Brief imagery rescripting vs. usual care and treatment advice in refugees with posttraumatic stress disorder: Study protocol for a multi-center randomized-control trial

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Abstract

Background: Many refugees have experienced multiple traumatic events in their country of origin and/or during flight. Trauma-related disorders such as posttraumatic stress disorder (PTSD) or complex PTSD (CPTSD) are prevalent in this population, which highlights the need for accessible and effective treatment. Imagery Rescripting (ImRs), an imagery-based treatment that does not use formal exposure and that has received growing interest as an innovative treatment for PTSD, appears to be a promising approach. Objective: This randomized-controlled trial aims to investigate the efficacy of ImRs for refugees compared to Usual Care and Treatment Advice (UC+TA) on (C)PTSD remission and reduction in other related symptoms. Method: Subjects are 90 refugees to Germany with a diagnosis of PTSD according to DSM-5. They will be randomly allocated to receive either UC+TA (n = 45) or 10 sessions of ImRs (n = 45). Assessments will be conducted at baseline, post-intervention, three-month followup, and 12-month follow-up. Primary outcome is the (C)PTSD remission rate. Secondary outcomes are severity of PTSD and CPTSD symptoms, psychiatric symptoms, dissociative symptoms, quality of sleep, and treatment satisfaction. Economic analyses will investigate health-related quality of life and costs. Additional measures will assess migration and stress-related factors, predictors of dropout, therapeutic alliance and session-by-session changes in trauma-related symptoms. Results and Conclusions: Emerging evidence suggests the suitability of ImRs in the treatment of refugees with PTSD. After positive evaluation, this short and culturally adaptable treatment can contribute to close the treatment gap for refugees in high-income countries such as Germany.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What can help refugees process traumatic grief?

There is limited strong evidence on interventions that specifically target traumatic grief. Prolonged and traumatic grief are usually closely associated with post-traumatic stress disorder (PTSD), and therefore many interventions target PTSD with grief symptoms as an auxiliary diagnosis. There appear to be some differences in interventions that target grief as a result of loss of […]

About this study

AGE: Adults

DIRECTION OF EVIDENCE: Positive impact

FULL TEXT AVAILABILITY: Free

GENDER: All

HOST COUNTRY: Germany

HOST COUNTRY INCOME: High

INTERVENTION DURATION: 10 100-minute sessions of manualized treatment within 10 weeks

INTERVENTION: Brief Imagery Rescripting

OUTCOME AREA: Mental Health

OUTCOME: PTSD

POPULATION: Refugees

REGION OF ORIGIN OF PARTICIPANT(S): Middle East

STRENGTH OF EVIDENCE: Moderate

TYPE OF STUDY: Impact evaluation

YEAR PUBLISHED: 2021

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