Effectiveness of a transdiagnostic group intervention to enhance emotion regulation in young afghan refugees: A pilot randomized controlled study

Behavior Research and Therapy

Theresa Kochab, Thomas Ehringa, Alexandra Liedl



There are several challenges to providing mental health care for refugees, including high comorbidity and structural barriers. Targeting transdiagnostic processes in a low-threshold group intervention appears particularly promising to meet these challenges. This study examined the feasibility, acceptability and effectiveness of a new transdiagnostic intervention, Skills-Training of Affect Regulation–A Culture-sensitive Approach (STARC), focusing on conveying strategies to improve emotional clarity and to regulate emotions. A parallel-group (STARC vs. waitlist) randomized-controlled study with 44 young male Afghan refugees was conducted in a routine clinical setting (NCT03162679). In intention-to-treat analyses, participants of STARC significantly improved in self-reported difficulties in emotion regulation (ΔdSTARC-Waitlist = 1.22), transdiagnostic symptom severity (ΔdSTARC-Waitlist = 1.69), posttraumatic stress symptoms (ΔdSTARC-Waitlist = 1.19), and caregiver-reported emotional competence (ΔdSTARC-Waitlist = −0.90), but not anger reactions (ΔdSTARC-Waitlist = 0.50) compared to waitlist. Effects were maintained over 3 months. STARC is a feasible transdiagnostic intervention in a routine clinical setting and effective for young Afghan refugees. If replicated in large-scale studies with active control groups, it might be promising as an initial low-threshold intervention offered in a phased-based and/or stepped care approach.

Keywords: Refugees, Trauma, Afghanistan, Transdiagnostic, Emotion Regulation, Group treatment, PTSD

Available online 27 June 2020, 103689

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