Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series

Carlijn Maria Van Es; Merel E Velu; Marieke Sleijpen; Niels van der Aa; Paul A Boelen; Trudy Mooren

doi:10.3389/fpsyg.2023.1125740

Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series

Front Psychol. 2023 Jun 1:14:1125740. doi: 10.3389/fpsyg.2023.1125740. eCollection 2023.

Authors

Carlijn Maria Van Es^{1

2}, Merel E Velu^{1

2}, Marieke Sleijpen², Niels van der Aa², Paul A Boelen^{1

2}, Trudy Mooren^{1

2}

Affiliations

¹ Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.
² ARQ Centrum'45, ARQ National Psychotrauma Centre, Diemen, Netherlands.

Abstract

Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs.

Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children's Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview.

Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed.

Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs.Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.

Keywords: depression; mixed-methods; multiple baseline; posttraumatic stress disorder; trauma-focused treatment approach; unaccompanied refugee minors.