Development of PTSD Symptoms of Unaccompanied Refugee Minors using a Culturally Adaptive Intervention

Abstract

Objective: Veerkracht II is a specially developed mental healthcare intervention designed to help unaccompanied refugee minors (URM) with traumatic experiences. This study aims to evaluate the potential effectiveness of a short-term treatment approach consisting of multiple trauma focused interventions. The main focus lies in the effectiveness on PTSD symptoms. The second aim of this study was to list factors that could explain the dropout rate among minors, as previous literature reported URMs experiencing major difficulties with mental healthcare. Method: The change in PTSD symptoms was analyzed using the pre and post-test scores of the CRIES-13. Since the research population was small, the Reliable Change Index (RCI) was used to test clinical and statistical significance for each individual. Potential dropout factors were obtained by reading the case reports, mainly focusing on the description of the main theme of the session and the general notes written at the end of each session. Results: The research population consisted of 44 participants (n=44). 15 participants had filled in the pre-test and posttest of the CRIES-13 and could therefore be included in the RCI (n=15). Nine respondents reported clinically significant improvement after the intervention (n=9). Two respondents reported statistical significant improvement (n=2). Four participants scored lower on the post-test, but the change in score was not significant (n=4). Nine respondents dropped out of therapy after 1-4 sessions (n=9). Lack of motivation and distrust towards others were the most recurring factors for dropping out of the intervention (n=6). Numerous URMs reported major difficulties with parts of the therapy, mainly EMDR (n=12). Two patients decided to stop with therapy as a result of EMDR (n=2) and four patients requested a different form of therapy (n=4). Conclusion: Veerkracht II has shown beneficial results and provides a good introduction into mental healthcare. All respondents attending at least two sessions reported to experience benefits from the intervention. Although reliable pre-and post-tests were limited, the general results were positive. The group of URMs that dropped out was small, potentially indicating that the intervention met the specific needs of this group. Although the outcome seems promising, there are reliability issues, due to a huge lack of data and inconsistent reporting by therapists.