Psychotherapy for traumatised refugees –
a randomised clinical trial
Jessica Carlsson, M.D., PhD
Charlotte Sonne, M.D.,PhD-student
Competence Center for Transcultural Psychiatry (CTP),
Psychiatric Center Ballerup
Objectives
Take home message
•To study the effect of Cognitive Behavioural
Therapy (CBT) with a focus on either Stress
Management or Cognitive Restructuring in a
clinical sample of traumatised refugees with
PTSD
•The present study will help to provide
knowledge regarding the effect of CBT in severly
traumatised refugees
•The study will compare the effect of CBT with a
focus on either thoughts (Restructuring) or
Stress Manangement
•To identify predictors for the treatment effect
•143 patients have been included and results will
be published ultimo 2013
Background
There is a lack of evidence
regarding which kind of
psychotherapy that is the
most effective when
treating traumatised
refugees. Studies on the
effect of psychotherapy
among other patient groups
with PTSD suggest a good
effect using CBT 1,2.
Pre-treatment
examination (project
information and inclusion)
Weekly consultations with
medical doctor:
manualised psychoeducation and when
needed pharmacological
treatment
Weekly consultations with
medical doctor:
manualised psychoeducation and when
needed pharmacological
treatment
At pre-treatment
examination:
Outcome measures
1st self-rating
1st HAM D + A
observer ratings
Primary outcome:
Harvard Trauma
Questionnaire (HTQ): PTSD
Week 1-6
of treatment
After 6 weeks of
treatment:
Secondary outcomes:
Hopkins Symptom Checklist25 (HSCL-25):
anxiety and depression
Sheehan Disability Scale
(SDS): functioning,
WHO-5: quality of life
VAS: pain
2nd self-rating
The Competence Center for
Transcultural Psychiatry
(CTP) has specialised in
the treatment of
traumatised refugees.
The clinical experience at
CTP suggests that
Cognitive Restructuring is
not always a useful tool
and that stress reducing
techniques could be more
useful. This hypothesis is
tested in the present study.
Weekly psychotherapy
sessions with psychologist
CBT: Stress Management
Monthly consultations with
medical doctor
Weekly psychotherapy
sessions with psychologist
CBT: Cognitive
Restructuring
Week 6-24
of treatment
Monthly consultations with
medical doctor
At end of
treatment:
After 6-7 months of treatment: End
of treatment and evaluation
Methods
All patients referred to CTP from June 2011 –
March 2012 and fulfilling the inclusion criteria
were offered to participate in the study.
Hamilton Depression and
Anxiety Rating Scales (HAM
D+A ):
anxiety and depression
3rd self-rating
2nd HAM D + A
observer ratings
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Author for correspondence:
Jessica Carlsson, M.D., PhD,
Competence Center for Transcultural Psychiatry
Psychiatric Center Ballerup
The Mental Health Services of the Capital Region of Denmark
E-mail: [email protected]
Participants were offered combined treatment
with a psychiatrist (psycho-education and
psychopharmacological treatment when needed)
and a psychologist (CBT). The duration of the
treatment was 6-7 months.
The participants were randomised to either:
CBT with a focus on Stress Management
or
CBT with focus on Cognitive Restructuring
Referencer
1) Bisson J., Andrews M., Psychological treatment of post-traumatic stress
disorder (PTSD). The Cochrane Library, 2009.
2) Crumlish N., O’Rourke K., A systematic Review of Treatments for PostTraumatic Stress Disorder among Refugees and Asylum seekers, J Nerv
Ment Dis 2010;198:237-51.
This study has been supported by