Promoting Asylum-seeking and Refugee Children's Coping With Trauma

Not Applicable

Completed

• Conditions: Mental Health Disorder; Social Anxiety; Post-Traumatic Stress Disorder in Adolescence; Depression
• Interventions: Behavioral: Teaching Recovery Techniques, TRT

• Registration Number: NCT03822598
• Lead Sponsor: Norwegian Institute of Public Health

Brief Summary

A short term trauma-focused cognitive- behavioral program to reduce trauma-related mental health problems among asylum-seeking and refugee children.

The main hypothesis of the study is that the TRT program significantly improves mental health (i.e. reduces symptoms of post-traumatic symptoms, depression and generalized anxiety and increases perceived quality of life (Qol) in the intervention group compared to the waiting-list control group.

Detailed Description

Teaching Recovery Techniques (TRT) was developed by Children and War Foundation (www.childrenandwarfoundation.org ) as a tool to support children in coping with their mental reactions to being exposed to war and catastrophes. TRT has proven to be effective in reducing trauma-related mental health symptoms in such contexts. However, it has never been used with children experiencing all the uncertainties and stress of an asylum-seeking context, or with refugee children in high-income countries. The main aim of the present study is therefore to implement and evaluate the TRT among asylum-seeking and refugee children in the context of four different care conditions: 1)asylum-seeking children who arrived accompanied by a legal care-taker 2) asylum-seeking children less than 15 years in care centers administered by the Child Welfare Services 3) asylum-seeking children 15 years and older living in asylum centers regulated by the Directorate of Immigration 4) Former unaccompanied asylum-seeking children who have been granted residence (refugees) and are resettled in a municipality in Norway.

Based on Power analyses, the target group is 40 children in each care condition (total n = 160) \> 9 years speaking Arabic, Tigrinya, Somali, Dari, or Pashto.

The study employs a randomized clustered experimental design that includes a waiting list control group, which will receive the TRT when the intervention group has completed the program.

Study Timeline

• Study Start: 2017-06-20
• Primary Completion: 2018-05-31
• Study Completion: 2018-06-30
• Status Verified: 2019-01
• Study First Submitted: 2019-01-21
• Study First Submitted QC: 2019-01-28
• Last Update Submitted: 2019-01-28
• Study First Posted: 2019-01-30
• Last Update Posted: 2019-01-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 170

Inclusion Criteria

• Accompanied asylum-seeking children living in reception centers,
• Unaccompanied asylum-seeking children living in reception centers
• Unaccompanied refugee minors who have been granted residence

Children in the target Groups reported symptoms of post-traumatic stress above clinical cut-off on Children's Revised Impact of Event Scale, 8 items

Exclusion Criteria

• Psychosis,
• Mental disabilities

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Wait-list control group	Teaching Recovery Techniques, TRT	Delayed implementation of Teaching Recovery Techniques (after the experimental group has completed the program)
Intervention group	Teaching Recovery Techniques, TRT	Teaching Recovery Techniques implemented 1- 3 weeks after recruitment

Primary Outcome Measures

Name	Time	Method
Children's Revised Impact of Event Scale (CRIES-13)	Change in CRIES-13 scores from baseline (T1) to two weeks (T2) and two months after intervention is completed.	Self-reported symptoms of intrusion, hyperarousal and avoidance. ' The participants check how often during the last week they had each symptom from "never" (0); "rarely" (1) "sometimes" (3) and "frequently" (5)

Secondary Outcome Measures

Name	Time	Method
Screen for Child Anxiety Related Disorders (SCARED). 9 items tapping symptoms of generalized anxiety disorder, and 7 items tapping symptoms of social anxiety	Change in SCARED-scores from baseline (T1) to two weeks (T2) and two months after intervention is completed.	Measures if children have perceived each anxiety symptom over the last three months from "not true, or hardly ever true" (0), "somewhat true or sometimes true" (1) "very true or often true" (2)
Cantril Ladder	Change in scores from baseline (T1) to two weeks (T2) and two months after intervention is completed.	Measures current subjective well-being on a ladder With 11 steps from "worst possible life" (0) to "best possible life" (10)
Montgomery-Aasberg Depression Scale, MADRS	Change in MADRS-scores from baseline (T1) to two weeks (T2) and two months after intervention is completed.	9 items assessing patients' mood, feelings of unease, sleep, appetite, ability to concentrate, initiative, emotional involvement, pessimism and zest for life over the last three days. Each item is scored between 0 (not a problem for me) and 3 (affects me very much), with three intermediate levels (0.5, 1.5, 2.5).

Trial Locations

Locations (15)

Trondheim municipality; 🇳🇴 Trondheim, Norway

Drammen Municipality; 🇳🇴 Drammen, Norway

Fredrikstad municipality; 🇳🇴 Fredrikstad, Norway

Bergen Municipality; 🇳🇴 Bergen, Norway

Stavanger municipality; 🇳🇴 Stavanger, Norway

Vadsø municipality; 🇳🇴 Vadsø, Norway

Nordre Land municipality; 🇳🇴 Dokka, Norway

Engerdal Municipality; 🇳🇴 Drevsjø, Norway

Gjøvik municipality; 🇳🇴 Gjøvik, Norway

Ringerike Municipality; 🇳🇴 Hønefoss, Norway

Grue municipality; 🇳🇴 Kirkenær, Norway

Levanger municipality; 🇳🇴 Leira, Norway

Lyngdal municipality; 🇳🇴 Lyng, Norway

Bærum municipality; 🇳🇴 Rud, Norway

Salten municipality; 🇳🇴 Sjøvegan, Norway