Feasibility and acceptability of Problem Management Plus with Emotional Processing (PM+EP) for refugee youth living in the Netherlands: study protocol
Open accessAbstract
Background: Refugee youth experience hardships associated with exposure to trauma in their homelands and during and after displacement, which results in higher rates of common mental disorders. The World Health Organization (WHO) developed Problem Management Plus (PM+), a non-specialist-delivered brief psychological intervention, for individuals who have faced adversity. PM+ comprises problem-solving, stress management, behavioural activation and strengthening social support. However, it does not include an emotional processing component, which is indicated in trauma-exposed populations.Objective: This pilot randomized controlled trial (RCT) aims to evaluate the feasibility and acceptability of PM+, adapted to Syrian, Eritrean and Iraqi refugee youth residing in the Netherlands, with and without a newly developed Emotional Processing (EP) Module.Methods: Refugee youth (N = 90) between 16 and 25 years of age will be randomized into PM+ with care-as-usual (CAU), (n = 30), PM+ with Emotional Processing (PM+EP) with CAU (n = 30) or CAU only (n = 30). Inclusion criteria are self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 > 16). Participants will be assessed at baseline, one-week post-intervention and three-month follow-up. The main outcome is the feasibility and acceptability of the adapted PM+ and PM+EP. The secondary outcomes are self-reported psychological distress, functional impairment, post-traumatic stress disorder (PTSD) symptom severity and diagnosis, social support, and self-identified problems. The pilot RCT will be succeeded by a process evaluation including trial participants, participants’ significant others, helpers, and mental health professionals (n = 20) to evaluate their experiences with the PM+ and PM+EP programmes.Results and Conclusion: This is the first study that evaluates the feasibility of PM+ for this age range with an emotional processing module integrated. The results may inform larger RCTs and implementation of PM+ interventions among refugee youth.Trial Registration: Registered to Dutch Trial Registry, NL8750, on 3 July 2020. Medical Ethical Committee of the Amsterdam University Medical Centre, location Vrije Universiteit Medical Centre, Protocol ID: 2020.224, 1 July 2020.
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A cut-off score of > 15.9 on the K10 indicates psychological distress.
“In line with previous research [48, 49] a cut-off score of > 15.9 is used, which indicates psychological distress [50].”
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Self-citation
- Authors
- Alozkan Sever, C., Cuijpers, P., Mittendorfer-Rutz, E., Bryant, R. A., Dawson, K. S., Holmes, E. A., Mooren, T., Norredam, M. L., & Sijbrandij, M.
- Affiliations
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health (NL)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- UNSW Sydney (AU)
- Uppsala University (SE)
- Utrecht University (NL)
- Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- ORCID
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2021-01
- Volume
- 12
- Issue
- 1
- Pages
- 1947003-1947003
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC8344241
- OpenAlex
- W3187364954
- Cited by
- 25
- References
- 35
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 9 · 2023: 9 · 2022: 2
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Vetenskapsrådet (2018-05783)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- Problem Management Plus, refugee youth, Syrian refugees, Eritrean refugees, Iraqi refugees, trauma exposure, post-traumatic stress disorder, psychological distress, functional disability, social support, behavioral activation, stress management, feasibility and acceptability, intervention adaptation
- MeSH terms
- Psychological Distress, Emotional Regulation, Adolescent, Adult, Crisis Intervention, Depression, Feasibility Studies, Female, Humans, Male, Netherlands, Pilot Projects, Surveys and Questionnaires, Refugees, Social Support, Stress Disorders, Post-Traumatic, Syria, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Eritrea, Young Adult
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