Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study

Youstina Demetry; Elisabet Wasteson; Tomas Lindegaard; Amjad Abuleil; Anahita Geranmayeh; Gerhard Andersson; Shervin Shahnavaz

doi:10.2196/46253

Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study

JMIR Form Res. 2023 Nov 24:7:e46253. doi: 10.2196/46253.

Authors

Youstina Demetry¹, Elisabet Wasteson², Tomas Lindegaard³, Amjad Abuleil⁴, Anahita Geranmayeh¹, Gerhard Andersson^{1

3

5}, Shervin Shahnavaz¹

Affiliations

¹ Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
² Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden.
³ Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
⁴ Competence Team for migration health, Region Jämtland Härjedalen, Östersund, Sweden.
⁵ Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

PMID: 37999955
PMCID: PMC10709795
DOI: 10.2196/46253

Abstract

Background: Most forcibly displaced refugees in Sweden originate from the Arab Republic of Syria and Iraq. Approximately half of all refugees are aged between 15 and 26 years. This particular group of youths is at a higher risk for developing various mental disorders. However, low use of mental health services across Europe has been reported. Previous research indicates that culturally adapted psychological interventions may be suitable for refugee youths. However, little is known about the feasibility, acceptability, and efficacy of such psychological interventions.

Objective: This study aimed to explore the feasibility, acceptability, and preliminary efficacy of an individually tailored and culturally adapted internet-based cognitive behavioral therapy for Arabic-speaking refugees and immigrant youths in Sweden.

Methods: A total of 17 participants were included to participate in an open trial study of an individually tailored and culturally adapted internet-based cognitive behavioral therapy targeting common mental health problems. To assess the intervention outcome, the Hopkins Symptom Checklist was used. To explore the acceptability of the intervention, in-depth interviews were conducted with 12 participants using thematic analysis. Feasibility was assessed by measuring treatment adherence and by calculating recruitment and retention rates.

Results: The intervention had a high dropout rate and low feasibility. Quantitative analyses of the treatment efficacy were not possible because of the high dropout rate. The qualitative analysis resulted in 3 overarching categories: experiences with SahaUng (the treatment), attitudes toward psychological interventions, and personal factors important for adherence.

Conclusions: The findings from this study indicate that the feasibility and acceptability of the current intervention were low and, based on the qualitative analysis, could be increased by a refinement of recruitment strategies, further simplification of the treatment content, and modifications to the cultural adaptation.

Keywords: Arabic; Arabic-speaking youth; anxiety; cultural adaptation; depression; internet-based interventions; mental disorder; mental health; psychological intervention; refugees; youth.

©Youstina Demetry, Elisabet Wasteson, Tomas Lindegaard, Amjad Abuleil, Anahita Geranmayeh, Gerhard Andersson, Shervin Shahnavaz. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.11.2023.