Lay-Led Intervention for War and Refugee Trauma: A Randomized Clinical Trial
Importance
The global refugee crisis disproportionately affects the Muslim world, leading to trauma-related mental health issues. Effective psychotherapy exists, but barriers to uptake by refugee groups and lack of culturally appropriate interventions remain.
Objective
To examine the efficacy of a brief, lay-led, mosque-based intervention, Islamic Trauma Healing (ITH), in improving mental health and well-being by adapting empirically supported cognitive behavioral principles.
Design, Setting, and Participants
In a randomized clinical trial, 101 participants received ITH or active assessment but delayed intervention (waiting list [WL]) in mosques and virtually in Seattle, Washington, and Columbus, Ohio. The participants were United States-based refugees from Somalia who experienced trauma exposure and posttraumatic stress disorder (PTSD) reexperiencing or avoidance.
Intervention
Islamic Trauma Healing included psychoeducation, discussion of the lives of prophets who had undergone trauma, informal prayer turning to Allah about the trauma, incorporating cognitive restructuring and imaginal exposure. Lay-leader training is purposely brief: two 4-hour sessions with weekly supervision.
Main Outcomes and Measures
The primary outcome was PTSD severity. Secondary outcomes included depression, somatic symptoms, and quality of well-being.
Results
ITH proved superior to WL in reducing PTSD severity, depression, and improving well-being. Gains were maintained through 12-week follow-up.
Conclusions and Relevance
The findings suggest that ITH has the potential to provide an easily trainable and scalable intervention, incorporating Islam and empirically supported principles, that addresses the psychological wounds of war and refugee trauma.
ClinicalTrials.gov Identifier: NCT03502278
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