Prevention of revictimization after sexual exploitation: Results from a feasibility study of a behavioural training

Background: Victims of sexual exploitation often have experienced several forms of (childhood) sexual abuse prior to the exploitation. In the general population there is strong scientific evidence indicating that being a victim to sexual violence puts one atrisk for future sexual victimization. People who have been victimized by sexual exploitation are referred our mental healthcare outpatient clinic for traumafocussed therapy. Additionally, we developed a 10- session module addressing this cycle of sexual revictimization in an attempt to work towards prevention of future revictimization. Objective: Raising awareness on dynamics of sexual violence among victims of sexual exploitation. Tailoring treatment to the broader needs of traumatized victims of sexual exploitation. Method: A feasibility and acceptability study will be carried out in 2019 among 12 female victims of sexual exploitation. Outcome measures will be increased knowledge, self-efficacy, interpersonal functioning, emotion regulation, mood and posttraumatic stress symptoms. Additionally, interviews will be carried out among therapists and patients to evaluate the module. Results and Discussion: Preliminary findings on the feasibility study will be presented, as well as an overview of the content of the behavioural training and implications for clinical practice

Extending the focus beyond trauma in the treatment of victims of sexual exploitation

This symposium discusses psychological treatment approaches tailored to specific needs of migrated victims of sexual exploitation. Treatment for this group is mostly trauma-focused. However, mental health consequences of individual life histories, and psychological problems resulting from traumatic experiences other than PTSD, may require a treatment focus beyond trauma. Personalized treatments are tailored to variations in psychological profiles and take patient preferences into consideration. In this symposium we present: (a) cognitive behavioural therapy aiming at prevention of revictimization after sexual exploitation; (b) disgust and the implications for treatment; disgust is a strong emotional reaction to sexual violence frequently unresponsive to traumafocused treatment; (c) Psychomotor Therapy and Recovery of Intimacy – the importance of raising body awareness and to increase a positive experience of intimacy and sexuality; and (d) schematherapy for victims of childhood abuse, human trafficking and forced migration. A programme has been developed that consists of group schematherapy and psychomotor therapy

Building evidence-based treatments for refugee populations: Results and pitfalls from the field

Numbers of refugees are growing worldwide, many of whom suffer from mental health problems. The need for evidence-based treatment for this population is urgent. However classical designs and guidelines for building evidence-based treatment do not fit this population. Well-known challenges are cultural and language barriers and high drop-out rates due to uncertain living conditions. As a result treatment studies are scarce, and its participants do not necessarily represent the population as a whole (i.e. selection bias). Challenges in designing and carrying out refugee treatment studies are rarely represented in the scientific literature. In the current symposium, we will present findings from several European refugee treatment studies and discuss the many pitfalls and compromises it takes to carry out such studies. Considering these refugee treatment studies, put forward realistic recommendations for future studies. A general introduction beforehand and a discussion afterwards will be part of the symposium

Feasibility and predictors of change of narrative exposure therapy for displaced populations: a repeated measures design

Background: Displaced victims of interpersonal violence, such as refugees, asylum seekers, and victims of sexual exploitation, are growing in numbers and are often suffering from a post-traumatic stress disorder (PTSD). At the same time, these victims are known to benefit less from trauma-focused therapy (TFT) and to be less compliant to treatment. The objective of this paper is to describe the rationale and research protocol of an ongoing trial that aims to evaluate different variables that might influence the feasibility of TFT for the study population. Specifically, perceived daily stress, emotion regulation, and mood are investigated as predictors of change in PTSD symptoms during a trauma-focused therapy (narrative exposure therapy (NET)). The feasibility of administering measures tapping these constructs repeatedly during treatment will also be evaluated. Methods/design: Using an observational treatment design, 80 displaced victims of interpersonal violence will be measured before, during, and after partaking in NET. Several questionnaires tapping PTSD plus the aforementioned possible predictors of PTSD change will be administered: Post-traumatic Stress Disorder Checklist-5, Perceived Stress Scale, Difficulties in Emotion Regulation Scale-18 (pre-test, post-test, and follow-up),subscale impulsivity of the Difficulties in Emotion Regulation Scale-18, Perceived Stress Scale short version, Primary Care Post-traumatic Stress Disorder and a single Mood item (each session). Multilevel modelling will be used to examine the relation between the possible predictors and treatment outcome. Discussion: The present study is the first to examine the interplay of facilitating and interfering factors possibly impacting treatment feasibility and effectiveness in displaced victims of interpersonal violence with PTSD receiving NET, using repeated measures. The current study can help to improve future treatment based on individual characteristics. Trial registration: Netherlands Trial Register: NTR7353, retrospectively registered. Date of registration: July 11, 2018

Feasibility and predictors of change of narrative exposure therapy for displaced populations: a repeated measures design

Background: Displaced victims of interpersonal violence, such as refugees, asylum seekers, and victims of sexual exploitation, are growing in numbers and are often suffering from a post-traumatic stress disorder (PTSD). At the same time, these victims are known to benefit less from trauma-focused therapy (TFT) and to be less compliant to treatment. The objective of this paper is to describe the rationale and research protocol of an ongoing trial that aims to evaluate different variables that might influence the feasibility of TFT for the study population. Specifically, perceived daily stress, emotion regulation, and mood are investigated as predictors of change in PTSD symptoms during a trauma-focused therapy (narrative exposure therapy (NET)). The feasibility of administering measures tapping these constructs repeatedly during treatment will also be evaluated. Methods/design: Using an observational treatment design, 80 displaced victims of interpersonal violence will be measured before, during, and after partaking in NET. Several questionnaires tapping PTSD plus the aforementioned possible predictors of PTSD change will be administered: Post-traumatic Stress Disorder Checklist-5, Perceived Stress Scale, Difficulties in Emotion Regulation Scale-18 (pre-test, post-test, and follow-up),subscale impulsivity of the Difficulties in Emotion Regulation Scale-18, Perceived Stress Scale short version, Primary Care Post-traumatic Stress Disorder and a single Mood item (each session). Multilevel modelling will be used to examine the relation between the possible predictors and treatment outcome. Discussion: The present study is the first to examine the interplay of facilitating and interfering factors possibly impacting treatment feasibility and effectiveness in displaced victims of interpersonal violence with PTSD receiving NET, using repeated measures. The current study can help to improve future treatment based on individual characteristics. Trial registration: Netherlands Trial Register: NTR7353, retrospectively registered. Date of registration: July 11, 2018