The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: study protocol for a multi-center randomized controlled trial (YOURTREAT).

Wilker S, Catani C, Wittmann J, et al. The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: study protocol for a multi-center randomized controlled trial (YOURTREAT). Trials. 2020;21(1): 185.BACKGROUND: Germany hosts a large number of refugees from war-affected countries. The integration of refugees, in particular young refugees from the Middle East, is one of the major current social challenges in Germany. Mental disorders, first of all post-traumatic stress disorder (PTSD) that results from war experiences, are common among young refugees and interfere with quality of life as well as functional integration. Evidence regarding effective treatment options for this population is scarce. In this trial, we aim to evaluate the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) for the treatment of young refugees in Germany.; METHODS: In a rater-blinded, multi-center, randomized-controlled trial, KIDNET is compared to treatment as usual (TAU) within the general health care system. A total number of 80 young refugees who fulfill the diagnostic criteria of PTSD will be randomized to either KIDNET or TAU. Diagnostic interviews will take place at baseline before treatment as well as 6 and 12months thereafter. They will assess exposure to traumatic events, PTSD and comorbid symptoms, as well as parameters of integration.; DISCUSSION: The results of this study should provide evidence regarding effective treatment options for young refugees in Germany, a population that has been understudied and received only limited access to mental health care so far. Next to the effects of treatment on mental health outcomes, integration parameters will be investigated. Therefore, this study should provide broad insights into treatment options for young refugees and their potential implications on successful integration.; TRIAL REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS), ID: DRKS00017222. Registered on 15 May 2019

School-based mental health screenings with Ukrainian adolescent refugees in Germany: Results from a pilot study

Catani C, Wittmann J, Schmidt TL, Wilker S, Neldner S, Neuner F. School-based mental health screenings with Ukrainian adolescent refugees in Germany: Results from a pilot study. Frontiers in Psychology. 2023;14.Since the Russian invasion of Ukraine in February 2022, high numbers of Ukrainians, mostly women and children, have left the country. As of today, Germany has accepted more than one million refugees fleeing from Ukraine including ~200,000 children and adolescents registered in German schools. Since refugee minors are typically affected by high rates of mental health issues, the identification of potential psychological problems at an early stage after arrival is essential in order to make timely referrals for vulnerable youth to diagnostic or treatment services possible. The aim of the present study was to test the feasibility of a classroom-based mental health screening procedure and to assess symptoms of PTSD, depression, and anxiety in a small sample of adolescents who had fled to Germany. Forty-two adolescents (n = 20 girls) took part in the study. Screening results showed that more than half of the sample had elevated ratings in the Refugee Health Screener (RHS) and about 45% reported clinically significant levels of PTSD. Overall, the amount of both mental health problems and current worries related to the war was significantly higher in girls compared to boys. In general, screenings were well received by the adolescents. The findings of this pilot study point to a considerable level of mental health problems and distress in adolescent refugees affected by the recent war in Ukraine. Brief psychological screenings within the school setting might represent a promising approach to identifying potential mental health disorders as early as possible in newly arriving refugee youth

The Bielefeld Screening Approach - A screen-and-treat approach for newly arrived refugees conducted by trained multilingual lay staff

Schmidt TL, Catani C, Dumke L, et al. The Bielefeld Screening Approach - A screen-and-treat approach for newly arrived refugees conducted by trained multilingual lay staff. In: Abstract book: The 17th biennial conference of the European Society for Traumatic Stress Studies. Trauma and resilience through the ages: A life course perspective. European Journal of Psychotraumatology . Vol 14. Abingdon: Taylor & Francis ; 2023.Background:Adequate health care provision for newly arrived refugees remains a challengeeven in countries with a highly developed health care system such as Germany and many otherEuropean countries. Care structures building on the principles of task-shifting and screen-and-treat may represent a cost-effective way to bridge the existing treatment gap.Objective:A manualized training program for so-called Intercultural Therapy Assistants (ITAs)will be presented. ITAs are intercultural mediators who are trained to conduct screenings andtake over other delegable tasks under the supervision of health care professionals.Furthermore, results of a feasibility study on a systematic screening approach conducted byITAs at a refugee reception camp in Bielefeld, Germany, will be presented.Method:ITAs were trained by the training manual. 167 newly arrived refugees underwent ascreening interview with the Refugee Health Screener (RHS). Afterwards, post-traumaticstress disorder (PTSD) and depression were assessed in a subsample of 48 persons by meansof structured validation interviews conducted by psychologists.Results:Findings demonstrated that it was feasible to conduct a systematic screeningprocedure during the initial immigration phase. However, adjustments of the screeningprocedure were necessary in order to meet the needs of a significant number of refugees insevere psychological crises and established cut-offvalues of the RHS had to be adapted.Conclusions:The Bielefeld Screening Approach conducted by ITAs may facilitate the earlysystematic identification of persons in need of mental health care and, thus, enable targetedinterventions that can help to prevent chronification of symptoms and consequentialproblems

The Efficacy of Narrative Exposure Therapy for Children (KIDNET) as a Treatment for Traumatized Young Refugees: A Multi-Center Randomized Controlled Trial (YOURTREAT)

Wilker S, Catani C, Preuße M, et al. The Efficacy of Narrative Exposure Therapy for Children (KIDNET) as a Treatment for Traumatized Young Refugees: A Multi-Center Randomized Controlled Trial (YOURTREAT). In: EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY. Vol 10. Abingdon: Taylor & Francis Ltd; 2019

The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: update to the study protocol for the multi-center randomized controlled trial YOURTREAT

Wittmann J, Groß M, Catani C, et al. The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: update to the study protocol for the multi-center randomized controlled trial YOURTREAT. Trials. 2022;23(1): 360.BACKGROUND: The trial YOURTREAT aims to compare the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) with treatment as usual (TAU) for the treatment of young refugees in Germany. This update outlines changes made to the study protocol in response to the current COVID-19 pandemic with the aim of allowing the continuation of the clinical trial while ensuring the safety of the staff and the participants, maintaining methodological quality, and ensuring compliance with legal regulations.; METHODS: The major amendments to the original study protocol include (1) the possibility of using telehealth technology for the conduction of diagnostic and therapy sessions, (2) a reduction of the diagnostic set, and (3) an increased flexibility in the time frame of the study protocol.; DISCUSSION: The adaptations to the study protocol made it feasible to continue with the trial YOURTREAT during the COVID-19 pandemic. Although the diagnostic set had to be shortened, the primary outcomes and the main secondary outcomes remain unimpaired by the amendment. Therefore, we expect the trial to provide evidence regarding effective treatment options for young refugees in Germany, a population that has received little scientific attention so far and has only very limited access to mental health care in the German health care system. In light of the current pandemic, which globally increases the risk of mental problems, the situation for young refugees is likely to aggravate further. Thus, the clinical and social relevance of the present trial YOURTREAT is even more important in these particular times.; TRIAL REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) DRKS00017222 . Registered on May 15, 2019. © 2022. The Author(s)

Welcome, how are you doing? – towards a systematic mental health screening and crisis management for newly arriving refugees

Background: Compared to the general German population, refugees in Germany are a high-risk group for trauma spectrum disorders. Currently, many barriers exist for the implementation of a screen-and-treat approach for mental disorders as part of the routine health care provision during the early stage of the immigration process. Objective: The aim of the present study was to develop and test a systematic screening approach to identify individual refugees in need of mental health care during the initial immigration phase. Method: 167 newly arrived refugees underwent a screening interview with the Refugee Health Screener (RHS) carried out by Intercultural Therapy Assistants (ITAs). The ITAs were super­vised by psychologists at a reception centre in Bielefeld, Germany. A subsample of 48 persons partici­pated in clinical validation interviews. Results: Findings demonstrated the need for and feasibility of a systematic screening during the initial immigration phase. However, established cut-off values of the RHS had to be adapted and the screening procedure had to be adjusted due to the needs of a significant number of refugees in severe psychological crises. Conclusion: A systematic screening that is applied shortly after arrival facilitates the early identification of refugees at risk of developing mental disorders and may be helpful to prevent chronic symptom development and an aggravation of psychological crises