Empowerment group therapy for refugees with affective disorders: results of a multicenter randomized controlled trial

Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention ) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project (MEHIRA). We aim to evaluate the effectiveness of the group intervent...

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Published inEuropean psychiatry Vol. 66; no. 1; p. e64
Main Authors Wiechers, Maren, Strupf, Michael, Bajbouj, Malek, Böge, Kerem, Karnouk, Carine, Goerigk, Stephan, Kamp-Becker, Inge, Banaschewski, Tobias, Rapp, Michael, Hasan, Alkomiet, Falkai, Peter, Jobst-Heel, Andrea, Habel, Ute, Stamm, Thomas, Heinz, Andreas, Hoell, Andreas, Burger, Max, Bunse, Tilmann, Hoehne, Edgar, Mehran, Nassim, Kaiser, Franziska, Hahn, Eric, Plener, Paul, Übleis, Aline, Padberg, Frank
Format Journal Article
LanguageEnglish
Published England Cambridge University Press 17.07.2023
Subjects
affective disorders
depression
Emotional regulation
Emotions
Empowerment
global mental health
Group therapy
Humans
Intervention
Linguistics
Mental depression
Mental disorders
Mental health
Mood Disorders
Persian language
Psychotherapy
Psychotherapy, Group
Quality of Life
Questionnaires
Refugees
Refugees - psychology
Resilience (Psychology)
Stress
Stress Disorders, Post-Traumatic - psychology
Syria
Iraq
affective disorders
Refugees
depression
group therapy
global mental health
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Abstract Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention ) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project (MEHIRA). We aim to evaluate the effectiveness of the group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU). At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life. Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9;  = 13.32,  < 0.001) and clinician-rated depressive symptoms (MÅDRS;  = 6.91,  = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (  = 0.68, 95% CI 0.21-1.15 for PHQ-9 and  = 0.51, 95% CI 0.04-0.99 for MÅDRS). In the MEHIRA project comparing an SCCM approach versus TAU, the group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.
AbstractList Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention ) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project (MEHIRA). We aim to evaluate the effectiveness of the group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU). At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life. Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9;  = 13.32,  < 0.001) and clinician-rated depressive symptoms (MÅDRS;  = 6.91,  = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (  = 0.68, 95% CI 0.21-1.15 for PHQ-9 and  = 0.51, 95% CI 0.04-0.99 for MÅDRS). In the MEHIRA project comparing an SCCM approach versus TAU, the group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.
Abstract Background Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU). Method At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery–Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life. Results Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F (1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F (1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21–1.15 for PHQ-9 and d = 0.51, 95% CI 0.04–0.99 for MÅDRS). Conclusion In the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.
Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU).BACKGROUNDAgainst the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU).At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life.METHODAt level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life.Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F(1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F(1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21-1.15 for PHQ-9 and d = 0.51, 95% CI 0.04-0.99 for MÅDRS).RESULTSIntention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F(1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F(1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21-1.15 for PHQ-9 and d = 0.51, 95% CI 0.04-0.99 for MÅDRS).In the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.CONCLUSIONIn the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.
BackgroundAgainst the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU).MethodAt level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery–Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life.ResultsIntention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F(1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F(1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21–1.15 for PHQ-9 and d = 0.51, 95% CI 0.04–0.99 for MÅDRS).ConclusionIn the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms.
ArticleNumber e64
Author Karnouk, Carine
Übleis, Aline
Hasan, Alkomiet
Hahn, Eric
Heinz, Andreas
Hoell, Andreas
Banaschewski, Tobias
Rapp, Michael
Bajbouj, Malek
Padberg, Frank
Kamp-Becker, Inge
Habel, Ute
Falkai, Peter
Burger, Max
Kaiser, Franziska
Bunse, Tilmann
Wiechers, Maren
Strupf, Michael
Jobst-Heel, Andrea
Stamm, Thomas
Plener, Paul
Goerigk, Stephan
Hoehne, Edgar
Mehran, Nassim
Böge, Kerem
AuthorAffiliation 5 Department of Child and Adolescent Psychiatry, Philipps-University Marburg , Marburg , Germany
9 Department of Psychiatry and Psychotherapy, RWTH Aachen University , Aachen , Germany
12 Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm , Ulm , Germany
11 Department of Psychiatry and Psychotherapy, Central Institute for Mental Health, Medical Faculty Mannheim , Mannheim , Germany
7 Social and Preventive Medicine, University of Potsdam , Potsdam , Germany
8 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg , BKH Augsburg, Augsburg , Germany
4 Charlotte Fresenius Hochschule, University of Applied Sciences , Munich , Germany
10 Brandenburg Medical School , Neuruppin , Germany
1 Department of Psychiatry and Psychotherapy, University Hospital LMU , Munich , Germany
2 Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin , Campus Benjamin Franklin, Berlin , Germany
6 Department of Child and Adolesce
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Copyright_xml – notice: The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Issue 1
Keywords affective disorders
Refugees
depression
group therapy
global mental health
Language English
License http://creativecommons.org/licenses/by/4.0
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
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M.W., M.S., A.Ü. and F.P. authors are contributed equally to this work.
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Snippet Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention ) for refugees at level 3...
BackgroundAgainst the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for...
Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees...
Abstract Background Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention...
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StartPage e64
SubjectTerms affective disorders
depression
Emotional regulation
Emotions
Empowerment
global mental health
Group therapy
Humans
Intervention
Linguistics
Mental depression
Mental disorders
Mental health
Mood Disorders
Persian language
Psychotherapy
Psychotherapy, Group
Quality of Life
Questionnaires
Refugees
Refugees - psychology
Resilience (Psychology)
Stress
Stress Disorders, Post-Traumatic - psychology
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Title Empowerment group therapy for refugees with affective disorders: results of a multicenter randomized controlled trial
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