What drives change in children receiving telephone-delivered Common Elements Treatment Approach (t-CETA)? A multiple n = 1 study with Syrian refugee children and adolescents in Lebanon.

Autor: Bosqui T; American University of Beirut, Beirut, Lebanon. Electronic address: tb33@aub.edu.lb., McEwen FS; Department of War Studies, King's College London, London, UK; Queen Mary University of London, London, UK., Chehade N; Médecins du Monde, Lebanon., Moghames P; Médecins du Monde, Lebanon., Skavenski S; Johns Hopkins Bloomberg School of Public Health, USA., Murray L; Johns Hopkins Bloomberg School of Public Health, USA., Karam E; Institute for Development, Research, Advocacy and Applied Care, Lebanon., Weierstall-Pust R; Medical School Hamburg, Oberberg clinics group, Berlin, Germany., Pluess M; Queen Mary University of London, London, UK; School of Psychology, University of Surrey, Guildford, UK.
Jazyk: angličtina
Zdroj: Child abuse & neglect [Child Abuse Negl] 2023 Aug 21, pp. 106388. Date of Electronic Publication: 2023 Aug 21.
DOI: 10.1016/j.chiabu.2023.106388
Abstrakt: Background: Although the evidence-base for mental health and psychosocial support (MHPSS) interventions in humanitarian settings is growing rapidly, their mechanisms of change remain poorly understood despite the potential to improve the effectiveness and reach of interventions.
Objective: This study aimed to explore the mechanisms or factors that drive change in a modular transdiagnostic telephone-delivered mental health intervention, Common Elements Treatment Approach (t-CETA).
Participants and Setting: Participants were Syrian refugee children and adolescents living in tented settlements in Lebanon.
Methods: We used a multiple n = 1 design, drawing on secondary data from 9 children who completed t-CETA during a pilot randomized controlled trial.
Results: Children with historical war-related trauma were more likely to show significant improvement across symptom clusters by the end of treatment compared to children presenting with depression related to daily living conditions. Children also showed fluctuating symptoms during the early stages of treatment (engagement and cognitive restructuring) but significant decline in symptoms after the trauma module (prolonged imaginal exposure) and depression module (behavioral activation). Salient external life events identified were starting or dropping out of school, working, change in living conditions, family conflict and the October Revolution; and interpersonal factors of parental engagement (with or without full attendance) and counsellor skills in building rapport were also identified as having an impact on treatment success.
Conclusions: Implications of our findings are discussed in terms of integrating active ingredients into MHPSS programming, and building on parental and multi-sector involvement in child and adolescent mental health care in humanitarian settings.
Competing Interests: Declaration of competing interest None.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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