Journal of Consulting and Clinical Psychology
Volume 76, Issue 4, 2008, Pages 686-694

Treatment of Posttraumatic Stress Disorder by Trained Lay Counselors in an African Refugee Settlement: A Randomized Controlled Trial (Article)

Neuner F.* , Onyut P.L. , Ertl V. , Odenwald M. , Schauer E. , Elbert T.
  • a Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, vivo Germany, Allensbach, Germany
  • b vivo Uganda, Mbarara, Uganda, Department of Science, Mbarara University of Science and Technology, Mbarara, Uganda
  • c Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, vivo Germany, Allensbach, Germany
  • d Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, vivo Germany, Allensbach, Germany
  • e Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, vivo Germany, Allensbach, Germany
  • f Department of Clinical Psychology, University of Konstanz, Konstanz, Germany, vivo Germany, Allensbach, Germany

Abstract

Traumatic stress due to conflict and war causes major mental health problems in many resource-poor countries. The objective of this study was to examine whether trained lay counselors can carry out effective treatment of posttraumatic stress disorder (PTSD) in a refugee settlement. In a randomized controlled dissemination trial in Uganda with 277 Rwandan and Somalian refugees who were diagnosed with PTSD the authors investigated the effectiveness of psychotherapy administered by lay counselors. Strictly manualized narrative exposure therapy (NET) was compared with more flexible trauma counseling (TC) and a no-treatment monitoring group (MG). Fewer participants (4%) dropped out of NET treatment than TC (21%). Both active treatment groups were statistically and clinically superior to MG on PTSD symptoms and physical health but did not differ from each other. At follow-up, a PTSD diagnosis could not be established anymore in 70% of NET and 65% TC participants, whereas only 37% in MG did not meet PTSD criteria anymore. Short-term psychotherapy carried out by lay counselors with limited training can be effective to treat war-related PTSD in a refugee settlement. © 2008 American Psychological Association.

Author Keywords

Therapy War Refugees posttraumatic stress disorder Dissemination

Index Keywords

refugee controlled clinical trial clinical trial randomization Rwanda psychotherapist Developing Countries human Life Change Events Refugees middle aged controlled study randomized controlled trial cognitive therapy Uganda voluntary worker psychotherapy Young Adult Humans Treatment Outcome male counseling female Narration Psychotherapy, Brief Article major clinical study adult posttraumatic stress disorder Somalia Stress Disorders, Post-Traumatic Inservice Training psychotrauma therapy effect
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-48549104295&doi=10.1037%2f0022-006X.76.4.686&partnerID=40&md5=4e0d3a436e673fc5ff70439b072557bf
DOI: 10.1037/0022-006X.76.4.686
ISSN: 0022006X
Cited by: 181
Original Language: English