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10 - Specific interventions

Published online by Cambridge University Press:  26 August 2022

By
Piyal Sen ,
Grace Crowley ,
Chris Maloney  and
Alison Summers
Edited by
Chris Maloney ,
Julia Nelki  and
Alison Summers
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Summary

People seeking asylum have particular needs that affect what kind of interventions will help, and how they should be offered.

The chapter first considers unmet physical health needs and the interconnectedness of physical and mental health.The role of medication for mental health difficulties is then reviewed, with detailed attention to the choice of medication, and to the practical and psychological context of prescribing.

The authorsconsider when formal psychological therapy may be helpful, looking at the factors common to all therapies, and at the specific options available. NET, EMDR, trauma focussed CBT and expressive, creative and body-based therapies are reviewed, together with a discussion of other forms of therapy.

Interventions for post-migration difficulties may be both the most acceptable and the most effective. The range of these interventions is considered, including the provision of medical evidence in an asylum claim. Risk management is reviewed, with attention to safety planning, minimising the harms of immigration detention, managing the threat of removal, and preventing destitution.

Keywords

Unmet physical health needsIntegrated (holistic) careMedicationNarrative Exposure Therapy (NET)EMDRTrauma-focused CBTExpressive and creative therapiesBody-focussed therapiesPost-migration difficultiesRisk management
Type
Chapter
Information
Seeking Asylum and Mental Health
A Practical Guide for Professionals
 , pp. 184 - 206
Publisher: Cambridge University Press
Print publication year: 2022

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References

Bisson, J., Baker, A., Dekker, W., and Hoskins, M. (2020). Evidence-based prescribing for post-traumatic stress disorder. The British Journal of Psychiatry, 216(3): 125–6. https://doi.org/10.1192/bjp.2020.40.CrossRefGoogle ScholarPubMed
Bisson, J. I., Berliner, L., Cloitre, M., et al. (2019). The International Society for Traumatic Stress Studies new guidelines for the prevention and treatment of PTSD: Methodology and development process. J Trauma Stress, 32: 475–83.CrossRefGoogle ScholarPubMed
Bhugra, D., Gupta, S., Bhui, K., et al. (2011). WPA guidance on mental health and mental health care in migrants. World Psychiatry, 10: 2–10.Google Scholar
Bhugra, D., Gupta, S., Schouler-Ocak, M., et al. (2014). EPA guidance mental health care of migrants. Eur Psychiatry, 29(2): 107–15.CrossRefGoogle ScholarPubMed
Bhui, K., Warfa, N., Edonya, P., McKenzie, K., and Bhugra, D. (2007). Cultural competence in mental health care: A review of model evaluations. BMC Health Services Research, 7: 15.Google Scholar
Boyles, J., Ewart-Biggs, R., Horn, R., and Lamb, K. (Eds) (2022). Group Work with Refugees and Survivors of Human Rights Abuses. London: Routledge.Google Scholar
Britnell, S. R., Jackson, A. D., Brown, J. N., and Capehart, B. P. (2017). Aripiprazole for post-traumatic stress disorder: A systematic review. Clin Neuropharmacol., 40(6): 273–98. https://doi.org/10.1097/WNF.0000000000000251.CrossRefGoogle ScholarPubMed
Clini, C., Thomson, L., and Chatterjee, H. J. (2019). Assessing the impact of artistic and cultural activities on the health and well-being of forcibly displaced people using participatory action research. BMJ Open, 9(2): e025465. https://doi.org/10.1136/bmjopen-2018-025465CrossRefGoogle ScholarPubMed
Davidson, J. (2015). Vintage treatments for PTSD: A reconsideration of tricyclic drugs. J Psychopharmacol., 29(3):264–9.CrossRefGoogle ScholarPubMed
De Graaff, A. M., Cuijpers, P., McDaid, D., et al. (2020). Peer-provided Problem Management Plus (PM+) for adult Syrian refugees: A pilot randomised controlled trial on effectiveness and cost-effectiveness. Epidemiology and Psychiatric Sciences, 29(e162): 1–24.CrossRefGoogle Scholar
Dieterich-Hartwell, R., and Koch, S. C. (2017). Creative Arts Therapies as Temporary Home for Refugees: Insights from Literature and Practice. Behavioral Sciences, 7(4): 69. https://doi.org/10.3390/bs7040069CrossRefGoogle ScholarPubMed
Ehlers, A. and Clark, D. M. (2000). A cognitive model of persistent PTSD. Behaviour Research and Therapy, 38: 19–45.Google Scholar
Goodkind, J. R., Hess, J. M., Isakson, B. et al. (2014). Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults. Psychological Services, 11(3): 333–46.CrossRefGoogle ScholarPubMed
Goodkind, J. R., Bybee, D., Hess, J. M., et al. (2020). Randomized controlled trial of a multilevel intervention to address social determinants of refugee mental health. American Journal of Community Psychology, 65(3–4): 272–89. https://doi.org/10.1002/ajcp.12418.CrossRefGoogle ScholarPubMed
Gray, A. E. L. (2011). Expressive arts therapies: Working with survivors of torture. Torture, 21(1): 2–47.Google ScholarPubMed
Griner, D., and Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy (Chic), 43: 531–48.CrossRefGoogle ScholarPubMed
Hijazi, A. M. (2016). Narrative Exposure Therapy to treat traumatic stress in Middle Eastern refugees: A clinical trial. Dissertation Abstracts International: Section B: The Sciences and Engineering, 74(2-B)(E).Google Scholar
Kaltenbach, E., McGrath, P. J., Schauer, M., et al. (2021). Practical guidelines for online Narrative Exposure Therapy (e-NET) – a short-term treatment for posttraumatic stress disorder adapted for remote delivery. European Journal of Psychotraumatology, 12: 1. https://doi.org/10.1080/20008198.2021.1881728.CrossRefGoogle ScholarPubMed
Kaplin, D., Parente, K., and Santacroce, F. A. (2019). A review of the use of trauma systems therapy to treat refugee children, adolescents, and families. Journal of Infant, Child & Adolescent Psychotherapy, 18(4): 417–31.CrossRefGoogle Scholar
Kashyap, S., Page, A. C., and Joscelyne, A. (2019). Post-migration treatment targets associated with reductions in depression and PTSD among survivors of torture seeking asylum in the USA. Psychiatry Research, 271: 565–72.Google Scholar
Kinzie, J. D. (2020). Psychobiology and psychopharmacology. In Evaluation and Treatment of Refugees, Kinzie, J. D. and Keepers, G. A. (Eds). Washington, DC: American Psychiatric Association Publishing.Google Scholar
Koch, T., Ehring, T., and Liedl, A. (2020). Effectiveness of a transdiagnostic group intervention to enhance emotion regulation in young Afghan refugees: A pilot randomized controlled study. Behaviour Research and Therapy, 132. https://doi.org/10.1016/j.brat.2020.103689.CrossRefGoogle ScholarPubMed
Levine, P. A. (2012). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. New York: Random House Publisher Services.Google Scholar
Liedl, A., Müller, J., Morina, N., et al. (2011). Physical activity within a CBT intervention improves coping with pain in traumatized refugees: Results of a randomized controlled design. Pain Medicine, 12(2): 234–45.CrossRefGoogle ScholarPubMed
Mitschke, D. B., Praetorius, R. T., Kelly, D. R., Small, E., and Kim, Y. K. (2017). Listening to refugees: How traditional mental health interventions may miss the mark. International Social Work, 60(3): 588–600.Google Scholar
Nagoshi, J., Nagoshi, C., Small, E. et al. (2018); Families preparing a new generation: Adaptation of an adolescent substance use intervention for Burmese refugee families. Journal of the Society for Social Work and Research, 9(4): 615–35.Google Scholar
National Institute for Health and Care Excellence. Post-Traumatic Stress Disorder (NICE Guideline NG 116). NICE, 2018. www.nice.org.uk/guidance/ng116.Google Scholar
Neuner, F., Elbert, T., and Schauer, M. (2018). Narrative exposure therapy (NET) as a treatment for traumatized refugees and post-conflict populations. In Morina, N and Nickerson, A (Eds.), Mental Health of Refugee and Conflict-Affected Populations: Theory, Research and Clinical Practice (pp. 183–99). Cham: Springer Nature Switzerland.Google Scholar
Neuner, F., Onyut, P. L., Ertl, V., et al. (2008). Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 76(4): 686–94.Google Scholar
Nosè, M., Ballette, F., Bighelli, I., et al. (2017). Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis. PLoS One, 2(2): e0171030. https://doi.org/10.1371/journal.pone.0171030.Google Scholar
Otto, M. W., Hinton, D., Korbly, N. B., et al. (2003). Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: A pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone. Behav Res Ther., 41(11): 1271–6.Google Scholar
Pain, C., Kanagaratnam, P., and Payne, D. (2014). The debate about trauma and psychosocial treatment for refugees. In Refuge and resilience: Promoting resilience and mental health among resettled refugees and forced migrants. Simich, L. and Andermann, L. (Eds.), pp. 51–60. Cham: Springer Science + Business Media.Google Scholar
Paloma, V., Morena, I. , and López-Torres, C. (2019). Promoting posttraumatic growth among the refugee population in Spain: A community-based pilot intervention. Health & Social Care in the Community, 28(1): 127–36. https://doi.org/10.1111/hsc.12847.Google Scholar
Rothschild, B. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. New York: W.W. Norton.Google Scholar
Schaeffer, A. J. and Cornelius-White, J. H. D. (2021). Qualitative studies on body-based interventions for refugees: a meta-synthesis. Body, Movement and Dance in Psychotherapy, 16(4): 267–85. https://doi.org/10.1080/17432979.2021.1893810.Google Scholar
Schauer, M., Neuner, F., and Elbert, T. (2011). Narrative Exposure Therapy: A Short-term Treatment for Traumatic Stress Disorders (2nd rev. and expanded ed.). Cambridge, MA: Hogrefe Publishing.Google Scholar
Schick, M., Morina, N., Mistridis, P., et al. (2018). Changes in post-migration living difficulties predict treatment outcome in traumatized refugees. Frontiers in Psychiatry, 9: 476. https://doi.org/10.3389/fpsyt.2018.00476.Google Scholar
Schouler-Ocak, M., Graef-Calliess, I., Tarricone, I., et al. (2015). EPA guidance on cultural competence training. European Psychiatry, 30(3): 431–40.CrossRefGoogle ScholarPubMed
Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2: 199–223. https://doi.org/10.1002/jts.2490020207.CrossRefGoogle Scholar
Smajkić, A., Weine, S., and Durić-Bijedić, Z., et al. (2001). Sertraline, paroxetine and venlafaxine in refugee post traumatic stress disorder with depression symptoms. Medicinski Arhiv., 55(1 Suppl 1): 35–8.Google Scholar
Stahl, S. M. (2017). Essential Psychopharmacology: Prescriber’s Guide, 6th ed. Cambridge: Cambridge University Press.Google Scholar
Steinert, C., Kruse, J., Leichsenring, F., Mattheß, H., and Wöller, W. (2019). Psychodynamically informed treatment for trauma in the context of refugee crises and political violence. In Contemporary psychodynamic psychotherapy: Evolving clinical practice. Kealy, D. and Ogrodniczuk, J. S. (Eds.) London: Elsevier Academic Press, pp. 319–34.Google Scholar
Summerfield, D. (2001). Asylum-seekers, refugees and mental health services in the UK. Psychiatric Bulletin, 25: 161–3.Google Scholar
Thompson, C. T., Vidgen, A., and Roberts, N. P. (2018). Psychological interventions for post-traumatic stress disorder in refugees and asylum seekers: A systematic review and meta-analysis. Clinical Psychology Review, 63: 66–79. https://doi.org/10.1016/j.cpr.2018.06.006.Google Scholar
Turrini, G., Tedeschi, F., Cuijpers, P., et al. (2021). A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD. BMJ Global Health, 6: e005029.Google Scholar
van de Kamp, M. M., Scheffers, M., Hatzmann, J., Emck, C., Cuijpers, P., and Beek, P. J. (2019). Body- and Movement-Oriented Interventions for Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis. Journal of Traumatic Stress, 32(6): 967–76. https://doi.org/10.1002/jts.22465CrossRefGoogle ScholarPubMed
Van der Gucht, K., Glas, J., De Haene, L., Kuppens, P., and Raes, F. (2019). A mindfulness-based intervention for unaccompanied refugee minors: A pilot study with mixed methods evaluation. Journal of Child and Family Studies, 28(4): 1084–93.Google Scholar
van der Kolk, B. A. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.Google Scholar
van Heemstra, H. E., Scholte, W. F., Haagen, J. F. G., and Boelen, P. A. (2019) 7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: A first quantitative evaluation. European Journal of Psychotraumatology, 10(1): 1673062. https://doi.org/10.1080/20008198.2019.1673062.CrossRefGoogle ScholarPubMed
Watanabe, N., Omori, I. M., Nakagawa, A., et al. (2011). Mirtazapine versus other antidepressive agents for depression. The Cochrane Database of Systematic Reviews, (12) CD006528. https://doi.org/10.1002/14651858.CD006528.pub2.Google Scholar
Wichniak, A., Wierzbicka, A., and Jernajzyk, W. (2012). Sleep and antidepressant treatment. Current Pharmaceutical Design, 18(36): 5802–17.Google Scholar
Yurtsever, A., Konuk, E., Akyüz, T., et al. (2018). An Eye Movement Desensitization and Reprocessing (EMDR) group intervention for Syrian refugees with post-traumatic stress symptoms: Results of a randomized controlled trial. Frontiers in Psychology, 9(9): 493. https://doi.org/10.3389/fpsyg.2018.00493.Google Scholar

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