

• Psychiatry
• Global Mental Health
• Trauma Studies

Background:

• Asylees exhibit elevated mental health issues, especially posttraumatic stress, stemming from trauma exposure and uncertain legal status.
• Culturally adapted cognitive behavioral therapy (CA-CBT), eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy (NET) are effective for asylee PTSD, but utilization is low.
• Identifying effective, credible, and acceptable PTSD interventions is crucial for improving asylee mental healthcare access.

Purpose of the Study:

• To assess the perceived effectiveness, credibility, and acceptability of various posttraumatic stress disorder (PTSD) interventions among asylees.
• To explore asylees' treatment engagement, barriers, and therapeutic goals.
• To compare the perceived difficulty of exposure-based therapies versus interpersonal therapy (IPT) for PTSD in asylees.

Main Methods:

• Structured virtual interviews were conducted with 40 asylees residing in the U.S. reporting PTSD symptoms.
• Participants discussed their experiences with and perceptions of CA-CBT, EMDR, NET, and IPT for PTSD.
• Qualitative analysis of participant comments provided insights into treatment perceptions and preferences.

Main Results:

• Asylees perceived interpersonal therapy (IPT) as significantly less difficult to engage with compared to exposure-based treatments (CA-CBT, EMDR, NET).
• Medium effect sizes (ds = 0.55-0.71) were observed for the perceived difficulty difference between IPT and exposure-based therapies.
• Qualitative data offered nuanced understanding of asylees' perspectives on PTSD treatment options.

Conclusions:

• Interpersonal therapy (IPT) may offer a more accessible entry point for asylees experiencing posttraumatic stress disorder (PTSD) due to its lower perceived difficulty.
• Findings can inform the development of more acceptable and effective PTSD interventions tailored to the asylee population.
• Addressing perceived treatment difficulty is a key factor in enhancing mental health service utilization among asylees.