Stress management versus cognitive restructuring in trauma-affected refugees — A follow-up study on a pragmatic randomised trial

Maria Barhoma*, Charlotte Sonne, Miriam J.J. Lommen, Erik Lykke Mortensen, Jessica Carlsson

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    Background: There is a lack of research and consensus with respect to long-term effective treatments for trauma-affected refugees. The purpose of this follow-up study of a randomised clinical trial was to investigate the effectiveness of Stress Management (SM) versus Cognitive Restructuring (CR) in treating trauma-affected refugees, six and 18 months post-treatment, respectively. Methods: From a total of 126 refugees with PTSD, the intention-to-treat sample in the original trial, 74 patients were present at the six-month follow-up (SM; n = 37, CR; n = 37) and 34 patients at the 18-month follow-up (SM; n = 14, CR; n = 20). During the trial, the patients had been offered a total of 16 psychotherapy sessions and 10 sessions with a medical doctor. Results: Mixed regression analyses at six and 18-month follow-up showed a non-significant small reduction in PTSD symptoms at both follow-up points with no significant between-group differences between the two psychotherapeutic interventions. Statistically significant between-group treatment effects were, however, observed with the patients receiving SM having significantly reduced symptoms of somatisation measured by the Symptom Checklist (β = 0.40), depression (β = 0.29) and anxiety (β = 0.37) (measured by the Hamilton Depression and Anxiety ratings) at 18 months post-treatment compared to the CR group. Limitations: Limitations to the present study include the dropout rate at follow-up(s). Conclusions: The findings suggest that the consolidation of coping strategies including relaxation, attention-diversion and behavioural activation in SM appears to be more beneficial than CR in reducing long-term somatisation, depression and anxiety symptoms for this population.

    Original languageEnglish
    Pages (from-to)628-637
    Number of pages10
    JournalJournal of Affective Disorders
    Volume294
    DOIs
    Publication statusPublished - 1-Nov-2021

    Keywords

    • Psychotherapy
    • PTSD
    • refugees
    • Stress Management
    • trauma

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