Phase-based treatment for PTSD in refugees and depression as predictor of treatment outcome: a preliminary evaluation
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Background: Refugees have an increased risk for developing PTSD with a comorbid major depression. According to the ISTSS Expert Consensus Treatment Guidelines for Complex PTSD, phase-based treatment can be applied to reduce posttraumatic stress disorder (PTSD) in populations with complex trauma. Nevertheless, little is known about phase-based PTSD treatment in refugees with PTSD and complex trauma, often with a comorbid depression. Aim: This study describes an evaluation of a phase-based treatment in refugees with complex trauma and PTSD. The second aim is to test if depression is a predictor of treatment outcome. Method: The Clinician Administered PTSD Scale (CAPS) was administered in a sample of 33 refugees with PTSD who participated in the phase-based treatment. From this sample, 25 refugees completed The Brief Symptom Inventory (BSI). The BSI was employed to assess depression. Treatment consisted of psycho-education, creative arts therapy, psychomotor therapy, Narrative Exposure Therapy (NET) and socio-therapy. Results: Analysis showed that PTSD symptoms were reduced after treatment. One-third of the participants demonstrated a reliable and clinically significant change. Depression was not significantly associated with treatment outcome and did not decrease after treatment. Demographic variables did not predict treatment outcome or depression scores. Conclusion: Because significant improvement was established, the phase-based treatment may be successfully applied to reduce PTSD symptoms in refugees with complex trauma and PTSD. A separate treatment for depression is suggested. Implications and recommendations for future research are discussed.