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Successfully treating refugees’ post-traumatic stress symptoms in a Ugandan settlement with group cognitive behaviour therapy

Published online by Cambridge University Press:  01 September 2020

Elsa J. Goninon ,
Lee Kannis-Dymand ,
Robi Sonderegger ,
Doddy Mugisha  and
Geoff P. Lovell Open the ORCID record for Geoff P. Lovell [Opens in a new window]
Elsa J. Goninon*
Affiliation:
School of Social Sciences, University of the Sunshine Coast, Queensland, Australia
Lee Kannis-Dymand
Affiliation:
Sunshine Coast Mind & Neuroscience – Thompson Institute, School of Social Sciences, University of the Sunshine Coast, Queensland, Australia
Robi Sonderegger
Affiliation:
Family Challenge Australia, Queensland, Australia
Doddy Mugisha
Affiliation:
Tutapona, Uganda
Geoff P. Lovell
Affiliation:
School of Social Sciences, University of the Sunshine Coast, Queensland, Australia Department of Sport, Hartpury University, UK
*
*Corresponding author. Email: elsa.goninon@gmail.com
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Abstract

Background:

High rates of post-traumatic stress disorder (PTSD) are documented within refugee populations. Although research supports effectiveness of trauma-focused cognitive behaviour therapy (TF-CBT) among Western populations, little research exists for its efficacy among refugees living in camps and settlements in developing nations.

Aims:

To investigate whether a culturally sensitive, group-based TF-CBT programme (EMPOWER) delivered in a Ugandan refugee settlement effectively reduced refugees’ post-traumatic stress symptoms (PTSS), and whether sociodemographic factors, trauma characteristics, or PTSS severity related to programme completion or treatment outcomes.

Method and Results:

Data linkages were conducted on information provided by 174 Congolese refugees living in a Ugandan settlement (mean age = 33.4 years, SD = 11.7; 49% male). Using a quasi-experimental design, participants who initially completed the intervention (n = 43) delivered across nine 90-minute sessions, reported significant reductions in self-reported PTSS with a large effect size. The delayed treatment group (n = 55) also reported significant treatment gains once they received the intervention. Participants who completed the programme reported significantly greater initial PTSS severity than those who dropped out, while no sociodemographic factors, trauma characteristics or PTSS were associated with better treatment outcomes.

Discussion:

A culturally sensitive, group-based TF-CBT programme delivered in a refugee settlement meaningfully reduces refugees’ PTSS severity and is equally effective for all participants, with the highest retention rates found among those in greatest need of treatment. Programmes such as this, with capacity to treat hundreds of people simultaneously, represent highly cost-effective, accessible, disseminable and effective treatment for PTSS among refugees living in humanitarian settings in developing nations.

Keywords

AfricaCBTgrouppost-traumatic stressPTSDrefugeesettlementtraumaUganda
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 1 , January 2021 , pp. 35 - 49
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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