Twelve-month follow-up of a randomised clinical trial of a brief group psychological intervention for common mental disorders in Syrian refugees in Jordan
Open accessAbstract
Aims: There is increasing evidence that brief psychological interventions delivered by lay providers can reduce common mental disorders in the short-term. This study evaluates the longer-term impact of a brief, lay provider delivered group psychological intervention (Group Problem Management Plus; gPM+) on the mental health of refugees and their children's mental health. Methods: This single-blind, parallel, controlled trial randomised 410 adult Syrians in Azraq Refugee Camp in Jordan who screened positive for distress and impaired functioning to either five sessions of gPM+ or enhanced usual care (EUC). Primary outcomes were scores on the Hopkins Symptom Checklist-25 (HSCL-25; depression and anxiety scales) assessed at baseline, 6 weeks, 3 months and 12 months Secondary outcomes included disability, posttraumatic stress, personally identified problems, prolonged grief, prodromal psychotic symptoms, parenting behaviour and children's mental health. Results: Between 15 October 2019 and 2 March 2020, 204 participants were assigned to gPM + and 206 to EUC, and 307 (74.9%) were retained at 12 months. Intent-to-treat analyses indicated that although participants in gPM + had greater reductions in depression at 3 months, at 12 months there were no significant differences between treatment arms on depression (mean difference −0.9, 95% CI −3.2 to 1.3;p= 0.39) or anxiety (mean difference −1.7, 95% CI −4.8 to −1.3;p= 0.06). There were no significant differences between conditions for secondary outcomes except that participants in gPM + had greater increases in positive parenting. Conclusions: The short-term benefits of a brief, psychological programme delivered by lay providers may not be sustained over longer time periods, and there is a need for sustainable programmes that can prolong benefits gained through gPM + .
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The evidence for beneficial effects of CBT has been found to be questionable.
“Although the evidence for beneficial effects of CBT have been found to be questionable (Bryant et al. 2022;Bangpan et al. 2019), its popularity is not surprising, as CBT offers important advantages in severely resource-poor contexts like that of Palabek.”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Bryant et al. 2022
The Discussion reports that the brief group Problem Management Plus intervention showed no benefit on primary outcomes at 12 months, despite earlier reductions in depression. This raises questions about the durability of that intervention’s benefits, but the paper does not establish that evidence for beneficial effects of CBT generally is questionable. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEven when short-term benefits on participants' mental health can be demonstrated, these results disappear when measured one year after the delivery of the interventions.
“Even when benefits on participants' mental health can be demonstrated in the short-term, these results disappear when measured one year after the delivery of the interventions (see e.g., Bryant et al. 2022)”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Bryant et al. 2022
Assumptions that community psychosocial interventions lead to long-term mental health benefits are increasingly being challenged.
“Assumptions that community psychosocial interventions lead to long-term mental health benefits are increasingly being challenged (e.g., Bryant et al. 2022)”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Bryant et al. 2022
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Schäfer, S. K., Thomas, L. M., Lindner, S., & Lieb, K. (2023) · World Psychiatry · doi:10.1002/wps.21129 · Cited by 115 · see citing works
Torre, C. (2023) · London School of Economics and Political Science (LSE) · doi:10.21953/lse.00004557
- Authors
- Bryant, R. A., Bawaneh, A., Awwad, M., Al-Hayek, H., Giardinelli, L., Whitney, C., Jordans, M. J. D., Cuijpers, P., Sijbrandij, M., Ventevogel, P., Dawson, K., & Akhtar, A.
- Affiliations
- UNSW Sydney (AU)
- International Medical Corps (US)
- War Child (NL)
- Vrije Universiteit Amsterdam (NL)
- Office of the United Nations High Commissioner for Refugees (CH)
- Corresponding author
- Bryant, Richard A.
- ORCID
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022
- Volume
- 31
- Pages
- e81-e81
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC9677446
- OpenAlex
- W4309166333
- Cited by
- 37
- References
- 19
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 11 · 2023: 7
- FWCI
- 7.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- This project was supported by the National Health and Medical Research Council-European Union Collaborating Grant (1142605)
- European Union Horizon 2020 Research and Innovation intervention Societal Challenges Grant (733337)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- brief psychological intervention, lay providers, Syrian refugees, refugee mental health, depression, anxiety, post-traumatic stress, prolonged grief disorder, parenting behaviour, child mental health, treatment retention, long-term treatment outcomes
- MeSH terms
- Psychosocial Intervention, Adult, Mental Disorders, Child, Follow-Up Studies, Humans, Jordan, Psychotherapy, Refugees, Syria, Single-Blind Method
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