The effect of a low-level psychological intervention (PM+) on post-migration living difficulties - Results from two studies in Switzerland and in the Netherlands

Julia Spaaij; Anne M de Graaff; Aemal Akhtar; Nikolai Kiselev; David McDaid; Hanspeter Moergeli; Monique C Pfaltz; Matthis Schick; Ulrich Schnyder; Richard A Bryant; Pim Cuijpers; Marit Sijbrandij; Naser Morina; STRENGTHS consortium

doi:10.1016/j.comppsych.2023.152421

The effect of a low-level psychological intervention (PM+) on post-migration living difficulties - Results from two studies in Switzerland and in the Netherlands

Compr Psychiatry. 2023 Nov:127:152421. doi: 10.1016/j.comppsych.2023.152421. Epub 2023 Sep 9.

Affiliations

¹ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
² Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
³ School of Psychology, University of New South Wales, Sydney, Australia; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
⁴ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; PluSport, Umbrella Organization of Swiss Disabled Sports, Volketswil, Switzerland; Swiss Research Institute of Public Health and Addiction (ISGF), University of Zürich, Zurich, Switzerland.
⁵ Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.
⁶ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Mid Sweden University, Department of Psychology and Social Work, Östersund, Sweden.
⁷ University of Zurich, Zurich, Switzerland.
⁸ School of Psychology, University of New South Wales, Sydney, Australia.
⁹ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Electronic address: naser.morina@usz.ch.

PMID: 37708580
DOI: 10.1016/j.comppsych.2023.152421

Abstract

Aims of the study: After arriving in host countries, most refugees are confronted with numerous post-migration stressors (e.g., separation from family, discrimination, and employment difficulties). Post-migration living difficulties (PMLDs) significantly contribute to the development and persistence of mental disorders. Effective treatment approaches focusing on reducing post-migration stress are urgently needed. The aim of the present study was to examine the effect of a brief psychological intervention, Problem Management Plus (PM+), on PMLDs among Syrian refugees in two European countries.

Methods: We merged data from two single-blind feasibility trials with Syrian refugees experiencing elevated levels of psychological distress and impaired functioning in Switzerland (N = 59) and the Netherlands (N = 60). Participants were randomised to receive either five sessions of PM+ or an enhanced care-as-usual control condition. PMLDs were assessed at baseline and 3 months after the intervention. To estimate treatment effect on PMLD, linear mixed model analysis was performed.

Results: Three months after the intervention, participants in the PM+ condition reported significantly fewer PMLDs compared to the control condition. Further analyses at item-level showed that interpersonal and family related PMLDs, such as "worries about family back home" significantly improved over time in the PM+ condition.

Conclusions: This exploratory study suggests that brief psychological interventions have the potential to reduce PMLDs in refugees and asylum seekers. The reduction of post-migration stress in turn may subsequently lead to an overall reduction in psychological distress.

Clinical trial numbers: BASEC Nr. 2017-0117 (Swiss trial) and NL61361.029.17, 7 September 2017 (Dutch trial).

Keywords: Common mental disorders; Exile-related stressors; Post-migration living difficulties; Problem management plus; Psychosocial interventions; Refugees.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Mental Disorders* / therapy
Netherlands / epidemiology
Psychosocial Intervention
Refugees* / psychology
Single-Blind Method
Stress Disorders, Post-Traumatic* / psychology
Switzerland