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Problem management plus with emotional processing module for refugee youth in the Netherlands: pilot trial of
Cansu Alozkan Sever1,2, Pim Cuijpers1,2,3, Ellenor Mittendorfer-Rutz4
1Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, the Netherlands.
Background:
Refugee youth are at elevated risk for post-traumatic stress disorder (PTSD) and other mental health disorders, yet systemic and cultural barriers limit access to care. Scalable, transdiagnostic interventions such as Problem Management Plus (PM+) are promising, but their impact on trauma symptoms is modest. Incorporating brief trauma-focused components may enhance effectiveness.
Aims:
To evaluate the feasibility and acceptability of PM+ with an emotional processing module (PM+EP) for refugee youth aged 16-25 years in the Netherlands.
Method:
Refugee youth with elevated psychological distress (K10 > 15) and impaired functioning (World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) > 16) were randomised into PM+EP, PM+ with supportive counselling (PM+SC), or care as usual (CAU). Feasibility and acceptability were assessed via recruitment, adherence, fidelity and qualitative interviews. Psychological distress, PTSD symptoms, functioning and self-identified problems were measured at baseline, post-intervention and follow-up. Registered in Overview of Medical Research in the Netherlands (OMON; Trial ID: NL-OMON56254).
Results:
Fifty-two participants were randomised (PM+EP: n = 17; PM+SC: n = 19; CAU: n = 16). Attendance and fidelity were high, and PM+ interventions were rated as acceptable and culturally appropriate. No significant between-group differences were observed in the primary analyses. Exploratory analyses suggested greater short-term symptom reduction for probable depression in PM+EP versus CAU (b = -0.79, s.e. = 0.38, p = 0.04). Effect size estimates ranged from small to large across outcomes (Hedges' g = -0.98 to 0.19).
Conclusions:
PM+ is feasible, acceptable and safe for refugee youth aged 16 years and older. The potential added value of the EP module remains unclear and warrants further investigation.
Trial Registration Number:
The trial was registered in the Dutch clinical trial registration: Overview of Medical Research in the Netherlands (OMON) (Trial ID: NL-OMON56254; https://onderzoekmetmensen.nl/en/trial/56254).
