Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
J Child Psychol Psychiatry. 2018 Nov;59(11):1171-1179. doi: 10.1111/jcpp.12908. Epub 2018 Apr 6.
As access to evidence-based treatments for young refugees with posttraumatic stress symptoms (PTSS) is limited, we developed the trauma-focused group intervention Mein Weg to be delivered by trained social workers. A recently published pilot study delivered preliminary evidence of the intervention with regard to symptom reduction and its feasibility. The aim of this study was, therefore, to determine whether the intervention, in addition to usual care (UC), is more effective in reducing PTSS (primary outcome) compared to UC alone.
A parallel group randomized controlled trial was conducted in seven German child and adolescent welfare agencies. Participants were randomly assigned to either six sessions Mein Weg (n = 50; M = 17.00, 94% male) or UC (n = 49; M = 16.92, 92% male). Mixed effect models, with fixed effects of group and time as well as their interaction, were performed on the relevant outcome measures. This trial was registered in the German Clinical Trials Registry (#DRKS00010915, https://www.drks.de/drks_web/).
Intention-to-treat analyses showed that Mein Weg was significantly superior to UC regarding symptom improvement of self-reported PTSS (Mein Weg: d = .61, UC: d = .15) and depression (Mein Weg: d = .63, UC: d = -.06), but not regarding caregiver-reported symptoms and self-reported dysfunctional posttraumatic cognitions.
Mein Weg is effective for young refugees according to self-reports and can be viewed as a valuable component in a stepped care approach for this vulnerable population. The findings need to be replicated with independent clinical assessments.
由于获得针对创伤后应激症状 (PTSS) 的年轻难民的循证治疗的机会有限，我们开发了由经过培训的社会工作者提供的以创伤为中心的小组干预措施 Mein Weg。最近发表的一项试点研究提供了该干预措施在减轻症状及其可行性方面的初步证据。因此，本研究的目的是确定干预措施（除了常规护理 (UC) 外）是否比单独接受 UC 更能有效降低 PTSS（主要结果）。
在七个德国儿童和青少年福利机构中进行了一项平行组随机对照试验。参与者被随机分配到六次 Mein Weg （n=50；M=17.00，94%为男性）或 UC（n=49；M=16.92，92%为男性）。使用混合效应模型，固定效应为组和时间及其交互作用，对相关结局测量进行分析。该试验在德国临床试验注册处（#DRKS00010915，https://www.drks.de/drks_web/）进行了注册。
意向治疗分析表明，与 UC 相比，Mein Weg 在自我报告的 PTSS（Mein Weg：d=0.61，UC：d=0.15）和抑郁（Mein Weg：d=0.63，UC：d=-0.06）方面的症状改善方面显著更优，但在照顾者报告的症状和自我报告的创伤后认知功能障碍方面没有差异。
根据自我报告，Mein Weg 对年轻难民有效，可以被视为针对这一弱势群体的阶梯式护理方法的有价值组成部分。需要使用独立的临床评估来复制这些发现。
