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Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center

Background: Due to persecution, human rights violations and armed conflicts, the prevalence of post-traumatic stress disorder (PTSD) is high in refugee populations. Previous studies indicate that trauma-focused treatments are highly effective in treating PTSD in refugees. However, these approaches r...

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Autores principales: Zehetmair, Catharina, Kaufmann, Claudia, Tegeler, Inga, Kindermann, David, Junne, Florian, Zipfel, Stephan, Herpertz, Sabine C., Herzog, Wolfgang, Nikendei, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215850/
https://www.ncbi.nlm.nih.gov/pubmed/30420815
http://dx.doi.org/10.3389/fpsyt.2018.00533
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author Zehetmair, Catharina
Kaufmann, Claudia
Tegeler, Inga
Kindermann, David
Junne, Florian
Zipfel, Stephan
Herpertz, Sabine C.
Herzog, Wolfgang
Nikendei, Christoph
author_facet Zehetmair, Catharina
Kaufmann, Claudia
Tegeler, Inga
Kindermann, David
Junne, Florian
Zipfel, Stephan
Herpertz, Sabine C.
Herzog, Wolfgang
Nikendei, Christoph
author_sort Zehetmair, Catharina
collection PubMed
description Background: Due to persecution, human rights violations and armed conflicts, the prevalence of post-traumatic stress disorder (PTSD) is high in refugee populations. Previous studies indicate that trauma-focused treatments are highly effective in treating PTSD in refugees. However, these approaches rely on the stability of the therapeutic setting, treatment continuity, and safe housing. Although early treatment of PTSD is recommended, these requirements are not met in reception centers. Therefore, we conducted a pilot study to examine the effect of imaginative stabilization techniques derived from psychodynamic psychotraumatology therapy for the early stabilization of traumatized refugees in a reception center. Methods: From May 2017 to April 2018, 86 imaginative stabilization group therapy sessions have taken place. A sample of 43 out of 46 traumatized refugees completed self-report questionnaires assessing PTSD, depression, and anxiety symptoms prior to attending open imaginative stabilization group therapy sessions. Furthermore, participants filled in self-report questionnaires on distress and emotional state (valence/arousal/dominance) before and after each session. After having participated in four consecutive sessions, a sub-group of 17 participants completed a follow-up assessment of PTSD, depression, and anxiety symptoms. Follow-up interviews were conducted with 25 participants 2 weeks after their last session attendance to explore self-practice habits post intervention. Results: The pre-post-intervention comparison of scores indicated a significant reduction of distress (z = −3.35, p < 0.001, r = −0.51) and an improvement of affective reports for valence (z = −4.79, p < 0.001, r = −0.82) and dominance (z = −3.89, p < 0.001, r = −0.59), whereas arousal scores were not affected. We found a significant reduction of anxiety symptoms (z = −2.04, p < 0.05, r = −0.49), whereas PTSD and depression scores remained unchanged. Follow-up interviews revealed that 80% of the participants continued to practice the imaginative stabilization techniques after redistribution to other accommodation. Conclusion: The results indicate that imaginative stabilization techniques are a promising and feasible approach to treat refugees in unstable reception center settings. In regular imaginative stabilization group therapy sessions, we were able to reduce the participants' distress and anxiety symptoms while strengthening their internal resources and increasing their emotional stability.
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spelling pubmed-62158502018-11-12 Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center Zehetmair, Catharina Kaufmann, Claudia Tegeler, Inga Kindermann, David Junne, Florian Zipfel, Stephan Herpertz, Sabine C. Herzog, Wolfgang Nikendei, Christoph Front Psychiatry Psychiatry Background: Due to persecution, human rights violations and armed conflicts, the prevalence of post-traumatic stress disorder (PTSD) is high in refugee populations. Previous studies indicate that trauma-focused treatments are highly effective in treating PTSD in refugees. However, these approaches rely on the stability of the therapeutic setting, treatment continuity, and safe housing. Although early treatment of PTSD is recommended, these requirements are not met in reception centers. Therefore, we conducted a pilot study to examine the effect of imaginative stabilization techniques derived from psychodynamic psychotraumatology therapy for the early stabilization of traumatized refugees in a reception center. Methods: From May 2017 to April 2018, 86 imaginative stabilization group therapy sessions have taken place. A sample of 43 out of 46 traumatized refugees completed self-report questionnaires assessing PTSD, depression, and anxiety symptoms prior to attending open imaginative stabilization group therapy sessions. Furthermore, participants filled in self-report questionnaires on distress and emotional state (valence/arousal/dominance) before and after each session. After having participated in four consecutive sessions, a sub-group of 17 participants completed a follow-up assessment of PTSD, depression, and anxiety symptoms. Follow-up interviews were conducted with 25 participants 2 weeks after their last session attendance to explore self-practice habits post intervention. Results: The pre-post-intervention comparison of scores indicated a significant reduction of distress (z = −3.35, p < 0.001, r = −0.51) and an improvement of affective reports for valence (z = −4.79, p < 0.001, r = −0.82) and dominance (z = −3.89, p < 0.001, r = −0.59), whereas arousal scores were not affected. We found a significant reduction of anxiety symptoms (z = −2.04, p < 0.05, r = −0.49), whereas PTSD and depression scores remained unchanged. Follow-up interviews revealed that 80% of the participants continued to practice the imaginative stabilization techniques after redistribution to other accommodation. Conclusion: The results indicate that imaginative stabilization techniques are a promising and feasible approach to treat refugees in unstable reception center settings. In regular imaginative stabilization group therapy sessions, we were able to reduce the participants' distress and anxiety symptoms while strengthening their internal resources and increasing their emotional stability. Frontiers Media S.A. 2018-10-29 /pmc/articles/PMC6215850/ /pubmed/30420815 http://dx.doi.org/10.3389/fpsyt.2018.00533 Text en Copyright © 2018 Zehetmair, Kaufmann, Tegeler, Kindermann, Junne, Zipfel, Herpertz, Herzog and Nikendei. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Zehetmair, Catharina
Kaufmann, Claudia
Tegeler, Inga
Kindermann, David
Junne, Florian
Zipfel, Stephan
Herpertz, Sabine C.
Herzog, Wolfgang
Nikendei, Christoph
Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title_full Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title_fullStr Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title_full_unstemmed Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title_short Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center
title_sort psychotherapeutic group intervention for traumatized male refugees using imaginative stabilization techniques—a pilot study in a german reception center
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215850/
https://www.ncbi.nlm.nih.gov/pubmed/30420815
http://dx.doi.org/10.3389/fpsyt.2018.00533
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