Problem management plus with emotional processing module for refugee youth in the Netherlands: pilot trial of feasibility, acceptability and safety.

BACKGROUND

Refugee youth are at elevated risk for post-traumatic stress disorder (PTSD) and other mental health disorders, yet systemic and cultural barriers limit access to care. Scalable, transdiagnostic interventions such as Problem Management Plus (PM+) are promising, but their impact on trauma symptoms is modest. Incorporating brief trauma-focused components may enhance effectiveness.

AIMS: To evaluate the feasibility and acceptability of PM+ with an emotional processing module (PM+EP) for refugee youth aged 16-25 years in the Netherlands.

METHOD: Refugee youth with elevated psychological distress (K10 > 15) and impaired functioning (World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) > 16) were randomised into PM+EP, PM+ with supportive counselling (PM+SC), or care as usual (CAU). Feasibility and acceptability were assessed via recruitment, adherence, fidelity and qualitative interviews. Psychological distress, PTSD symptoms, functioning and self-identified problems were measured at baseline, post-intervention and follow-up. Registered in Overview of Medical Research in the Netherlands (OMON; Trial ID: NL-OMON56254).

RESULTS

Fifty-two participants were randomised (PM+EP: n = 17; PM+SC: n = 19; CAU: n = 16). Attendance and fidelity were high, and PM+ interventions were rated as acceptable and culturally appropriate. No significant between-group differences were observed in the primary analyses. Exploratory analyses suggested greater short-term symptom reduction for probable depression in PM+EP versus CAU (b = -0.79, s.e. = 0.38, p = 0.04). Effect size estimates ranged from small to large across outcomes (Hedges' g = -0.98 to 0.19).

CONCLUSIONS

PM+ is feasible, acceptable and safe for refugee youth aged 16 years and older. The potential added value of the EP module remains unclear and warrants further investigation.

TRIAL REGISTRATION NUMBER: The trial was registered in the Dutch clinical trial registration: Overview of Medical Research in the Netherlands (OMON) (Trial ID: NL-OMON56254; https://onderzoekmetmensen.nl/en/trial/56254).