Lay-Led Intervention for War and Refugee Trauma: A Randomized Clinical Trial

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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